Concept Of Therapeutic Landscapes Research Articles

‘It's probably more about the people’: For a person‐centred approach to understanding benefits of nature‐based interventions

AbstractNumerous studies demonstrate the benefits of the role of nature, activities, and social interaction at nature‐based interventions in improving participants' wellbeing. These health‐enabling encounters between people and places have typically been framed in geography via the concept of therapeutic landscapes. Empirical studies and theory have primarily focused on the characteristics of physical and social environments of therapeutic landscapes, while understanding why particular relational encounters are affective in co‐creating therapeutic experiences has been given less attention. This paper focuses on understanding the nature of a person, and of interactions between people, as a fundamental part of understanding the way in which nature‐based interventions co‐create benefits to participants' wellbeing. To consider this we turn to person‐centred psychotherapy, where we draw on Carl Rogers' conceptualisations of the person and the therapeutic relationship. Person‐centred psychotherapy highlights the importance of a non‐judgemental, empathic, and authentic therapeutic relationship in providing an environment for change and that a person is agentic in perceiving and engaging with affective relations in co‐creating therapeutic encounters. These encounters have the potential to alleviate and/or transform aspects of a person's sense of self. These shifts in a person's self‐concept are part of a process, which enables the flow of benefits from an intervention into participants' daily lives. Our approach is underpinned by using interviews with facilitators and participants of nature‐based interventions. We propose that developing geographical understanding of the relational impacts on a person's sense of self and actions has implications beyond health geography.

The concept of therapeutic landscape and its research progress in health geography

The concept of therapeutic landscape and its research progress in health geography

Nature-based tourism as therapeutic landscape in a COVID era: autoethnographic learnings from a visitor’s experience in Iceland

One of the few silver linings in the COVID pandemic has been a new appreciation for, interest in, and engagement with nature. As countries open, and travel becomes accessible again, there is an opportunity to reimagine sustainable nature-based tourism from a therapeutic landscape lens. Framed within the therapeutic landscape concept, this paper provides an autoethnographic account of a visitor’s experience of three different natural landscapes in Iceland shortly after the country’s fourth wave of the pandemic. It adds to the understanding of the healing effects of the multi-colored natural landscapes of Iceland. The natural landscapes of interest herein include: the southern part of the Westfjörd peninsula, Jökulsárlón glacial lagoon, and the Central Highlands. In totality, the natural, built and symbolic environments worked in synchronicity to produce three thematic results: restoration, awe and concern, all which provided reduced stress, renewed attention, as well as enhanced physical and psycho-social benefits for the autoethnographic visiting researcher. Implications of these restorative outcomes for sustainable nature-based tourism in a post-COVID era are discussed. This paper highlights how health and tourism geographers can work collaboratively to recognize, protect, and sustain the therapeutic elements of natural landscapes, recognized as a cultural ecosystem service. In so doing, such collaborations can positively influence sustainable nature-based tourism development and consumption through proper and appropriate planning and development of such tourism destinations.

Vernacular healing landscapes in Australian aged-care gardens

Designing for people’s health and well-being is one important purpose for landscape design in healthcare environments. The concept of therapeutic landscapes has been applied widely in various healthcare settings. This research extends the concept of therapeutic landscapes in ordinary everyday context and explores the role of gardens in Australian aged-care facilities. Fieldwork shows aged-care residents reclaim the outdoor environment by actively shaping the landscape to create special meanings and embed memories in characterising their current living space. Findings suggest broadening the current understandings of therapeutic landscapes to incorporate residents’ vernacular healing landscapes. This paper addresses a gap in existing literature and introduces the importance of vernacular healing landscapes in aged-care facilities for its holistic reflection of older people’s landscape experiences and connection with residents' memories, which positively contributes to their health and wellbeing. It argues for future design to value and incorporate residents' vernacular healing landscapes in aged-care gardens.

Therapeutic Landscapes and Psychiatric Care Facilities: A Qualitative Meta-Analysis.

The environment in healthcare facilities can influence health and recovery of service users and furthermore contribute to healthy workplaces for staff. The concept of therapeutic landscapes seems to be a promising approach in this context. The aim of this qualitative meta-analysis is to review the effects of therapeutic landscapes for different stakeholders in psychiatric care facilities. A systematic literature search was conducted in the four data bases PubMed, PsycInfo, CINAHL, and Web of Science. Thirteen predominately qualitative studies were included in this qualitative meta-analysis. The methodological quality of these qualitative studies was assessed, using an adapted version of the Journal Article Reporting Standards for Qualitative Research, and a thematic analysis was conducted. The results were categorised into the three main themes of the physical (built and natural), social, and symbolic dimensions of the therapeutic landscape. Given the heterogeneity of the summarised data and an overall methodological quality of the included studies that can be rated as medium, the results should be interpreted with caution. Current findings are based almost exclusively on qualitative studies. Therefore, there is a need for quantitative study designs that investigate the relationship between specific environmental elements and mental health outcomes for different stakeholders in psychiatric facilities.

