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Information on Social & Therapeutic Horticulture

Brief History of Horticultural Therapy

Social & Therapeutic Horticulture is also known by many different names, it can also be known as Nature Based Therapy, Nature Based Practice, Therapeutic Horticulture, Nature Based Interventions, Garden Therapy, Social Horticulture, Nature Based Therapeutic Services, EcoTherapy, Green Care, Social and Rehabilitative Horticulture and Therapeutic Gardening.  Horticultural Therapy is the engagement of a client in horticultural activities facilitated by a trained therapist to achieve specific and documented treatment goals.

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.

Benefits of Horticultural Therapy and Therapeutic Gardens

The power of nature in helping people recover and heal from a vast range of ailments has been known for thousands of years. The benefits of involvement in horticultural activities and exposure to nature can be seen in cognitive, psychological, social, and physical realms and research continues to reveal these connections across many groups of people. The following list includes some of the benefits that have been cited in the literature. Please note that many of these studies report on specific populations and the benefits may or may not be applicable to all groups.

Cognitive Benefits:

  • Enhance cognitive functioning (Kaplan & Kaplan, 1989; Cimprich, 1993; Herzog, Black, Fountaine & Knotts, 1997)
  • Improve concentration (Wells, 2000; Taylor et al., 2001)
  • Stimulate memory (Namazi & Haynes, 1994).
  • Improve goal achievement (Willets & Sperling, 1983).
  • Improve attentional capacity (Hartig, Mang & Evans, 1991; Ulrich et al., 1991; Ulrich & Parsons 1992; Ulrich, 1999; Taylor et al., 2001)

Psychological Benefits:

  • Improve quality of life (Willets & Sperling, 1983; Waliczek et al., 1996)
  • Increase self-esteem (Moore, 1989; Blair et al., 1991; Smith & Aldous, 1994; Feenstra et al., 1999; Pothukuchi & Bickes, 2001)
  • Improve sense of well-being (Relf et al.1992; Ulrich & Parsons, 1992; Galindo & Rodrieguez, 2000; Kaplan, 2001; Jarrott, Kwack & Relf, 2002; Barnicle & Stoelzle Midden 2003; Hartig, 2003)
  • Reduce stress (Ulrich & Parsons, 1992; Whitehouse et al., 2001; Rodiek, 2002)
  • Improve mood (Wichrowski, Whiteson, Haas, Mola & Rey, 2005; Whitehouse et al., 2001)
  • Decrease anxiety (Mooney & Milstein, 1994)
  • Alleviate depression (Relf, 1978; Mooney & Milstein, 1994; Cooper Marcus & Barnes, 1999)
  • Increase sense of control (Relf et al., 1992)
  • Improve sense of personal worth (Smith & Aldous, 1994)
  • Increase feelings of calm and relaxation (Moore, 1989; Relf et al., 1992)
  • Increase sense of stability (Blair et al., 1991; Feenstra et al., 1999; Pothukuchi & Bickes, 2001)
  • Improve personal satisfaction (Blair et al., 1991; Smith & Aldous, 1994; Feenstra et al., 1999; Pothukuchi & Bickes, 2001)
  • Increase sense of pride and accomplishment (Hill & Relf, 1982; Matsuo, 1995)

Social Benefits:

  • Improve social integration (Kweon, Sullivan & Wiley, 1998)
  • Increase social interaction (Langer & Rodin, 1976; Moore, 1989; Perrins-Margalis, Rugletic, Schepis, Stepanski, & Walsh 2000).
  • Provide for healthier patterns of social functioning (Langer & Rodin, 1976; Kuo, Barcaicoa & Sullivan, 1998)
  • Improved group cohesiveness (Bunn, 1986)

Physical Benefits:

