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By: Susan Patterson, Master Gardener
Using garden therapy is a great way to heal nearly anything that ails you. There’s no better place to relax or become one with nature than in a physical therapy garden. So what is horticultural therapy and how is it used? Let’s learn more about healing gardens for therapy and the horticulture therapeutic benefits they provide.
What is Horticultural Therapy?
Essentially, it is using gardens and plants to help with physical or emotional healing.
The art of using plants as tools for healing is not a new practice. Ancient civilizations and various cultures throughout time have incorporated the use of horticultural therapy as part of a holistic healing regimen.
Horticultural Therapeutic Benefits
The horticulture therapeutic benefits for people with physical, emotional, mental and social challenges are numerous. Professionals cite that people who successfully grow and care for plants tend to be more successful in other aspects of their lives.
In addition to stimulating the senses, garden therapy tends to release stress, alleviate depression, improve creativity, promote pleasant emotions, improve motor skills and reduce negativity.
Patients recovering from illness or minor surgery who have been exposed to healing gardens for therapy tend to recover faster than those that have not been exposed.
Where Are Healing Gardens Used?
Using garden therapy has gained much attention in the United States recently and has always been embraced by eastern cultures. Horticultural therapy centers are popping up all over the country in response to a growing recognition and acceptance of natural therapies.
Natural health centers often employ horticultural therapists, as do nursing homes, group homes, hospitals and rehabilitation centers. Patients who are recovering from orthopedic and reconstructive surgeries regain mobility and strength in a physical garden setting.
Healing gardens for therapy offer patients a place to relax, regain strength and allow their bodies, minds and emotions to heal. With more people becoming interested in non-invasive methods of treatment, healing gardens and horticultural therapy provides a safe and natural alternative to conventional treatments.
Creating a Healing Garden
Everyone can benefit from a healing garden, and they can be easily incorporated into any landscape with ease. Healing garden designs vary depending on use, and many plans are available online or in print. Before constructing a healing garden, be sure to draw up a detailed plan and visit a few healing gardens locally to get an idea of what plants and hardscape features are included.
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Read more about Accessible Gardens
Horticultural therapy (also known as social and therapeutic horticulture or STH) is defined by the American Horticultural Therapy Association (AHTA) as the engagement of a person in gardening and plant-based activities, facilitated by a trained therapist, to achieve specific therapeutic treatment goals.  Direct contact with plants is believed to guide a person's focus away from stress enhancing their overall quality of life.  The AHTA believes that horticultural therapy is an active process which occurs in the context of an established treatment plan.  Horticultural therapists are specially educated and trained members of rehabilitation teams (with doctors, psychiatrists, psychologists, occupational therapists and others) who involve the client in all phases of gardening, from propagation to selling products, as a means of bringing about improvement in their life.
Horticultural therapy offers benefits for physical rehab patients
When enrolling in a physical rehabilitation program, many patients already know what to expect. Rehabbing after a joint replacement? You’ll be spending plenty of time in physical therapy. Recovering from a brain injury? Your days might involve a mix of occupational, physical and speech therapy. Very few patients might expect to be spending time in a greenhouse.
However, thanks to an increase of horticultural therapy programs at rehabilitation facilities across the country, more and more patients are finding themselves experimenting with a green thumb as part of their treatment.
“Horticultural therapy is a change of pace from traditional therapies. Recovering from a serious injury can be physically and emotionally taxing, and horticultural therapy allows patients the opportunity to contribute to their recovery in a natural, calming environment,” explains Pam Young, who oversees the Horticultural Therapy Program and Sydney Thayer III Horticultural Center at Bryn Mawr Rehabilitation Hospital.
Although patients may appreciate the unique environment of horticultural therapy and a ‘break’ from the gym or therapy classroom, time spent in the garden or greenhouse isn’t an interruption of a patient’s treatment it’s a supplement to their treatment.
Horticultural therapy allows patients to continue working on their rehabilitation goals in a one-on-one or group setting. By taking part in interactive activities like planting seeds and watering or repotting plants, patients improve their mobility, balance, endurance, memory, and social skills.
“Getting back to nature is key to a patient’s recovery. Our horticultural therapists work with a patient’s entire care team to define an individualized plan of care based on their age, health status, and ability,” says Young. “In addition to being physically beneficial, many patients also say that horticultural therapy is spiritually and emotionally beneficial.”
Not a gardener? Not a problem, says Young.
“Horticultural therapy doesn’t require you to have a green thumb. Horticultural therapy encompasses a number of different activities. We find a role for every interested patient,” she says.
Activities vary widely, from starting seeds and arranging and pressing dried flowers to outdoor activities, like growing vegetable plants. At Bryn Mawr Rehab, patients are also involved in donating harvest from the vegetable garden to local good banks, and putting freshly-blossomed flowers to use as centerpieces in the hospital dining room.