From safe places to therapeutic landscapes: The role of the home in panic disorder recovery

The concept of therapeutic landscapes explores the interactions between people and their environment, and the impacts that these interactions have on health and wellbeing. However, authors have so far not engaged in-depth discussions of what recovery might mean and how therapeutic landscapes work. In this paper, I draw from the findings of my doctoral study and offer a discussion of the spatiality of recovery for panic disorder sufferers. I argue that, in order to deepen our understanding of how therapeutic landscapes ‘work’ (beyond a temporal palliation of symptoms), we must explore how therapeutic landscapes can yield a deeper transformation for those seeking a therapeutic effect. I do this by exploring the spatiality of panic disorder and the emergence of the home as a temporary safe space in the process of recovery.

Natural outdoor environments’ health effects in gentrifying neighborhoods: Disruptive green landscapes for underprivileged neighborhood residents

BackgroundCities are restoring existing natural outdoor environments (NOE) or creating new ones to address diverse socio-environmental and health challenges. The idea that NOE provide health benefits is supported by the therapeutic landscapes concept. However, several scholars suggest that NOE interventions may not equitably serve all urban residents and may be affected by processes such as gentrification. Applying the therapeutic landscapes concept, this study assesses the impacts of gentrification processes on the associations between NOE and the health of underprivileged, often long-term, neighborhood residents. MethodsWe examined five neighborhoods in five cities in Canada, the United States and Western Europe. Our case studies were neighborhoods experiencing gentrification processes and NOE interventions. In each city, we conducted semi-structured qualitative interviews on NOE interventions, equity/justice, gentrification and health (n = 117) with case study neighborhood residents, community-based organizations, neighborhood resident leaders and other stakeholders such as public agencies staff. ResultsRespondents highlighted a variety of interconnected and overlapping factors: the insufficient benefits of NOE to counterbalance other factors detrimental to health, the use of NOE for city branding and housing marketing despite pollution, unwelcomeness, increase of conflicts, threats to physical displacement for themselves and their social networks, unattractiveness, deficient routes, inadequate NOE maintenance and lack of safety in NOE. ConclusionsOur study demonstrated that underprivileged neighborhood residents were perceived to experience new or improved NOE as what we call “disruptive green landscapes” (i.e. non-therapeutic landscapes with which they were not physically or emotionally engaged) instead of as therapeutic landscapes.

Evaluating the literature of therapeutic landscapes with an emphasis on the search for the dimensions of health: A systematic review.

Health geography emphasizes landscape capacity as a perspective for examining health dimensions. Much of this emphasis is on the concept of therapeutic landscapes. In the last two decades, changes in the therapeutic landscapes concerning health, as well as why and how the development of the emphasis on the dimensions of the health in the landscape in proportion to the temporal-spatial course of literature in this field can be considered. The framework of the present study is based on a systematic review of therapeutic landscapes in the geography of health in the last two decades. This systematic literature review followed the PRISMA guidelines. Searching for "Therapeutic Landscapes" term at Science Direct and PubMed, screening, 56 eligible articles were selected in the journal Social Science and Medicine, and Health and Place. The results of the systematic review, aiming to search for the health dimensions of the therapeutic landscape, and recognize main gaps, identified three main issues: scale and range of users of therapeutic landscapes, the position importance of experiences in therapeutic landscapes, therapeutic landscapes as the holistic paradigm. The results of the research show that in recent years, attention to multiple dimensions of health, especially non-physical relationships of therapeutic landscapes and multiple dimensions of health, has been considered more and more by researchers. Personal-social perceptions and experiences are also continually evolving, so the concept of therapeutic landscapes and its relationship to health is considered living and dynamic.

Urban design and therapeutic landscapes. Evolving theme.

The global pandemic of COVID-19, which enforced strict isolation, demonstrated the responsibility of architects and planners for public health promotion. While the concept of therapeutic landscapes is rather new, the quest for designing health-promoting human environment is at least as old as urban planning. The garden suburbs of Ebenezer Howard and Patrick Geddes were planned to promote health and well-being. The ultimate goal of Le Corbusier was to provide daylight and fresh air to each apartment. However, towers in open green space, which were built according to his visions, turned into unfriendly large suburbs. Today, the definition of therapeutic landscapes encompasses not only physical aspects of environment but also social and psychological factors. This study focuses on attempts to create health-promoting places. The interesting question is what are the architectural features linked to health promotion? Although the individual perception of health-promoting places is subjective and may vary, there are some objective qualities of eco-neighbourhoods that are conducive to human health and longevity. This study combines literature review with field observation and resultes in the development of the conceptual framework which can be consolidated into the universal standards for health-promoting places.

