Healing vs. Restorative vs. Therapeutic Garden: What Ulrich, Kaplan, and Cooper Marcus Each Meant — and Which Applies to Your Backyard
Most gardeners use these three terms as synonyms. Researchers never do. Here’s the framework Ulrich, Kaplan, and Cooper Marcus each built — and which one actually applies to your backyard.
Search “healing garden ideas” and the results will use “restorative garden” and “therapeutic garden” in the same paragraph, as if they meant the same thing. They don’t — at least not to the researchers who coined them.
Within 3–4 minutes of viewing natural settings, blood pressure drops, respiration slows, and mood shifts from anxious to calm [2]. That much is settled science. But the three terms describe different research frameworks, different design traditions, and different user populations. Knowing which one you’re actually building changes what you plant, where you put seating, and what you reasonably expect your garden to deliver.
This article maps each term to its origin: Roger Ulrich’s stress recovery research, Rachel and Stephen Kaplan’s attention restoration work, and Clare Cooper Marcus’s clinical typology. By the end, you’ll know which framework best describes a private US backyard — and how to put both relevant theories to work at the same time. For the evidence-based design principles behind the healing garden tradition, see the healing garden design principles guide.
The Research Tradition Behind “Healing Garden”
Roger Ulrich’s 1984 paper in Science is one of the most cited studies in environmental design [9]. He examined records of 46 patients recovering from gallbladder surgery at a Pennsylvania hospital — 23 whose rooms faced leafy trees, 23 whose rooms faced a brick wall. The tree-view patients had shorter stays, needed fewer doses of pain medication (analgesics rather than narcotics), and received fewer negative nursing notes about their behavior and mood.
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This was the study that launched “healing garden” into common use. But it’s important to understand what Ulrich was actually measuring: psychophysiological stress recovery. His Stress Recovery Theory (SRT) holds that exposure to unthreatening natural environments immediately triggers a positive affective response — a drop in heart rate, blood pressure, and stress hormones — that interrupts the stress cycle and blocks negative thought patterns.
The mechanism is evolutionary. Humans respond to open natural environments — savannah-like views, water, diverse vegetation — as safety signals. Enclosed urban settings with hard geometry and no vegetation trigger the opposite. This response is rapid (minutes, not hours) and requires no effort. You don’t have to do anything. You just have to be there.
In a 2002 expansion of his framework, Ulrich identified four design factors that support stress recovery in garden settings:
- Sense of control: clear wayfinding, choice between sun and shade, social and solitary spaces
- Social support: seating that facilitates connection without forcing it
- Positive nature distractions: diverse vegetation, water, birds and butterflies that draw the eye without demanding cognitive effort
- Movement and exercise: accessible, well-marked pathways that encourage walking
The word “healing” became attached to this framework because Ulrich’s research took place in hospitals. The underlying mechanism — nature triggering immediate physiological stress reversal — operates anywhere, including your backyard.
The Research Tradition Behind “Restorative Garden”
By the late 1980s, environmental psychologists Rachel and Stephen Kaplan at the University of Michigan were studying a different problem: directed attention fatigue. Their insight was that concentrated mental work — the kind required in modern office environments, during prolonged decision-making, or while managing competing demands — depletes a specific cognitive resource. Without recovery, performance degrades, mood worsens, and impulse control weakens. You can be physiologically calm and still have an exhausted prefrontal cortex.
Their 1989 book The Experience of Nature proposed Attention Restoration Theory (ART): certain environments replenish directed attention by allowing it to rest while something else holds the mind gently. Four properties make an environment restorative [8]:
- Being Away: psychological distance from habitual demands. This doesn’t require travel — a garden screened from street view delivers it.
- Soft Fascination: stimuli that hold attention effortlessly without demanding cognitive effort. Ornamental grasses moving in a breeze, water rippling over stones, a butterfly crossing lavender. The Kaplans contrasted this with “hard fascination” — television, sports, notifications — which absorbs attention so completely it leaves no room for recovery.
- Extent: sufficient coherence and richness that the space feels like a world unto itself, not a strip of border plants alongside pavement.
- Compatibility: the environment fits what you want to do. A space designed for active gardening chores may not be compatible with passive restoration.
The word “restorative” is Kaplan’s, not Ulrich’s. Kaplan explicitly included private gardens in his definition of restorative environments, writing that nature for these purposes encompasses “street trees and backyard gardens” [8]. Tennessen and Cimprich (1995) demonstrated that students with nature views from dormitory windows outperformed those without on directed attention tests — an ART result, not an SRT one. The mechanism was cognitive restoration, not stress relief [8].
