What is horticultural therapy?

Sue McIntyre has always liked plants and spending time in nature, but it wasn’t until she learned about horticultural therapy that she realized the mental and physical health benefits both can bring. She first learned of it about 20 years ago, when her employer offered horticultural therapy workshops using gardens, plants and nature as a way to improve people’s well-being.

McIntyre has been hooked ever since, and says it has helped her be “an evolving and more aware and connected human being.” She’s also learned simple yet effective techniques — like taking a moment to step outside if she’s feeling stressed.

“It’s that opportunity to stop and be mindful and connect with what’s going on,” she said.

While McIntyre has known about horticultural therapy for two decades, it has only become more popular in recent years, according to Cheney Creamer, who chairs the Canadian Horticultural Therapy Association (CHTA) and who introduced McIntyre to the practice. Since 2020, CHTA’s membership — comprised of people who have an interest in horticultural therapy but aren’t necessarily practitioners — has doubled. The group now has more than 300 members.

At the same time, COVID has caused more and more people to have mental health struggles. An Angus Reid and CBC survey from March found 54 per cent of respondents said their mental health worsened during the two years of the pandemic.

“We’ve always known mental health is important, but clearly, COVID has amped that up to a new level of urgency,” Creamer said.

Creamer, who’s the founder of a corporate wellness company and is on track to become a registered horticultural therapist with CHTA, believes this form of therapy is particularly beneficial for mental wellness. It hits a number of bases, including psychological, physical, cognitive, social and spiritual.

There’s research that backs this up. A 2017 review of 22 case studies found that gardening — including horticultural therapy — has a “significant positive effect” on health outcomes. It can reduce depression, anxiety, stress and mood disturbance, while also increasing quality of life, sense of community, physical activity and cognitive function.

What is horticultural therapy?

Horticultural therapy doesn’t seem to have one neat definition, and each horticultural therapist has a different way of delivering it, Creamer says. It’s used for a diverse set of groups, including the elderly, youth, people with mental or physical illnesses, and corporate wellness.

Creamer describes it as a way “to maximize the potential for meaningful, therapeutic people-plant interactions.” She begins her sessions by taking her clients to a park, asking them what plant they are drawn to, then having a conversation about what challenges they think the plant is facing — and, importantly, how they can relate that to their own life. This provides an outlet for people to learn about themselves, she explained.

At the intensive tertiary rehab unit at Vancouver General Hospital’s Segal and Family Health Centre, Moira Solange defines horticultural therapy programs a bit differently. She works with a group of long-term clients with complex mental health conditions and describes the therapy as teaching gardening with specific goals in mind.

These goals vary depending on the person. For some, it is to create a hobby that can continue once they leave the hospital. For others, it is to exercise, build self-confidence or cognitively challenge themselves. It also helps with social and communication skills.

She is cautious not to oversell the benefits of horticultural therapy, saying it works in conjunction with nurses, psychiatrists, occupational therapists, physiotherapists and others to support clients with their mental health.

“In tertiary mental health, it's not going to turn a person's life around. But it may widen their world a little bit. It may allow them some normalcy, some new contacts, some new conversations,” Solange said.

The program has spinoff effects felt in other parts of the hospital. The garden itself is a space where anyone can “enjoy a bit of nature, a bit of peace, a bit of interest,” Solange says.

And the gardens enhance other aspects of the hospital. They grow cherry tomatoes, wild strawberries, beans and peas — “plants where you can just kind of pick and snack and graze on,” Solange says. There’s also lettuce, kale, flowers and herbs, which dietitians and occupational therapists will harvest and cook with their clients.

Farmers on 57, an urban farm in South Vancouver, has a weekly garden club run by a horticultural therapist to support some of the George Pearson Assisted Living Facility’s residents. Sarah Wenman, the therapeutic garden co-ordinator, says she can see how it adds to their well-being.

“People seem to really like having something to take care of and something that's their own. And, you know, the success of growing something that you really are responsible for has really worked well,” she said.

The farm also spreads the cheer by delivering flower bouquets to residents who can’t leave their rooms — for example, those on ventilators.

“There’s a benefit of getting to be around the colour and the smell, for people who can’t eat, that’s really meaningful,” Wenman said.

Horticultural therapy is still a relatively small practice in Canada. There are just 40 horticultural therapists registered with CHTA, though Creamer says several hundred are on their way to being fully registered. According to Statistica, there were nearly 19,000 psychologists in Canada in 2018. Creamer is encouraged by the growing interest she’s seen in the field. She says people now recognize it as a valid form of therapy.