Research and Design Guidelines
There have been several explanations on the restorative benefits of nature by scientists. Three widely accepted theories are:
The term biophilia was first coined by social psychologist Erich Fromm and defined as “the passionate love of life and all that is alive”. The biophilia hypothesis states that people have an innate emotional affiliation to nature and other living beings and hence, derive benefits from contact with nature.
Attention Restoration Theory
A person has several states of attention including directed attention and effortless attention. Directed attention requires effort and is used when concentrating on specific tasks, such as working on the computer. This requires voluntary effort and prolonged usage will lead to directed attention fatigue, resulting in ineffectiveness and human error.
According to the Attention Restoration Theory (ART), restoration of directed attention fatigue can be derived from the use of effortless attention when a person is in a natural environment. Based on ART, gardens provide an opportunity for people to rest since they do not have to exercise directed attention. They do not have to consciously exert effort to pay attention to their surroundings and this is termed as “effortless” attention. As this state of attention is effortless, it provides an opportunity for us to rest from a state of directed attention.
Stress Reduction Theory
The stress reduction theory states that contact with nature has been shown to reduce stress. People who are sick or caring for the sick tend to experience stress. Hence, green spaces have beneficial effects on patients and care givers through the reduction of stress.
The National Parks Board, in collaboration with the National University Health System, has conducted two research studies to investigate the benefits of Therapeutic Horticulture in promoting the mental well-being and cognitive functioning of the elderly.
The first study, which focused on healthy seniors, showed that there was an improvement in the psychological status, biological markers and immune cell composition of the participants. The second study, on elderly from senior care centres, showed that participants maintained healthy sleep patterns and psychological health, as well as showed significant reduction in anxiety and improvement in cognitive functioning. In addition, they reported an increase in mean happiness score after each session.
The research studies provide evidence that the nature-based intervention may improve participants’ moods, immunity and moderate geriatric conditions, including inflammatory diseases, dementia and depression and for Therapeutic Horticulture to be translated to programs to benefit older adults in the tropics.
The following are publications arising from the research studies:
Sia, A., Tam, W.W.S., Fogel, A., Kua, E. H., Khoo, K. and Ho, R. C. M. (2020). Nature‑based activities improve the well‑being of older adults. Sci Rep 10, 18178.
- Sia, A., Diehl, E. (2020). Nature-based Activities for Older Adults: A Case Study in Singapore. Journal of Therapeutic Horticulture 30(1).
- Collection of therapeutic horticulture activities from the research study on elderly from senior care centres
- Wong G., Ng, K. S. T., Lee, J.L., Lim, P.Y., Chua3, S., Tan, C., Chua, M., Tan, J., Lee, S., Sia, A., Ng, M., Mahendran R., Kua, E.H., Ho R., Larbi, A. (2020). Horticultural Therapy Reduces Biomarkers of Immunosenescence and Inflammaging in Community-Dwelling Older Adults: A Feasibility Pilot Randomized Controlled Trial. Int. J. Gerontol: Series A, glaa271.
- Ng, K. S. T., Sia, A., Ng, M. K. W., Tan, T. Y C., Chan, H. Y., Tan, C. H., Rawtaer, I., Feng, L., Mahendran, R., Larbi, A., Kua, E. H., and Ho, R. C. M. (2018). Effects of Horticultural Therapy on Asian Older Adults: A Randomized Controlled Trial. Int. J. Environ. Res. Public Health 15, 1705.
- Sia, A., Ng, K. S. T., Ng, M. K. W., Chan, H. Y. Tan, C. H., Rawtaer, I., Feng, L., Mahendran, R., Kua, E. H., Ho, R. C. M. (2018). The Effect of Therapeutic Horticulture on the Psychological Wellbeing of Elderly in Singapore. Journal of Therapeutic Horticulture 28(1).
- Chan, H. Y., Ho, R. C., Mahendran, R., Ng, K. S., Tam, W. W., Rawtaer, I., Tan, C. H., Larbi, A., Feng, L., Sia, A., Ng, M. K. W., Gan, G. L., Kua, E. H. (2017). Effects of horticultural therapy on elderly' health: protocol of a randomized controlled trial. BMC Geriatrics 17(1).
Design Features of Therapeutic Gardens
The design features of a therapeutic garden include the use of plants to evoke the senses, ignite memories and bring about mental well-being; and universal design for accessibility and other user centric amenities.
The gardens offer physical and emotional comfort, providing choices of both serene restorative spaces with an immersive ambience amidst nature, as well as invigorating active spaces with facilities for therapeutic horticulture programmes. Plants that elicit a calming effect are selected for the restorative spaces, whilst those in the active spaces come in warm bright colours to energise the users.
Find out more about the design guidelines for therapeutic gardens.