Making Connections Editor: Christine Capra
Program Manager, HT Institute

2021 Summer Newsletter

Horticultural Therapy is making an impact on people’s lives.
Read more about how it’s happening.

HTI Director’s Note:
Messages from a Garden Walk

By Rebecca Haller, HTM

Yesterday my home garden was one of those featured on a neighborhood garden tour which was very well attended despite the 90+ degree heat. Besides the usual extra care and preparation that we all do when showcasing our private or horticultural therapy garden, the tour also had a benefit in that it involved the whole family in gardening to a greater extent than usual. A few take-aways from the experience that may relate to your HT gardens are:

  • Allowing and encouraging everyone to fully participate in the planting and care helps to make it their garden too.
  • Remember to include some ‘showstoppers’ in the design and plant selection to engage and delight the individuals you serve and visitors to the garden. I tend to get excited about more unusual plants such as my dwarf bristlecone and dwarf pinyon pines, the hardy snapdragon, the newly planted challenge-to-grow native paintbrush, the purple-flowered passion vine, a wide array of penstemons, the un-watered side yard, etc. But tour-goers were wowed by a huge double pink peony, a variegated beech (which is spectacular and quite uncommon in Denver), and most anything in full bloom.
  • It was delightful to witness the change in people as they entered the small oasis of the backyard featuring several ‘garden rooms’, shade from a covered patio and redbud tree, lots of texture with spots of color, three audible water features, the vegetable garden and grill areas, as well as a brick compost bin. All of this seemed to affect them as it does me. I saw people take a breath, slow down and experience and describe their appreciation.

Remember to include the gardeners, some wow-factor plants, and selected therapeutic garden principles in your HT garden. Include elements that may reduce stress and perhaps serve as a place for respite. Everyone who encounters it will benefit.

-Rebecca Haller

Horticultural Therapy Changes Lives-New Fall Classes!

By Christine Capra

Fundamentals of Horticultural Therapy class Anchor Center for Blind Children in Denver, Colorado

It is not an overstatement that the field of horticultural therapy (HT) changes lives—of both the therapist and those they serve. At the Institute, the experienced faculty provide advice to students entering the field. “The positive changes in the people you will assist will be rewarding and a continual source of inspiration, “said Rebecca Haller, HTM the Horticultural Therapy Institute’s director. After 20 years of training hundreds of students, the HT Institute continues to be at the forefront of education in the field. Haller, along with three other instructors at the Institute nurture each student as they journey towards bringing a career in HT to life. Deciding to pursue an education in HT is the start of that journey.

This fall the journey begins with Fundamentals of Horticultural Therapy offered both in an online or face-to-face format. This class is a pre-requisite for the remaining three classes in the HT certificate at the Institute and is available in three different sections:

Fundamentals of Horticultural Therapy online class

Fundamentals of HT
Denver, Colorado (Face-to-face)
Oct. 21-24, 2021
Deadline for enrollment: Sept. 21

Fundamentals of HT
Online (mountain time zone)
Nov. 11-14, 2021
Deadline for enrollment: Oct. 11

Fundamentals of HT
Online (mountain time zone)
Dec. 2-5, 2021
Deadline for enrollment: Nov. 2

“There is a tremendous need for HT in our communities. If you feel drawn to working with people and plants, trust your heart. The growth in HT work touches everyone, including the horticultural therapist. Know that everyone at HTI is committed to providing a positive educational experience and welcome diversity of people, plants and life experiences,” noted Jay Rice, HTI faculty.

Not only does the Institute embrace the individual student as they learn the key aspects of HT, but faculty also strive to teach best practices. The Institute spearheaded the 2019 publication of, The Profession and Practice of Horticultural Therapy, the first new textbook in HT in 21 years.

“Take advantage of the rich learning environment that includes both faculty and fellow students with diverse education and work experiences by embracing group work, networking with others, and exploring the carefully selected class sites.  Also, approach in and out of class work with a personal growth mindset.,” said Karen Kennedy, HTI faculty.  Pam Catlin, another faculty member notes, “Go in with an open mind. Even if you have a great deal of experience in the field of health care, being open to the information through the lens of the HT is valuable. Do the homework and recognize it is all work that can be put into action in your future HT endeavors.”

What makes HTI unique?

