Concept Of Therapeutic Landscapes Research Articles

Medical Tourism: A History and Overview of the Industry and the Case Study of Addiction Recovery in Spain


 
 
 This paper focuses on the emerging global market in medical tourism. The industry continues to expand and become increasingly profitable with greater popular support. This paper conveys the findings of a literature review on the origins, history and contemporary development of the industry. It explores the rationale and access of the medical tourist, and the purported benefits and costs to involved parties including patients, caregivers, citizens and governments. Ultimately it reveals that this phenomenon leads to lower costs, better care, discretion and leisure benefits to wealthy and mobile international clients while reducing available resources and quality of care for residents of host countries, which are mostly low and middle income countries and potentially costing source countries in aftercare. This paper examines the case study of international treatment for addiction in Spain and analyze two websites advertising the treatment for their use of promotional tactics, the importance of place and the relevance of Wilbert Gesler’s therapeutic landscape concept in marketing services. This reveals that international mobility allows businesses to profit from permissive legal environments and popular therapeutic landscapes abroad.
 
 

Modelling spa-goers' choices of therapeutic activities

Abstract Owing to the dearth of studies analysing choices of treatments in spa settings, this study drew on choice theory and Gesler's concept of therapeutic landscape to offer novel insights on spa-goers' choice of treatments. Evidence from 314 spa-goers in Ghana revealed that on average, spa-goers undertake three main treatments in varied combinations, with massage, beauty therapy and thermotherapy being the most patronised. Further, a multinomial logit and a zero truncated negative binomial regression showed that choice of type and number of treatments are both influenced by a multiplicity of factors including age, level of education, travel party size, spa experience, type of guest, length of stay and expected benefits. Given the increasing desire of governments and other policy makers in enhancing the health status of citizens, this information could serve as a valuable means for enticing participation in promotional health activities in spas. Much more, wellness service providers and destination marketing organisations can rely on these findings for segmenting patrons of wellness products and services.

Therapeutic landscapes and non-human animals: the roles and contested positions of animals within care farming assemblages

The concept of therapeutic landscapes has been used as a way to critically understand how health and well-being are related to place. However, traditional discourses on therapeutic landscapes have been constructed from an anthropocentric perspective, completely ignoring and silencing the agency and experiences of non-humans. Building on the idea of therapeutic spaces as assemblages, I highlight the heterogeneity of elements that come together to produce therapeutic space. Mobilizing empirical research undertaken in spaces involved in the practice of ‘care farming’, I demonstrate how non-human presence actively creates and facilitates a therapeutic engagement with place. However, with this recognition of the non-human in therapeutic spaces, there is a need to discuss animals’ contested positions, and question the ways in which being part of these assemblages impacts animals; for whom are these landscapes therapeutic? Thus, this article advocates a critical understanding of the role of non-human animals as both co-constituents and co-participants of therapeutic spaces, moving from framing therapeutic spaces – and the animals within them – purely in relation to human needs and desires.

Postcolonial healing landscapes and mental health in a remote Indigenous community in subarctic Ontario, Canada

ABSTRACTThe concept of therapeutic landscape is concerned with a holistic, socio-ecological model of health, but most studies have attempted to explore land-health links from a Western perspective. On an Indigenous reserve in Northern Ontario, part of the Canadian subarctic, we explore the importance of spaces and places in creating postcolonial therapeutic landscapes to treat the wounds inflicted by colonialism. The aim of this research is to gain insight from views and experiences of First Nations residents living on reservations that are undergoing a process of regaining traditional spiritual beliefs and teachings to construct therapeutic spaces to face mental health problems caused by legal opioid analgesic abuse. This qualitative study used semi-structured interviews with Cree and Ojibwe participants to understand how they are reconnecting with earth, spirituality and traditional animist beliefs on their way to recovery. We find that practices such as taking part in ceremonies and ritual spaces, and seeking knowledge and advice from Elders assist with personal healing and enable Indigenous people to be physically and mentally healthy. Our research findings provide important insights into the relationship between space, healing and culture as determinants of health and well-being and document some key factors that contribute to substance abuse recovery.

Therapeutic landscapes and wellbeing in later life: Impacts of blue and green spaces for older adults

This paper extends the concept of therapeutic landscapes by investigating how green and blue spaces affect older adult health and wellbeing. We draw on interview data from participants aged 65–86 years old who described their everyday experiences with green and especially blue spaces across Metro Vancouver, Canada. Landscapes embedded with therapeutic qualities included parks, gardens, street greenery, lakes, and the ocean. Interactions with these spaces influenced participants' perceived physical, mental, and social health. Issues of safety, accessibility, and personal perception complicated this relationship. Overall, the findings indicate that nature plays a nuanced and influential role in the everyday lives of older adults. Better understanding how older adults experience health and landscape is critical towards developing everyday contact with nature that can improve quality of life for ageing populations.

