Horticultural Therapy

  • Difficulty Rating: Beginner
Horticultural Therapy

What formulates our need for nature?

Why do hospital patients feel better after sitting in a garden, or working with plants? How are gardens within nursing homes helping patients with Alzheimer’s disease safely enjoy the outdoors?

Answers to these questions lie within the landscape of horticultural therapy. Horticultural therapy is a broad term applied to many fields of interest regarding plants and people. Because of my mother’s car accident twenty-two years ago, I’ve personally witnessed numerous sessions of rehabilitative and occupational therapy. Mom would tell you it is much easier to do twenty repetitions of a particular exercise if sunshine, soil and seeds are involved.
Unable to walk long distances, my mother isn’t well enough to grow a large garden, but that doesn’t stop her from enjoying planting containers, something she and I do each year around Mother’s Day. I gather plants, soil and tools, and Mom supplies the enthusiasm.

After thinking about how much it buoys Mom’s spirits, last week, I spoke to Nancy Chambers, HTR, Director, Glass Garden, Rusk Institute of Rehabilitation Medicine at the NYU Medical Center. For over sixty years, the Glass Garden at the Rusk Institute has been a vanguard in the horticultural therapy field, and its presence is still enjoyed by patients and the local community. However, a dark cloud looms over the horizon for the Glass Garden. Although the gardens are public botanic gardens, most, including the conservatory, will be eliminated by 2012. Still, Chambers assures me programs will go on indoors within therapy rooms. Plants will still come to the patients, but the community will lose the gardens, the bunnies and the greenhouse.

“Many gardens throughout the U.S. have been patterned after those at the Rusk Institute,” she said, “We’ve trained people all over the country and will continue to do so.” Training is offered at the institute and through seminars throughout the country.

The origins of horticultural therapy bloomed in several parts of the United States almost simultaneously with one of the first institutions being the Quakers Friends Hospital Asylum in Philadelphia. The Quakers were among the first to believe nature was an essential part of healing, and that mental illness could be healed. The Menninger family in Topeka, KS, also incorporated these ideals within their sanitarium.

Later, Dr. Howard Rusk worked with veterans returning from WWII and started the Rusk Institute in 1949 in New York City. He asked horticultural philanthropist, Enid A. Haupt, to build a greenhouse so therapeutic work could go on year round.

“It was her first garden donation, and she enjoyed it so much that she later created other gardens at the Smithsonian and saved the conservatory at the New York Botanical Garden,” said Chambers.

The American Horticultural Therapy Association defines four types of therapy:

  • Horticultural Therapy led by a trained therapist with defined goals;
  • Therapeutic Horticulture led by an individual with horticultural therapeutic training, but goals are not clinically defined and documented;
  • Social Horticulture, also called community horticulture, examples are community gardens or garden clubs; and
  • Vocational Horticulture is training to help individuals to work in some aspect of the horticulture industry.

Prisons programs often fit into the last category because, while working in gardens helps prisoners reduce stress, it also provides them with opportunities to learn a vocational skill.

“Many prison gardens feed people so prisoners see value in their work,” said Chambers, “It is rewarding and valuable, and it is also a career in a very complex industry. Plants respond to care, but aren’t complicated like people.”

For rehabilitative therapy, the main goal is to help patients achieve independence and to bring them to their highest level of productivity in regular, everyday activities. To do this while working with plants makes the rehab much easier and more pleasurable.

“Pouring water from a watering can is like pouring a glass of milk for your child,” said Chambers, “Working in horticulture lets you practice in a beautiful setting.”

She stresses you don’t need specialized tools. At the Rusk Institute, they use chopsticks as dibbers, ice cream scoops as trowels, whatever is easily obtained. They also use real pots and soil, although to be as sensory as possible, they use a potting soil with only peat moss, perlite and coir.

To build a therapeutic garden, Chambers suggests raised beds sixteen to eighteen inches high because it is easier to work down with your arms than up.

“You don’t want people with disabilities to stand out. You want them to be able to garden with others,” she said.

A big growth area for horticultural therapy as a career is in nursing homes and assisted living centers.


Working with plants or even seeing them can boost one’s mood and help patients heal faster. According to biologist and naturalist, E.O. Wilson, humans are predisposed to living in a savannah like that of Africa, and we still yearn for that type of landscape. Rachael and Stephen Kaplan in their Attention Restoration Theory propose humans are better able to concentrate after being in nature or even looking at a picture of nature. They theorize gardens are “soft fascinations” which only require “effortless attention” like leaves gently blowing in the wind. Such images give our minds a rest from the “directed attention” required by our highly technical world.

There are many outstanding therapeutic gardens and landscapes throughout the United States, including those listed below. They make a great visit for anyone because we could all use a bit of therapy sometimes.

  • Eighth floor Olson Family Garden at the St. Louis Children’s Hospital
  • Borgheest Garden, Friend’s Hospital, Philadelphia, PA
  • The Bryn Mawr Rehab Hospital Sydney Thayer III Horticultural Center, Malvern, PA
  • Jacqueline Fiske Healing Garden, Jupiter Medical Center Jupiter, Florida

For more information on therapeutic landscapes, visit the Therapeutic Landscapes Network website here.