Horticultural Therapy
How can horticultural therapy nourish you?
Horticultural therapy is a gentle, accessible modality that invites people to care for and engage with nature. It is based on the activity of gardening, but with an added therapeutic focus which can range from teaching social interaction skills to helping people regain movement. It can help to stimulate the mind while providing the relaxing benefits that come with being in a green space.
Gardening is known to provide multiple health benefits, such as reducing stress and improving quality of life[1]. Tasks such as growing seedlings, propagating plants and even mowing the lawn are used in a non-invasive, supportive manner to help people learn new skills, plan for the future, and learn to care for and take responsibility for living organisms[2]. For this reason, it is increasingly used in a variety of hospital settings, aged care and disability providers, schools and prisons[3]. Many practitioners also have a background in other fields such as occupational therapy, counselling or social services.
According to the American Horticultural Therapy Association[4], horticultural therapy has been used in some form since the 19th century after Dr Benjamin Rush, the ‘Father of American Psychiatry’, documented the “positive effect working in the garden had on individuals with mental illness.” Its use in the 1940s and 1950s in the rehabilitation of war veterans helped it gain even more popularity.
In Australia, Therapeutic Horticulture Australia[5] is a national body that requires its full members to have qualifications in horticulture or allied health and social services at a Certificate 3 level, or a minimum of 400 hours of validated experience in horticultural therapy. It provides its members with continuing training and access to information and a professional network.
Benefits of horticultural therapy
Horticultural therapy is easily integrated into any lifestyle or rehabilitation program and is useful for anyone from a healthy person to people with impaired physical or mental health. As gardening requires physical activity, it is useful for people with limited mobility or those who seek to improve their motor skills[6]. It has also been used to assist in the rehabilitation of those with acquired brain Injuries[7] and to help people rebuild their lives after trauma, with reports that engaging in tasks in nature helped them to take their minds off the reality of their situation and start the healing process.
Older adults often report poorer quality of life[8], whether due to reduced social interaction, or increased health conditions. Horticultural therapy has been studied for use in the elderly, with encouraging results. A Singaporean study of older adults reported that a 24-week Horticultural Therapy program resulted in improved cognitive function and reduced anxiety[9], with these effects lasting up to six months after the completion of the program. The researchers suggested that an added dimension to the benefits of Horticultural Therapy was its ability to ‘encourage a waiting and nurturing attitude, offering a deep sense of purpose in the longer term’. Another study similarly reported that horticultural therapy reduced stress levels and increased relaxation[10] in the elderly.
Horticultural therapy may also help to improve cognitive function, and this is supported by some recent evidence in this area. A 2019 meta-analysis of horticultural therapy in patients with dementia found that it reduced agitation levels and helped to alleviate negative emotions[11], which contributed to improved quality of life. Another meta-analysis of 10 non-randomised controlled trials conducted in 2020 determined that ‘horticultural therapy significantly improved cognitive function’[12]. These positive effects were attributed to the social nature of the modality, which is known to help people with dementia maintain cognitive function. Horticultural therapy may also be a useful complementary therapy for those with mental illness, as a study found that it improved participants’ mental well-being, helped them to develop patience and to remain focused on tasks[13].
Its benefits also extend to children, with a study concluding that it may help primary school children improve emotional intelligence[14], as they have the opportunity to collaborate with others and share emotional experiences. Further, viewing plants was reported to activate the temporal lobe of the brain which functions in emotional expression. Some organisations also use horticultural therapy to support children with disabilities, or those who have experienced trauma.
Horticultural therapy may assist in relieving symptoms related to:
What to expect from a horticultural therapy session
Therapeutic horticulture is a hands-on modality, where you will be involved with and have responsibility for various gardening tasks or even woodcraft projects, depending on the program. This can include things such as harvesting vegetables, pruning shrubs, composting or weeding.
The programs all differ in length and aims, and if you attend a horticultural therapy program with a specific focus, you may be asked whether you have any goals. Your therapist can then help you to plan how you may reach this goal using horticultural activities. You can also expect to work alongside other people on garden maintenance tasks, as social interaction and engagement with other participants or instructors are a large feature of horticultural therapy programs.
You may experience more benefits if you are able to participate in horticultural therapy regularly. This will allow you to build connections with other attendees, as well as have the rewarding opportunity to see plants grow and gardening projects take shape throughout the changing seasons.
As with any complementary practice, please consult your medical professional before commencing horticultural therapy. If you have any concerns at all, also speak to a therapist, who will be happy to address these and evaluate whether it is a suitable option for you.
References
1. Soga M, Gaston KJ, Yamaura Y. Gardening is beneficial for health: A meta-analysis. Preventive Medicine Reports; 2016.
2. Davis H. A path to wellbeing: the growing world of gardening therapy. The Guardian; 2018.
3. What is Horticultural Therapy and How Does it Work? Australian & New Zealand Mental Health Association; 2018.
4. Home. American Horticultural Therapy Association; [cited on 2024 Nov 28].
5. Home. Therapeutic Horticulture Australia; [cited on 2024 Nov 28].
6. Social and Therapeutic Horticulture information centre. Thrive; [cited on 2024 Nov 28].
7. Jennings J. A blooming future for horticultural therapy in healthcare settings. The Sydney Morning Herald; 2017.
8. García LMR, Navarrro JMR. The Impact of Quality of Life on the Health of Older People from a Multidimensional Perspective. Journal of Aging Research; 2018.
9. Sia A, Tam WWS, Fogel A, Kua EH, Khoo K, Ho RCM. Nature-based activities improve the well-being of older adults. Scientific Reports; 2020.
10. Tu PC, Cheng WC, Hou PC, Chang YS. Effects of types of horticultural activity on the physical and mental state of elderly individuals. International Journal of Environmental Research and Public Health; 2020.
11. Lu LC, Lan SH, Hsieh YP, Yen YY, Chen JC, Lan SJ. Horticultural Therapy in Patients With Dementia: A Systematic Review and Meta-Analysis. American Journal of Alzheimer S Disease & Other Dementias®; 2019.
12. Tu, HM., Chiu, PY. Meta-analysis of controlled trials testing horticultural therapy for the improvement of cognitive function. Sci Rep; 2020.
13. Siu AMH, Kam M, Mok I. Horticultural Therapy Program for People with Mental Illness: A Mixed-Method Evaluation. International Journal of Environmental Research and Public Health; 2020.
14. Oh YA, Lee AY, An KJ, Park SA. Horticultural therapy program for improving emotional well-being of elementary school students: an observational study. Integrative Medicine Research; 2020.