Therapeutic landscapes and living with breast cancer: The lived experiences of Thai women

Breast cancer is an “emotionally debilitating disease” that affects the lives of women of all ages. In this paper, we discuss the lived experience of breast cancer among women in southern Thailand and situate our discussions within the concept of therapeutic landscapes. We adopted a feminist framework as our research methodology and employed qualitative and innovative methods. The therapeutic landscapes of healing involved multiple levels of landscape changes including body, home, neighbourhood, health care and cultural contexts. Our findings offer a particular insight into the role of emotions, cultural beliefs, and practices in forming therapeutic landscapes among women living with breast cancer in Thailand. It is crucial that health care providers understand the emotional experiences of women with breast cancer and their particular cultural needs for emotional healing landscapes. Our findings could be used as evidence for developing culturally appropriate therapeutic strategies and interventions for women with breast cancer in Thailand and elsewhere.

Exploring imagined therapeutic landscapes: trainee social care practitioners in Ireland

The concept of therapeutic landscape, as introduced to geographers by Gesler, has had a significant impact on what has become a reformed geography (or geographies) of health. Burgeoning research in this field has developed the number and type of sites that have been characterised as therapeutic landscapes. It is notable, however, that in this expansion, little focus has been given to imagined therapeutic landscapes, perhaps indicating a dominance of positivist, masculinist approaches. Although several researchers provide suggestions as to what these mindscapes might depict, little more than anecdotes currently exist. This research explores the imagined therapeutic landscapes of 80 trainee social care professionals, based on thematic analysis influenced by Heideggerian hermeneutic phenomenological approaches. Findings indicate that although there may be widespread unity in the mindscapes of many, the diversity within each field is notable. This study also notes that, although primacy is routinely given to the visual landscape, the impact of the other senses in moulding therapeutic mindscapes must not be underestimated. Cultural and gender relationships are explored and suggestions for further research are made.

Therapeutic micro-environments in the Edgelands: A thematic analysis of Richard Mabey's The Unofficial Countryside

The concept of therapeutic landscapes, as introduced by Gesler, has had a significant impact on what has become a reformed geography (or geographies) of health. Research in this field has developed the number and type of sites that have been characterised as therapeutic landscapes. A wide range of environments have now been explored through the analytical lens of the ‘therapeutic landscape’. This research further expands current descriptions of such environments by exploring Edgelands as therapeutic micro landscapes. Edgelands refer to the neglected and routinely ignored interfacial zone between urban and rural that are a routine characteristic of the urban fringe resulting from dynamic cycles of urban development and decay. Using a hybrid method of thematic analysis incorporating both inductive and deductive approaches, this research explores Richard Mabey's seminal work on this topic, The Unofficial Countryside. Previous examinations of the features of therapeutic environments are therefore scrutinised to explore both scale and the possibility of further extending the kind of environments that may be described as therapeutic to include Edgelands. This approach is informed, in part, by principles of mindfulness, a historically Eastern, but increasingly Western approach to exploring oneself and the environment.This research identifies that these overlooked and neglected landscapes are in fact vibrant, resilient and enthralling environments teeming with life, renewal and re-birth. Examination reveals that there are three crucial outcomes of this research. The first relates to the issue of scale. Mabey's book provides evidence of the importance of micro environments in providing a therapeutic environmental focus. Secondly, this research explores the potential of mindfulness as an approach in Geography. Lastly, this research also identifies Edgelands as therapeutic sites and calls for an increased understanding and appreciation of their potential.

Transforming the health landscape in northern communities: Shared leadership for innovation in nursing education

People living in northern areas throughout the world experience poorer health status than their southern neighbours. Accessibility to health care services and availability of health care professionals play a role in the building of health capacity in northern regions. The College of Nursing at the University of Saskatchewan developed a principled approach to the creation of an indigenous nursing workforce in Northern Saskatchewan. This approach builds on Williams’ concept of Therapeutic Landscapes, which recognizes the connectedness among environment, social interaction, and symbolic meaning within a population, and offers a way to analyze the influence of the contextual factors of place on health, and values and attitudes on well-being. In order to succeed, the College developed mutually beneficial, capacity-building relationships with northern communities, finding local champions to assist them. They reorganized their administrative structure to give visibility to their northern relationships, and built a distributive learning approach based on the commitment to “learn where you live”. Measuring the success of such approaches requires the development of new and innovative evaluation strategies, beyond the usual markers of individual student success. It requires approaches that capture the impact of such education programming on the fabric of the community as a whole.

Redefining racial residential segregation and its association with physical activity among African Americans 50 years and older: a mixed methods approach.

