A therapeutic garden or wellness garden is an outdoor garden space that has been specifically designed to meet the physical, psychological, social and spiritual needs of the people using the garden as well as their caregivers, family members and friends. Therapeutic gardens can be found in a variety of settings, including hospitals, skilled nursing homes, assisted living residences, continuing care retirement communities, out-patient cancer centers, hospice residences, and other related healthcare and residential environments. The focus of the gardens is primarily on incorporating plants and friendly wildlife into the space. The settings can be designed to include active uses such as raised planters for horticultural therapy activities or programmed for passive uses such as quiet private sitting areas next to a small pond with a trickling waterfall. Design Nature is referred to as a ‘positive distraction’ by Roger Ulrich, Ph.D. at Texas A&M University. History The American Horticultural Therapy Association (AHTA) Definitions and Positions Paper draws a distinction between a therapeutic garden and a healing garden. The AHTA defines a healing garden as "plant dominated environments including green plants, flowers, water, and other aspects of nature. They are generally associated with hospitals and other healthcare settings, designated as healing gardens by the facility, accessible to all, and designed to have beneficial effects on most users." On the other hand, a therapeutic garden is "designed for use as a component of a treatment program such as occupational therapy, physical therapy, or horticultural therapy programs and can be considered as a subcategory of a healing garden." A therapeutic garden can be described as being therapeutic in nature when it has been designed to meet the needs of an individual or group. Individuals or groups strive to improve their well-being through active engagement by using plants and engaging in activities ranging from planting, growing and maintaining plants. Horticulture has been soothing man's senses as early as 2000 BC in Mesopotamia. Lush agricultural plots lay in the fertile river valleys between the Tigris and Euphrates providing agriculture and inspiration for the first designed gardens in this typical arid landscape. In the 5th century AD, gardens were generally perceived to contribute to the improvement of health and have been used as a place of respite from travels, to serve as a place to recover or recuperate from an illness, or to simply isolate the sick or infirm from the healthy individuals. Gardens located within Christian