**8. Discussion**

Successful therapeutic landscapes address the social and cultural contexts of their location as well as respond to the environmental, mental and physical needs of each user. In defining therapeutic environments as reliant on a series of encounters, networks, and associations, Duff [16] classified these enabling resources into three categories: social, affective, and material. Social resources are grounded in relationships but are also directly linked to place, since they are a product of it and simultaneously enable everyday experiences. Affective resources are the fusion of individual or collective feelings that define or restrict orientations or actions. Material resources characterise the way in which relationships are established through the materiality of place and how they impact our access to goods, services, and information. Therapeutic landscapes can strengthen and improve the overall well-being of an individual, a community or even a population. In the case studies, a variety of processes were used to foster therapeutic environments, bringing together the relational, affective, emotional and cognitive skills that create and maintain social networks and promote meaningful experiences, closely weaving together land, culture and health.

## **8.1 The land**

Landscapes are experienced in different ways by different people. Different cultural orientations may also lead to different experiences of the same space; however, this does not negate its therapeutic qualities. Similarly, the experience of therapeutic landscapes will vary based on previous experiences or attachments. In the literature, sense of place is discussed as being related to the inclusivity of the design and the intention of the user, but it can also refer to the historical connection with the space, which can enrich the 'place identity'. Placemaking enables the restorative and healing abilities of therapeutic landscapes, aiding those seeking the social inclusion or home comfort and attachment that is often formed through activities and the communal associations made [39]. The spaces that were the most successful in creating a holistic healing landscape for the community, were those environments that were welcoming and established a strong sense of place for all users. Hereby, the sense of place in a therapeutic landscape can result from place identity and place attachment and is often felt by a user when they have an emotional or historical connection to that place.

Two case studies, in particular, illustrate how the land grounds the therapeutic nature of the place. The Kopupaka Reserve in Aoteroa-New Zealand guides visitors along constructed boardwalks. The surrounding waterways provide an abundance of life with views over the wetlands and freshwater streams to the varied birdlife and biologically-diverse horticulture. Open spaces for communal activities are contrasted with private places for emotional retreat, providing a human experience that engages with all the senses through sight, sound and smell. With the attention shift from intimate perspectives to distance views, the approach also changes from a very singular and internal healing process to a communal and inclusive one. The design is permeable and flexible, allowing the materials to flex with the movement of the land and using materiality to will enable the ecology to flow.

Freedom Park in South Africa also uses the land to bring people together. One of the strongest features of this park is its engagement with the sense of place. Bringing together formerly alienated groups in a neutral landscape that offers both distant views over a cityscape and intimate pocket spaces, it is concerned with the physical, mental, spiritual, societal and environmental landscapes of South Africa, embodying them into one space for all. Emotions typically run high when the historical injustices of apartheid are situated in a specific place. The park is designed to seamlessly disappear into its natural context as the materiality of the built environment emulates and draws inspiration from the surrounding nature.

*Therapeutic Landscapes: A Natural Weaving of Culture, Health and Land DOI: http://dx.doi.org/10.5772/intechopen.99272*

#### **8.2 Culture**

Therapeutic landscapes can provide an opportunity to embed cultural and traditional practices that do not often get conveyed in everyday contexts. For example, the Jardín Etnobotánico de Oaxaca (Mexico) began as a passion project for many locals in the community who wanted to see the preservation of art, culture and the environment. The garden tells a story about the cultural and artistic traditions of Oaxaca as well as its place in the natural history of Mexico. There are many repetitive and empowering cultural and historical motifs that feature in the garden and speak to Oaxaca's history. From a social perspective, it brings together artists, horticulturalists, scientists and anthropologists as well as the community at large to reflect the purpose of the garden as an exploration of the relationship between plants and people. The use of materials and hardscaping is also unique to the garden and emphasises the specific narrative of Oaxaca's history. In this project, the health of individuals reflects the strength of the community and collective triumphs are celebrated over the personal gains of the individual.