Physical inactivity is one of the factors contributing to disproportionate disease rates among older African Americans. Previous literature indicates that older African Americans are more likely to live in racially segregated neighborhoods and that racial residential segregation is associated with limited opportunities for physical activity. A cross-sectional mixed methods study was conducted guided by the concept of therapeutic landscapes. Multilevel regression analyses demonstrated that racial residential segregation was associated with more minutes of physical activity and greater odds of meeting physical activity recommendations. Qualitative interviews revealed the following physical activity related themes: aging of the neighborhood, knowing your neighbors, feeling of safety, and neighborhood racial identity. Perceptions of social cohesion enhanced participants' physical activity, offering a plausible explanation to the higher rates of physical activity found in this population. Understanding how social cohesion operates within racially segregated neighborhoods can help to inform the design of effective interventions for this population.

Walking together: The embodied and mobile production of a therapeutic landscape

This paper draws on a case study of led group walks in the South-East of England to explore the affective potency of shared movement for producing therapeutic landscapes (landscapes that through placed practices become associated with health and healing). The paper addresses the lack of attention to embodiment and movement in work on therapeutic landscapes through an exploration of how shared movement can produce supportive social spaces that are experienced as restorative. Drawing on an expansive conception of mobility inspired by the ‘mobilities turn’ in the social sciences in the last decade, the paper explores how the therapeutic landscape concept can be enriched by being approached through the lens of the body in movement. A complimentary concern in the paper is the ways in which supportive socialities and group dynamics are integral to many therapeutic landscape experiences. Walking together is found to have a significant impact on social interaction and together embodied mobilities and supportive socialities transform the countryside walkscape into a mobile therapeutic landscape and a site for shared therapeutic body work.

Exploring imagined therapeutic landscapes: trainee social care practitioners in Ireland

The concept of therapeutic landscape, as introduced to geographers by Gesler, has had a significant impact on what has become a reformed geography (or geographies) of health. Burgeoning research in this field has developed the number and type of sites that have been characterised as therapeutic landscapes. It is notable, however, that in this expansion, little focus has been given to imagined therapeutic landscapes, perhaps indicating a dominance of positivist, masculinist approaches. Although several researchers provide suggestions as to what these mindscapes might depict, little more than anecdotes currently exist. This research explores the imagined therapeutic landscapes of 80 trainee social care professionals, based on thematic analysis influenced by Heideggerian hermeneutic phenomenological approaches. Findings indicate that although there may be widespread unity in the mindscapes of many, the diversity within each field is notable. This study also notes that, although primacy is routinely given to ...

Reprint of: “I'm always entirely happy when I'm here!” Urban blue enhancing human health and well-being in Cologne and Düsseldorf, Germany

Water is one of the most important landscape elements. In settled areas, planners rediscovered urban blue in the form of rivers as a soft location factor in post-industrial times. Although the recognition of the need for recreational or ‘healthy’ places like urban green or urban blue in cities is increasing, current urban planning is mostly conducted without taking beneficial health issues into account. In this paper an extended concept of therapeutic landscapes is used to analyse two promenades on the river Rhine in the centres of two German cities (Cologne and Düsseldorf). A complex of qualitative and quantitative methods from diverse disciplines is applied to obtain a multi-dimensional image of salutogenic health processes. The results show that the promenades are favourite places to spend leisure time and to engage in recreational activities, in addition to providing restoration from everyday stresses. Water is a strong predictor of preference and positive perceptive experiences in urban environments. Users of the promenades also report strong emotional attachments to the place. Urban blue space may be interpreted as a therapeutic landscape in various ways. The study forms a contribution to planning issues, particularly considering benefits for human health, and enhances current research concerning therapeutic landscapes.

Surfing therapeutic landscapes: Exploring cyberpilgrimage

The therapeutic landscape (TL) concept recognises that places and settings encompass physical/built, symbolic and social environments that all relate, in combination, to achieving renewal, healing or, at the very least, a sense of well-being. These relationships have been observed repeatedly in the case of material, real-world religious/spiritual pilgrimages and have been shown to be conducive to healing. Employing the TL concept, this phenomenological research specifically explores the experience of cyberpilgrimage, the phenomenon of embarking on pilgrimages over the Internet. A sample of four devotional Catholic cyberpilgrimage websites are explored to shed light on whether they contain elements of the three characteristic TL themes: physical/built, symbolic and social environments. It is found that the websites do, in fact, reflect the TL themes, although differently in manner and extent.