  • Background and experience of faculty
  • Both online and face-to-face teaching format options
  • Flexible scheduling and locations
  • An emphasis on learning by doing.
  • Varied classroom experiences including group discussions, peer learning, and hands-on activities.
  • Solid connections between students
  • Diverse student population

According to Catlin, teaching for the Institute over the years helps her to remain relevant with the field and with the world of small business and marketing (coursework she teaches). “HTI has high standards and, is an organization I’m honored to be part of,” said Catlin. “I’ve watched the field of HT grow with the addition of these amazing students from the program. Students bring an energy and new ideas to the field, and many go on to be board members of AHTA, conference presenters and more. I love the process of witnessing students put all the pieces together and have that ‘ah ha’ moment when they realize they really have what it takes to do the work.”

“Providing students, the necessary tools to do the work of HT is the mission of the Institute and continues to allow students to follow their passion for connecting people and plants, to improve lives, to make a commitment to the training and work, and professionally conduct themselves which will lead to their success,” said Haller.

The remaining three classes in the HT certificate will be held in 2022 with one section of each class being offered online and one face-to-face. Dates and locations to be announced later this summer.

For more information on the Horticultural Therapy Institute or to enroll in the Fundamentals of HT class go to or email [email protected].

HTI Program Profile:
The Medical University of S. Carolina

By Carmen Ketron, MS, MPA & Noni Langford

Optimal Healing in an Urban Landscape

Founded in 1824, the Medical University of South Carolina (MUSC) strives for excellence in education, research and patient care and offers the restorative properties of nature as part of the hospital experience to patients, guests and employees. MUSC educates and trains more than 3,000 students and nearly 800 residents in six colleges and employs more than 17,000 people. Situated in the heart of downtown Charleston, South Carolina, the MUSC main campus is a premier institution for medical training and healthcare for the Southeastern United States.

The clinical health system of the Medical University of South Carolina, called MUSC Health, works to provide the highest quality patient care available, while training competent, compassionate health care providers.

Across the 91-acre downtown campus, the medical university landscape is home to multiple therapeutic gardens, designed to serve as a patient care facility as well as serene space for the staff, students and the community. In 2010 MUSC received Arboretum designation through Tree Campus USA and in 2020 received Tree Campus Healthcare designation with the mission to transform the university campus into a place of optimal healing and learning by creating an urban landscape that invigorates, inspires, and teaches through nature.

Currently, MUSC offers both social therapeutic horticulture, providing serene horticultural spaces as well as targeted programming for individual patients and their treatment goals. MUSC offers a diverse range of horticultural therapy offerings, providing complimentary services to a range of established social, psychological, and physical treatment programs at MUSC and the greater Charleston community. The Grounds Team at MUSC houses a horticultural education team trained to design and support programs for a range of group based treatments.

Therapeutic Gardens at MUSC

MUSC Urban Farm

The MUSC Urban Farm is a half-acre urban community garden in the middle of the MUSC campus that serves to build a healthier community by growing crops and social connections while educating and inspiring people with local, nutritious, and delicious food.

The Urban Farm provides a place where students, faculty, staff, patients and community members can come together to learn about the connection between food and health. It serves as the home base where the horticulture team grows produce, herbs, flowers and other plant materials for sensory activities; a gathering space with inclusive beds, seating, and outdoor kitchen for demonstration and interactive programs; and storage facility to house specialized equipment for different adaptive needs of each group.

Here the team services out-patient programs and community groups that come for both targeted treatment programs as well as general therapeutic gardening experiences. The ADA compliant garden walkways and inclusive bed designs provide a variety of spaces for people to garden in-ground, in raised beds, and raised planters. This allows for patients to be able to experience the outdoors as a safe and fulfilling place to work with professionals to meet their physical, cognitive, social, and psychological goals.

Children’s Sensory Garden

The Children’s Sensory Garden is adjacent to the MUSC Urban Farm and allows children and their parents an opportunity to take a break from medical and dental procedures to experience the healing effects of nature. The new garden will be visited daily by families from all of the designated areas specified in the Joanna Foundation guidelines. Research shows that people/plant interactions promote personal health improvements and improved well-being. The goal of this project is to provide a playful, colorful and stimulating environment for families visiting the MUSC campus. This space will also be used for programming horticultural therapy activities.


