Cultivating Health: Gardening as Medicine

Horticultural therapy integrates human experiences with plants, gardening, and nature-based activities to promote physical, mental, and emotional well-being.

I first learned about the practice of horticultural therapy in Atlanta while working on a Starvine (Schisandra glabra) research project at Emory. On a visit to the greenhouses at the nearby senior living facility of Wesley Woods, I met Kirk Hines, a Horticultural Therapist. [Read more about the Starvine story and my lab’s publication on the chemistry of Starvine here.] In the garden and greenhouses, I found seniors happily working with plants as they met the goals of their physical therapy exercises with garden tools and living plants under the guidance of their medical care providers. I’ve been fascinated by this approach to health ever since!

Origins of the Practice

Horticultural therapy (HT) has a long history and has gained acceptance as a valuable therapeutic practice. Since ancient times, the benefits of garden environments have been recognized (for example, in Mesopotamia and Egypt thousands of years ago).

Dr. Benjamin Rush. Source.

In 1812, Dr. Benjamin Rush (1746-1813)—signer of the American Declaration of Independence and popularly known as the ‘American Hippocrates’—published his findings on the positive effects of gardening on individuals with mental illness.

The practice of HT expanded during the 1940s and 1950s when it was used to rehabilitate war veterans. In 1973, HT emerged as a professional field and the American Horticultural Therapy Association (AHTA) is described as “the only national US organization advocating for the development of the horticultural therapy profession and the practice of horticulture as therapy for human well-being.”

Today, horticultural therapy is widely accepted and utilized in various rehabilitative, vocational, and community settings.

Definition

The AHTA definition of HT:

Horticultural therapy is the participation in horticultural activities facilitated by a registered horticultural therapist to achieve specific goals within an established treatment, rehabilitation, or vocational plan. Horticultural therapy is an active process which occurs in the context of an established treatment plan where the process itself is considered the therapeutic activity rather than the end product.

How It Works

HT helps individuals acquire new skills and regain lost ones. It has been found to improve memory, cognitive abilities, language skills, and socialization.

• In physical rehabilitation, it aids in strengthening muscles and enhancing coordination, balance, and endurance.

• In vocational settings, horticultural therapy promotes independent work, problem-solving, and the ability to follow directions.

HT also supports mental health through sensory stimulation, mindfulness and stress reduction practices, social interactions, cognitive stimulation, and through providing an outlet for emotion and expression.

Medical Conditions it Treats

Horticultural therapy has proven to be effective in treating a wide range of medical conditions. In mental health, it has shown promising results for individuals with depression, anxiety, post-traumatic stress disorder (PTSD), and substance abuse disorders. It has also been beneficial for people with neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Moreover, horticultural therapy has been used to improve cognitive function in individuals with dementia and to support physical rehabilitation in those with chronic illnesses or disabilities.

Who can hold the title of a Horticultural Therapist?

The AHTA defines a horticultural therapist as someone who:

1. Has a minimum of a bachelor’s degree in horticultural therapy, or the minimum of a bachelor’s degree with additional coursework in plant science, human science, and horticultural therapy.

2. Has completed a 480-hour internship in horticultural therapy supervised by a professionally registered horticultural therapist.

3. Is professionally registered as a horticultural therapist with the American Horticultural Therapy Association and is designated by the professional credential HTR, Horticultural Therapist-Registered.

Steps to Treatment

HT treatment plans are developed and implemented by the horticultural therapist. Here are some common steps to this process.

1. Assessment: The first step involves an evaluation of the participant's physical, cognitive, and emotional abilities, as well as their interests and goals. This evaluation helps the therapist tailor the therapy to meet the individual's needs.

2. Treatment Planning: Based on the assessment, the therapist designs a personalized treatment plan that includes specific gardening activities, goals, and desired outcomes. The plan may incorporate activities like planting, pruning, watering, or even designing a garden layout.

3. Implementation: The participant engages in the planned activities under the guidance and support of a horticultural therapist. This hands-on involvement with plants and nature helps foster a sense of connection and purpose.

4. Evaluation: Regular evaluation of the participant's progress is crucial to determine the effectiveness of the therapy and make any necessary adjustments to the treatment plan. Observations may include changes in mood, behavior, social interaction, and overall well-being.

5. Transference: The skills and benefits gained from horticultural therapy can be transferred to the participant's daily life. This step encourages participants to continue gardening or other nature-related activities independently, fostering a lifelong connection with nature for ongoing well-being. well-being.

The Takeaway

You may be surprised at the number of institutions that have begun to include HT in their medical programs in your state. In Georgia, here are just a few:

• A.G. Rhodes Senior Rehabilitation Services (treating elderly patients)

• Trellis Horticultural Therapy Alliance (treating patients recovering from catastrophic injuries)

• Hillside Atlanta (treating children with mental health disorders)

HT provides a structured platform for treatment, vocational, and physical rehabilitation programs to use in meeting the specific medical needs of patients. Often conducted in therapeutic gardens, these facilities are designed with disability access in mind. I’m excited about the possibilities of HT in improving health outcomes for patients in a holistic way.

Yours in health, Dr. Quave

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Cassandra L. Quave, Ph.D. is a scientist, author, speaker, podcast host, wife, mother, explorer, and professor at Emory University School of Medicine. She teaches college courses and leads a group of research scientists studying medicinal plants to find new life-saving drugs from nature. She hosts the Foodie Pharmacology podcast and writes the Nature’s Pharmacy newsletter to share the science behind natural medicines. To support her effort, consider a paid or founding subscription, with founding members receiving an autographed 1st edition hardcover copy of her book, The Plant Hunter.