Addiction A-Z

Horticultural therapy

If you’re like most people, the word horticulture elicits mental images of elaborate gardens, glass-enclosed greenhouses, and nurseries that cater to professional landscapers.  You probably wouldn’t, however, associate the term with “therapy” as most people haven’t heard of this particular treatment approach.

Sometimes referred to as Social and Rehabilitative Horticulture, horticultural therapy involves the practice of growing and caring for gardens and plants specifically for therapeutic purposes.  The power of nature in helping people recover and heal from a vast range of ailments has been known for thousands of years.  In fact, in ancient times, physicians who tended to kings, queens, and other members of royalty recommended walks in the garden to help alleviate mental health problems.  Spending time in such a tranquil, beautiful setting – particularly a lavish palace garden – helped reduce symptoms of depression, anxiety, and other disorders.

A time-tested form of treatment, horticultural therapy is a client-centered approach that’s designed to meet the specific needs of clients and patients, whatever those may be.   It’s used to help individuals recover from illness, rehabilitate from an addiction or injury, reduce psychiatric symptoms, improve social skills, and strengthen declining cognitive abilities.  It’s also used to simply improve people’s overall health and sense of wellbeing.

Horticultural therapy is typically offered in a group setting.  Professionally trained therapists work with patients in “therapeutic gardens” to help them set and reach their treatment goals. Although programs may be tailored to the unique needs of the individual, primary therapeutic tasks include growing and caring for flowers, vegetable- and fruit-bearing plants, and other types of plants.  This puts the patient in a caregiver role, which can be highly empowering and therapeutic in and of itself in a variety of ways.  The community atmosphere of horticultural therapy gives patients a sense of connection to others while helping them develop or improve their communication and social skills.

Cultivating plants has multiple physical, psychological, social, and even spiritual benefits, which is one of the reasons why horticultural therapy has such a broad reach in terms of who it can help.  For example, it can be just as beneficial to the individual learning to cope with a disability or recover from an injury as it can for the individuals struggling with a chronic psychiatric disorder. For some patients, the primary goal is physical in nature, such as improving balance, dexterity, and coordination, while for others the primary goal may be a reduction in psychiatric symptoms.  What many therapy participants find, however, is that they benefit in multiple ways that had nothing to do with the primary goal of treatment (e.g. the mental health patient gains better physical health and coordination, or the individual in need of physical rehabilitation also notices a greater sense of calm or a noticeable boost in mood).

The popularity of horticultural therapy has been growing in recent years.  This is likely due, at least in part, to the growing need so many people have to reconnect with nature.  After all, a large percentage of the population currently lives most or all of their lives in urban settings where concrete and pavement have replaced far too many trees and plants.  Horticultural therapy helps people get back to their collective, primal roots – the sense of feeling grounded and centered that nature so readily and beautifully provides – while addressing a plethora of problems and challenges in the process.  It’s a very rare person who wouldn’t benefit from this particular type of therapy.

Therapeutic Gardens

The term “therapeutic garden” typically refers to a garden setting that’s meets the primary criteria for use in horticultural therapy.  Many therapeutic gardens are specifically designed by professional landscapers in collaboration with horticultural therapy programs. However, many different types of plant-dominated, garden-like settings can be utilized effectively even if they weren’t originally set up for this purpose.

Therapeutic gardens benefit patients by giving them the opportunity to engage with nature, either actively or passively depending on various factors, in a way that promotes recovery and healing.  There are different types of therapeutic gardens, including:

  • Healing gardens
  • Restorative gardens
  • Rehabilitation gardens
  • Enabling gardens

Ideally, therapeutic gardens should:

  • Be easily accessible
  • Have a universal design, making it enjoyable, therapeutically beneficial, and appropriate for a wide range of individuals
  • Have abundant and lush plant growth
  • Be secure
  • Be free from hazards (e.g. pesticides and other chemicals)
  • Allow for a variety of experiences and activities
  • Be comfortable
  • Have distinct perimeters
  • Allow patients and visitors to easily see, touch, smell, interact with, and study the plants
  • Have simple, clearly defined open spaces, workplaces, and pathways
  • Represent each distinct season throughout the year (e.g. most or all the plants don’t become dormant in the winter or bloom only in the spring)
  • Be designed to optimize the therapeutic experience

In addition to the above, it probably goes without saying that patients won’t gain the full benefits of a therapeutic garden – no matter how elaborate or perfectly designed – outside the context of a horticultural therapy program.  The expertise and skills of a professional horticultural therapist are, of course, key elements.  Also, a good program and skilled therapists can benefit patients even with a garden that doesn’t have all the ideal characteristics listed above.

Brief History of Horticultural Therapy

Compared to more traditional forms of therapy, horticultural therapy is relatively new.  However, the therapeutic use of gardening and connecting with nature is anything but.   Dr. Benjamin Rush, known as the “father of American psychiatry”, noticed that mental health patients improved when they engaged in gardening.  That was over 200 years ago, in the early 1800s.

Around that same time, scientists and medical professionals in the U.K. and the U.S. began utilizing the therapeutic benefits of plants in clinical settings.  The Asylum for Persons Deprived of their Reason (known today as Friends Hospital) was one of the first to create a park-like setting to help psychiatric patients recover more quickly.  Soldiers wounded in WWI and WWII used garden work as part of their rehabilitation.

