Note: the following article was originally written in French, and can be viewed in French here.
“What am I?” answers Andreas Niepel when I ask him to introduce himself and describe his background during our encounter by videoconference. “I am a gardener.” Then he goes into detail.
“While working in a hospital during my military service I discovered the social and therapeutic value of gardening. Then my first job led me to plant production, which I hated. I wanted to combine gardening and people and become a therapeutic gardener one day. But that didn’t exist at the time. When you have a dream, you either realize it or you forget it.” Andreas did not put his dream aside. On the contrary, he has become a driving force in Germany and far beyond, practicing, teaching, writing and federating the growing garden therapy community.
Thirty Years of Experience
Andreas joined a clinic specializing in neurological and neurosurgical rehabilitation in Hattingen, North Rhine-Westphalia – today known as VAMED Klinik Hattingen – where he has been head of the garden/horticultural therapy department since 1992.
At the same time, he launched his own consulting company in the field of therapeutic gardens (Andreas Niepel Grünplanung) and an institute called “Gardens help live“, thanks to which he gives training courses and seminars in Germany, but also in Poland, in the Czech Republic, and in Iraq.
Spreading the culture of care through the garden inevitably involves writing, in Germany and other countries, if we want to get away from our dependence on English. It is not only a question of language, since different sensitivities can emerge. Andreas has several books to his credit. “Garten und Therapie – Wege zur Barrierefreiheit” (together with Silke Emmrich, published by Eugen Ulmer, 2005), “Gartentherapie” (published by the German Association of Occupational Therapists), “Praxisbuch Gartentherapie” (together with Thomas Pfister, 2009), to name but a few.
Since 2009, his mission has also included the chairmanship of the Internationale Gesellschaft Gartentherapie (IGGT), the International Society for Garden Therapy, which brings together existing associations. “It is an “umbrella” organization whose members are all institutions, associations, e.g. of occupational therapists, and universities. The objective is to work together for a quality development of our practices.”
Development of “gartentherapie” in Germany
“In Germany, it all starts with psychiatry, like Pinel in France and Benjamin Rush in the United States, with patients working in the fields,” Andreas explains. “And then came the Nazis. For years after the war, it was impossible to think about having people work in the fields again. Finally, at the end of the 1980s, Konrad Neuberger, a psychotherapist and co-founder of the IGGT, came along and revived the movement. It was like an empty field with little flowers growing here and there: social workers, educationalists creating gardens…”
For his part, Andreas feels he was lucky. “I started in this clinic at ground zero. The founder had a personal interest in gardening. He asked me to write a text about the effects that could be expected for the patients. The idea was that the garden would become another ‘room’ of care.” The Hattingen gardener cites a figure: almost three out of four Germans have a garden or would like one. “So imagine that among our patients! There was no argument against the benefits as a therapeutic intervention.” In September 2022, Andreas celebrated his 30th anniversary on the job at the Hattingen clinic.
“Our program, like many others in Germany, developed by starting small and especially by collaborating with other professions: occupational therapists, pedagogues, psychologists. We did joint projects, they saw the potential of the gardens in a holistic approach”, Andreas explains. “The art and music therapists were less interested. For us, the goal was to decrease some of the difficulties and increase the resources of the patients to improve their quality of life. We talk about health promotion, the boundaries are close to pedagogy or education.”
Horticultural Therapy vs. gartentherapie
At this point, it is necessary to clarify the terms used. “At first in German, we spoke of horticultural therapy. When I went to the United States for the first time, I realized that in order to talk about horticultural therapy in this country, the patient has to be active. The patient has to plant something, to have an action in the garden. In Germany, we consider that for a person with dementia, for example, to sit quietly with the group, to relive memories, to be fascinated with their senses awake, is important.” Thus, the term that is most used in Germany today is “gartentherapie.”
“Garden therapy is a participant-centered process in which trained experts define and verify individual goals and plan and use garden or plant-related activities as therapeutic tools to promote health-related aspects of the participants,” according to a text from the Hochschule für Agrar- und Umweltpädagogik in Vienna (University College of Agrarian and Environmental Pedagogy), a member of the IGGT that we got to know through Birgit Steininger.
“I work with patients who have had strokes. We start the work very early, at the bedside. They have deficits in nature. I think of this old lady we took out to the garden in a wheelchair. She started crying and said she hadn’t been outside for a year. We didn’t ‘do’ anything together.” When Andreas brings up this anecdote, I tell him about Oliver Sachs, who tells the story of his first trip to a garden after a serious accident so eloquently.
