Elements of a Residential Therapy Garden

Learn how to bring home the om. As interest in outdoor spaces that can help heal and satisfy physical, emotional, and spiritual needs expands, make sure you understand the mix of features that make up these restful, inspirational oases.

Outdoor living can add enormous joy to homeowners’ lives, expand usable square footage, and provide a boost when marketing a house for resale. But with more and more Americans focused on wellness, a new gardening niche is emerging. Of course, the idea of a therapeutic garden offering refuge after an illness or trauma—or space to meditate, destress, and connect with one’s spiritual self—is hardly new. During the Middle Ages, monastery hospitals developed therapy gardens, and for centuries Japanese people have been using Zen rock gardens as sacred places to perform their daily rituals.

In the last few decades, hospitals, memory-care centers, and cancer clinics have taken the lead in constructing gardens that incorporate different features to serve patients’ specific needs, says landscape architect Jack Carman, founder and president of Design for Generations in Medford, N.J. Owners of businesses outside the health care industry concerned about workplace stress soon followed suit. Jarrod Baumann, CEO of Zeterre Landscape Architecture in San Francisco, has designed many on-site gardens where employees at high-tech companies can unwind.

As more research emerged that nature can boost healthfulness, the idea of having a therapy garden at home has gained traction. How they look, smell, sound, and feel, and what they’re called beyond the umbrella “therapy” term—healing, meditative, spiritual, sensory, sanctuary, or pain management—varies to reflect specific client goals. But a universal goal unites them, according to Carole Aine Langrall, a Baltimore and Santa Fe–based master gardener who’s designed many therapy gardens, including one for herself: “Frustration and fear can be replaced by tranquility and hope.”

These therapy gardens aren’t just for those seeking relief, however, says Langrall, who also writes the “Santa Fe in Bloom” column for the Santa Fe New Mexican. “Caregivers may find it helpful to escape outside for a few minutes to relieve their stress,” she adds.

With interest in therapy gardens growing, it’s important that you’re able to help clients understand what elements they might want to incorporate, including plants, hardscape, and architectural features. And if you land a listing that already has this kind of garden, make sure you understand how it can help a home stand out amid less nurturing inventory.

First decide on size, care, location

Therapy gardens needn’t be large. In fact, a small footprint can make them easier and less costly to tend. They can be sited almost anywhere on a property, but terrain, a homeowner’s wish for privacy, and the amount of light needed for the desired plantings will help determine the best spot. Many therapy gardens are built in secluded places, away from a house and neighbors or at a different elevation, says Sacramento, Calif.–based landscape designer Michael Glassman.

Some prefer to locate them in the open for better views, to be social, or because of cultural traditions, says Topher Delaney, a garden designer with Delaney + Chin in San Francisco. “Many Hispanic families are very inclusive—at a hospital, we’ve seen 15 members of a family show up—while other groups want it quieter. You need to have different strategies to address different cultures,” he says.

Accessibility is also an important feature in site selection. Langrall says it’s important to consider universal design principles for those with mobility issues or who want to age in place.

Second, consider the senses

Therapy gardens tend to be most successful when they have features that appeal to at least one of the senses all year round, Carman says. However, smell is one sense that varies quite a bit depending on the client’s needs. Gardens with fragrant plants such as lilacs have been found to trigger sweet memories for those with dementia and brain injuries. “Smell is one of the last senses to go,” says Naomi Sachs, founding director of Cornell University’s Therapeutic Landscapes Network. For that reason, one garden at the Marianjoy Integrative Pain Treatment Center at Northwestern Medicine outside Chicago has plants that stimulate the olfactory system, says Kyle Butzine, a staff physical therapist at the Wheaton, Ill., campus gardens. Among those are lavender, lemon verbena, and scented geraniums. Conversely, gardens for those undergoing chemotherapy usually are designed without scents since many cancer treatments make patients highly sensitive to smell and easily nauseated, Sachs says. Too much light can also be unsettling. “Those going through any kind of chemotherapy find it affects their eyes,” Delaney says. But the good news is that nature, even without bright sunlight and smells, can help lower blood pressure, reduce stress, balance circadian rhythms, and increase vitamin D absorption, according to Roger Ulrich’s research into how seeing greenery can influence surgical recovery. “It also can be a positive distraction that takes people’s minds off their ills,” Carman says.