In my own experience with a zone 6b mixed border, the difference between a planting with and without movement is striking. A clump of Karl Foerster grass at the end of a path holds attention the way Kaplan described — gently, without demanding anything back.
What “Therapeutic Garden” Actually Means
By the 1990s, Clare Cooper Marcus at UC Berkeley was conducting post-occupancy evaluations of hospital gardens — studying who used them, for how long, and what they reported afterward. Her 1994 survey found that 90 percent of garden users experienced a positive mood change after outdoor time [3]. Her 1999 book Healing Gardens and the 2014 follow-up Therapeutic Landscapes (co-authored with Naomi Sachs) established the evidence-based design vocabulary the field uses today.
Marcus and the profession made a deliberate terminological decision: they moved from “healing” to “therapeutic” because “healing” risked implying that the garden replaced medical treatment rather than complementing it [3]. Therapeutic was more accurate and more defensible.
The American Horticultural Therapy Association (AHTA) defines a therapeutic garden as “a plant-dominated environment purposefully designed to facilitate interaction with the healing elements of nature” [6]. The critical distinction isn’t the plants — it’s design intent and target user population. Therapeutic gardens are built for specific populations with specific clinical goals, typically falling into subtypes [6][7]:
- Enabling gardens: raised beds, adapted tools, designed for physical rehabilitation and occupational therapy
- Horticultural therapy gardens: active plant-based treatment led by registered horticultural therapists, with documented goals and outcomes
- Rehabilitation gardens: movement, balance, and coordination work in a structured outdoor setting
- Dementia gardens: predictable wayfinding, low-stimulation planting, secured perimeters for patient safety
The AHTA notes that a professionally designed garden without active programming often underperforms its therapeutic potential [6]. Design alone isn’t the therapy. A 2024 study of 418 hospital garden users found that 77.5 percent considered healing gardens “important” or “very important,” and 87 percent of hospital staff specifically requested dedicated garden space — yet only 15 percent of existing outdoor spaces were rated “very satisfying” [5]. Cooper Marcus’s own research found that 75 percent of designated healing gardens were rated only “good” or “fair” [3]. The gap between design intention and actual performance is persistent across the field.
Healing, Restorative, and Therapeutic: A Side-by-Side Comparison
| Dimension | Healing Garden | Restorative Garden | Therapeutic Garden |
|---|---|---|---|
| Key researcher | Roger Ulrich (1984) | Rachel & Stephen Kaplan (1989) | Cooper Marcus / AHTA (1990s–2014) |
| Theory | Stress Recovery Theory (SRT) | Attention Restoration Theory (ART) | Evidence-based clinical typology |
| Problem addressed | Psychophysiological stress | Directed attention fatigue | Specific clinical / rehabilitation goals |
| Core mechanism | Nature triggers immediate physiological calm | Soft fascination replenishes cognitive capacity | Structured program + population-specific design |
| Typical setting | Hospital, healthcare | Any natural space, including backyards | Hospital, care facility, clinical program |
| User engagement | Passive (views sufficient) | Passive or active | Active, professionally facilitated |
| Applies to home garden? | Principles transfer | Yes, directly | Rarely without professional programming |
Which Framework Actually Applies to a US Backyard?
Most private gardens fit the restorative framework (ART) most directly. Here is why the setting matters.
Ulrich’s healing garden research was conducted in hospitals with patients recovering from surgery — people under acute physiological stress with minimal control over their environment. His Supportive Design Theory optimizes for that context: maximizing nature exposure when people cannot choose to leave.
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→ Plan My Garden LayoutKaplan’s restorative garden research explicitly included ordinary people in everyday settings, including backyards. The directed attention fatigue his theory addresses accumulates during any normal working day of meetings, screens, and decisions. The mechanism — soft fascination — is available in any backyard with the right plants and a water feature. You don’t need healthcare-grade design standards; you need moving grasses, a water sound, and enough greenery that the space feels like somewhere, not nowhere.
That said, SRT and ART are complementary, not competing. A well-designed backyard delivers both simultaneously. A 30-minute session by a water feature replenishes directed attention (ART) while triggering physiological stress reversal (SRT). Within 3–4 minutes of nature exposure, blood pressure and stress hormones drop measurably [2]. The two pathways run in parallel through the same garden.
What your backyard almost certainly is not is a therapeutic garden in Cooper Marcus’s clinical sense. That classification requires population-specific design features and professional facilitation — locked gates for dementia patients, no fragrant plants near chemotherapy patients, accessible raised beds for wheelchair users. Borrowing the label informally is harmless. Applying Cooper Marcus’s design standards to a private space with different users will produce over-engineered, mismatched solutions. A thoughtfully planted backyard achieves genuine restorative and healing effects without qualifying as therapeutic in the institutional sense.
