Potentials and opportunities of therapeutic landscape in psychological treatment settings, what to do: a study from Kigali city, Rwanda.

For the attention of: Hospital planners, designers and managers, and psychologists, in African and other tropical low- and middle- income countries

The problem: Despite much research into the significant effects of green and blue landscape design on health recovery processes, the landscapes within psychological centres frequently include few elements known to contribute to therapeutic environments.

These missing components in the landscape can result in avoidable confinement of patients undergoing medical treatment to indoor spaces.

We examine the therapeutic quality of landscapes at Ndera and Icyizere psychological centres in Kigali city, Rwanda, and use site analysis to highlight the potential and opportunities of including therapeutic elements.

What we did and why: We used qualitative methods such as unobtrusive observation, photography, sketching, interviews, site analysis, and graphical techniques to capture data. Then, through analysis, we were able to evaluate missing aspects of an effective therapeutic landscape and opportunities for improvement.

What our study adds: Our findings identified that the spatial structure of both centres focussed on the buildings, due to the standardization of hospital design, with little attention given to landscape in terms of its clinical impact.

Despite obvious opportunities; the targets, objectives, and strategies of green and blue landscapes were less- or not-included as therapeutic considerations in the centres’ design or management. This oversight resulted in fewer outdoor activities, and outdoor environments lacking in sensory variety.

Implications for city policy and practice: There are opportunities in tropical counties to apply therapeutic landscape knowledge for wellbeing of users. We see an urgent need to develop policies that encourage therapeutic landscapes as part of hospital construction and management plans. In particular:

  • Conduct research, audits and analysis of the current condition of hospitals with regards to therapeutic use of outdoor space.
  • Design outdoors environments to include more variety and sensory stimulation with regard to colour, scent, and materials.
  • Better connect outdoor and indoor spaces.

A therapeutic landscape design approach could improve the quality of treatment and ultimately the health of patients.

Full research article: Insight into the missing aspects of therapeutic landscape in psychological centres in Kigali

Authors: Rahman Tafahomi & Reihaneh Nadi

Editor: Marcus Grant (@MarcusxGrant)