Third, choose a few essential elements 

When planning their own garden, homeowners should be selective and make decisions based on how much maintenance they want to undertake—or pay to have done. Too many features, or the wrong kind, may add stress, says Delaney. And that’s the opposite intention of these gardens.

1. Plants and herbs. In most gardens, it’s best to seek out a variety of heights, textures, and colors. If privacy and quiet are desired, evergreens like spruces or a “wall” of noninvasive bamboo may be a good choice. Landscape designer Donna Christensen of Christensen Landscape Services in Northford, Conn., uses lilacs not just for their fragrance but because she can also group them to create a privacy hedge. But be aware that too many plant walls can create a dark, claustrophobic space. Color may contribute to healing, too. Blue is a good universal choice because most find it calming, Langrall says. Those with cataracts find it easier to see bolder rather than pastel hues. Butterfly bushes do double duty by displaying colorful flowers and attracting butterflies to add vibrancy, but be sure to choose a seedless or low-fertility variety, as the plants are considered invasive in some areas. Other plants that attract pollinators include cosmos, foxgloves, and cone varieties. Certain herbs have a symbolic connection and can offer freshness in favorite recipes and a medicinal effect. Chamomile is one standout example of this archetype as it’s equated with comforting, but is also thought to work as an antioxidant, anti-inflammatory agent, and tissue regenerator. Tomatoes and leafy greens also help fight inflammation, and herbs can be seeped in water to flavor what can be a healthy alternative to soda, says Lisa Schwartz, a physical therapist and coordinator at the Marianjoy Center. “Planting in raised beds or along walls also is smart, so people don’t have to bend and reach as much,” Schwartz says. And for those wanting something tactile, many therapy gardens, especially those designed for children, feature fuzzy, soft lamb’s ear, which has the additional benefit of bearing a cute name, Sachs says.

2. Rocks, hardscape, and paths. Rocks artfully arranged in their own grouping or along paths are another key because of their long association with Zen and “dry landscape” gardens. While smaller pebbles add a pleasant crunching sound for those who want an auditory component, they can be tough to traverse. That’s why Sachs instead suggests concrete pavers without gaps. For those with dementia, a path should always be laid out in a circle that winds around to the starting point rather than coming to a dead end that may cause confusion about where to go next, she adds. At the Marianjoy gardens, there’s a labyrinth to practice navigation, which could be replicated on a smaller scale at a home.

3. Audible charms. Wind chimes may please some; others, such as neighbors, may find them annoying, Sachs warns. That’s why she cautions homeowners to be thoughtful about how they incorporate them. Sachs also notes that a mass of tall decorative grasses can add soft rustling noise as a less intrusive sonic alternative. Because of the cost and space needs associated with large water features, home owners may want to avoid a pond or babbling brook, says Carman. But a small stream can add tranquil sights and sounds. Alternatively, a soaking tub can offer a source of calm and way to ease aches and pains, Christensen says. Landscape designer Susanne Fyffe, whose eponymous firm is based in Arlington, Va., has used a recirculating fountain to add trickling noises without wasting water, which also drowns out street traffic. Song birds and bees add wonderful music to the air too, Carman says. And besides using just plants, berries, and flowers to attract them, water in the form of baths and feeders stocked with food will likely bring more to your garden, Sachs says. The plethora of wireless speakers also makes it easy to bring music into a garden. Baumann says the addition of a chicken coop in the therapy garden behind their firm’s office has offered a new way to experiment with some less predictable outdoor features: “There is something about chickens and animals that brings us all back to our childhood—that simplicity of interacting is healing. We all have a bit of nostalgia, don’t we?”

