Issues in Mental Health Nursing, 35:155, 2014 Copyright © 2014 Informa Healthcare USA, Inc. ISSN: 0161-2840 print / 1096-4673 online DOI: 10.3109/01612840.2014.883790
FROM THE EDITOR
Therapeutic Horticulture Deserves Wider Implementation Sandra P. Thomas, PhD, RN, FAAN, Editor
In March, gardeners like myself can hardly wait to begin cleaning out our flower beds and lovingly preparing the soil to receive new plantings. Weeds must be banished before the new additions can flourish. Then, many months of weeding, watering, and diligent surveillance will ensue. Some plants will need to be transplanted to better locations; some will require extra nurturance and fertilization. The rewards of all this work? Pride in the garden’s growth, pleasure in its beauty, the peace I feel when communing with nature on a daily basis. Only recently are these benefits of gardening being afforded to inpatients who have addictive and/or mental health disorders. An article about a therapeutic greenhouse at an addiction treatment center in Texas caught my attention (Enos, 2013). In the greenhouse, master gardeners work with patients to ensure that their hands-on activities in the garden reinforce the growth-oriented aims of their addiction treatment. The gardeners deliberately select fast-growing plants so that patients can see the results of their efforts before discharge. Some plantings are designed to inculcate lessons. For example, sunflowers are planted in a poor location; when they thrive despite their environment, patients can grasp the possibility of surmounting their own less-than-ideal environments after discharge from the facility. I especially liked the lesson imparted by a demonstration that some plants fail when trying to thrive on their own, in contrast to a group of plants that were supported by stakes that bound them together for mutual support. Therapeutic horticulture is defined as “a process that uses plant-related activities through which participants strive to improve their well-being through active or passive involvement” (GrowthPoint, 1999, p. 4). To me, it is intuitive to assume therapeutic horticulture would be beneficial to individuals who are metaphorically struggling with the outcomes of poor soil, lack of nurturance, and a lot of ugly weeds choking their fragile growth process. Before psychiatry had any formal notion of “therapeutic horticulture,” it was actually common for residents of many state hospitals in the United States to raise crops on the hospital grounds. Many residents’ occupation prior to their hospitalization was farming, so this work was congenial to them. Misguided legislation later took away this opportunity, mandating that patients would have to be paid a wage if they performed “work” while hospitalized. The consequence of this legislation?
Instead of spending hours outside in fresh air, caring for their crops, patients sat in dayrooms for hours watching television. Research to support the benefits of therapeutic horticulture is sparse, but I recall an article by Scandinavian researchers that we published in 2011 (Gonzalez, Hartig, Patil, Martinsen, & Kirkevold). The researchers designed a 12-week therapeutic horticulture project, using four urban farms, for individuals with clinical depression. The study participants prepared beds for the plants, sowed seeds, and cultivated the plants as they grew. Outcomes were measured at baseline, at the end of the 12-week program, and at 3-month follow-up. Depression severity was significantly reduced at both post-program measurements, and 96% of the participants experienced working with the plants as meaningful (Gonzalez et al., 2011). I also recall the long-ago example of the York Retreat in England (founded in 1796), where psychiatric patients enjoyed aesthetically pleasing gardens and engaged in productive work (Thomas, 2010). As I prepare my flower beds for another growing season, I wish that therapeutic horticulture were offered to more people battling addictions and mental health problems. If you work in an institution, brainstorm about a small plot of soil that you could set aside for a garden, or about a nearby farm that might welcome some extra hands to help with watering and weeding. If you work in an outpatient setting, help your clients think about what they could grow in their own yards or windowboxes. It is time for wider implementation of therapeutic horticulture. Declaration of interest: The author reports no conflicts of interest. The author alone is responsible for the content and writing of the paper.
REFERENCES Enos, G. A. (2013). A place for plants to grow and people to recover. Behavioral Healthcare, 33(5), 45–46. Gonzalez, M., Hartig, T., Patil, G., Martinsen, E., & Kirkevold, M. (2011). A prospective study of existential issues in therapeutic horticulture for clinical depression. Issues in Mental Health Nursing, 32, 73–81. GrowthPoint. (1999). Your future starts here: Practitioners determine the way ahead. GrowthPoint, 79, 4–5. Thomas, S. P. (2010). The university of life: A promising idea. Issues in Mental Health Nursing, 31, 241.
