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The Effects of Horticultural Therapy

Molly Blankenship
Tarleton State University

Horticultural therapy is not a well-known form of therapy. Even though it has been

around for ages, it has just recently been researched. Horticultural therapy can be used to assist

in aiding a number of mental and physical ailments with the use of nature. At this point in time,

it is mostly used as therapy for older people in nursing homes. Many strides have been made in

the uses of horticultural therapy and how it has affected patients mental and psychological well-

being, but there are still many unanswered questions regarding its use on college students and

other young adults. With all of the stress and other mental strains put on young adults in this day

and age, a new therapy that causes the senses to calm down would be highly beneficial.

The Effects of Horticultural Therapy

The field of Horticultural Therapy is an up and coming career. With an abundance of

research regarding it, people are beginning to realize the many qualities that nature possesses in

the realm of healing. Therapy with horticulture has progressed from and 1800s belief that

working in the agricultural filed could benefit mental patients, to the use of gardening as activity

and therapy for physical rehabilitations (Haller 2006) and is still being practiced today.

Research has been conducted to see how it has been helping patients with mental and physical

disabilities. Horticultural therapy should be further researched to see how it affects the mental

health of college students and other young adults.

The Roots of Horticultural Therapy
Horticultural therapy is a professionally conducted client-centered treatment modality

that utilizes horticulture activities to meet specific therapeutic or rehabilitative goals of its

participants. The focus is to maximize social, cognitive, physical and/or psychological

functioning and/or to enhance general health and wellness (Haller 2006, p. 5). This therapy is

really gardening in most ways, something that most people enjoy doing, but do not really see it

as a therapeutic activity. The use of horticultural therapy has been developed into an activity in

nursing homes. Many may think of nursing homes as a stuffy old folks home, but it is actually a

place where people should be able to stay and enjoy their golden years with assistance. But in

some circumstances, they can be denied the space or ability to do certain things that they enjoyed

while living on their own. Horticultural therapy and other related activities are great ways to

give people back a small part of their life that was lost. While giving enjoyment to the people

participating, Haller and Kramer (2006) mention that horticultural therapy also serves the

physical, cognitive, and emotional needs, sensory stimulation, interpersonal/social skills and

community integration of the residents (p. 34).

While there could be many reasons that the patients of nursing homes and rehabilitation

centers are there, they more than likely have some type of illness. Recent studies reported by

Bringslimark, Hartig, and Patil (2009) state the experiences of nature can be beneficial for

human well-being and that passive and active engagement with nature outdoors can, for

example, increase positive affect, reduce psychophysiological arousal, and renew ability to

perform tasks that require concentration (p. 422). These effects could cause the people

interacting with them to feel like they are contributing to something helpful and not just sitting

around a home. If just being around things from nature can help so much, imagine what all

horticultural therapy could do for them.

Illnesses Treated with Horticultural Therapy
Horticultural therapy can be used for a wide range of mental and physical ailments in

patients. Recently, a study done to measure the level of agitation of patients suffering from

dementia. While the study did not provide concrete evidence that there was truly an amazingly

noticeable difference in the two different groups being tested (control and variable groups), there

was enough a decreasing trend in physically non-aggressive behavior observed in the

experimental group [that] may indicate potential for lowering agitation in the more severely

cognitively impaired (Luk p. 436). This study shows that the therapy may be on track to lessen

the agitation in certain residents with dementia. While this study, as shown, showed results that

could cause for excitement in the HT world, the trial was not long enough for the results to be

counted as absolute fact. Though it showed great strides in the realm of emotional well-being,

another study on chronic musculoskeletal pain recorded by Kamioka and others (2014) reported

that the addition of HT to a pain management program improved participants physical and

mental health. These two examples show how the therapy can be used to treat not only the

physical pain brought on by a patients disorder, but also assist in the emotional and

psychological well-being as they go through everything. But while the person going through the

ailment is struggling to keep a morally uplifted spirit, their family and caregivers are also

struggling to keep a positive outlook on the situation that their loved one is in.
Caregivers are really the unsung heroes to their family members while they are going

through everything. All that they want for their loved one is for them to be comfortable and as

happy as they can be in the place they are at. In the article A Review of Horticultural Therapy

and Caregivers Burden, Chia-Hui Lin concludes that horticultural therapy programs enable

participants to tend to their crops as well as their own spiritual, physical, mental, intellectual and

social well-being (p. 144). The aesthetic qualities that the use of horticultural therapy

introduces into the lives of patients may help them in ways that are not able to be seen on the

outside. The mental health of patients is just as important as their physical health. If a person is

depressed and they get sick, it would be harder for them to beat off the illness because they are

not mentally prepared to fight it off. Gardening gives people a purpose; those plants need to be

taken care of. If they are not given the proper care while they are growing, they will shrivel up

and die. So in this sense, horticultural therapy provides not only physical help in the activities

that the patients perform but mental help in giving patients a purpose to continue on.
Where Has the Therapy Been Implemented?
Horticultural therapy has been implemented in many different settings, but mainly in

nursing homes. The purpose was to see how patients with physical and mental disabilities would

handle a different approach to therapy. Luk (2011) and his companions state in their article that

Horticultural activities are unique and unlike other therapies in that they foster reciprocal

relationships between nature and people (p. 436). While most therapies center around the idea

of one on one interaction with a therapist, therapy with horticulture really focuses on the patient

and their own relationship with nature in a healing environment. One study done studied the

effect of horticultural therapy on the agitation of dementia patients in nursing home. While

finding no definite material, Luk (2011) did find a small trend:

To conclude, no significant reduction of agitated behavior resulted from the intervention.