Although horticultural therapy has become a more popular program in recent years, it is not offered at all physical rehabilitation centers. Young, who has seen firsthand the benefits it offers her patients, urges individuals and families to do their research when choosing a rehab center.
"Horticultural therapy offers patients the opportunity to address their therapy goals in a unique and special way. It provides a healing environment that our patients are drawn to and connect with, and it makes them feel productive because they're able to do something meaningful during their recovery, which can be a difficult time," she says.
If you’re looking for horticultural therapy for yourself or a family member, visit local rehabilitation facilities to learn more or inquire about local programs.
Social and therapeutic horticulture
Gardening is a wonderfully flexible medium that can transform lives and Thrive sees first-hand how gardening can help everyone, regardless of age or disability.
Social and therapeutic horticulture uses the garden as a safe and secure place to develop someone's ability to mix socially, make friends and learn practical skills that will help them to be more independent.
Using gardening tasks and the garden itself, Thrive's horticultural therapists build a set of activities for each gardener to improve their particular health needs and to work on certain goals they want to achieve.
The benefits of a sustained and active interest in gardening include:
- Better physical health through exercise and learning how to use or strengthen muscles to improve mobility
- Improved mental health through a sense of purpose and achievement
- The opportunity to connect with others – reducing feelings of isolation or exclusion
- Acquiring new skills to improve the chances of finding employment
- Just feeling better for being outside, in touch with nature and in the 'great outdoors'
The diagram shows the many benefits of social and therapeutic horticulture with overall health and wellbeing at the centre.
Therapy and rehabilitation
Social and therapeutic horticulture (STH) can benefit people in a number of ways:
- It can be part of a person’s rehabilitation process, to help them recover and 'find their feet again' after an illness or a difficult time in their lives
- It can help people recover from a wide range of conditions
- It can help people to learn new skills
- It can help slow down the deterioration seen when someone has a degenerative illness.
Social and therapeutic horticultural also benefits people with many different disabilities, including those recovering from stroke and heart disease, blind and partially sighted people, those in the early stages of dementia and people with physical and learning disabilities.
People can benefit from horticultural therapy:
- At a garden project, where they are referred and funded by their doctor, social worker or care professional. Others start at a project through their own initiative and their place may be funded by their family and friends.
- Through gardening at home, perhaps by starting with a simple idea like planting a small container or window box, or growing some herbs on a sunny window sill.
Garden projects Garden projects can be small informal places, perhaps organised and run by volunteers, or they can be more formal, larger organisations and charities, run by permanent staff. Projects may have their own site or they may share facilities, perhaps within a garden centre or nursery. Garden projects are also found in the grounds of prisons or hospitals.
Horticultural therapists Many horticultural therapists working at garden projects in the UK have completed specialist training programmes in social and therapeutic horticulture at Thrive. They may also hold other professional qualifications in areas such as horticulture, health and social care, teaching, occupational therapy or nursing. If you're thinking of studying STH, visit our training section. Alternatively you can email our training team at [email protected] or call 0118 988 5688.
Research Thrive is active in researching and promoting the benefits of gardening and horticultural activity. It is important to increase people's understanding of the power that gardening has, so Thrive learns and shares ideas with others to continually improve the ways that we work with disabled people.
Want to know more? If you, or someone you know could benefit from social and therapeutic horticulture, call Thrive on 0118 988 5688 to find out how we can help.
Thrive can also help if you would like to know more about a career in social and therapeutic horticulture or if you would like details of courses, call our Training team on 0118 988 5688, or email us. Thrive can also put you in touch with a garden project in your local area, so if you are interested in volunteering or finding a place for a friend or relative, call us on 0118 988 5688 or email our Information Service.
Craig’s horticultural therapy program has two approaches, leisure and therapeutic.
The leisure approach focuses on identifying accessible gardening equipment and tools specific to the patient’s needs and interests for their return to gardening. “We want to show people how they can continue to garden after having a brain injury or spinal cord injury. That involves working with people and helping them learn the different tools and techniques to do it,” says Susie. “We introduce adaptive equipment that help people to become more independent with watering, pruning, weeding and planting.”
With the therapeutic approach, the horticultural therapist meets with the patient and their physical, occupational, or speech therapist and uses plant-related activities to work on individualized therapy goals. For example, a speech therapist might have specific goals they are working on with a patient such as cognition, visual, following directions, focusing, staying on task. The horticultural therapist would then identify gardening activities that help patients work toward those goals. “With the therapeutic approach, you are thinking first about the therapy goals and using gardening activities as the means to reach that goal,” says Susie.
