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  • Home
  • About
    • About FLHHN
    • Mission and vision
    • Advisory Committee
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    • CULTIVATE (EPUB)
    • Upcoming Webinars
    • Recorded Webinars
    • Event Calendar
  • Subscribe
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  • Networking Forum

Horticultural Therapy & Health Services

Health services that use horticulture as an integral part within a therapeutic modality framework include: 
Horticultural therapy (HT) & Therapeutic horticulture (TH) 
Allied therapeutic modalities- (occupational, recreation, physical therapy) 
Nature-based therapies- (ecotherapy, ecopsychology, wilderness camps, aromatherapy, forest  bathing, veteran to farmer programs) 

Some of these disciplines and programs require specialized training and credentialing.  
​HORTICULTURAL THERAPY & THERAPEUTIC HORTICULTURE (HT & TH) 
Key Organization
The American Horticultural Therapy Association (AHTA)  
 
“Horticultural Therapy (HT) is the participation in horticultural activities facilitated by a registered horticultural therapist to achieve specific goals within an established treatment, rehabilitation, or vocational plan. Horticultural therapy is an active process which occurs in the context of an established treatment plan where the process itself is considered the therapeutic activity rather than the end product. 
 
Therapeutic Horticulture (TH) is the participation in horticultural activities facilitated by a registered horticultural therapist or other professionals with training in the use of horticulture as a therapeutic modality to support program goals. Therapeutic horticulture is the process through which participants enhance their well-being through active or passive involvement in plant and plant-related activities” (AHTA, 2021). ​
Books, journals & epublications on horticultural therapy & therapeutic horticulture ​
AHTA Magazine  
American Horticultural Therapy Association Resources  
Cultivate epublication   
Digging In epublication   
Cooper Marcus, C. & Sachs, N. (2013). Therapeutic Landscapes: An Evidence-Based Approach to 
 Designing Healing Gardens and Restorative Outdoor Spaces.
 Wiley.  
Fleming, L. (2016). Therapeutic Horticulture A Practitioner’s Perspective. Smashwords.  
Haller, R, Kennedy, K. & Capra, C. (2019). The Profession and Practice of Horticultural Therapy. CRC Press.   
Haller, R. L., and C. L. Kramer. 2006. Horticultural Therapy Methods: Making Connections in Health 
 Care, Human Service, and Community Programs
. Binghamton, NY: Hawthorne Press. 
Journal of Therapeutic Horticulture
​Layman, G. (2018). Gather & Make. Azara Publishing.  
Research & articles on horticultural therapy & therapeutic horticulture ​
Recently published selected research & articles: 
​

      Blake M. & Mitchell, G. (2016). Horticultural therapy in dementia care: A literature review. Nurs Stand. 
         
30
(21), 41-7. 

     Chua, M, Tan, J, Lee, S, Sia, A, Ng, MKW, Mahendran, R, Kua, EH, Ho, RCM. & Larbi, A. (2021).  
         Horticultural therapy reduces biomarkers of immunosenescence and inflammaging in 
         community-dwelling older adults: A feasibility pilot randomized controlled trial. 
J Gerontol A 
         Biol Sci
 Med Sci. 76
(2), 307-317. 

      Diehl, E. & Park Brown, S. (2016). Horticultural therapy. 
University of Florida AFAS Extension. 
         Retrieved from https://edis.ifas.ufl.edu/publication/EP145 

      Fleming, L. & Wilson, C. (2021). Compassion satisfaction and compassion fatigue [applications for 
         HT]. 
Digging In 7(4), 1-3. 

      Fleming, L. (2021). Superfood garlic: Applications for people-plant programs. 
Digging In 7(3), 1-3. 

      Hart, B. & Zanskas, S. (2021). Cultivating care: Trauma, homeless veterans, and nature-based therapy. 
         
Journal of Therapeutic Horticulture 31(1), 25-38. 

      Harvey, ML, Bowman, K. & Karr, A. (2021). The gardening spirit: Evidence that frequency of gardening 
         precisely predicts ecospirituality. 
Journal of Therapeutic Horticulture 31(1), 1-9. 