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Copyright of Issues in Mental Health Nursing is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
FROM THE EDITOR
Therapeutic Horticulture Deserves Wider Implementation Sandra P. Thomas, PhD, RN, FAAN, Editor
In March, gardeners like myself can hardly wait to begin cleaning out our flower beds and lovingly preparing the soil to receive new plantings. Weeds must be banished before the new additions can flourish. Then, many months of weeding, watering, and diligent surveillance will ensue. Some plants will need to be transplanted to better locations; some will require extra nurturance and fertilization. The rewards of all this work? Pride in the garden’s growth, pleasure in its beauty, the peace I feel when communing with nature on a daily basis. Only recently are these benefits of gardening being afforded to inpatients who have addictive and/or mental health disorders. An article about a therapeutic greenhouse at an addiction treatment center in Texas caught my attention (Enos, 2013). In the greenhouse, master gardeners work with patients to ensure that their hands-on activities in the garden reinforce the growth-oriented aims of their addiction treatment. The gardeners deliberately select fast-growing plants so that patients can see the results of their efforts before discharge. Some plantings are designed to inculcate lessons. For example, sunflowers are planted in a poor location; when they thrive despite their environment, patients can grasp the possibility of surmounting their own less-than-ideal environments after discharge from the facility. I especially liked the lesson imparted by a demonstration that some plants fail when trying to thrive on their own, in contrast to a group of plants that were supported by stakes that bound them together for mutual support. Therapeutic horticulture is defined as “a process that uses plant-related activities through which participants strive to improve their well-being through active or passive involvement” (GrowthPoint, 1999, p. 4). To me, it is intuitive to assume therapeutic horticulture would be beneficial to individuals who are metaphorically struggling with the outcomes of poor soil, lack of nurturance, and a lot of ugly weeds choking their fragile growth process. Before psychiatry had any formal notion of “therapeutic horticulture,” it was actually common for residents of many state hospitals in the United States to raise crops on the hospital grounds. Many residents’ occupation prior to their hospitalization was farming, so this work was congenial to them. Misguided legislation later took away this opportunity, mandating that patients would have to be paid a wage if they performed “work” while hospitalized. The consequence of this legislation?
Instead of spending hours outside in fresh air, caring for their crops, patients sat in dayrooms for hours watching television. Research to support the benefits of therapeutic horticulture is sparse, but I recall an article by Scandinavian researchers that we published in 2011 (Gonzalez, Hartig, Patil, Martinsen, & Kirkevold). The researchers designed a 12-week therapeutic horticulture project, using four urban farms, for individuals with clinical depression. The study participants prepared beds for the plants, sowed seeds, and cultivated the plants as they grew. Outcomes were measured at baseline, at the end of the 12-week program, and at 3-month follow-up. Depression severity was significantly reduced at both post-program measurements, and 96% of the participants experienced working with the plants as meaningful (Gonzalez et al., 2011). I also recall the long-ago example of the York Retreat in England (founded in 1796), where psychiatric patients enjoyed aesthetically pleasing gardens and engaged in productive work (Thomas, 2010). As I prepare my flower beds for another growing season, I wish that therapeutic horticulture were offered to more people battling addictions and mental health problems. If you work in an institution, brainstorm about a small plot of soil that you could set aside for a garden, or about a nearby farm that might welcome some extra hands to help with watering and weeding. If you work in an outpatient setting, help your clients think about what they could grow in their own yards or windowboxes. It is time for wider implementation of therapeutic horticulture. Declaration of interest: The author reports no conflicts of interest. The author alone is responsible for the content and writing of the paper.
REFERENCES Enos, G. A. (2013). A place for plants to grow and people to recover. Behavioral Healthcare, 33(5), 45–46. Gonzalez, M., Hartig, T., Patil, G., Martinsen, E., & Kirkevold, M. (2011). A prospective study of existential issues in therapeutic horticulture for clinical depression. Issues in Mental Health Nursing, 32, 73–81. GrowthPoint. (1999). Your future starts here: Practitioners determine the way ahead. GrowthPoint, 79, 4–5. Thomas, S. P. (2010). The university of life: A promising idea. Issues in Mental Health Nursing, 31, 241.
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Copyright of Issues in Mental Health Nursing is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
