A summary of the main findings of a review of the literature on
social and therapeutic horticulture – the use of horticulture and
gardening to promote health, well-being and social inclusion
among vulnerable people

Jo Aldridge (1253874)

Joe Sempik (7188350)

English

Loughborough University Institutional Repository

evidenceissue6Social and TherapeuticHorticulture: evidence andmessages from researchA summary of the main findings of a review of the literature onsocial and therapeutic horticulture – the use of horticulture andgardening to promote health, well-being and social inclusionamong vulnerable people.■ Although horticulture in many different forms has beenused as a therapy or as an adjunct to therapy, hardevidence as to its effectiveness is scant and of variablequality.■ From the available literature the review examined theuse of social and therapeutic horticulture for a numberof different client groups and analysed emergentmessages and themes including the benefits ofgardening and horticulture to these groups.■ Groups include those recovering from major illness orinjury, those with physical disabilities, learningdisabilities and mental health problems, older people,offenders and those who misuse drugs or alcohol.■ The reported benefits of social and therapeutichorticulture include increased self-esteem and self-confidence, the development of horticultural, social andwork skills, literacy and numeracy skills, an increasedsense of general well-being and the opportunity forsocial interaction and the development ofindependence.■ In some instances involvement in social and therapeutichorticulture programmes can also lead to employmentor further training or education.‘Horticultural therapy is the use of plantsby a trained professional as a mediumthrough which certain clinically definedgoals may be met’. ‘Therapeutic horticulture is the process bywhich individuals may develop well-beingusing plants and horticulture. This isachieved by active or passive involvement’(Growth Point, 1999, p. 4).Social and therapeutic horticulture is theterm now used by the charity Thrive.The literature in contextThe literature review forms part of a larger study whichaims to examine how social and therapeutic horticulturepromotes social inclusion, health and well-being forvulnerable adults. More than 300 articles were examinedin detail in the course of the review from approximately1000 available titles. These were identified by searchinglibrary databases, references from known published workand by consulting with researchers in the field. It ispossible to identify some broad themes in the literaturerelating to rehabilitation, horticultural therapy andpsychology, including landscape and environmentalpsychology.The reported benefits andoutcomes of therapeutichorticultureBenefits and outcomes of social and therapeutichorticulture are reported among a wide range ofindividuals and groups of vulnerable or socially excludedpeople. Although less evidence is available on thebeneficial effects of horticulture and gardening in termsof improvement of physical health, a number of studieshave looked at outcomes here for stroke patients, thosewith aphasia, the victims of car accidents and childrenwith cerebral palsy for example. One study looking ataphasia concluded: ‘Most endeavours require some degree ofverbal skill, and it is always a challenge tofind recreational activities which aresuitable for individual with aphasia. Clearly,the nature of horticultural activities lendthemselves easily to communicativedisabled individuals’(Sarno and Chambers, 1997, p. 89).Evidence is more widely available concerning the impactof horticulture and gardening in terms of improving mentalhealth. In 1955, O’Reilly and Handforth were among thefirst authors to examine the value of horticulture as atherapy for psychiatric patients. They evaluated theefficacy of a horticultural programme for 14 womenpatients who had been considered refractory to all formsof treatment. ‘Of the 14 patients who participated in ourpilot project, only one has failed to show astriking degree of improvement’ (p. 766). Improving self esteem, self confidence and socialinteraction are also seen as significant outcomes forpeople with mental health problems and those withlearning difficulties. Smith and Aldous (1994) for example found students withlearning disabilities increased their ‘feelings of value and worth in that theyconsidered themselves more desirable thanbefore as individuals. Therapeutichorticulture