The STAR Yarden is a collection of raised beds and containers making up a therapeutic garden in the “play yard” of the MUSC STAR Children’s Day Treatment program facility. The one-acre fenced in green space attached to the facility serves as an interactive play space for child and adolescent patients participating in the out-patient therapy program seeking treatment for behavioral disturbances.

The garden beds play host to an interactive “self esteem” garden setting where patients participate in year round vegetables, fruits, herbs, and flowers as part of a horticultural therapy program once a week.

Serenity Garden at Shawn Jenkins Children’s Hospital

The Boeing Company and the family of Anita Zucker teamed up to create a serene outdoor child life space. The serenity garden is located on the 7th floor rooftop of the MUSC Shawn Jenkins Children’s hospital. This accessible outdoor garden provides a therapeutic space for patients and families to enjoy the therapeutic interaction of plants and nature to foster healing in an outdoor space designed for children’s imagination. Complete with play area, winding paths, shade trees, native vegetation, and interactive sensory plants and dig spaces, patients are able to safely play and interact with the world around them even while in a hospital setting. The space is the setting for the  occupational therapists and recreational therapists in the Child Life Services Department to work together with the horticultural therapy team to provide safe and fun places for children to develop curiosity and explore the world amongst a  garden in the sky.

Hollings Cancer Center Healing Garden

The Hollings Cancer Center offers state-of-the-art diagnostic therapies and surgical techniques on campus. The Hollings Cancer Center Pearlstine Healing Garden was dedicated in April, 2008. This courtyard garden includes a large sheltered area, a water feature, ornamental trees and accessible paths to quiet spaces. The garden is designed to provide respite for patients and families and an opportunity to be in nature while receiving outpatient treatment at Hollings Cancer Center.  

HT Teams with a Variety of Programs

The horticultural therapy team partners with a number of established programs at MUSC to design and support each individual group’s therapeutic goals serving a variety of patient populations including psyhco-social, emotional, and physical focus areas.

In Patient Programs

Institute of Psychiatry In-patient Child and Adolescent Program

The inpatient program at the Institute of Psychiatry provides brief crisis stabilization of children (5 to 17) with severe emotional disorders. Youth in crisis situations who are a risk to themselves or others learn new skills to better cope at home after discharge. Daily activities on the unit, work on goals such as:

  • daily goal-setting
  • group therapies focused on teaching personal awareness and learning coping skills
  • recreational and activity therapies focused on group socialization, interactions, and cohesiveness

The horticultural therapy team members, in collaboration with the recreational and activity therapists, have designed interactive programming using safe plant materials for patients staying in the facility. The team members provide in-service training for new recreational and occupational therapists at the facility as well as growing and providing plants and plant materials for therapists to use in weekly activities. The horticultural team provides bi-monthly programming in conjunction with the recreational therapy program to offer patients targeted horticultural therapy activities:

  • Seasonal planting and mulching in facility’s secured atrium
  • Flower arranging as a constructive means to express feelings
  • Sensory herb bundles for stress relief and mindful grounding techniques

Outpatient Programs

MUSC Pain Rehabilitation Program

South Carolina’s only comprehensive chronic pain rehabilitation program works to restore function and quality of life for people with chronic pain. The program is suited for people whose chronic pain is negatively affecting their mood, overall health and who are experiencing a decline in quality-of-life. The MUSC Health Pain Rehabilitation Program is a tested, evidence-based model that runs for three weeks.

  • Resume leisure, recreational, volunteer, and work activities
  • Increase physical strength, stamina, and flexibility
  • Learn stress management and relaxation techniques

During the three week program 3 to 5 patients will come to the MUSC Urban Farm to receive one 1.5 hour session at the MUSC Urban Farm location. Sessions include:

  • Ergonomic gardening demonstration, and interactive practice activity to demonstrate recreational activity in a safe manner.
  • Container garden demonstration and planting to provide active movement at standing or seated position.
  • Sensory tour of edible culinary herbs in the garden, cutting herb bundles to take home and calming exercises using plant materials to promote mindful sensory stimulation.