  • Improve immune response (Hartig, Mang & Evans, 1991; Ulrich et al., 1991; Ulrich & Parsons 1992; Ulrich, 1999)
  • Decrease stress (Rodiek, 2002)
  • Decrease heart rate (Wichrowski, Whiteson, Haas, Mola & Rey, 2005)
  • Promote physical health (Ulrich & Parsons, 1992; Kweon, Sullivan & Wiley, 1998; Cooper Marcus & Barnes, 1999; Armstrong, 2000; Rodiek, 2002)
  • Improve fine and gross motor skills and eye-hand coordination (Moore, 1989)

Mental Health Benefits

The mental health benefits for social and therapeutic horticulture include:

  • Psychological restoration and increased general mental wellbeing
  • Reduction in depression, anxiety and stress related symptoms
  • Improvement in dementia-related symptoms
  • Improved self-esteem, confidence and mood
  • Increased attentional capacity and cognition
  • Improved happiness, satisfaction and quality of life
  • Sense of peace, calm or relaxation
  • Feelings of safety and security
  • Increased social contact, inclusion and sense of belonging
  • Increase in work skills, meaningful activity and personal achievement

Benefits of contact with nature for people living with dementia

There is also emerging evidence of the benefits of engagement with the natural environment for those living with dementia. Research suggests that social interaction and access to the outdoors and nature is important for people living with dementia and that these activities have an important role in their quality of life (Mapes and Hine, 2011; Chalfont, 2007; Clark et al., 2013). In a recent review of the literature relating to dementia and contact with nature, Clark et al (2013) found the benefits of nature contact for people with dementia included: improved emotional state: reduced stress, agitation, anger, apathy and depression; improved sleeping and eating patterns; improved verbal expression, memory and attention; improved awareness, sense of well-being, independence, self-esteem and control; as well as improved social interaction and a sense of belonging.

People & Facilities Benefiting from Horticultural Therapy & Therapeutic Gardens

People of all ages and special needs can benefit from involvement in horticultural therapy. Programs operate throughout the world and can be found in the following facility and program types:

  • Vocational, pre-vocational, occupational, and rehabilitation programs
  • Psychiatric hospitals and mental health programs
  • Substance abuse programs
  • Hospitals, clinics, and skilled nursing facilities
  • Hospice and palliative care programs
  • Cancer centers
  • Correctional facilities
  • Shelters for the homeless and victims of abuse
  • Public and private schools
  • Assisted living and senior centers
  • Adult day care
  • Community and botanic gardens

 Research Papers and Articles

What Is the Evidence to Support the Use of Therapeutic Gardens

What Is the Evidence to Support the Use of Therapeutic Gardens for the Elderly

Therapeutic Horticulture theory and evidence factsheet

Therapeutic Horticulture Horticulture as a Medical Treatment

Therapeutic gardening in a long-term detention setting

The use of sensory perception of plants in horticultural therapy of alcohol addiction

The benefits of gardening and food growing for health and wellbeing

Social and Therapeutic Horticulture in the UK The Growing Together Study

Social and Therapeutic Horticulture and Mental Health

Perspectives on Horticultural Therapy in Australia

Nature-Based Therapeutic Service The power of Love in Helping and Healing

Nature based practice and goverence

National Parks Singapore Research programmes on benefits of greenery


Introduction to Animal and Nature Assisted Therapies A Service Learning Model for Rural Social Work

Health Benefits of Gardens in Hospitals Gardening for seniors

Garden Walking for Depression A Research Report

Exposure to Greenness and Mortality in a Nationwide Prospective Cohort Study of Women


Development of the Nature-Based Therapy Concept for Patients with Stress-Related Illness Denmark

Defining HT Care farms and care gardens – Horticulture as therapy in the UK


A review of nature-based interventions for mental health care. BRAGG, R., ATKINS, G. 2016. Natural England Commissioned Reports

A Dose of Nature Addressing chronic health conditions by using the environment

Websites with Information on Social & Therapeutic Horticulture & Nature Based Therapies

American Horticultural Therapy Association

Canadian Horticultural Therapy Association

Thrive UK

Horticultural Therapy Alliance

Horticultural Therapy Association of Victoria

Horticultural Therapy Institute

Therapeutic landscape network

Gardening Leave

Farming for Health

Human Issues in Horticulture – Horticulture Therapy

Kinder Garden Horticultural therapy

Michigan Horticultural Therapy Association

The Sensory Trust A charity promoting communication between disability groups and environmental organisations.

