Numerous studies published in recent years have established a connection between proximity to nature and enhanced mood as well as improved mental health. At least 17 studies have investigated patients in dementia special care facilities, demonstrating that therapy programs held in gardens featuring wandering paths, non-toxic trees and shrubs, grassy areas, raised beds, gazebos, fish ponds, and benches lead to a reduction in agitation (Whear et al., 2014). Furthermore, two of these studies have indicated a decrease in medication usage due to the implementation of therapy programs (Detweiler et al., 2008, 2009).
In essence, the concept of therapeutic landscapes underscores the dynamic interplay of environmental, individual, and societal elements, emphasizing their context-sensitive and relational role in the healing journey (Williams 1998, 2017; Wilson 2003; Conradson 2005; Lea 2008; Bell et al., 2018).
While the mere presence of nature in a passive sense is known to offer benefits, the combination of a natural environment with physical activity has demonstrated the potential to enhance the quality of life and alleviate physiological stress indicators, such as the stabilization of neuroendocrine and immunological markers (Lehmann et al., 2018).
In the context of trauma treatment, particularly for PTSD, engagement with nature emerges as an effective therapeutic approach. A 2018 study examined 28 veterans suffering from PTSD who engaged in self-initiated horticultural therapy in a garden setting. These veterans participated in a survey comprising various questions, with the most significant inquiries centering around the importance of the garden to them and the emotional impact of being in that environment. Responses encompassed themes of privacy, fresh air, a sense of tranquility and security, and an acknowledgment of personal progress (Lehmann et al., 2018).
As designers, we have the power to offer our clients landscapes that serve multiple purposes. The Alnarp Rehabilitation Garden at the Swedish University of Agricultural Sciences is an example of a therapeutic garden that follows the Supportive Environment Theory (SET) for both its design and therapy programs. This theory is based on how humans interact with their surroundings—physical, cultural, and social—through their senses, emotions, thoughts, and reflections (Adevi et al., 2018). According to this theory, people's interactions vary based on their situation, mental state, and needs.
In essence, the theory suggests that individuals with lower executive function need more support from their environment. Designing a landscape that caters to patients with different levels of executive function makes the recovery process smoother. Even the simplest interventions such as the addition of color and greenery in the urban environment have been shown to increase neighborhood trust, stewardship, and general happiness (Negami 2018).
Adevi, Anna A, et al. “Therapeutic Interventions in a Rehabilitation Garden May Induce Temporary Extrovert and/or Introvert Behavioral Changes in Patients, Suffering from Stress-Related Disorders.” ScienceDirect.Com, Elsevier GmbH, 10 Oct. 2018,
Havlick, David G. et al. “Therapeutic Landscapes, Outdoor Programs for Veterans, and Public Lands.” Social Science & Medicine, Pergamon, 19 Nov. 2020, www.sciencedirect.com/science/article/pii/S0277953620307590#abs0015.
Lehmann, Lauren P. et al. “Veterans in Substance Abuse Treatment Program Self-Initiate Box Gardening as a Stress Reducing Therapeutic Modality.” Complementary Therapies in Medicine, Churchill Livingstone, 31 Oct. 2017, www.sciencedirect.com/science/article/pii/S0965229917303618.
Negami, Hanna R., Robin Mazumder, Mitchell Reardon, and Colin G. Ellard. 2018. “Field Analysis of Psychological Effects of Urban Design: A Case Study in Vancouver.” Cities & Health 2 (2): 106–15. https://doi.org/10.1080/23748834.2018.1548257
Sok-Paupardin, Eloïse. “Stress Reduction Theory: Why Looking at Nature Is Beneficial to Our Mental and Physical Health.” SageGlass, www.sageglass.com/industry-insights/stress-reduction-theory-why-looking-nature-beneficial-our-mental-and-physical#:~:text=This%20theory%20states%20that%20looking,alert%20following%20a%20stressful%20situation. Accessed 26 Aug. 2023.
Taheri, Shima, et al. “The Role of Therapeutic Landscape in Improving Mental Health of People with PTSD.” IntechOpen, IntechOpen, 24 Sept. 2019, www.intechopen.com/chapters/67301.