“Isn’t every garden a healing garden?” Part II

Healing Garden at Good Samaritan Cancer Center, Puyallup, WA 

KMD Architects; photo by Michael O’Callahan 

Click here for Healthcare Design Magazine’s write-up of this project. 

“A healing garden is an outdoor (and sometimes green indoor) space designed to promote and improves people’s health and well-being. A true healing garden must be successful in fulfilling the design intent.” Naomi Sachs and the Therapeutic Landscapes Resource Center’s working definition of “healing gardens.”  

In my post yesterday, I gave my very broad definition of “Landscapes for Health,” (recap: A Landscape for Health is defined as any landscape that promotes and facilitates health and well-being). And I left you with a cliffhanger, promising to define “healing gardens” today. And none too soon, as I seem to have already caused confusion, as evidenced by Henry’s comment on yesterday’s post and a friend’s email to me:

“So is a playground a healing garden??  (Slightly joking/slightly serious.)  The best way to get my daughter to forget she has teething pain is to take her to the playground and the best way to help mom forget she is tired and overwhelmed is to take her to the playground – her joy makes us both forget the owie.” – K.W.

Is a playground a Landscape for Health? Absolutely, according to my definition and my friend’s experience. But is it a healing garden? Maybe. Depends who designed it, for whom, and why. I agree with Henry that we need a more narrow and specific definition for healing gardens, one that refers to outdoor (and some green indoor) spaces that are designed, preferably with Evidence-Based Design (EBD), to have healing effects on the people using them.

I have a confession: I started the Therapeutic Landscapes Database in 1999, and have been avoiding coming up with a simple, one-or-two-sentence definition for “healing gardens” ever since. I find it to be extremely daunting, and others must, too, because nine years later, there is still no agreed-upon, industry-standard definition that I can blithely quote. Maybe that’ll happen someday soon, but for now there’s a lot of confusion around the terminology. The American Horticultural Therapy Association (AHTA) just recently issued a Position Paper with helpful definitions of some terms including “healing gardens,” “therapeutic gardens,” and “restorative gardens,” among others. I’ve included some of those definitions below, along with other discussions, but today I’ve finally come up with my own working definition, which means that it is still very much subject to discussion and change. I hope people will leave comments and constructive criticism about what I’ve got so far. 

I have a pet peeve about people’s overzealous use of dictionary definitions, but in this case I think that’s a good starting point: 

1. Healing: The Oxford English Dictionary gives four definitions for the verb “heal”:

a. To become sound or healthy again;

b. To cause (a wound, a disease, or a person) to heal or be healed;

c. To put right (differences, etc.);

d. To alleviate (sorrow, etc.).

So “healing” implies making someone well, or at least improving the health of someone who is or was not well.  

Garden: The OED’s definitions for garden are just too darn long for this already-too-long posting, so I’ll just paraphrase: A garden is a designed, or at least cultivated, space, usually outdoors and usually including vegetation. A garden doesn’t have to be gardenesque, but it does have to be designed or cultivated by someone instead of having just evolved that way. So whereas the Grand Canyon might be a Landscape for Health, it would not fit my definition of a healing garden. 

So you put those two definitions together and you get “a designed or cultivated outdoor space that heals people or at least makes them feel better than they did before they encountered the garden.” But we want to also include something about intent, that these gardens were designed specifically to elicit positive outcomes of improved physical, psychological, and/or emotional health. And we also want to say that these gardens were not only designed to be healing, but they actually are (believe me, I’ve seen plenty of examples of designed “healing gardens” that couldn’t possibly be salutary). How about this? 

A healing garden is an outdoor (and sometimes green indoor) space designed to promote and improve people’s health and well-being. A true healing garden must be successful in fulfilling the design intent of healing. Positive outcomes can be achieved through passive experience of the garden (viewing of or presence in the garden) and/or active involvement in and with the garden (gardening, rehabilitative therapy, and other activities).

And then there are all the other terms, like restorative landscapes, and wellness gardens, and therapeutic gardens, but I’m going to save that for another day. 

If you feel like reading more, I would suggest:

1. The American Horticultural Therapy Association (AHTA) recently-released Position Paper on Definitions and Positions:

Types of Gardens 

Healing Gardens 

Healing gardens are plant dominated environments including green plants, flowers, water, and other 

aspects of nature.  They are generally associated with hospitals and other healthcare settings, 

designated as healing gardens by the facility, accessible to all, and designed to have beneficial effects on 

most users.  A healing garden is designed as a retreat and a place of respite for clients, visitors, and 

staff and to be used at their desire.  Healing gardens may be further divided into specific types of 

gardens including therapeutic gardens, horticultural therapy gardens, and restorative gardens.  These 

garden types are likely to have overlap and the following definitions should be regarded as guidelines 

since no two gardens are the same. 


Therapeutic Gardens 

A therapeutic garden is designed for use as a component of a treatment program such as occupational 

therapy, physical therapy, or horticultural therapy programs and can be considered as a subcategory of a 

healing garden.  A garden can be described as being therapeutic in nature when it has been designed to 

meet the needs of a specific user or population.  It is designed to accommodate client treatment goals 

and may provide for both horticultural and non-horticultural activities.  It should be designed as part of a 

multi-disciplinary collaborative process by a team of professionals.  A therapeutic garden may exist on its 

own as an extension of an indoor therapeutic program area or it may be part of a larger healing garden. 


Horticultural Therapy Gardens 

A horticultural therapy garden is a type of therapeutic garden; it is designed to accommodate client 

treatment goals, but it is designed to support primarily horticultural activities.  A horticultural therapy 

garden is also designed in such a manner that the clients themselves are able to take care of plant 

material in the garden. 


Restorative Gardens 

A restoration or meditation garden may be a public or private garden that is not necessarily associated 

with a healthcare setting.  This type of garden employs the restorative value of nature to provide an 

environment conducive to mental repose, stress-reduction, emotional recovery, and the enhancement of 

mental and physical energy.  The design of a restorative garden focuses on the psychological, physical, 

and social needs of the users. 

2. Annalisa Gartman Vapaa has a nice discussion of the definition of healing gardens on page three of her masters thesis, Healing Gardens: Creating Places for Restoration, Meditation, and Sanctuary,”  MLA thesis for Virginia Polytechnic Institute and State University, 2002.

3. Clare Marcus and Marni Barnes on pages 3-4 of Healing Gardens: Therapeutic Benefits and Design Recommendations (see this recent post for more on this book).

4. Jain Malkin in her fabulous new book A Visual Reference for Evidence-Based Design, on pages 4-6, and 132.

5. Henry Domke suggested this definition: “A healing garden is created using design informed by credible research to achieve the best possible health outcomes,” a modification of the recently revised definition of “Evidence-Based Design” from the Center for Health Design