Trellis “Supporting health through horticulture.”

Social and Therapeutic Horticulture

Nature, health and Wellbeing Ireland

Using nature as a therapeutic partner by Lindsey Philips

Nature Based Therapy connect and grow

Nature Based Therapy Benefits for Veterans

International Nature and Forest Therapy Alliance

Ecotherapy/ Nature Therapy

Nature Based Therapy

Ecopsychology and Ecotherapy Association of Ireland

Nature Therapy Yoshifumi Miyazaki | TEDxTokyo

Nature and Recovery How your connection can help you to heal from addiction and mental health issues

Getting Back to Nature to Support Addiction Recovery


Just Some Reference Papers:

Armstrong, D. (2000). A community diabetes education and gardening project to improve diabetes care in a northwest American Indian tribe. Diabetes Educator 26(1), 113-120.
Barnicle, T. & Stoelzle Midden, K. (2003). The effects of a horticultural activity program on the psychological well-being of older people in a long-term care facility. HortTechnology 13(1), 81-85.
Blair, D., Giesecke, C. & Sherman, S. (1991). A dietary, social, and economic evaluation of the Philadelphia urban gardening project. Journal of Nutrition Education 23:161–167.
Bunn, D.E. (1986). Group cohesiveness is enhanced as children engage in plant stimulated discovery activities. Journal of Therapeutic Horticulture 1:37–43.
Cimprich, B. (1993). Development of an intervention to restore attention to cancer patients. Cancer Nursing 12(4), 22-27.
Cooper Marcus, C. & Barnes, M. (1999). Healing gardens: Therapeutic benefits and design recommendations. Chichester, UK: J. Wiley.
Feenstra, G., McGrew, S. & Campbell, D. (1999). Entrepreneurial community gardens: Growing food, skills, jobs and communities, Publication 21587. Davis CA: University of CA- Davis.
Friends Hospital (2005). Healing with plants: The wonders of horticultural therapy. Retrieved October 22, 2006 from
Galindo, M. & Rodrieguez, J. (2000). Environmental aesthetics and psychological well-being: Relationships between preference judgements for urban landscapes and other relevant affective responses. Psychology in Spain 4: pp.13-27.
Gerlach-Spriggs, N., Kaufman, R.E. & Warner, S.B. (1998). Restorative gardens: The healing landscape. New Haven and London: Yale University Press.
Hartig, T. (2003). Restorative environments: Guest editor’s introduction. Environment and Behavior 33 (4), 475-479.
Haller, R. & Kramer, C. (Eds.). (2006). Horticultural therapy methods: Making connections in health care, human service, and community programs. Binghamton, NY: The Haworth Press.
Hartig, T., Mang, M. & Evans, G.W. (1991). Restorative effects of natural environment experiences. Environment and Behavior 23(1), 3-26.
Herzog, T., Black, A., Fountaine, K., Knotts, D. (1997). Reflection and attentional recovery as distinct benefits of restorative environments. Journal of Environmental Psychology 17(2) 165-170.
Hill, C. & Relf, P.D. (1982). Gardening as an outdoor activity in geriatric institutions. Activities, Adaptations and Aging 3(1):47–54.
Jarrott, S.E., Kwack, H.R. & Relf, D. (2002). An observational assessment of a dementia-specific horticultural therapy program. HortTechnology 12(3), 402- 410.
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Kaplan, R. & Kaplan, S. (1989). The experience of nature. New York: Cambridge University Press.
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Kuo, F.E., Bacaicoa, M. & Sullivan, W.C. (1998). Transforming inner-city landscapes. Trees, sense of safety and preference. Environment and Behavior 30(1), 28-59.
Kweon, B.S., Sullivan, W.C. & Wiley, A.R. (1998). Green common spaces and the social integration of inner-city older adults. Environment and Behavior 30(6), 832-858.