“I'm always entirely happy when I'm here!” Urban blue enhancing human health and well-being in Cologne and Düsseldorf, Germany

Water is one of the most important landscape elements. In settled areas, planners rediscovered urban blue in the form of rivers as a soft location factor in post-industrial times. Although the recognition of the need for recreational or ‘healthy’ places like urban green or urban blue in cities is increasing, current urban planning is mostly conducted without taking beneficial health issues into account. In this paper an extended concept of therapeutic landscapes is used to analyse two promenades on the river Rhine in the centres of two German cities (Cologne and Düsseldorf). A complex of qualitative and quantitative methods from diverse disciplines is applied to obtain a multi-dimensional image of salutogenic health processes. The results show that the promenades are favourite places to spend leisure time and to engage in recreational activities, in addition to providing restoration from everyday stresses. Water is a strong predictor of preference and positive perceptive experiences in urban environments. Users of the promenades also report strong emotional attachments to the place. Urban blue space may be interpreted as a therapeutic landscape in various ways. The study forms a contribution to planning issues, particularly considering benefits for human health, and enhances current research concerning therapeutic landscapes.

Encountering place: A psychoanalytic approach for understanding how therapeutic landscapes benefit health and wellbeing

This paper applies new thinking in psychoanalytic theory to demonstrate how certain therapeutic landscapes work to enhance health and wellbeing. Over the past two decades health geographers have extended the concept of therapeutic landscapes to analyse place and health as it applies to diverse locations embodying therapeutic qualities for different groups of people. Various approaches to how the process works have been psychoanalytic and psychotherapeutic theories. The concept of ‘mentalising’ as applied to therapeutic landscapes is offered by this paper as a further, hopefully enriching contribution to this line of enquiry. It examines the significance of prior familiarity with representations of specific landscapes, what the actual landscape offers to imaginative or projective reconstructions, the importance of cultural resources enabling landscape to be apprehended metaphorically, and the contribution of landscapes seen in this way to therapeutic effects. Therapeutic landscapes are shown to improve individual self-understanding and to enhance the capacity to empathise with others.

Urban-indigenous therapeutic landscapes: A case study of an urban American Indian health organization

We engage and extend the concept of therapeutic landscapes through a case study at an urban American Indian health organization in the Midwestern United States. This case affords insights at the unique confluence of indigeneity and urbanization, prompting us to coin the construct “urban-indigenous therapeutic landscapes” to characterize such sites. These landscapes warrant urgent attention in light of increasing urbanization and health disparities among indigenous peoples internationally. On the basis of thematic content analysis, three themes were identified from 17 open-ended interviews with American Indian community members. Specifically, respondents viewed the health organization as (a) a vital place to be among other American Indians and connected to Native culture, (b) a place where one feels at home and welcome, and (c) a place in which health services are delivered in an especially intimate and hospitable manner. Significant challenges and tensions were also communicated, in terms of unique intersections of health care and indigeneity. Results are interpreted in terms of urban Indian health organizations as urban-indigenous therapeutic landscapes.

Inpatient versus outpatient cervical priming for induction of labour: Therapeutic landscapes and women's preferences

A qualitative study was conducted in Australia to explore women's preferences for inpatient or outpatient settings for cervical priming for induction of labour. The concept of therapeutic landscapes was used to explore the different aspects of the home and hospital that make them therapeutic to women. The therapeutic value of the home and hospital landscapes was defined by their ability to provide women with ‘comfort’ and ‘safety’, and women were found to draw on a range of contextual factors to negotiate between the comfort of home and the perceived safety of the hospital. The study provides important information for health professionals to enable them to enhance women's wellbeing should they be offered the choice of inpatient or outpatient priming.

Theoretical injections: On the therapeutic aesthetics of medical spaces

In this paper we present a dialogue about the seemingly innocuous presence of environmental art in hospital settings as a way of furthering critical perspectives on the therapeutic landscapes concept and its application to medical spaces. We explicitly consider the potential utility of two perspectives, Foucaultian and Lacanian readings, for understanding the relationship between environmental art and the hospital waiting room. We use this paper as a vehicle to demonstrate how such theoretical perspectives can enhance critical scholarship on the therapeutic landscape concept, particularly as it is applied to settings such as health clinics and hospitals. A brief agenda for further critical engagements with the therapeutic nature of health care spaces is put forth in the conclusion.

What the papers say: Reading therapeutic landscapes of women's health and empowerment in Uganda

The Ugandan Ministry of Health emphasises the pivotal position of women in securing the nation's health. Drawing on the concept of therapeutic landscapes, this paper explores media constructions of health in Uganda in order to question what role these may play in creating or undermining a ‘therapeutic landscape’ which supports women's empowerment in a health context. The paper argues for the importance of understanding discursively constructed notions of health in order to ground the promotion of a health care strategy in the everyday lives and discourses of the users implicated. Given the Ugandan government's current drive to both empower women and push an agenda of formally provided health care, this paper provides an exploratory analysis of how far newspapers facilitate or hinder this vision.