Icons of Healthcare & Therapeutic Garden Design Interview Series: Daniel Winterbottom, FASLA

by Shan Jiang, PhD, International ASLA, and Melody Tapia

Children's garden play space
The Seattle Children’s PlayGarden / image: courtesy of Daniel Winterbottom

An Interview with Daniel Winterbottom, RLA, FASLA, Professor of Landscape Architecture at the University of Washington and Founder of Winterbottom Design Inc., Seattle, WA

The Healthcare and Therapeutic Design Professional Practice Network (PPN) is honored to present this interview with Daniel Winterbottom, RLA, FASLA, one of the most respected educators, designers, and influencers in the field of therapeutic gardens and participatory design-build. He has been published widely in Northwest Public Health, Places, the New York Times, Seattle Times, and Landscape Architecture Magazine. He is the author of two books—Wood in the Landscape (2000) and Design-Build (2020)—and he has also co-authored the award-winning book Therapeutic Gardens: Design for Healing Spaces.

When did you start your work in the field of therapeutic landscapes and what inspires you to do this type of work?

I guess what inspired me goes back to 1991, and a little before that. I was a bit challenged, in hindsight, with depression, and did not know it at the time, and, unfortunately, began to self-medicate. To come out of that, I spent a lot of time in nature; it was something that helped me evolve and come back from where I was. But more significant was the diagnosis of my mother with ovarian cancer. I spent a lot of time in hospitals, and it was at the time almost identical to Roger’s study (Roger Ulrich, 1986) that we were in the room when she pointed at a tree. She talked a lot about the tree; it was the only tree and was the only piece of nature in the view. I realized that she just clung to it—a totem of reality that you can attach to because the rest of reality was so oppressive. Almost at the same time, I entered into the landscape architecture profession. And because of the social convictions stemming back to the 60s and 70s, it all came together with me that there was an opportunity to explore this area, so I sought out working with marginalized populations.

Could you describe your first project in the field of therapeutic landscapes?

My first project was at a place called Inclination Children’s Center and it was a center for children who had either lost their parents, or their guardians were incarcerated or unable to take care of them, or they had AIDS or HIV. It was the first so-called foster home and was essentially a hospice because at that point in time there was no cure for AIDS. This was around 1997 and I brought students and we designed a garden. It was absolutely magical being with these kids. What I realized at the time was that they were kids, and they deserve to have a childhood no matter how short their life may turn out to be. The experience confirmed my belief, my theories, and my tangential hypotheses, that nature had a power and had an important place in people’s lives.

The kids in the center had not seen a lot of nature and couldn’t go to parks because of the stigmatization of AIDS and HIV. So, we created the park in their home and that way they could at least have that experience. It was small and just a little piece of park; it wasn’t the grand park that you might see in upper Manhattan. But nonetheless, it was what it was. And that prompted me to say this is the work I want to do.

After that, we went to Guatemala and I was able to partner with an amazing organization (Safe Passage) and the executive director had the same conviction that I did. She was interested in finding similar ways to get kids outside Guatemala City. Safe Passage is a non-profit organization that provides educational programs and after-school support for poor children whose families scavenge the Guatemala City garbage dump in Guatemala City. We worked with them for three years to create gardens within the school settings, which was the only piece of nature in that entire neighborhood dedicated to the children, seeing the magic and children’s curiosity evolve as they were in nature. That experience convinced me again that nature is the thing that matters. Nature seems to be a relatively modest intervention in terms of cost when compared to a building, and yet the results are enormous.

There has been growing interest around therapeutic landscapes and a burst of research in the past decade. In comparison to 10 years ago, what has been the biggest change in this field?

One area is that it has been embraced by the public health community, and public health is a fast-growing area of practice and research. For example, Dr. Andrew Dannenberg at the University of Washington is one of the people involved, with an emphasis on the physical aspects. A lot of the initial research and practices were in response to obesity and other physical health problems. I think they’re just beginning to look at the mental health and emotional health benefits of it, but that really threw it into a much broader network. The second aspect is the growing population and the aging population. When they build communities now, they really look into gardens. Still, some of the gardens are poorly designed and just shown to put in the catalog, and they really aren’t usable. I think that is a growing area of both research and practice.

The increasing amount of evidence that is emerging is also pushing interest in the area. Though it is becoming more respected, we need a lot more evidence. I think there’s also a bit of a frustration with some of the conventional treatments and how some of these things just aren’t working. Post-traumatic stress disorder (PTSD) is one example. Veterans hospitals have been trying to treat PTSD for decades, since the Vietnam War, and there are no real medications that they can use. Aside from the talk therapy and experiential therapy, it seems that more recent therapies are taking huge advantages by taking patients into nature. People with PTSD would go to the most remote places in the country, such as Alaska and Idaho; they went because of the nature and isolation, and they consider humans as a threat and contact with humans is the most difficult thing. I think threats to the environment are also making people more aware of the value and fragility of nature in this global era.

Another difference between now and the past is that we have technologies to evaluate outcomes, such as using brain, heart, and sweat monitoring, from the medical standpoint. I think technology has opened a whole window of validation that we didn’t have previously.

In the pandemic context, urban nature is being used tremendously. However, I think there’s also the issue of equity and access. We’re looking with geospatial techniques at where urban green spaces are located, who lives there, and who has access to it. This is one of the most critical things because people in the most marginalized environments have the most stressors. If nature is the counterpoint to stress, then those are the most critical places to have it.