Langer, E. & Rodin, J. (1976). The effects of choice and enhanced personal response for the aged: A field experiment in an institutional setting. Journal of Personality and Social Psychology 34(2), 191-198.
Matsuo, E. (1995). Horticulture helps us to live as human beings: Providing balance and harmony in our behavior and thought and life worth living. Acta Horticulturae 391:19–30.
Mooney, P.F. & Milstein, S.L. (1994). Assessing the benefits of a therapeutic horticulture program for seniors in intermediate care. In M. Francis, P. Lindsay & R.J. Stone (Eds.), The healing dimension of people-plant relations: Proceedings of a research symposium (pp.173-187). University of CA.
Moore, B. (1989). Growing with gardening: A twelve-month guide for therapy, recreation, and education (pp. 3-10). Chapel Hill: University of North Carolina Press.
Namazi, K.H. & Haynes, S.R. (1994). Sensory stimuli reminiscence for patients with Alzheimer’s disease: Relevance and implications. Clinical Gerontology 14(4), 29–45.
Perrins-Margalis, N., Rugletic, J., Schepis, N., Stepanski, H., & Walsh, M. (2000). The immediate effects of group-based horticulture on the quality of life of persons with chronic mental illness. Occupational Therapy in Mental Health 16(1), 15-30.
Pothukuchi, K. & Bickes, J. (2001). Youth nutrition gardens in Detroit: A report on benefits, potential, and challenges. Detroit, MI: Wayne State University.
Relf, P.D. (1978). Horticulture as a recreational activity. American Health Care Association Journal 4(5), 68–71.
Relf, P.D. (2006) Agriculture and health care: The care of plants and animals for therapy and rehabilitation in the United States. In J .Hassink & M. van Dijk (Eds.), Farming for health (pp.309-343). The Netherlands: Springer.
Relf, D., McDaniel, A. & Butterfield, B. (1992). Attitudes toward plants and gardening. HortTechnology 2:201–204.
Rodiek, S. (2002). Influence of an outdoor garden on mood and stress in older persons.
Journal of Therapeutic Horticulture 13: pp13-21.
Rush, B. (1812). Medical inquiries and observations upon diseases of the mind. Philadelphia: Kimber & Richardson. Retrieved October 22, 2006 from
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Smith, D.V. & Aldous, D.E. (1994). Effect of therapeutic horticulture on the self-concept of the mildly intellectually disabled student. In M. Francis, P. Lindsay & R.J. Stone (Eds.), The healing dimension of people-plant relations: Proceedings of a research symposium (pp.215-221). University of CA.
Taylor, A.F., Kuo, F.E. & Sullivan, W.C. (2001). Coping with ADD: The surprising connection to green play settings. Environment and Behavior 33:54–77.
Ulrich, R.S., Simons, R.F., Losito, B.D., Fiorito, E., Miles, M.A.,& Zelson, M. (1991). Stress recovery during exposure to natural and urban environments. Journal of Environmental Psychology 11: 201-230.
Ulrich, R.S. & Parsons, R. (1992). Influences of passive experiences with plants on individual well-being and health. In D. Relf (Ed.), The role of horticulture in human well-being and social development (pp.93-105). Portland, OR: Timber Press.
Ulrich, R.S. (1999). Effects of gardens on health outcomes: Theory and research. In C. Cooper Marcus & M. Barnes (Eds.), Healing gardens: Therapeutic benefits and design recommendations (pp.27-86). New York: Wiley.
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Wells, N.M. (2000). At home with nature: Effects of “greenness” on children’s cognitive functioning. Environment and Behavior 32:775–795.
Wichrowski, M., Whiteson, J., Haas, F., Mola, A. & Rey, M. (2005). Effects of horticultural therapy on mood and heart rate in patients participating in an inpatient cardiopulmonary rehabilitation program. Journal of Cardiopulmonary Rehabilitation 25(5), 270-274.
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