      Lu, LC, Lan, SH, Hsieh, YP, Yen, YY, Chen, JC. & Lan, SJ. (2020). Horticultural therapy in patients with 
         dementia: A systematic review and meta-analysis. 
American Journal Alzheimers Disease & 
         Other 
Dementias 35, 1533317519883498 

      Meore, A. et al. (2021). Pilot evaluation of horticultural therapy in improving overall wellness in  
         veterans with history of suicidality. Complementary Therapies in Medicine 59, 102728.  

      Millet, P. (2009). 
Integrating horticulture into the vocational rehabilitation process of Individuals with  
         fatigue, chronic fatigue, and burnout: A theoretical model
. Journal of Therapeutic Horticulture  
         19, 11-22. 


      Nicholas, SO, Giang, AT. & Yap, PLK. (2019). The effectiveness of horticultural therapy on older 
         adults: A systematic review. 
Journal American Medical Directors Association 20(10): 
         1351.e1-1351.e11. 

      Palsdottir, AM, O’Brien, L, Varning Poulson, D. & Dolling, A. (2021). Exploring a migrant’s sense of 
         belonging through participation in a urban agricultural vocational training program in Sweden. Journal of                   Therapeutic Horticulture 31
(1), 10-24. 

      Shao, Y, Elsadek, M. & Liu, B. (2020). Horticultural activity: Its contribution to stress recovery and 
         wellbeing for children. 
Int J Environ Res Public Health 17(4), 1229.  

      Siu, AMH, Kam, M. & Mok I. (2020). Horticultural therapy program for people with mental illness: A 
         mixed-method evaluation. 
Int J Environ Res Public Health 17(3), 711. 

      Tu, HM. & Chiu, PY. (2020). Meta-analysis of controlled trials testing horticultural therapy for the 
         improvement of cognitive function. 
Sci Rep. 10(1), 14637. 
​
      Zhao, Y, Liu, Y. & Wang, Z. (2020). Effectiveness of horticultural therapy in people with dementia:  
​         quantitative systematic review. 
Journal Clinical Nursing. 
Examples of horticultural therapy & therapeutic horticulture programs ​
The Therapeutic Horticulture Program at Wilmot Botanical Gardens University of Florida, Gainesville, FL. 
Programs for veterans, student wellness group, alumni, women veterans, Florida Recovery Center groups. 

Rehab South Florida, Lantana, FL 
Program for people overcome emotional & cognitive challenges in a rehab setting.  

Plants & People Horticultural Therapy Program @ Fairchild Tropical Botanic Garden, Miami, FL. 
Programs for individuals living with dementia and children with autism spectrum disorder along with care partners and family.  

Chicago Botanic Garden Horticultural Therapy Services, Chicago, IL. 
A variety of services are available including direct service, consultation, & speakers.  ​

Videos & webinars on horticultural therapy & therapeutic recreation ​
The Farm at Penny Lane Horticultural Therapy Program
Horticultural Therapy 101: History, Definitions, Examples  
 Horticultural Therapy for Veterans 
Related organizations ​
Canadian Horticultural Therapy Association (CHTA)   
Mid Atlantic Therapeutic Horticulture Network (MAHTN)  
Carolinas Horticultural Therapy Network 
​Hong Kong Association of Therapeutic Horticulture (HKATH) (link unsecure)
​International People Plant Council
ALLIED THERAPEUTIC MODALITIES  
These include occupational, physical, recreation therapy where horticulture is used as therapeutic activity, using adaptive gardening tools and techniques & garden settings. Health providers across disciplines including counsellors, social workers, nutritionists, & mental health staff also use horticulture in their services.    ​
key organizations
American Therapeutic Recreation Association (ATRA)
American Occupational Therapy Association 
Books, journals & epublications on allied therapeutic modalities ​
American Journal of Recreation Therapy
Research & articles on allied therapeutic modalities ​
Recently published selected research & articles:

