Design for Healing Spaces - Therapeutic Gardens by Daniel Winterbottom and Amy Wagenfeld (Timber Press 2015)
Reviewed by Michael Westley C.M.L.I.
This book is written & edited by two friends & colleagues with whom I write & publish in the US. - Landscape Architect, Daniel Winterbottom and Occupational Therapist, Amy Wagenfeld. The exciting possibilities of trans-disciplinary creative endeavor drive our collaborations. That same spirit created the thoughtful insight behind the text of this book, whose premise is that responsive and intentional design should arise from a comprehensive ‘briefing’ process in which all ‘actors’ and ‘stakeholders’ voices are heard and responded.
I provided a case study on Westley Design’s ‘Dolphin House’ project, together with images and text of our other projects to illustrate specific concepts regarding therapeutic garden design. The objective was also to explore and describe the value of using an inter-professional design approach to placemaking that meets the needs of all users regardless of ability.
The book begins by developing understanding in areas such as participatory design, healing gardens, public health and even the design process; all illustrated by case studies and informed by the accounts of the people involved in them.
Refreshingly, it does not limit its consideration to hospitals and healthcare environments. Its notion of healing or therapeutic landscape design extends to broader areas of public and shared private space, driven by wider understanding of human wellbeing. So we find informed discussion and rich description of the design principles and places created for: military veterans, children with special needs, specific cultural communities and social issues such as obesity.
Usefully, the book also considers maintenance, from a social as well as a programmatic and physical perspective. It explores the central idea of healing space from so many different perspectives, designers, users, commissioning clients that each page or case study surprises with an insight or something of relevance.
Described below are three case studies taken from the projects of Westley Design’s portfolio, which are sampled in the book. All are located on the campus of the Royal Cornwall Hospital Trust at Treliske, Truro, Cornwall (U.K.)
1. Play 4 Life was designed as a resource for hospital visitors, therapists and service users from across the hospital and as a learning play facility for the Hospital School.
In the Play 4 Life project Westley Design worked as project brief generator, developing a program of consultation across the different stakeholder groups within the hospital. This in turn led to the generation of promotional material for external funding purposes.
The consultation activity was designed to work at both a professional and statistical level in terms of health outcomes, and also at a public level. For instance, creative, eye catching sculpture pieces supporting consultation were circulated around the hospital departments and public areas, to maximize stakeholder response. These were delivered through a partnership between children and the teaching team of the hospital’s school, and also with local schools, a visual artist and the Health Trust Play Officer.
There was also an audit style exploration of clinical service delivery possibilities and benefits within the outdoor setting by a range of clinical departments, a patients’ representative group, the hospital’s Improving Working Lives team, and estates department.
The final design was developed through a series of iterative design workshops for stakeholders, using a variety of media, including 3D models and sketches. Play 4 Life’s thoughtfully designed spatial qualities meet the needs of different ages and user capabilities. It was achieved by reinterpreting the site’s existing qualities and attributes - preserving hedges and mature trees, reusing the demolition material to create mounds for climbing, and defining and creating spaces for users to experience relative solitude and encourage exploration.
The circulation system offers a range of challenges in terms of step height, surface texture, speed, direction, and gradient. The result is myriad of flexible and diverse experiences to be enjoyed by families, clinicians, and school staff. A series of defined spaces was developed with particular play leaning/ healing objectives. At first glance however the impression is of a richly varied garden, rather than a playground. This encourages use by a wider spectrum of users.
2. Dolphin House was designed specifically as a facility serving special needs children experiencing a range of serious conditions.
To support the therapeutic play/ treatment program delivered at Dolphin House through playful interaction between children, clinicians, care staff, and families and staff, it was necessary for Westley Design and the Royal Cornwall Hospital Trust (RCHT) team to co-facilitate a brief for learning/ healing, play, and improved overall experience within a challenging small space.
A series of design workshops attended by psychologists, occupational therapists, teaching /care team staff, and patients was facilitated by Westley Design. As a way of rooting responses through shared experiences, the team asked participants to relate their detailed play experiences as children, observations of their children, and close observation of staff practicing in the existing space. Later in the process, a design development conversation was facilitated between the client group and the fabricators and contractors, using models and visits to workshops. In addition to maximising the functionality and efficiency of the final product, this built a sense of shared ownership among the stakeholders.
The outcome was a central single, playful piece of sculpture furnishing that functioned as a focal point in the courtyard, and that divided the space around it into sub-spaces of varied character and provided opportunities for self-directed play and learning for children. In clinical use the staff can select from a range of kinesthetic, proprioceptive, and tactile sensory elements to tailor a unique and creative and appropriate experience for each child.
3. Grenville Ward Courtyard was designed as a therapeutic space associated with a ward for post-operative elderly patients, including people recovering from stroke.
At the Grenville Ward Courtyard project, Westley Design worked closely with the Health Trust Arts Officer and a core team of hospital staff representing clinical, nursing, and estate management to generate a performance brief for a modest space and limited budget.
Reminiscence workshops were implemented with the elderly patient groups, and reflective interviews were held with staff focusing on their personal experiences of living with elderly people’s needs. Clinician and nursing teams were then asked to consider how key elements of their practice might be delivered in a garden setting with a five-year timescale, due to the temporary nature of the ward accommodation. Ward staff were involved in the planting of the design and its continued maintenance after completion.
At the Grenville Ward Courtyard, a sense of layering is present in a serpentine pathway and architectural hand railing system, which adds a softening curvilinear movement and articulates the subspaces along the length of an otherwise harshly rectilinear courtyard. The railing element doubles as a handrail and distance guide along which occupational and physical therapists can work with patients with balance and mobility challenges and walking and exercise in a pleasing outdoor environment.
The needs of staff are cared for specifically through provision of a seating area subtly screened from the rest of the garden by planting and a water wall fountain.
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