4. Seating and other accessories. Furniture can provide a comfortable place to sit and savor a view, but the choice of what type should be made carefully with the prime users in mind. Elderly people or those with health problems may need seats with arms, backs, and cushions. Outdoor rugs add color and pattern and can become a soft place to perform yoga or meditate. Aside from furniture, Monterey, Calif.–based feng shui expert Preeti Sodhi Sharma likes to use accessories to set the tone. “Buddhas and other statues help improve the chi energy in a garden and remind users to stay in the present.” For those with more space, a simple structure such as a small wooden bridge can work as part of a physical therapy program to improve balance and coordination, says Ray Ward, who helped to design and maintains several of Marianjoy’s Wheaton campus gardens.

5. Light and fire. Low-voltage, energy-efficient illumination for the outdoors is now easy to install, even without an electrician. It can be placed along paths, in grass, water features, and trees to extend garden use past dusk. Lighting also helps homeowners enjoy their gardens from afar by spotlighting different garden focal points so they can be enjoyed during inclement weather or when residents are otherwise unable to venture out. Real flames and light can flicker safely in gas-fired tiki-style torches or a fire pit to expand a garden’s use into evening. Fire offers a mental health benefit since it tends to call people together to sit and linger, which is especially helpful for for those feeling isolated. “There’s something almost tribal about being around a fire together,” says Sachs.

Finally, learn to use the garden as a marketing tool 

Most buyers probably don’t have a therapy garden on their “must have” list, but when they see one it may pique their interest, says Yancy Whittaker, associate broker with Coldwell Banker Trails West Realty in Santa Fe, N.M. “It definitely enhances appeal and increases the perceived living space, since so many homes in our area have zero lot lines,” he says. That was the case when Langrall sold her house in the same area. The photos and description of her garden made it a magnet. “The house sold to a family that fell in love with the garden,” she says. To foster interest, Whittaker suggests three useful steps:

  • Look at several photographers’ portfolios and hire the one who knows best how to photograph a garden, highlight its most attractive features, and capture the best angles
  • Make sure you describe what’s in the garden and why in your marketing materials
  • Pose an enticing question with your listing, such as “Are you looking for a private space for meditation and relaxation?”

Resources to tap for more information

  • Healing Landscapes is a site that lists landscape designers who can help create the right kind of home therapy garden for specific needs. Jack Carman, a landscape architect whose Design for Generations is based in Medford, N.J., suggests simply searching the web for “therapeutic” or “meditation” gardens and your local area to find designers who can help.
  • The American Horticultural Society lists master gardeners and other information such as how to plant pollinator gardens.
  • More and more botanic centers offer therapy garden education. The Chicago Botanic Garden in Glencoe, Ill., was among the first to do so and offers two certificate programs—one on horticultural therapy and another for health care garden design.
  • Several useful books include Garden Retreat: Creating an Outdoor Sanctuary by Barbara Blossom Ashmun (Chronicle Books, 2000); Therapeutic Landscapes by Clare Cooper Marcus and Naomi Sachs (Wiley, 2013); Gardeners’ World: The Healing Garden by Gay Search (BBC Books, 2001); Nature Fix by Florence Williams (W.W. Norton & Co., 2017); and Gardens for the Soul by Pamela Woods (Conran Octopus, 2002).
  • If you’re looking for inspiration, ask hospitals and wellness centers in your area if they have therapy gardens that the public can use. Mercy Medical Center in downtown Baltimore planted trees, boulders, paths, and water features on three outdoor levels of its new Mary Catherine Bunting Center building with the firm of Mahan Rykiel Associates in charge. “Families, staff, and patients enjoy seeing greenery flourish through windows and when outdoors. It helps them remember that life goes on as patients recover,” says Dr. Joseph Costa, medical director of the intensive care unit.