Fleming, L., House, B. & Kirby, J. (2018). Half-day intensive grow your professional skills: Gardening, gardens & therapeutic horticulture [for recreation professionals]. Canadian Therapeutic Recreation Association. 
Kaplanis, G.F. (2019). Harnessing nature for occupational therapy: Interventions and health promotions. Doctoral dissertation. Nova Southeastern University College of Health Care Sciences. Retrieved from https://nsuworks.nova.edu/cgi/viewcontent.cgi?article=1065&context=hpd_ot_student_dissertations
OTDUDE (2021). Occupational therapy gardening ideas for adults (& kids). Retrieved from https://www.otdude.com/ot-practice/occupational-therapy-gardening-ideas-for-adults/
Pieters, H.C, Ayala, L., Schneider, A., Wicks, N., Levine-Dickman, A. & Clinton, S. (2018). Gardening on a psychiatric inpatient unit: Cultivating recovery. Archives of Psychiatric Nursing 33(1): 57-64. doi: 10.1016/j.apnu.2018.10.001
Porter, J. Y., & Porter, W. C. (2010). Transforming counseling pedagogy with horticulture therapy techniques. http://counselingoutfitters.com/vistas/vistas10/Article_52.pdf
Wagenfeld, A., & Atchison, B. (2014). Putting the occupation back in occupational therapy: A survey Of occupational therapy practitioners’ use of gardening as an intervention. The Open Journal of Occupational Therapy 2(4).
Examples of allied therapeutic modalities ​
The Mobility Garden at Sarasota Memorial Hospital Rehabilitation Pavillion in Sarasota, FL.
Occupational therapists use the Mobility Garden for treatment of compromised physical abilities. 

LeadingAge Florida association and Eldergrow GARDEN project across Florida
Funded in 2021 from the Agency for Health Care Administration to implement therapeutic horticulture programs at 22 nursing homes in Florida. 
Videos & webinars of allied therapeutic modalities ​
Therapy Garden at MVAMC 
​Ergonomic Gardening Tips for Arthritis Patients 
Using Gardens in a Holistic Approach to Occupational Therapy with Deedee Levine
Related organizations ​
Florida Physical Therapy Association (FPTA)
Florida Counseling Association 
NATURE-BASED THERAPIES & INTERVENTIONS 
Included in this category are all types of nature-based therapies & interventions, ecotherapy, ecopsychology, ecowellness, wilderness camps, aromatherapy, forest bathing and forest therapy where horticulture places a significant role.​
Key Organizations ​
Alliance of International Aromatherapists 
Association of Nature & Forest Therapy
Center for Health and Nature University of Texas
 
Children & Nature Network Nature and Health University of Washington
 
Books, journals & epublications on nature-based therapy & interventions ​
Aromatics in Action journal from the Alliance of International Aromatherapists

Buzzell, L. & Chalquist, C. (Eds.). (2002). Ecotherapy: Healing with nature in mind. Sierra Club Books.

Ecopsychology journal 

Harper, N.J. & Rose, K. (2019). Nature-based therapy: A practitioner’s guide to working outdoors with
children, youth, and families.
New Society Publishers.

Journal of Ecopsychology

 Journal of Environmental Psychology 
McGeeney A. (2016). With nature in mind: The ecotherapy manual for mental health professionals.
Jessica Kingsley Publishers.

Nature and Health (2021). Publications 

Research Digest journal from Children & Nature Network

Stigsdotter, U.K, Palsdottir, A.M, Burls, A, Chermaz, A, Ferrini, F. & Grahn, P. (2010). Nature-based
therapeutic interventions. In K. Nilsson M. Sangster, C. Gallis, T. Hartig, S. deVries, K. Seeland, & J. Schipperijn (Eds.) Forests, trees and human health. Springer.
Research & articles on nature-based therapies & interventions ​
Recently published selected research & articles:

