TY - BOOK

T1 - The Therapy Garden Nacadia®

T2 - The interplay between evidence-based health design in landscape architecture, nature-based therapy and the individual

AU - Sidenius, Ulrik

PY - 2017

Y1 - 2017

N2 - Mental illness is one of the main challenges to public health in the EU and Denmark. For this reason, there is an increasing demand for innovative interventions and practices to treat mental illness. Treatments should be evidence-based and validated to ensure high quality and positive effects. The research group, Nature, Health & Design, conducts research on the relationship between nature, human health and design from an evidence-based health design in landscape architecture (EBHDL) approach using the most up to date evidence. From 2008 to 2010, the therapy garden, Nacadia®, was designed through an EBHDL process, which was a multidisciplinary collaborative process using state-of-the-art evidence and experts in therapy gardens and nature-based therapy (NBT) for people suffering from stress-related illnesses. Alongside the design of the garden, a NBT programme was developed. A diagnostic post occupancy evaluation (DPOE) is part of the EBHDL process and an efficient tool for examining the possible impact of the design. The overall objective of this PhD project is to gain a deeper understanding of landscape architecture in therapeutic interventions for people suffering from severe stress in a Danish context. It is an exploratory case study to examine NBT in Nacadia (NBTN) for people (N=42) suffering from severe stress. In order to explore the case thoroughly, the following mixed methods were selected based on the objectives of the study: Landscape analyses, behaviour mapping (BM), participant logbooks (LB), semi-structured interviews (SSI), and EQ-VAS rating scale. Article I focuses on 4 groups of participants (n=27) in NBTN during spring, summer, autumn and winter to gain and overall understanding of usage and preferences regarding Nacadia, based on illustrative clustering of BM data and thematic analysis of SSI. Article II studies the participants’ experiences with the case using ‘reflective lifeworld research’, based on SSIs with 14 participants, which are corroborated by BM and LB data. Article III examines the case using a DPOE approach based on findings from LA, BM, SSI, LB and EQ-VAS to assess the quality and effectiveness of the landscape design of Nacadia in relation to its original aim and objectives. Article I determines how different categories of activities were distributed in the garden, and found that the most preferred spaces were described as: “Enclosed”, or “slightly closed” but with a “view out”, to “see far”, and “see the sky” to get a “sense of expanse”. It gave the participants the feeling that their “backs were covered” and that they were “protected from behind”. Such places were preferred for emptying the mind, reflecting in peace or getting small experiences. Study I further found that the changing seasons had no noticeable negative influence on use or preferences. Study II found that NBTN is experienced as a dynamic evolving process of exploring and developing to see and live life from new perspectives and approaches for moving on after NBTN. While there was a fluctuation in mental and physical capabilities during the course of the project, there was a linear increase in executive functions (EF). Article III found a number of successes and failures of Nacadia. The garden design meets the original aims and objectives sufficiently. The issue of exposure was the most significant failure in the design. Article III further developed and applied a generic model of DPOEs for therapy gardens.

AB - Mental illness is one of the main challenges to public health in the EU and Denmark. For this reason, there is an increasing demand for innovative interventions and practices to treat mental illness. Treatments should be evidence-based and validated to ensure high quality and positive effects. The research group, Nature, Health & Design, conducts research on the relationship between nature, human health and design from an evidence-based health design in landscape architecture (EBHDL) approach using the most up to date evidence. From 2008 to 2010, the therapy garden, Nacadia®, was designed through an EBHDL process, which was a multidisciplinary collaborative process using state-of-the-art evidence and experts in therapy gardens and nature-based therapy (NBT) for people suffering from stress-related illnesses. Alongside the design of the garden, a NBT programme was developed. A diagnostic post occupancy evaluation (DPOE) is part of the EBHDL process and an efficient tool for examining the possible impact of the design. The overall objective of this PhD project is to gain a deeper understanding of landscape architecture in therapeutic interventions for people suffering from severe stress in a Danish context. It is an exploratory case study to examine NBT in Nacadia (NBTN) for people (N=42) suffering from severe stress. In order to explore the case thoroughly, the following mixed methods were selected based on the objectives of the study: Landscape analyses, behaviour mapping (BM), participant logbooks (LB), semi-structured interviews (SSI), and EQ-VAS rating scale. Article I focuses on 4 groups of participants (n=27) in NBTN during spring, summer, autumn and winter to gain and overall understanding of usage and preferences regarding Nacadia, based on illustrative clustering of BM data and thematic analysis of SSI. Article II studies the participants’ experiences with the case using ‘reflective lifeworld research’, based on SSIs with 14 participants, which are corroborated by BM and LB data. Article III examines the case using a DPOE approach based on findings from LA, BM, SSI, LB and EQ-VAS to assess the quality and effectiveness of the landscape design of Nacadia in relation to its original aim and objectives. Article I determines how different categories of activities were distributed in the garden, and found that the most preferred spaces were described as: “Enclosed”, or “slightly closed” but with a “view out”, to “see far”, and “see the sky” to get a “sense of expanse”. It gave the participants the feeling that their “backs were covered” and that they were “protected from behind”. Such places were preferred for emptying the mind, reflecting in peace or getting small experiences. Study I further found that the changing seasons had no noticeable negative influence on use or preferences. Study II found that NBTN is experienced as a dynamic evolving process of exploring and developing to see and live life from new perspectives and approaches for moving on after NBTN. While there was a fluctuation in mental and physical capabilities during the course of the project, there was a linear increase in executive functions (EF). Article III found a number of successes and failures of Nacadia. The garden design meets the original aims and objectives sufficiently. The issue of exposure was the most significant failure in the design. Article III further developed and applied a generic model of DPOEs for therapy gardens.

UR - https://soeg.kb.dk/permalink/45KBDK_KGL/fbp0ps/alma99121965813805763

M3 - Ph.D. thesis

BT - The Therapy Garden Nacadia®

PB - Department of Geosciences and Natural Resource Management, Faculty of Science, University of Copenhagen

ER -