MENTAL HEALTH TIPS: What Is Horticultural Therapy?

Young Black woman planting inside a greenhouse

By Jessica Nowacki, Clinical Intern

Horticultural therapy is a therapeutic intervention using plants and gardening as the basis for improving mental and physical health. The American Horticultural Therapy Association (AHTA) says the value is that:

  • A relationship between people and plants improves quality of life.
  • Attraction to green plants and flowers is an inherently human one.
  • Work with plants promotes well-being on a physical, emotional and mental level.

Horticultural therapy arose out of a task-based, holistic approach to mental health; current interventions are strongly connected to mindfulness and positive psychology. The key goals of horticultural therapy are:

  1. Working with plants to bring about positive psychological and physical changes (i.e., use of a “people-plant connection”).
  2. Improving the quality of life for the individual.

During a session with a horticultural therapist, clients can expect to cultivate and appreciate plants and assist with creating landscapes. Therapeutic gardens are designed specifically to promote people-plant interaction with the healing properties of nature. Therapeutic gardens may be focused specifically on physical rehabilitation or emotional wellness.

AHTA says plants are chosen based on the garden’s function. During my internship at Hope Grows in Moon Township, I learned a healing garden has very different plants and sections than a rehabilitation garden. For example, a Zen garden for raking sand and a fairy garden for promoting imagination and creativity. These types of sections encourage reflection and relaxation rather than active planting or harvesting.

Horticultural therapists can be found in a variety of mental health settings, including vocational programs, community gardens, rape crisis centers, centers for at-risk youth, hospice agencies, hospitals and community mental health facilities.

What Are the Benefits of Horticultural Therapy?

Horticultural therapy has been around since the 19th century. Psychiatrists recognized benefits for patients who spent time working in the garden or walking outdoors. Current research shows horticultural therapy can help with grief, addiction, intellectual disabilities, dementia, PTSD and physical rehabilitation. 

  • Physical rehabilitation. For those learning to use their bodies again after injury or those coping with a long-term physical disability, horticultural therapy develops participants’ ability to acquire new skills or redevelop lost ones. Musculoskeletal strength, balance, coordination and cardiovascular endurance improve through tending a garden or planting.

    When a client starts flowers or vegetables from seed, that person learns to use the hands or other body parts in ways that support physical healing. In doing so, they develop a new understanding of the physical body and how that body is growing alongside the plants themselves. In this way, horticultural therapy can be a powerful integrative healing experience. It unites the mind, body and spirit under the umbrella of growth.
  • Intellectual and cognitive disability. In addition to assisting those with physical disabilities, horticultural therapy also helps participants with intellectual deficits, degenerative brain diseases or traumatic brain injuries. Cultivation of plants improves memory, information processing, task focus, language and social interaction.

    Participants engage in independent work, learn how to solve new kinds of problems and carry out instructions. These abilities can significantly improve quality of life for participants with intellectual, social and/or cognitive deficits. Their self-efficacy grows and, with it, their self-esteem and belief in their own capability. When you see this self-growth, the ability to connect with others grows. When we sow seeds together, tend to them and support their growth, we become life-affirming.
  • Mental health. Horticultural therapy is particularly beneficial for those dealing with addictions, grief and PTSD. It can also treat anxiety, depression, job burnout and adjustment disorders.

    Being outdoors, engaged in physical activities, fostering growth or simply appreciating the life around us lifts our mood. It provides us with a sense of meaning and place and focuses us on the here-and-now through the full use of our five senses.

    When we plant a seed, we feel the soil and sunlight feeding the plant. We smell the soil’s richness. We taste the sweetness of the air around us. We see the colors of the dirt, the pot and any surrounding plants. We hear the wildlife and sounds of planting. This sensory-rich experience is calming and deeply restorative.

    As a survivor who personally deals with panic, flashbacks and loss of meaning, I can say being outdoors with plants has saved me from falling into fear and hopelessness. It has restored my ability to center myself and see myself as a giver and cultivator of life. When I eat a pesto created with basil I have cared for, I taste the sunshine and feel the coolness of the earth. I see the bright green of the leaves and smell their sweetness, and I hear their bright crunch. I nourish the leaves, they nourish me, and so we are bound in a meaningful and gratifying symbiotic mutual affirmation of life.

How Does Being Outside Improve Mental Health?

Even if you don’t have access to a therapeutic garden, a place to plant seeds or a formal horticultural therapy program, just being outside can provide similar benefits. Japanese culture, for example, has a technique called shinrin-yoku, or “forest bathing.” In his book Forest Bathing: How Trees Can Help You Find Health and Happiness, Dr. Qing Li, a medical doctor at Tokyo’s Nippon Medical School, says appreciating and interacting with natural landscapes can:

  • Lower our blood pressure.
  • Reduce stress levels.
  • Strengthen the body’s systems.
  • Improve mental health, cognitive capabilities and mood.

Li believes our disconnection from the plants around us has an adverse impact on our minds and bodies.