Antonelli, M., Barbieri, G. & Donelli, D. (2019). Effects of forest bathing (shinrin-yoku) on levels of
cortisol as a stress biomarker: A systematic review and meta-analysis. International Journal of Biometeorology 63(8):1117–1134. https://doi.org/10.1007/s00484-019-01717-x

Bang, K.S., Lee, I. & Kim, S. (2017). The effects of a campus forest-walking program on undergraduate
and graduate students' physical and psychological health. International Journal of Environmental Research and Public Health 14(7). doi: 10.3390/ijerph14070728

Blaschke, S., O’Callaghan, C.C. & Schofield, P. (2017). Identifying opportunties for nature engagement
in cancer care practice and design: Protocol for four-round modified electronic Delphi. BMJ Open 7(3) e013527. doi: 10.1136/bmjopen-2016-013527
​
Chaudhury, P. & Banerjee, D. (2020). Recovering with nature: A review of ecotherapy and
implications for the OVID-19 pandemic. Frontiers in Public Health 10. https://doi.org/10.3389/fpubh.2020.604440

Clatworthy, J., Hinds, J. & Camic, P.M. (2013). Gardening as a mental health intervention: A review.
Mental Health Review Journal 18(4):214–225. https://doi.org/10.1108/MHRJ-02-2013-0007

Coventry, P.A., Brown, J.E., Pervin, J., Brabyn, S., Pateman, R., Breedvelt, J., Gilbody, S., Stancliffe, R.,
McEachan, R. & White, P.L. (2021). Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis. SSM Popul Health 16:100934. doi: 10.1016/j.ssmph.2021.100934

Eskilsson, R. & Palsdottir, AM. (20xx). Qualities for rest and recovery in nature-based rehabilitation at
Grona Rehab, Sweden. Acta Horticulturae (in press).

Fleming, L. (2015). Veteran to farmer programs: An emerging nature-based programming trend.
Journal of Therapeutic Horticulture 25(1):27-48.
​
Hansen, M.M., Jones, R. & Toccini, K. (2017). Shinrin-Yoku (forest bathing) and nature therapy: A
state-of-the-art review. International Journal of Environmental Research and Public Health 14(851). doi: 10.3390/ijerph14080851

Hall, C. & Knuth, M. (2019). An update of the literature supporting the well-being benefits of plants: A
review of the emotional and mental health benefits of plants. Journal of Environmental Horticulture 37(1):30-38. https://doi.org/10.24266/0738-2898-37.1.30

Hatala, A., Morton, D., Njeze, C., Bird-Naytowhow, K. & Pearl, T. (2019). Reimagining miyo-
wicehtowin: Human-nature relations, land-making, and wellness among indigenous youth in a Canadian urban context. Social Science & Medicine 230:122-130.

Kaplan, S. (1995). The restorative benefits of nature: Toward an integrative framework. Journal of
Environmental Psychology
15(3):169–182. https://doi.org/10.1016/0272-4944(95)90001-2

Kurth, A.M., Narvaez, D., Kohn, R. & Bae, A. (2020). Indigenous nature connection: A 3-week
intervention increased ecological attachment. Ecopsychology 12(2):101-117.

Li, Q. (2010). Effect of forest bathing trips on human immune function. Environmental Health and
Preventative Medicine
15:9-17. https://doi.org/10.1007/s12199-008-0068-3

Nadkami, N.M, Thys, T.M., Ruff, J.S., Anholt, A., Trevino, J. & Yeo, S.K. (2021). Providing virtual nature
experiences to incarcerated men reduces stress and increases interest in the environment. Ecopsychology 13(2):71-83.

Oh, K.H., Shin, W.S., Khil, T.G. & Kim, D.J. (2020). Six-step model of nature-based therapy process.
International Journal of Environmental Research Public Health 17(3):685. https://doi.org/-
10.3390/ijerph17030685

Painter, K. (2007). Plant seeds of healing: Nature makes you feel better. USA Today. http://www.usatoday.com/news/health/painter/2007-04-15-seeds-of-healing_N.htm?csp=34

Park, B.J., Tsunetsugu, Y., Kasetani, T., Kagawa, T., & Miyazaki, Y. (2008). Physiological effects of shinrin-yoku (Taking in the atmosphere of the forest) in a mixed forest in Shinano Town, Japan. Scandinavian Journal of Forest Research 23(3):278–83.