As part of the horticultural therapy program at Craig, Susie works with patients to show them equipment modifications to make gardening more accessible. A popular addition to gardening tools are the forearm or universal cuff, a design created by Craig volunteers. Download the cuff patterns here and explore the modifications below!
Why incorporate horticulture activities in your programming?
- Age Appropriate Many horticultural activities are suitable for most age groups.
- Disability Appropriate Many populations including those with cognitive, emotional, physical, mental, and substance abuse issues have benefited from Horticultural Therapy
- Evidence Based Studies have shown the benefits of using Horticultural Therapy for various groups.
- Budget Friendly A greenhouse or landscaped garden isn’t cheap, but many activity ideas won’t drain your monthly budget.
Unfortunately, budget constraints and other issues facing facilities may make hiring a full time Registered Horticultural Therapist difficult. As a Recreation Therapist or Activity Professional, incorporating horticultural activities into leisure programming provides your participants the chance to interact with nature.
Some Therapeutic Benefits of Horticultural Therapy Activities:
- Learning new skills
- Building self-confidence
- Increased feelings of empowerment
- Creating a sense of responsibility/accomplishment
- Promoting enthusiasm/interest in the future (especially in seniors)
- Sensory stimulation
- Developing and improving motor skills
- Physical activity
- (Re)connecting with the outdoors
- Decreased depression
- Stress reduction
Don’t have a greenhouse or area for a therapeutic garden? Start with a simple window sill and grow your programming from there. Below are a couple easy Horticultural Therapy activities to try with your participants.
Growing Plants from Seeds
Tiny sprouts from a lemon seed.
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After the snack and everyone washes their hands, let them plant a few seeds into a containter filled with potting soil. Generally, planting seeds about a half to a quarter inch into the soil then lightly covering them is sufficient. Regular watering and plenty of sunlight will allow the seeds to sprout to the delight of everyone invested in the activity. Do some research on the seeds you use–some may take weeks before sprouting, and others require special conditions.
You could also purchase seed packets or starter kits for an easier option.
Flowers are blooming all around us this time of year. Want to have a little reminder of these beautiful colors during the dreary days of winter? Flower pressing involves pressing the flowers until they are dried out and flat. By using this technique, the flowers could be preserved for years or used in other types of crafts.
Ready to start flower pressing? This durable kit can easily get you started.
Make a Miniature Succulent Garden
Succulents are relatively easy to care for and aesthetically pleasing. An appropriate container, some special soil, and affordable succulent plants could liven up any room and give those with little horticultural experience success. Here is a good primer for creating a thriving succulent garden.
Simple Pine Cone Bird Feeder
Gather some pine cones from the ground or a craft store. Have your participants spread peanut butter on them. Sprinkle birdseed on top of the peanut butter and lightly press down so the seeds stick. Using yarn or other decorative string, hang it from trees or bushes in a viewable area. Within no time, your participants will be talking about the visiting birds. Take some time to discuss the types of birds and anything else the participants noticed.
Don’t undervalue the benefits of being outside. Give your clients the opportunity to appreciate the outdoors in whatever setting you find appropriate. A simple walk through a park or nearby forest preserve offers many positive benefits. Residents stubbornly clinging to their rooms may be revitalized after persuading them to come outside.
There is no doubt connecting with nature is important to everyone’s well-being. From raised planters, therapeutic gardens, opportunities to landscape, and participating in simple horticultural activities, Horticultural Therapy offers many opportunities to address your participants’ need areas. It also illuminates Mother Nature’s fascinating processes of we often take for granted.
Even if you don’t have a green thumb, integrating simple horticultural activities into your recreation programming will benefit you and your participants. Don’t be overwhelmed. Good potting soil, seeds, light, and water will give you and your participants the self-confidence and drive to blossom a thriving horticulture program.
Careers of HTI “Graduates”
The innovative field of horticultural therapy continues to attract people from all walks of life who want to combine their passion for gardening with a desire to help others though horticultural therapy. With each group of students who joins the Horticultural Therapy Institute, new learners are trained with the skills to practice HT and apply their training in both clinical and non-clinical programs. Some of our past students are working as horticultural therapists in the following positions and settings:
- Activity director-mental health hospital for youth
- Vocational program with developmentally disabled
- Community based adult day treatment facility
- Special education after school program
- Community and public garden programs
- Therapeutic recreation in a children’s hospital
- Residential hospice care
- Youth at risk summer gardening program
- Residence for people with dementia
- Landscape design for HT programs
- Rape crisis support group
- Residential farm for youth at risk
- HT with art therapy-community mental health
- Physical therapy in a rehabilitation hospital
- Vocational services in a veteran’s Hospital
An excellent way to explore the many possible applications of HT is to enroll in Fundamentals of Horticultural Therapy with the Horticultural Therapy Institute.