Conceptualising Therapeutic Environments through Culture, Indigenous Knowledge and Landscape for Health and Well-Being

Abstract

Academic research has long established that interaction with the natural environment is associated with better overall health outcomes. Notably, the area of therapeutic environments has been borne out of the recognition of this critical relationship, but much of this research comes from a specific Western perspective. In Aotearoa-New Zealand, Māori (the Indigenous people of the land) have long demonstrated significantly worse health outcomes than non-Māori. Little research has examined the causes compared to Western populations and the role of the natural environment in health outcomes for Māori. The present study aimed to explore the relationship between Māori culture, landscape and the connection to health and well-being. Eighteen Māori pāhake (older adults) and kaumātua (elders) took part in semi-structured interviews carried out as focus groups, from June to November 2020. Transcribed interviews were analysed using interpretative phenomenological analysis and kaupapa Māori techniques. We found five overarching and interrelated key themes related to Indigenous knowledge (Mātauranga Māori) that sit within the realm of therapeutic environments, culture and landscape. A conceptual framework for Therapeutic Cultural Environments (TCE) is proposed in terms of the contribution to our understanding of health and well-being and its implications for conceptualising therapeutic environments and a culturally appropriate model of care for Māori communities.

Re-orientating health and nursing care: a qualitative study on indigenous conceptualisations of wellbeing

“…The concept of wellbeing is frequently presented as several fractured and distinct concepts. For example, physical wellbeing as distinct from mental wellbeing[ 46 , 47 ]; this research highlights that pakeke, or older Māori adults, consider wellbeing in a balanced and holistic manner, which is consistent with the perspective of other Indigenous cultures that describe wellbeing as an interdependent and multi-faceted concept [ 6 , 11 , 12 , 16 , 48 ]. This exploration has revealed a paradigmatic lens of pakeke, offering unique and undocumented insights into their lifeworld.…”

“Ko Au te Whenua, Ko te Whenua Ko Au: I Am the Land, and the Land Is Me”: Healer/Patient Views on the Role of Rongoā Māori (Traditional Māori Healing) in Healing the Land

“…Māori, in common with other Indigenous peoples around the world identify strongly with and see themselves connected to the land, place or country from which they hail. The interconnection between Māori as an Indigenous people and the land that they occupy and inhabit has been well documented in the academic literature [ 2 , 4 , 5 , 6 , 7 , 8 , 10 , 11 , 24 , 25 , 26 ]. For Māori, that relationship is one based on a whakapapa or genealogical connection [ 1 , 5 , 10 , 27 ].…”

“…The interconnection between Māori as an Indigenous people and the land that they occupy and inhabit has been well documented in the academic literature [ 2 , 4 , 5 , 6 , 7 , 8 , 10 , 11 , 24 , 25 , 26 ]. For Māori, that relationship is one based on a whakapapa or genealogical connection [ 1 , 5 , 10 , 27 ]. This study supports the understanding that, as an Indigenous people, the health and wellbeing of Māori is intrinsically connected to being able to access traditional lands and maintain a living, reciprocal and harmonious relationship with those lands.…”

“…For Māori, access to natural places for health, spiritual well-being and cultural connections is vital. Contact with the land links Māori to mātauranga and tikanga (knowledge and customs), hinengaro and wairua (mind and spirit), tinana and tāngata (body and people) [ 5 ]. The practice of traditional healing (Rongoā Māori) includes the sustainable use of the whenua and moana (sea); the care, protection and appropriate use of mātauranga Māori (ancestral knowledge); and te reo Māori (the Māori language) [ 6 ].…”

Adapting Traditional Healing Values and Beliefs into Therapeutic Cultural Environments for Health and Well-Being

“…The link between whenua (land) and the health of Indigenous people has been acknowledged internationally [ 9 , 27 , 82 , 83 , 84 ]. However, few studies explore the connection between the landscape and the health of people culturally associated with it [ 17 , 85 , 86 ], mainly described as ‘therapeutic cultural landscapes’. By understanding therapeutic cultural landscapes, key concepts can be amalgamated and lead to meaningful and reflective places.…”