FORMER REFUGEES' THERAPEUTIC LANDSCAPES IN DUNEDIN, NEW ZEALAND

During resettlement in a new environment Former Refugees often face challenges for their physical, social and mental health and wellbeing such as past trauma, language and cultural differences. This article uses the therapeutic landscapes concept to explore how the physical, symbolic and social aspects of outdoor places in Dunedin, New Zealand, such as the beach and urban green spaces contribute to former refugees’ wellbeing during the resettlement process. 15 former Syrian refugees (from 4 families) participated in group interviews and at times shared photographs to illustrate what outdoor places they enjoyed and were therapeutic for them. This article argues that participants had diverse therapeutic landscapes that ranged from pristine scenic spots to everyday places such as the local park, but to enjoy and utilise the therapeutic values of these places more attention needs to be paid to access barriers.

Architecture of geothermal places: socially and culturally responsive therapeutic landscapes

ABSTRACT There is increasing recognition that culture plays a crucial role in shaping therapeutic environments; from fundamental conceptions of wellness and healing, through to cultural relationships with the natural world, and to how spaces are shaped by culturally-specific construction methods and materials. This paper approaches the concept of therapeutic landscapes from an architectural perspective, analysing three separate case studies relating to geothermal architecture from the Ring of Fire. It attempts to bridge a gap in the literature regarding geothermal therapeutic landscapes, by understanding these places not purely as ‘blue spaces’ but rather as socio-cultural encounters which influence material and physical architectural conditions. This paper contributes to our understanding of the role of culture in producing and maintaining architectural places by reflecting on the way in which individuals and groups engage with place, their range of social encounters, experiences, narratives, affective beliefs, and embodiments that combine with architectural materiality and the associated complex culturally-produced meanings.

Place, sociality, health: Forms of relocation and recuperation in modern Japan

After the earthquakes hit northeastern Japan and caused the catastrophic meltdowns at Fukushima on 11 March 2011, a large number of families chose not to relocate and are still living in contaminated areas. From the summer of 2011, Japan started a hoyo—health recovery camp which has been mainly aimed at helping people, especially children, to relieve the stress of their minds and bodies that have been affected by the radioactivity. This camp offers children therapeutic treatments by sending them for a few days to places that are out of the radioactive contamination zone. In the camp, a place with less pollution becomes the key link between the recovering person and the program, and the landscapes are therapeutic for the human body and mind. In this article, I focus on the health recovery camp as being a form of relocation and recuperation from a historical perspective and show how this camp provides a therapeutic landscape for healing. I consider the concept of therapeutic landscape which was developed by Wil Gesler in the early 1990s to be an insightful and effective approach for studying closely the process of healing in the nuclear pollution era, even though the cultural contexts of Gesler’s and the present study are very different. Working from a non-Western perspective and also from that of health recovery from radiation exposure, my study focuses on the interaction between health recovery camp participants and the natural, built, symbolic, and social factors which Gesler mentions as aspects of “healing environments.”

Politics, economics, how about our health? Impacts of large-scale land acquisitions on therapeutic spaces and wellbeing in coastal Tanzania

One question that has remained unexplored in the global land rush debate is how large-scale land acquisitions affect health and wellbeing of local populations. As part of a larger study, this study advances our understanding in this area by applying the concept of therapeutic landscapes to analyze interviews conducted in two coastal communities in Tanzania where land investments have been prevalent. Our analysis found that local populations perceived traditional lands with sacred sites as therapeutic spaces, which embodied cultural values, and promoted health and wellbeing when protected. Intrusion into these spaces through large-scale land investment is believed to remove their therapeutic attributes, thereby turning them into unhealthy landscapes. Dispossession of these spaces is perceived to heighten community distress resulting in poor psychosocial health. Based on our findings, we suggest that health consequences of land investments should move to the center of the large-scale land acquisition discourse. Health policy should refocus on the psychosocial health impacts of global land investments in Tanzania and other low-income countries. Ultimately local participation in land governance should be strengthened through land reforms in Tanzania and similar contexts, as this may provide a buffer to poor psychosocial health.