Another important example of a successful therapeutic environment that celebrates cultural values and includes Indigenous and traditional materials and practices within the design of the landscape is the Kopupaka Reserve (New Zealand). Importance was given to creating a place identity and understanding of how the land was used pre-colonisation. The New Zealand case study adopted a series of principles, Te Aranga framework, to ensure a cultural approach was taken to design that encouraged designers to engage with local Māori tribes in all aspects of the design and construction processes and to ensure that plants and materials had been chosen correctly. Cultural values hereby affect and maintain physical, emotional, mental and spiritual health and well-being. Our findings align with those of Andrews [17], whereby a successful therapeutic landscape has been shaped by the influence of a belief system/culture and emotionally engages with human experience. If these are embedded within the design, the environment will inherently respond to the needs of each individual user in a holistic sense and provide the foundation for a more affluent, healthier lifestyle. For many, connection through place or land includes not just the individual but the entire community of beings, living and non-living, putting the need for connection at the forefront.

#### **8.3 Health**

The literature review highlighted some clear themes relating to health that are thread throughout the discussion of therapeutic landscapes and what a successful holistic healing space should provide. Therapeutic environments and healing environments need to be designed to the needs of the user; which includes the needs of the marginalised. Two landscapes that are specifically designed for unique human experience are the Jiyan Healing Garden (Iraq) and Lions Park (Australia).

In the Jiyan Healing Garden, the healing garden is designed for victims of trauma and to address the social tensions that had widened the gap between the places of emotional retreat and healing from those of everyday sociability. Here the healing garden serves as an emotional retreat that facilitates an 'extraordinary' healing experience. For this reason, it takes a unique approach and involves access to animal therapy and pays attention to the specific needs of the user. In addition, it offers the chance for patients to work on the upkeep of a garden actively, activities they may have done at home [23]. Participation at this level creates a sense of ownership and sense of place in the facility, improving the productivity of healing and rehabilitation. Wellness and health of a community do not rely solely on the physical gains from gardening but also the mental gains. Feelings of loneliness

and isolation can be mitigated by involvement in communal gardening as well as the practice of plant propagation and cultivation [34]. Concerning the material, a diverse range of spaces and activities are essential to the inclusivity of a space. For this garden, the choice of plants was vital, which targeted the user and their preferred activities [23]. While the garden's main intention is to provide relief and help those suffering trauma from torture and acts of war, it also gives the community access to adequate green space. Green spaces that are inclusive and contain structured activities are crucial for creating more robust and resilient communities. This is the grounding essence of a therapeutic landscape.

Similarly, the Lions Park (Queensland, Australia) has been designed for participation and socialisation on a much smaller scale. With its design focus on intergenerational socialisation and inclusion for those with disabilities, interactive areas provide for various body movements that include vestibular and proprioception and sound, sight, smell, and touch. Social inclusion is achieved through the creation of spaces that meet the needs and desires of all potential users. There are also spaces of refuge that can be used to hide away, for relaxation or contemplation. Playgrounds provide various bodily movements that stimulate the mind and body, similar to the activity of gardening. In particular, play equipment was included within the design of the playground to ensure that users of all abilities were included. Wheelchairfriendly paths, shelters for those who are light-sensitive, tactile panels, visually stimulating signs and planting combinations all combine to create an inclusive and restoratively productive environment.

## **9. Conclusion**

Our understanding of what makes up a therapeutic landscape is evolving. Social issues including; quality of life, access to health care, social inclusion and supportive environments were all addressed in most literature, but overall, we found a lack of engagement with the important cultural context of the therapeutic landscapes and in particular, the inclusion of Indigenous practices. Our research finds that Indigenous methods can provide a holistic approach to health and well-being in our communities and a finer grained understanding of a therapeutic environment.

Our case studies varied in scale from large and expansive natural landscapes to small manmade interventions, but all shared social inclusion as a recurrent theme and all acknowledged aspects of land, culture and health. The successful therapeutic environments were tied to the inclusivity of the design and the intention of the users, but also the historical connection to enrich the place identity. Most of these spaces have come about as projects as a response to passion and request from the local community or as a response to social or cultural demands. This has resulted in the inclusion of the community's needs in the designed spaces and their physical input in the landscape.

The concept of therapeutic landscapes has evolved with research and theory to reflect society's current values. Most recently, this has shifted with the desire to have healthy and strong communities. A stronger sense of place is considered to create stronger communities and improved community-wide health and well-being. The success of a community cannot be separated from the success of its place, including the natural settings, the local culture and wider surroundings. In this way weaving land, culture and health is essential to the concept of the therapeutic environment.

## **Conflict of interest**

The authors declare no conflict of interest.

*Therapeutic Landscapes: A Natural Weaving of Culture, Health and Land DOI: http://dx.doi.org/10.5772/intechopen.99272*