The neurologist Oliver Sachs becomes a patient after a serious accident. He leaves his room for the first time after a month of hospitalization. “Pure joy and intense happiness, ineffable happiness of the sun on my face, of the wind in my hair, of the sound of the birds, of the caress and the spectacle of the living plants that I could touch with my fingers. An essential link, a communication with nature had just been re-established after the horrible isolation and alienation I had gone through. When I was taken to the garden, a part of me came back to life, a part of me that was starving, perhaps dead without my knowledge.” A sick or injured person, Sachs writes, by definition needs an “in-between”, “a quiet place, a shelter, a refuge”. One cannot “throw oneself back into the world all at once” (quoted in “The Well Gardened Mind” by Sue Stuart Smith).
“In intensive care, we don’t work with plants, we work with imagination. Did you have a garden? You can close your eyes and transport yourself there. The next step is to bring in pictures of their garden. This is gartentherapy, but it’s not horticultural therapy”, says Andreas. “Where do we place horticultural therapy in the biopsychosocial model? We’ve talked about it to define our practices. In fact, this model does not go far enough. Nature has an impact on the human being that is not taken into account in the biopsychosocial model. We have known since the 1960s that we can be ecologically ill. For us, it is an ecological therapy in contact with nature.”
An Accepted and Evolving Therapy
“From the beginning, it was clear that these approaches were accepted. But was it serious? Was it therapeutic? The first level was acceptance by colleagues, patients and their families. At first, patients liked this mediation very much, but did not consider it as a therapy like any other. Then research and studies showed that they were extremely satisfied with gartentherapy.”
The second step is the relatives. “In nursing homes, we know that the people we talk to are the families. They ask for their parent to go out and garden because it has always been one of their favorite daily activities.” And then come the institutions. “In 2023, a major German insurance company will launch a program with the IGGT to bring more gartentherapy into institutions. Gartentherapy falls within the scope of prevention and health promotion.”
“We can also talk about an acceptance from within. For the past 20 or 30 years, many disciplines have contributed and brought diversity to our practice. Assessments can be made from many different perspectives and we benefit from this diversity,” Andreas explains. “As a result, our discipline has gone in directions that were not originally planned.”
One of these directions is health promotion and prevention. “Prevention had a second-class therapy status. But if you look at what therapy should do, according to the Greeks, it’s ‘Primum non nocere.’ First do no harm. Not to the patients, not to the caregivers. What about psychological needs? Being confined for six weeks in a ward could well hurt you. In order not to harm the patients, you need to keep a social contact, a contact with nature. Allow them to enjoy, to have fun, to be themselves.”
Training and Certification, Two Essential Links
“Training developed in Germany, in Switzerland at the University of Zurich and in Austria at the Hochschule für Agrar- und Umweltpädagogik in Vienna, which offers one of the oldest training programs. However, the programs were all different and one of the first tasks of the IGGT was to harmonize them. At any given time in the German-speaking countries, about 100 people are being trained in our discipline.”
Another focus of the IGGT is certification. “Who can call themselves a ‘registrierter Gartentherapeut?’ We have devised a point system according to the profession, further education, experience and practice. This is a key point for the quality of the profession. Currently, we have about 70 ‘registrierter Gartentherapeut’ and many more who are not.”
Where are there programs in Germany? “Many work with elderly people with dementia. I would say that in Germany 90% of the institutions for these people have a special garden. There are between 400 and 500 programs. Rehabilitation like the clinic where I work is another important area as well as psychiatry and the field of addictions with more than 50 programs. Finally, sheltered work programs for people with disabilities are common. As a result of Covid, a growing number of projects involve children and youth.”
With 30 years of experience, Andreas can draw on his experience to identify challenges and opportunities. “I see development. I also see waves. In the 1990s, creative disciplines such as art and music therapy were popular, but then their popularity declined. In the late 90s and early 2000s, gardening was going strong. And then we saw robotics and computer-assisted programs come in and nature took a back seat. But we’re coming back from that.”
“The most important thing is that we can define ourselves. When we started combining gardening and therapy, we brought together a wide variety of disciplines to get to where we are today. With Covid, everyone saw that the garden was their personal therapy. For my grandfather, the garden was primarily economic. For me, it was ecological, meaning for nature. Today, what brings us to the garden in Germany? Our soul, our spirit. The garden gives us energy and calms us down. Covid has shown that we all need the garden.”
And he concludes our marathon interview talking about a program aimed at young people: “This winter, I participated in a program with young people – they were the ones who suffered most from Covid. The idea that “others are dangerous” has become a common one. They are more stressed than I was at their age,” notes Andreas. “Well, we planted together. The idea that their plants might not grow was considered a failure. “Learning to fail” became a theme. So how do you motivate them? As a therapist, what resources can I draw on in them? We often send them negative images, for example that they are always on their screens. Well, they posted what we did on Instagram. And there, they felt capable.” Adaptation, is a key word for any therapist.