provided each individual withthe opportunity to express themselves in apositive way…’(p. 217).The link between physical activity and health in olderpeople has been extensively researched and there is amass of evidence which suggests that physical activity isassociated with good health and reduced risk factors forheart disease and other illnesses. However, gardening isseen as only one of many factors here and few studieshave looked specifically at the benefits, both physical andpsychological of gardening itself.Among other identified groups to benefit from social andtherapeutic horticulture are offenders and those whomisuse alcohol or substances. Some studies had specificobjectives in terms of teaching horticulture and otherskills in prisons, for example, particularly for training inlife skills. The range of positive outcomes here aredescribed as: providing meaningful activity and work; foodproduction; providing skills (for example, in responsibility,social skills, work ethic) to succeed in horticultural andother activities. In one study of horticultural programmesfor juvenile offenders, the authors concluded:‘This research indicates that this vocationalhorticulture curriculum may be a tool toimprove social bonding of juvenile offenders,[and that such vocational training could be]effective at evoking certain changes inattitudes about personal success andindividual perceptions of personal jobpreparedness’(McGuin and Relf, 2001, p. 432).A further outcome of social and therapeutic horticulture,which isn’t referred to explicitly but which can be inferredfrom some of the studies, is that social inclusion can be apositive consequence of participating in horticulturalprojects. The four dimensions of social inclusion relate toconsumption, production, social interaction and politicalengagement. The extent to which these dimensions canbe influenced by horticulture and gardening will vary fromgroup to group and person to person, so for example,gardening may promote social interaction among olderpeople while the production dimension can be addressedby gardening programmes seeking to provide employment,work discipline, development of skills and socially usefulactivities.Mechanisms of therapeutichorticultureThe theoretical framework that underpins therapeutichorticulture relates to the ways in which landscape andnature can influence emotions, health and behaviour.Environmental psychology has provided considerableinformation about the restorative qualities of naturalenvironments and both cognitive (reasoned) andevolutionary (inherited) components may be present. Twokey areas of research here focus on attention fatigue andcentre for child and family research evidenceissue6its restoration by the natural environment, and the role ofthe natural environment in recovery from stress. Studieslook at mental fatigue and how it arises as a result of theeffort involved in inhibiting competing influences whenattention is directed towards a specific task. The naturalenvironment is said to stimulate involuntary attentionwhich requires no effort and is therefore restorative. Afurther example is the study of the preference fordifferent types of landscape and on the effects oflandscape on recovery from physical and psychologicalstress (for example, the view from a hospital window andits impact on recovery processes, see Ulrich, 1984).A model of activities, processesand outcomesFrom the examination of the literature on social andtherapeutic horticulture it is possible to construct amodel (shown in figure 1) which illustrates the mainactivities, processes and outcomes as drawn from theavailable evidence. At the base of the model lie theunderlying foundations which determine the inherentappeal of the natural environment. This has also beencentre for child and family research evidenceissue6called ‘Biophilia’ (Wilson, 1984) and suggests that humanbeings possess an innate attraction to nature. The originof this attraction is still under debate. It may beevolutionary; it may be learned or acquired. But whateverits nature it supports both the passive appreciation oflandscape and the active participation in horticulture andgardening. Within the divisions of ‘active’ and ‘passive’there are many processes and activities which are inter-related and which provide rehabilitation, acceptance andinclusion on one side and tranquillity, peace andspirituality on the other. These are represented as twodistinct groupings – but nonetheless connected. Thereason for separate