Creating “therapeutic landscapes” at home: The experiences of families of children with autism

This study explores the challenges faced within the home environment by North American families of children with autism. The study also examines the diversity and extent of physical modifications introduced by the families to alleviate these challenges. The concept of therapeutic landscapes is employed as a framework to examine how physical modifications transform the home environment into a place of healing for both the children with autism and their family members. Finally, the study offers a general design framework that can ultimately guide home designers and policymakers in developing friendly home environments for children with autism and their families.

Therapeutic landscapes and nationalism: Turkey and the curative waters of Kemalism

ABSTRACTHypothesised as a promising research concern for medical geographers, the therapeutic landscape concept promised to bridge divides between methods and approaches in humanistic, structural, and critical geographies. Despite early reference to ideology and the topic’s potential, engagements with political ideas and identity politics remain underdeveloped. Analysing a range of historical sources, this article examines the therapeutic landscapes of early republican Turkey from the vantage of its guiding philosophy and identity construct, Kemalism. In doing so, it reveals the politicised and ideological nature of many therapeutic landscapes and their place in one of the major projects of the modern era: nation-building.

The therapeutic landscapes concept as a mobilizing tool for liberation

In this reflection, I argue for using the therapeutic landscapes concept as a tool for mobilizing positive change in the world. I first lay out three major research areas in therapeutic landscapes inquiry, and provide a review of similarities in this area of inquiry in both health geography and medical anthropology. Next, I argue for the application of the therapeutic landscapes concept in liberating, if even in a small way, the growing population of the most vulnerable in our society, countries, and globe. I note two anthropological contributions that illustrate how the concept of therapeutic landscapes can be employed in liberating vulnerability, before discussing a work in progress, specific to an intentional ashram community with a mandate dedicated to world peace. I conclude by setting out the importance of this new direction for the future application of the therapeutic landscape concept as a tool for liberation.

Commentary on the origins and early development of the therapeutic landscapes concept

n/a

Constructing landscapes

The concept of therapeutic landscapes has been adopted from geography by anthropologists with a similar commitment to addressing the intersections between the construction of place and the multifaceted and symbolic dimensions of health. Drawing from health geography and medical anthropology, we take up the challenge from these fields to approach health broadly in order to understand how health decision making is connected to intersecting political, economic, social, and cultural processes that shape what options are available to people. This article presents findings from an ongoing study of the political ecology of health in northeastern South Africa. We consider how therapeutic landscapes are produced by physical infrastructure, social dynamics, and the use of natural resources for livelihoods and health management. While each of these dimensions is critical in shaping human health, we argue that it is through their interaction that therapeutic landscapes are produced. Landscapes of care are thus complicated and shifting, with rural households making strategic decisions to leverage government support, social support, and resources for health management. We conclude by emphasizing the need for further integration of anthropological and geographic frameworks in studying human health.

Boom and bust

In this think piece I argue that there is an interactive relationship between physical and symbolic landscapes, and that the interplay of the two forms a ‘therapeutic landscape’. This reformulation of Gesler’s (1992) concept of the therapeutic landscape helps to make visible the relationship between utilitarian systems of natural resource extraction and notions of deservingness for care. I show how in Alberta, Canada, there was a shift in the therapeutic landscape following the late 2014 crash in the global price of oil. Alberta is an ‘oil economy’ with an economic system that is strongly dependent on its oil and gas extractive industry; its public health care system is supported in part by royalties paid by private oil companies. When the global price of oil dropped, both health policy researchers and parents of children with rare and severe genetic diseases worried that costly treatments might be valued differently in this new terrain and that patients might be deemed undeserving of such expense. The therapeutic landscape concept applied in this way becomes a tool for understanding the linkages between economies of care and the political economy of place.

Allergic to the Twentieth Century: Intentional Communities and Therapeutic Landscapes in The Village and Safe

The concept of therapeutic landscapes has been used to explore diverse spaces and places of healing or wellness, from hospitals to gardens, libraries to smoking areas. A central strand of this work considers rural and/or natural landscapes as affording particular healing experiences. In this paper, I draw on this lineage of work alongside research into the formation of intentional communities in rural settings and the body of writing on representations of rural landscapes and country life. The two representations I analyse are films: The Village (M. Night Shyamalan, 2004) and Safe (Todd Haynes, 1995). In the former, an apparent settler village in rural Pennsylvania is revealed, in the film’s denouement, as an intentional community built as a retreat from the violence of contemporary urban life, guarded by Elders and a shared mythology about border-policing creatures. In Safe, the health hazards of modern suburban living, which lead the central character to develop multiple chemical sensitivity (MCS), can only be escaped by a similar retreat to a wilderness commune in the American desert. In both films, the spaces of rural life are constructed as therapeutic landscapes through their nostalgic, anti-modern withdrawal, and their protective boundary keeping.