Nature-assisted Therapy…Garden Therapy…the list goes on!
How does one distinguish horticultural therapy from all others?
By Colleen Griffin, HTR
The above question is addressed in every course at the Horticultural Therapy Institute, from Fundamentals through Management. For students learning what horticultural therapy (HT) is and how it is utilized, similar sounding terms can cause confusion. Active practitioners of HT find the need to “define” their practice is incessant. Since the pandemic, a societal shift has occurred and increasingly, people began seeking out natural environments and using time in nature as a method for the prevention and mitigation of stress-related illnesses. Out of this increased exposure to nature, the perceived need for outdoor therapies has flourished. To distinguish one therapeutic practice from another, terms and descriptions were developed. Many times, the descriptions overlap, resulting in some disorientation as to the specific purpose or focus of a therapeutic practice. The following is an effort to categorize some of the more common “green therapy” practices used today to better understand similarities and differences.
Eco-therapy
Currently, there is very little consensus as to a definition for the term “eco-therapy”. The American Psychological Association (APA) describes the term eco-therapy as covering a wide range of interventions, not all of which are evidence-based. What is agreed upon is that eco-therapy was born from the academic discipline of ecopsychology. Howard Clinebell, PhD, a pastoral counselor, was one of the first to use the term “eco-therapy” in his book Ecotherapy: Healing Ourselves, Healing the Earth, which was published in 1996. Eco-therapy as a descriptive term is often used in conjunction with wellness practices that may not be evidence-based nor conducted by a trained therapist. It is frequently used as an umbrella term for any wellness activity that is conducted outdoors. An example would be walk and talk therapy, where a professionally trained mental health counselor conducts therapy sessions outdoors, while strolling through a natural environment with their client. In contrast, if an individual is listening to a self-guided meditation session on their phone while sitting quietly in a green space, is this also ecotherapy? This is not to say that participants don’t receive health benefits from this type of outdoor activity, but how does one identify a professional therapeutic practice from a wellness activity. The answer may be in identifying the differences between evidence-based therapeutic practices and wellness activities. To better understand these differences let’s look at a selection of therapies that have been referred to as “eco-therapy”.
Natural Environment Therapies
These therapiesoccur outdoors and are well suited to able bodied individuals. They have been successful in treating teenagers and young adults with mental health challenges.The include the following:
Wilderness Therapy, which began as a therapeutic intervention in the mid-1990’s, involves remote, immersive experiences like multi-day backpacking trips and it is commonly used for substance abuse and behavioral problems. Wilderness therapy is commonly identified as an evidence-based therapeutic intervention conducted by trained and credentialed mental health professionals.
Outdoor Adventure Therapy uses green spaces and physically challenging experiences that will hone resilience, confidence and coping skills for participants. Challenge-based activities, in the form of group tasks, are utilized for a wide range of interventions. A trained professional is not necessarily involved. Evidence-based studies have been difficult to quantify due to the broad structure of activities.
Forest Therapy or Shinrin-yoku, focuses on using all five senses and meditation/grounding practices while being immersed in a forest setting and is commonly used as a wellness practice to improve health and well-being. Forest therapy is conducted by a trained forest therapy guide and is accessible to able bodied individuals.
Surf Therapy is often used as an intervention choice within a mental health program. This practice should not be confused with Adaptive Surfing that is formally recognized by the International Surfing Association. Surf therapy is considered a “blue therapy” and has proven successful as a trauma-informed therapeutic intervention when used with teens and young adults.
Nature-Based Therapy
Nature-based therapies are generally intervention-based programs using activities and experiences specifically designed to meet the needs of the participants. Participants range in age from young children to older adults and all abilities are served. They include:
Green Care Farms have been used very successfully across Europe and have been especially successful with older adults with memory issues such as dementia. Some green care farm programs are residential while others are conducted in a day care format. Purposeful agricultural activities are combined with medical care services that improve and maintain a participant’s quality of life. In most cases a team approach to a participant’s care is utilized.
Horticultural Therapy is a client centered treatment modality facilitated by a trained professional to meet specific therapeutic, vocational or rehabilitation goals of the client. Horticultural therapy (HT) and therapeutic horticulture (TH) are conducted year-round, indoors as well as outdoors, and serve clients of all ages and abilities. Horticultural therapy is conducted by a trained professional.
Garden Therapy is often confused with the professional practice of horticultural therapy. Garden therapy is a term used by garden clubs in the US. and is not a professional therapeutic practice but rather a social activity conducted by garden club members. This term is also used outside the US, typically in European countries, to describe therapeutic practices that involve plants and nature.
What makes HT/TH different from other eco-therapies?
A hallmark of horticultural therapy and therapeutic horticulture is the interaction between the client, the plant and a trained therapist to achieve a specific goal. The practice of HT and TH are formally recognized and supported through the American Horticultural Therapy Association (AHTA). Both HT and TH are proven to work well in group sessions as well as individual or private sessions.
Lastly, Hortophilia is a term developed by Oliver Sacks, MD to describe the innate need for humans to interact with plants. Through this interaction humans gain cognitive, psychological, emotional and physical benefit. The HT/TH is trained to utilize this interaction, also referred to as the people-plant relationship for the benefit of reaching therapeutic, rehabilitation or vocational goals specific to the client.