For plant-by-plant guidance on the species that deliver soft fascination most effectively, see the meditation plants guide and the broader outdoor meditation garden design guide.
Design Elements That Serve Both SRT and ART
You don’t have to choose between Ulrich and Kaplan. Their design implications overlap significantly, and the practical elements that deliver both frameworks are the same ones that separate a wellness garden from a standard planting scheme.
Soft fascination plants. Ornamental grasses produce the continuous, gentle visual rhythm the Kaplans identified as the core restorative mechanism. Karl Foerster feather reed grass (Calamagrostis × acutiflora ‘Karl Foerster’, zones 4–9) moves in even a light breeze and maintains structure from midsummer through winter. Russian sage (Salvia yangii, zones 4–9) and English lavender (Lavandula angustifolia, zones 5–8) add seasonal change and gentle scent without pulling attention sharply.
Water for double duty. A water feature delivers ART soft fascination while simultaneously reducing noise stress (SRT). Even a small recirculating fountain achieves both. Irregular water sound — water moving over stones rather than a smooth sheet fall — provides the non-repetitive acoustic texture most effective for cognitive restoration. For water feature options and placement, the sensory garden for mindfulness guide covers the key trade-offs.
Screening for Being Away (ART) and sense of control (SRT). Dense plantings on the garden boundary reduce visual intrusions from streets and adjacent properties. Both frameworks improve when the space feels contained and self-directed. Miscanthus sinensis ‘Morning Light’ (zones 5–9) or clumping bamboo (Fargesia murielae, zones 5–9, non-invasive) provide effective screening without a solid fence that shuts out sound and wind entirely.
Plant density. A minimum 70 percent vegetation coverage is the evidence-based baseline [1]. Cooper Marcus advocates for a 7:3 plant-to-hardscape ratio [3]. The 418-user hospital study found 81 percent of respondents wanted more plants, not more paving [5] — more greenery is consistently the right call.
Prospect-refuge seating. Place your primary seating with a solid backing — a hedge, fence, or dense shrub mass — and open sightlines to the garden’s main view. This is Ulrich’s prospect-refuge principle: humans reliably find backed, open-facing positions more restorative than exposed or fully enclosed seats. It also satisfies Kaplan’s compatibility requirement — a clearly defined, orientation-backed seat signals that this space is for sitting and observing.
Frequently Asked Questions
Is a meditation garden the same as a restorative garden?
Not exactly. Meditation gardens are designed around contemplative practice — quiet, distraction-free, often with Japanese-influenced aesthetics. A Kaplan restorative garden is broader: any space with sufficient soft fascination, being-away quality, extent, and compatibility qualifies. A well-designed meditation garden satisfies all four ART criteria, but the aesthetic isn’t required to achieve the cognitive restoration outcomes Kaplan’s research documented.
How much time in a garden is actually needed?
Research suggests 3–5 minutes is enough to produce measurable drops in stress hormones and blood pressure [1]. Significant directed attention recovery (ART) typically requires longer — most studies use 20-minute to 60-minute sessions. A 10-minute outdoor break is enough to interrupt the directed attention depletion that accumulates during a standard working day.
Can my backyard be a therapeutic garden?
In the colloquial sense, yes — if your garden helps you feel better, the informal label is reasonable. In Cooper Marcus’s clinical sense, therapeutic gardens require population-specific features and often professional facilitation. Most backyards aren’t designed for clinical patient populations. That doesn’t reduce their restorative or healing value — it just identifies the correct vocabulary.
Do I need a professional to design a restorative garden?
No. The core ART requirements — soft fascination plants, screening for being-away, sufficient plant density, and a compatible seating position — are achievable without professional design. A dense mixed border of ornamental grasses and perennials, a small recirculating water feature, and a bench backed by a hedge satisfy all four Kaplan criteria without an architect’s drawing.
Sources
- UC ANR, The Real Dirt. Healing Gardens.
- University of Minnesota, Taking Charge. What Are Healing Gardens?
- Pacific Horticulture. Therapeutic Gardens.
- PMC10621031. Therapeutic Hospital Gardens: Literature Review and Working Definition. HERD, 2023.
- PMC10722422. Design Guidelines for Healing Gardens in the General Hospital. Frontiers in Public Health, 2024.
- American Horticultural Therapy Association. Therapeutic Garden Design & Clinical Benefits. ahta.org/about-therapeutic-gardens
- Penn State Extension. How to Create a Healing Garden.
- Positive Psychology. Attention Restoration Theory.
- Nature Sacred. Roger Ulrich, PhD.