However, a decreasing trend in physically non-aggressive behaviors was observed in the

experimental group. The observed correlation between the C-MMSE and C-CMAI may

indicate potential for lowering agitation in the more severely cognitively impaired. (p.

The information shows that the effects of this therapy have an impact on the psychological

disabilities of patients. The study may have had more concrete results had it been observed for

longer than six weeks. With longer research trials, researchers may find the information that

they need to further implement horticultural therapy into nursing homes and other areas that may

benefit from a different form of therapy. The use of the therapy has shown drastic changes in the

psychological health of patients receiving this revolutionary therapy. Moods have been

improved, agitation has decreased, and the patients are all around happier than they were before

the therapy was implemented. Many may wonder why such a therapy would actually affect

people, but it is a proven fact that nature and things related to it have a calming psychological

effect on people. Its because nature tends to calm people mentally to the point where they dont

even realize that they are calmer. Studies in nursing homes has shown that the effects of

horticultural therapy actually help in physical aspects as well. While physical and occupational

therapy work wonders, horticultural therapy, in some ways, manages to implement both of these

therapies into one, causing the effects to be more prominent. The maintenance and care that the

patients nurture the plants with causes them to be more independent and mobile in the care that

they provide. The therapies in themselves are great at healing, but the question arises: why are

two therapies when they can be combined into one and get the same results with the same

patients as before? Horticultural therapy may also show signs of being the better therapy for

people with mental disabilities in that they learn how to care for other living things that depend

on them, which in turn, could help them improve their way of living.
What Does This Mean for College Students?
College students as a whole are stressed out most of the time. Between juggling classes,

homework, family, and a social life, time just bunches up to where there are not enough hours in

a day to do everything that needs to be done. This stress causes the average college student to

look for other means of relaxation, such as drugs, alcohol, and other undesirable activities.

These activities with the added effect of stress take out an emotional and mental toll on a person.

With the use of horticultural therapy to relieve the stress that students go through, they may be

less stressed due to the fact that they are actually doing a productive activity that is not harmful

to themselves or others. The use of horticultural therapy on children has shown that it does

indeed have an effect on the mental aspects of the children. While these children were also

diagnosed with mental illnesses, there really is no evidence to suggest that the therapy would not

work just as well on children and young adults who have not been diagnosed with any mental

and psychological disorders. Studies into the effects of the therapy on younger adults ranging

from late teens to young adults up to the age of 40 could provide an interesting discussion and

research point to the future of horticultural therapy. Why could something that has helped so

many mentally ill patients not work just as well on those who just need to have a safe

recreational activity to act as a stress reliever? It is a proven fact that nature tends to have a

soothing effect on people. Kim (2012) states that

The efficacy of HT became apparent when horticultural activities were tested on people

with mental disabilities and children with intellectual disabilities. A positive impact of

HT on children with intellectual disabilities was established with improvements in


attention and motivation (Kang, 1998), sociality and social relationships, self-concept and

linguistic communication (Cho, 2001; Kim, 2001; Lee, 20014). In addition, their self-

confidence and self-efficacy was strengthened (Lee, 2004). (p. 320)

The fact remains that horticultural therapy is a very under-researched topic that could really

prove to be just as beneficial to younger generations as it has been to patients in nursing homes.

The intervention of horticultural therapy has begun to be implemented in hospitals. In the

research by Kamioka and others (2014) found that influences brought upon by horticultural

therapy have included the patients, some of who were young adults, beginning to participate in

social life and alleviate stress (p. 931).

In Conclusion
Horticultural therapy should be further researched to see how it affects the mental health

of college students and other young adults. The research points positively to horticultural

therapys ability to influence the mental health of young adults as well as it has with patients in

nursing homes and the mentally disabled. While the field has not been extensively researched to

see how it would affect people college age to middle age, due to the research reported on

younger children, there are a multitude of possibilities on how they would be effected. With

these positive influences, the field is on its way to becoming an even more serious option for

people who require therapy for mental disabilities or just to relax from their everyday lives.

Reference List
Bringslimark, T., Hartig, T., Patil, G. 2009. The Psychological Benefits of Indoor Plants: A

Critical Review of the Experimental Literature. Norway. Journal of Environmental

Haller, R., Kramer, C. Horticultural Therapy Methods. New York: The Hawthorn Press, 2006.
Kam, M., Siu, A. 2010. Evaluation of a Horticultural Activity Programme for Persons with

Psychiatric Illness. Hong Kong, China. Hong Kong Journal of Occupational Therapy.
Kamioka, H., et al. 2014. Effectiveness of Horticultural Therapy: A Systematic Review of

Randomized Controlled Trials. Japan. Complementary Therapies in Medicine.

Kim, B., Park, S., Song, J., Son, K. 2012. Horticultural Therapy Program for the Improvement

of Attention and Sociality in Children with Intellectual Disabilities. Korea.

Lin, C. 2013. A Review of Horticultural Therapy and Caregivers Burden. Taiwan. The

International Journal of Organizational Innovation.

Luk, K., et al. 2011. The Effect of Horticultural Activities on Agitation in Nursing Home

Residents with Dementia. Hong Kong, China. Geriatric Psychiatry