Florence Williams, author of The Nature Fix: Why Nature Makes Us Happier, Healthier and More Creative, emphasizes the positive effects nature has on our brain and the results of these effects on our health and relationships. In a world where staying inside more is becoming the norm, getting outside is more important than ever. When we mindfully and intentionally connect with nature, we connect with our own humanity.

Here are simple strategies to reduce stress and anxiety by interacting with plants:

  • Nature writing. Wallace Stegner, a great writer of the American west, called nature and the observation of it “the geography of hope.”

    “We simply need that wild country available to us, even if we never do more than drive to its edge and look in,” he says. “For it can be a means of reassuring ourselves of our sanity as creatures, a part of the geography of hope.”

    Choose a favorite place where you have access to plants and focus on one plant, or study a picture of a favorite plant. Observe the plant carefully and quietly. In your journal, write a description of the plant. What does it look like? What’s its growth season? Where is the plant in its lifecycle? Now, connect it to your life: Why did this plant speak to you? What memory does it evoke? How did connecting to that plant enrich the memory? What lesson can that plant teach? Spend 15 to 20 minutes on this journaling activity each week.

  • Community gardening. Growing food and flowers to nourish the bodies and spirits of those with whom we share our community is deeply gratifying. It also helps us get outside of ourselves. Urban gardening efforts, such as the Pittsburgh Urban Gardening Initiative, encourage community members to make efforts to improve access to healthy food and to foster a culture of sustainability.
  • Finding your greenspace. Local parks and other greenspaces are everywhere in Western Pennsylvania. When I decided to relocate from the New York metro area in the late 1990s, this is one key reason why I found Pittsburgh so appealing. Few cities have such a rich juxtaposition of green and urban spaces. The Pittsburgh Parks Conservancy is an excellent resource to find your favorite place to connect with nature.

    Pittsburgh also has a number of unexpected trails and greenspaces that wind through it. One place I love is a small trail of about a mile or so that weaves alongside the Crafton, Westwood and West End neighborhoods. This trail used to be a trolley track, but now it’s a lovely and quiet little place for a short walk or a rest under the shelter of big, old oaks and maples. Community volunteers and city workers even built a couple of benches and shelters along the trail for relaxing to appreciate the landscape. There are gems like this trail all over the city and if, like me, you don’t have a spacious and wooded backyard, I encourage you to find one!

Trying one of these strategies is a good way to introduce yourself to horticultural therapy in the absence of a professional guide. As horticultural therapy is a relatively new mental health specialty, locating a licensed clinician with specialized training certified by the AHTA can be challenging. With that said; however, giving yourself time in nature in addition to any mental health treatment you are receiving can help reduce associated anxiety and depression symptoms.

How Do You Ground Yourself Mentally?

Grounding is another nature-based method for improving mental, physical and spiritual wellness. According to Alicia Nortje, a research fellow at the University of Cape Town, “Within the field of mindfulness, ‘grounding’ refers to the ability to return to the present moment with sustained attention.”

The most common way to understand grounding is by using the five senses to connect with our immediate physical environment or through breathing. A related, yet somewhat different, way to understand it is by connecting physically to the earth; this practice is called “earthing.”

Four approaches to ground yourself mentally in nature are:

  1. Five living things. This strategy focuses on the sense of sight as a way to bring yourself back to the present moment. To make this activity nature-based, scan the environment around you and identify five living things or pictures of them. For example, as I write this post, I can see a bird outside on the telephone wire. I see my neighbor’s maple tree, a small clementine, my cat and a picture of a brown bear. For this activity, spending time focusing on the details of each thing you see can bring calm and focus back and also reconnect you with the abundance of life.
  2. Kick off your shoes. If it is warm enough outside, walk out your front door without shoes. Stand on the grass or concrete barefoot. Notice how your feet feel. Then, let your awareness travel up the rest of your body until you reach the crown of your head.
  3. Outdoor yoga. The COVID-19 pandemic forced many activities to change. One activity that has become much more widespread and available now is an outdoor yoga class. Outdoor yoga not only unites movement with breath, but it also reconnects us with the earth and our relationship to it. If you cannot afford a yoga class but have a smartphone or tablet, choose from many of the wonderful free yoga videos and move your practice outdoors on your own. If you’re craving connection to people and nature, enlist a friend or two to practice with you for more of a class-like vibe.
  4. Grounding diet. Eating a more plant-based diet is linked to reduced anxiety and improved physical health. Adding root vegetables, such as beets, potatoes, carrots, radishes and ginger, is a good start. Other foods with grounding benefits are nuts, seeds, mushrooms, squash, oats and tea. As you eat, you may also try to be more mindful. As you take a bite of sweet potato, take time to also notice its texture, temperature, color and smell. If you are able to grow any of these vegetables yourself or access them through a community garden program, all the better!

I recommend trying each strategy at least three times and journaling about changes you see – or don’t see – in your mental, physical and spiritual health.

If you are struggling navigating feelings of anxiety, depression or trauma, Anchorpoint’s family counseling services are here to help. Call at (412)-366-1300 or use our Digital Intake Form to schedule an appointment today. Hope is only a phone call away.