groups is that the former,rehabilitation, acceptance and inclusion are frequently thegoals of active programmes whilst passive appreciation ofnature is often associated with tranquillity, peace andspirituality. This division is not a ‘hard and fast’ rule ofany sort but an attempt to show the diversity of the aimsof different programmes. The two groups of attributes areshown to be interconnected as one can lead to the otherand vice versa. In most cases this exchange is desirableand intended; acceptance and inclusion should lead topeace and tranquillity; and peace and tranquillity can bePassive: Nature AppreciationFood, Cultivation,ConsumptionEmploymentSkillsDevelopment Physical ActivityAttention Restoration,Recovery from StressSocial Processes,Interaction,Esteem-BuildingHealth, Well-beingRehabilitation, Acceptance,Social InclusionTranquillity, Peace,SpiritualityInnate Factors – Evolutionary – BiophiliaActive: Horticulture, GardeningFigure 1. Health and Well-being Through Nature and Horticulture: a simple model of some of the processes, activities and outcomes of social and therapeutic horticulture as described in the literature showing the interconnectedness of all elements.evidenceissue6Research PartnerThrive, The Geoffrey Udall Centre, Beech Hill, ReadingRG7 2ATFunderCommunity FundWhere to find more evidenceSempik, J., Aldridge, J. and Becker, S. (2002) Social andTherapeutic Horticulture: evidence and messages fromresearch, Thrive (in association with the Centre for Childand Family Research): Reading.www.growingtogether.org.ukFull details of other outputs can be found in the CCFRbrochure or on the website: www.ycrg.org.ukThis paper was written by: Jo Aldridge and Joe Sempik,December 2002For further information about the CCFR please contact:Dr Harriet WardDirectorH.Ward@lboro.ac.ukProfessor Saul BeckerAssociate DirectorS.Becker@lboro.ac.ukSuzanne DexterAdministratorS.Dexter@lboro.ac.ukCentre for Child and Family ResearchDepartment of Social Sciences Loughborough UniversityLeicestershire  LE11 3TU  UK+44 (0)1509 228355+44 (0)1509 223943www.ccfr.org.ukThis CCFR Evidence paper forms part of the CCFR Family and Environment research programmethe steps to acceptance, inclusion and rehabilitation. Thefinal components of the model are health and well-being,at its summit. This is the ultimate goal of social andtherapeutic horticulture and represents a major part of allinterpretations of ‘quality of life’.The data reviewed in the literature on social andtherapeutic horticulture provide evidence for theeffectiveness of horticulture and gardening in a number ofdifferent therapeutic settings. However, there is a needfor more research in this area which examines outcomesin greater detail, and with a range of different groups.This would provide robust evidence in support oftherapeutic horticulture for a wide range of vulnerablegroups and individuals.ReferencesGrowth Point (1999) ‘Your future starts here:practitioners determine the way ahead’, Growth Point, vol.79, pp. 4-5.McGuinn, C. and Relf, P.D. (2001) ‘A profile of juvenileoffenders in a vocational horticultural curriculum’,HortTechnology, vol. 11, (3, Jul-Sep), pp. 427-468.O’Reilly, P.O. and Handforth, J.R. (1955) ‘Occupationaltherapy with ‘refractory’ patients’, American Journal ofPsychiatry, vol. 111, pp. 763-766.Sarno, M.T. and Chambers, N. (1997) ‘A horticulturaltherapy program for individuals with acquired aphasia’,Activities, Adaptation & Aging, vol. 22, (1-2),  pp.81-93.Smith, V.D. and Aldous, D.E. (1994) ‘Effect of therapeutichorticulture on the self concept of the mildly intellectuallydisabled student’, in: The Healing Dimensions of People-Plant Relations, Francis, M., Lindsey, P. and Rice, J.S.(eds), UC Davis, CA: Centre for Design Research, pp. 215-221.Ulrich, R.S. (1984) ‘View through a window may influencerecovery from surgery’, Science, vol. 224, pp. 420-421.Wilson, E.O. (1984) Biophilia: The Human Bond with OtherSpecies, Cambridge: Harvard University Press.Principal researchers■ Joe Sempik, Research Fellow CCFR■ Jo Aldridge, Research Fellow CCFR■ Saul Becker, Associate Director CCFR

Social and therapeutic horticulture: evidence and messages from research

https://repository.lboro.ac.uk/articles/Social_and_therapeutic_horticulture_evidence_and_messages_from_research/9579848/files/17216870.pdf

Social and therapeutic horticulture: evidence and messages from research

Abstract

Similar works

Full text

Available Versions

Loughborough University Institutional Repository