Poulsen, D.V., Stigsdotter, U.K., & Refshage, A. D. (2015). Whatever happened to the soldiers? Nature-assisted therapies for veterans diagnosed with post-traumatic stress disorder: A literature review. Urban Forestry & Urban Greening 14(2):438–45.

Reese, R.F. (2016). EcoWellness and guiding principles for the ethical integration of nature into
counseling. International Journal for the Advancement of Counselling, 38(4):345–357. https://doi. org/10.1007/s10447-016-9276-5

Reese, R.F. & Myers, J.E. (2012). Ecowellness: The missing factor in holistic wellness models. Journal of Counseling and Development, 90(4):400–406. https://doi.org/10.1002/j.1556-6676.2012.00050.x

Sia, A., Tam, W., Fogel, A., Kua, E. H., Khoo, K., & Ho, R. (2020). Nature-based activities improve the well-being of older adults. Scientific reports 10(1):18178. https://doi.org/10.1038/s41598-020-74828-w

Summers, J.K. & Vivian, D.N. (2018). Ecotherapy-A forgotten ecosystem service: A review. Frontiers in
Psychology
9(1389). doi: 10.3389/fpsyg.2018.01389

Thompson, M. (2009) Reviewing ecopsychology research: Exploring five databases and considering
the future. Ecopsychology 1(1):32-37.

Twohig-Bennett, C. & Jones, A. (2018). The health benefits of the great outdoors: A systematic
review and meta-analysis of greenspace exposure and health outcomes. Environmental Research, 166:628–637. https://doi.org/10.1016/j.envres.2018.06.030

Weeland, J., Moens, M.A., Beute, F., Assink, M., Staaks, J.P.C. & Overbeek, G. (2019). A dose of
nature: Two three-level meta-analyses of the beneficial effects of exposure to nature on children’s self-regulation. Journal of Environmental Psychology 65(101326). https://doi.org/10.1016/j.jenvp. 2019.101326

Wilson, E. O. (1984). Biophilia: The Human Bond with Other Species. Harvard University Press.

White, M.P., Elliott, L.R., Grellier, J., Economou, T., Bell, S., Bratman, G. N., Cirach, M., Gascon, M.
Lima, M. L., Lohmus, M., Nieuwenhuijsen, M., Ojala, A., Roiko, A., Schultz, P. W., van den Bosch, M., & Fleming, L.E. (2021). Associations between green/blue spaces and mental health across 18 countries. Scientific Reports 11(8903). doi: 10.1038/s41598-021-87675-0
Examples of nature-based therapies & interventions ​
Florida Center for Recovery in Fort Pierce, FL.
Programs using ecotherapy along with other modalities in addiction recovery. 

The Veterans Florida Agriculture Program in Gainesville, FL.
A six-month training fellowship for transitioning veterans as vocational education for agribusiness, and other agriculture careers. 

Operation Eco Vets in Sarasota FL.
Located at Green Path Veterans Farm, with support from Easterseals. Activities focus on sustainable gardening, addressing post-traumatic stress, and sense of community.

Videos & webinars on nature-based therapies & interventions ​
Rodiek, S. (2009). Access to nature for older adults [3 DVDs – 93 minutes]. Center for Health Systems & Design.
Prescribing nature for health TedxNashville 
Ten principles: How and why they are so effective – EcoPsychology Initiative
Ecopsychology: Reinventing the human-nature relationship in the digital age Part 1 
Science Pub – EcoWellness: Optimizing time outdoors 
The art and science of forest Bathing with Dr. Quing Li
Making the case: Community engagement for equitable access to nature
Related organizations ​
International Ecopsychology Society (IES) 
International Nature and Forest Therapy Alliance (INFTA) 
National Association for Holistic Aromatherapy 
Ecopsychology Initiatives 
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