Therapeutic Landscapes: An Evidence-Based Approach to Designing Healing Gardens and Restorative Outdoor Spaces
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More About This Title Therapeutic Landscapes: An Evidence-Based Approach to Designing Healing Gardens and Restorative Outdoor Spaces


This comprehensive and authoritative guide offers an evidence-based overview of healing gardens and therapeutic landscapes from planning to post-occupancy evaluation. It provides general guidelines for designers and other stakeholders in a variety of projects, as well as patient-specific guidelines covering twelve categories ranging from burn patients, psychiatric patients, to hospice and Alzheimer's patients, among others. Sections on participatory design and funding offer valuable guidance to the entire team, not just designers, while a planting and maintenance chapter gives critical information to ensure that safety, longevity, and budgetary concerns are addressed.


Clare Cooper Marcus is Professor Emerita in the Departments of Architecture and Landscape Architecture at the University of California, Berkeley. She is recognized internationally for her pioneering research on the psychological and sociological implications of the design of housing, public open space, and restorative landscapes.

Naomi A. Sachs is founder and Director of the Therapeutic Landscapes Network. She is currently pursuing a PhD in architecture at Texas A&M University. Naomi writes and lectures frequently about the restorative benefits of nature.


Foreword vii

Acknowledgments ix

ONE Introduction 1

TWO History of Hospital Outdoor Space 6

THREE Theory, Research, and Design Implications 14

FOUR Types and Locations of Therapeutic Landscapes in Healthcare 36

FIVE The Participatory Design Process 47
Teresia Hazen

SIX General Design Guidelines for Healthcare Facilities 56

SEVEN Children’s Hospital Gardens 91

EIGHT Gardens for Cancer Patients 115

NINE Gardens for the Frail Elderly 129

TEN Gardens for People with Alzheimer’s and Other Dementias 148

ELEVEN Hospice Gardens 165

TWELVE Gardens for Mental and Behavioral Health Facilities 179

THIRTEEN Gardens for Veterans and Active Service Personnel 206

FOURTEEN Rehabilitation Gardens 222

FIFTEEN Restorative Gardens in Public Spaces 235

SIXTEEN Horticultural Therapy and Healthcare Garden Design 250
Teresia Hazen

SEVENTEEN Planting and Maintaining Therapeutic Gardens 261
Marni Barnes

EIGHTEEN Therapeutic Landscapes and Sustainability 288

NINETEEN The Business Case and Funding for Therapeutic Gardens 298

TWENTY Evaluation of Therapeutic Gardens 308



"This is an exceptionally well-written, well-researched and well-illustrated book on designing and creating therapeutic landscapes. Rarely before has this topic been so thoroughly documented in one easy-to-read book that provides essential information to landscape architects, garden designers, healthcare workers, therapists and patients." (Linda A. Irvine, Landscapes/Paysages Magazine, OALA, FCSLA, ASLA; Manager, Parks and Open Space Development, City of Markham, Ontario, Canada)

"Taking time to get in tune with your surroundings and learn to love nature has proven a therapeutic process for many, including Naomi Sachs. Sachs is Founding Director of the Therapeutic Landscapes Network, and has been able to translate a personal passion for nature into a new book, co-written by Clare Cooper Marcus, which just came out this week called Therapeutic Landscapes: An Evidence-Based Approach to Designing Healing Gardens and Restorative Outdoor Spaces. The new publication has been long-anticipated and referenced as the "single most comprehensive and authoritative guide to designing healing gardens and restorative outdoor spaces." (, October 2013)