STAR Yarden Horticultural Therapy

The STAR Yarden Program utilizes the garden at the STAR facility, supporting daily treatment provided by therapists and counselors as a co-treatment to traditional therapeutic techniques for children and adolescents. The horticultural therapy sessions are designed to use gardening and plant materials to address three group treatment goals:

  • Increase self-esteem through the connection with the natural world
  • Develop positive coping skills with horticultural activities and connection to nature
  • Enhance suitable socialization skill sets

Groups of 5 to 10 patients participate in 30-minute sessions each Friday throughout their four to six month treatment. Each session is planned and executed by a member of the Grounds Horticulture team and assisted by a STAR program social worker or clinical counselor. Programs are billed as social work.

Horticultural Therapy sessions include:

  • Group garden planning, planting, maintenance, and harvest
  • Group problem solving activities
  • Natural world observations and interaction
  • People-plant relationship development
  • Horticultural crafts

The horticultural therapy sessions continue to make an impact throughout the hospital continuum.

Carmen Ketron, and Noni Langford are urban farm educators and both are graduates of the HT Institute.

Tips for Practice: Beat the Heat!
Working with Patients in all Weather Conditions

By Carmen Ketron, MS, MPA & Noni Langford

The Medical University of South Carolina’s Horticultural Team provides a number of patient centered therapies and programs in indoor and outdoor settings throughout the year. The year 2020 saw an increase in numbers of patient groups that were required to host programs in outside venues to allow for safe, socially distanced offerings. Additionally, MUSC is home to many acres of therapeutic gardens and green spaces that serve as the perfect backdrop for outdoor programming. However, the weather can be dangerously hot and extra temperamental going into the summer months so having a plan and some tips on how to work with patients outdoors in all weather conditions is a must.

Be Health Aware

Working outside in the summer can be warm and glorious. However, in southern climates, mid-day can be dangerously hot, especially for patients who do not regularly do physical activity outside. The hours of 11am to 4pm can be some of the harsher periods in the day and lead to an unpleasant experience no matter how engaging an activity. Whenever possible, try to schedule sessions or appointments in the early morning or late afternoon. This allows for the most opportune time to water and plant as well as a pleasant time to be outside. If sessions need to be in the middle of the day due to scheduling, try to plan activities that can be done under the shade of a tree or in an indoor setting. Another option is to set up pop up tents to place over beds or planting areas.

If a patient does go into a heat induced malady, make sure you can identify what they are actually experiencing. Understanding and identifying the different signs of heat stress, heat exhaustion, and heat stroke are important to administering the proper first aid.

Have Weather Based Plans

Having a plan in case the weather does not cooperate is the benchmark for a safe and effective horticultural therapy program. We set a plan, a threshold, and specialized reaction we should take based on varying weather occurrences.

In coastal South Carolina, we determined what we were most at risk for and developed plans around those potential problems. In the Southeast we are most at risk for flash flooding, hurricanes, earthquakes, and dangerously high temperatures.

At the Medical University of South Carolina we have established some weather based thresholds to help us decide if we need to cancel or pivot our activity indoors. Heavy rain predictions above 80% chance will cause us to cancel or move the session indoors. Additionally, real heat temperatures predicted above 88 degrees Fahrenheit will trigger a cancellation for our activities outdoors because of heat stress potential. Additionally, if we receive alerts that there are lightning strikes within 5 miles of our location, we will cancel completely and seek shelter. We have established a shelter in place plan in case of an earthquake as well as established a location to move to after the quake.

We worked with our enterprise administration, risk management departments, and the safety department to get the best advice and be in compliance with all hospital regulations. We put it on paper in a safety document and offer training to all the new hires as part of the initial onboarding processes.

Additionally, it is always important to have back up activities planned that can be done indoors. We keep supplies on hand to be able to “grab-and-go”. Our favorite indoor activities include clay wildflower seed ball making and mini microgreen pots.

Weather-Based Alerts

Storms, tornados, and earthquakes can come up suddenly and unexpectedly when outdoors. It is important to know when something may be coming your way and to have a plan in place to determine when to seek shelter.

 To help determine if the thresholds we set in our weather plans have been met we use a combination of cell phone applications and emergency weather alert systems from local and state authorities. There are many cell phone applications and sign ups for alerts to send directly to your phone. While weather can be unpredictable, it’s important for any horticultural therapy program to have a plan in place for the safety of all clients.

Carmen Ketron, and Noni Langford are urban farm educators and both are graduates of the HT Institute.