The gardens at the Fisher House of Seattle’s Veterans Administration Medical Center. / image: courtesy of Daniel Winterbottom

Have you shifted your emphasis between types of projects throughout the years and what is your current interest?

Yes, my focus now is on incarceration, and I have done projects in places of incarceration. It seems to me that it is the most removed environment from nature, mainly because people can’t leave. Nature is considered a problem in terms of security; it is also seen as a luxury, and because we’re punitive in this country, we don’t have nature in places of incarceration. If we’re going to rehabilitate people, and I believe many if not most can be rehabilitated, we need to have mechanisms to enable rehabilitation. We incarcerate more people than any other country in the world. There are other ways to intervene, but the cost is enormous. So that’s where I’ve focused most recently, and I’m hoping to do some research and to do case study work on that. I’ve visited many other countries; for example, Norway has a model of how to do it right. There, prisons are integrated with nature: the prisons are in the woods and the woods are in the prison. The results from studies by a number of researchers are quite astonishing—the recidivism rate decreases and acts of violence inside decrease. I think there’s a whole range of both vocational, therapeutic, and spiritual places that we can create in correctional facilities that will help with reducing recidivism and rehabilitation.

What’s your typical design process for restorative garden projects and how do you integrate research and evidence-based approaches into them?

I’m a very fanatical believer in the participatory design process. I am about to do a garden in Italy this fall that is informed by autism. I know little about autism, but I have a passion to do this type of work, and I need experts. This project will be very interesting because usually in the participatory process, we work directly with those who are affected with autism, but that may be a challenge because many are non-vocal. So, we will bring in experts who have evidence and can share that information.

So that’s one way: bringing in the experts. The participatory process brings in the experts who inform us about how the users of the garden function, what their values are, and what their priorities are. The external experts have observational and data-driven perspectives, and a combination of both is essential. There is a paucity in research and references on gardens for people with autism. What is available is mostly from Clare Cooper Marcus; I know Naomi Sachs, ASLA’s work is wonderful, and early on, Martha Tyson’s work was wonderful. But when you get to very specific populations, there’s a tremendous lack of research. And that’s what I hope to add to. Autism is not an easy thing to get your head around. We’re going to design a sensory garden, but what is the sensory experience to some group of autists? Some research is being published in art therapy and different areas instead of the landscape architecture area, so you must be transdisciplinary to really find the data that you need at this point.

Earth and Sky Garden: A Therapeutic Garden for the Puget Sound Veterans Affairs Hospital / image: courtesy of Daniel Winterbottom

How did your international projects come about, and how have you managed cultural differences, coordination, and travel with your students?

We’ve got students all over the country in our overseas program, and it’s as much a cultural interchange as it is focusing on therapeutic interventions, and obviously more than that, including establishing relationships with universities and between the peer-students. Some students have a lot of traveling experience and some students have never left the Northwest. This program is the type of work for people who love uncertainty. It can be exhausting, and you must have absolute faith that you and your team have the skills and the resources to get through the uncertainties. Personally, I believe this is probably the most essential skill to teach a student when they go into academia and particularly if they go into practice. Traveling and working in a different culture is inherently full of unknowns, but the benefits are enormous. The students come back with a sense of self-confidence that I just don’t think they could have gotten in another experience. And it’s particularly challenging because we go into areas that can be quite disturbing. We deal with some serious trauma, such as domestic violence and sexual violence trauma, and for some students, this can open some doors.

Could you talk about the scope of the projects done by your firm?

It’s a small practice and the practice is focused mostly on therapeutic environments. I do a small number of projects each year and I try very much to work with communities that couldn’t afford a big professional practice. I came into academia from practice and it’s also a way to test your ideas. So it’s a little bit of a laboratory, although you try to use the best evidence and the best common sense, the best choices for safety, health, welfare, etc.

My biggest project was probably the Seattle Children’s Garden, which is a garden in an urban park that was designed for children with serious disabilities. It’s been around for 12 years now. It was started by speech therapists at the Boyer Children’s Clinic, which is one of the foremost clinics that provides early intervention services for children with neuromuscular disorders or developmental delays. They were very frustrated with the lack of progress they were making with the children and believed foundationally in nature and nature play as a form of therapy for these children, both cognitively, physically, and emotionally. There were animals (a pet therapy program), gardens, and nature play on site. The project is a remarkably interesting partnership between the Seattle Parks department and Seattle Children’s PlayGarden. It has become a regional destination because there’s nothing else like it.

My firm also does other types of projects, such as memorials, and a modest amount of residential projects. I’m working on a memorial in Ukraine for a cemetery that was destroyed in the second World War. I’ve done a couple of projects for transitional housing for women and for families where predominantly single parent women run the families. I’m able to do that type of work that would probably be difficult for larger firms to do. I can keep my rates low because I’m not solely dependent on it. I’m able to work with much more marginalized or fringe environments.

This interview with Daniel Winterbottom, RLA, FASLA, was conducted by Shan Jiang, PhD, International ASLA, and Melody Tapia, officers for the ASLA Healthcare and Therapeutic Design Professional Practice Network (PPN).

Check out the ASLA Healthcare & Therapeutic Design PPN’s previous interviews from their ongoing Icons of Healthcare & Therapeutic Garden Design Interview Series:

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