Formal degree programs in horticultural therapy first became available in the mid-1950s, and the first graduate level training program was offered in 1975.  Currently, many universities offer degree programs in the field.  The most prominent organization associated with horticultural therapy – and the only one of its kind in the U.S. – is the American Horticulture Therapy Association.

According to the AHTA website (, the organization is “committed to promoting and developing the practice of horticultural therapy (HT) as a unique and dynamic human service modality”.  In addition to promoting research and education in horticultural therapy, the AHTA defines the standard of practice for those in the profession, provides accreditation for training programs, and is committed to furthering and expanding the practice of horticultural therapy.

Benefits of Horticultural Therapy

There are many potential benefits to be gained from horticultural therapy, including the following:

  • Instills a deeper connection with nature
  • Reduces stress
  • Enhances sense of wellbeing
  • Instills and enhances a sense of purpose and value, which is particularly beneficial for those who’ve become isolated or have a disability
  • The relaxing nature of the activities helps reduce stress, which is especially beneficial for those struggling with mental health issues
  • Helps individuals feel energized and refreshed
  • Improves mood
  • Decreases the sense of isolation
  • Helps alleviate anxiety by spending time in a tranquil environment
  • Bolsters self-confidence
  • Improves problem solving skills
  • Increases ability to follow instructions
  • Strengthens memory and other cognitive functions
  • Positively impacts and improves social interactions
  • Strengthens communication skills
  • Provides a sense of accomplishment
  • Enhanced sense of spiritual connection and wellbeing
  • Increases endurance
  • Strengthens immunity
  • Improves physical coordination and balance
  • Increases muscle tone through movement
  • Improves dexterity
  • Provides a support system for those involved
  • Improves ability to work independently

Advantages of Horticultural Therapy

As a treatment intervention, there are multiple advantages to horticultural therapy, including the following:

  • The nature of this form of therapy is inherently versatile, making it a viable form of treatment for a wide range of ages, developmental levels, psychological problems and disorders, and physical health issues
  • Being quite different from traditional talk therapy, horticultural therapy can provide a desirable – and often much needed – respite from addressing mental health issues by addressing them in a less direct and intensive manner (but without compromising the therapeutic benefit)
  • The experiential and very hands-on element of horticultural therapy directly promotes development and growth in areas of a person’s life that traditional talk therapy, at best, can do only indirectly
  • Patients, who are used to being cared for by others, can benefit greatly from taking on the role of “caregiver” – which is an inherent and powerful aspect of horticultural therapy
  • Like other forms of experiential therapy, particularly those that allow participants to connect directly with nature (e.g. wilderness therapy), horticultural therapy involves many enjoyable activities. This makes it feel less like “treatment” and more like a fun activity with therapeutic side effects as a “bonus” rather than the goal.
  • Horticultural therapy can improve clinical outcomes for patients, including less need for or reliance upon pain medications and shorter hospital stays
  • A wide variety of psychological issues can be addressed with this form of therapy
  • Patients aren’t the only ones who benefit from horticultural therapy; family members, visitors, treatment providers, and other staff also benefit from and enjoy the beautiful, serene natural setting
  • It’s a time-tested form of therapy

Settings that use Horticultural Therapy

Horticultural therapy is typically provided as part of a comprehensive treatment plan.  It’s used in a wide variety of settings, including:

  • Psychiatric hospitals
  • Mental health clinics
  • Drug and alcohol treatment facilities
  • Residential treatment facilities
  • Schools
  • Community gardens
  • Therapeutic farms
  • Senior centers
  • Assisted living centers
  • Vocational rehab programs
  • Hospitals and medical clinics
  • Prisons
  • Community wellness centers and programs
  • Homeless shelters
  • Nursing homes
  • Hospice care facilities
  • Skilled nursing facilities
  • Physical rehabilitation programs

Disorders, Conditions, and Issues that can Benefit from Horticultural Therapy

The unique nature and versatility of horticultural therapy makes it a beneficial part of treatment for a variety of mental health issues, physical health conditions and challenges, and other life challenges, including (but not limited to):

  • Depression
  • Anxiety
  • Social isolation
  • Stress
  • Physical impairments (e.g. blindness or deafness, balance or coordination problems, etc.)
  • Learning disabilities
  • Dementia
  • Degenerative disorders
  • Pain issues
  • Addiction recovery
  • Developmental disorders
  • Autistic spectrum disorders
  • Grief and loss
  • Issues related to aging
  • Low self-esteem
  • Low self-confidence
  • Chronic medical issues or illnesses
  • ADHD / ADD

Finding a Horticultural Therapy Program

Horticultural therapists are required to receive the proper training from a program accredited by the AHTA.  Registered horticultural therapists have the credentials “HTR”.   They have been certified by the AHTA and are qualified to provide this type of therapy.

Programs are usually offered in the types of settings listed above. One of the best ways to find a horticultural therapy program in your area is to search for “horticultural therapy” (followed by your city).  That should give you some options with which to start your search.  From there, you can determine the type of program that most closely fits your needs (e.g. addiction recovery, vocational rehab, mental health issues, etc.). IF you’re already in a treatment program of any type, ask your doctor or treatment provider if he or she can recommend a horticultural therapy program in your area.

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