The purpose of this article is to encourage other people to be horticultural therapists and to use plants and gardening to improve people’s well-being, because we can make the difference.
In Spain, my country, interest in horticultural therapy programs is still emerging. For that reason, in 2018 I co-founded the Spanish Horticultural Therapy Association hoping to raise awareness of its enormous benefits to different population groups. We offer short courses, participate in conferences and workshops, study the situation of each horticultural therapy program in the country, and give advice and support to some interesting projects. The road is long, but we feel very passionate about it. Our mantra is “we grow at nature´s rhythm”
I grew up in a small city located in the northwest part of Spain, where nature is basically everywhere. The area is surrounded on one side by the Atlantic Ocean and on the other side by hills, mountains and forest.
When I was around 10, I remember playing with my friends in a nearby forest close to my father’s house. We were trying to find “paradise” riding our bikes through the forest. One day, when I was alone, I decided to explore the forest by myself. That day I found paradise. That image is still stuck in my mind. The sense of achievement, the scents, the colors, the sounds, the sun…what a feeling! I was so excited to tell my friends what I had discovered, so I took them next time. What was paradise for us? A glade of grass and wildflowers with a water creek running across the field, surrounded by trees. That forest is part of our lives. We grew up there playing hide and seek, cooking leaves, discovering insects, having our own girls’ tree (the boys didn’t allow us to use theirs which was bigger), wandering around, harvesting berries during summer time. Also, the Atlantic Ocean and the beach are part of my life. I think I have spent more hours in the sea than fishes! All good memories.
When it was time to go to University, I wanted to study something related to the environment so, I got a degree in Land-Based Engineering in 2005. I specialized in horticulture, landscape and gardening. In one of the landscaping classes, the teacher talked about designing a garden for visually impaired people, and that was a turning point for me. I had never heard about Horticulture as Therapy until then. I worked in plant production and other different projects. Always feeling lucky to work with and in nature, despite weather conditions. Valuing being outside, hearing the birds, smelling the scents of the flowers, always learning new lessons… Time went by and I moved to the UK where I finally studied Social and Therapeutic Horticulture, because in Spain until now there are no official courses or university degrees in this field.
I spent a year immersed in the horticultural therapy world, reading, studying, learning and writing. At the same time I started volunteering in a garden project working with adults and young people with additional support learning needs, physical mobility difficulties and mental health issues. I have also helped groups of elderly with early stages of dementia and Alzheimer’s. It was great to discover how meaningful activities in the garden can make an impact on the quality of life of this population group.
One of the sweetest stories I recall was a lady with Alzheimer’s who took part of the eight-week gardening program, funded by a local charity for the elderly. The group attended the garden once a week for three hours. During that period of time they tended the garden, contemplated the garden, enjoyed a cup of tea and chatted with peers. This lady wasn’t interested at all in garden activities, she always wanted to go back home after a while most of the days, but we encouraged her to enjoy the garden. I still remember her reaction when she saw the tray of lettuces that she had sown two weeks before. She couldn’t believe her eyes! She became very emotional! When we were close to the end of the eight sessions her family was willing to pay for more sessions as they could see how gardening had boosted her well being. Just attending one session per week, she was able to socialize, spend some time outdoors and reconnect with her memories. Before attending the program she lived in a nutshell, after two months her mind was active again.
In 2017, I got my first job as an Occupational Therapist Assistant, working with adults (18-65 years old) with mental health issues and learning difficulties in a mental health rehab unit, where there was a garden with three raised beds and a polytunnel. It was an ideal location for a horticultural therapist! I must confess that it took me some time to convince my colleagues (psychiatrist, psychologist, nurses and healthcare workers) that I wasn’t just entertaining patients. It was more than that.
Patients are referred to this hospital for their social inclusion. Most of them were in treatment for more than five years, few even more than 15, in different hospitals. Some of them were referred from prisons. Because they have spent so many years in treatments and therapies, our job was harder motivating them. The goals of our gardening program aimed to enhance: independence, responsibility, creativity, routines, math skills, budgeting, and so on. I also focused on improving their lifestyle habits by promoting physical activity, and introducing them to fresh vegetables and fruits. Most patients with severe mental health issues were obese as a side effect of medication, a poor diet and a lack of physical activity.
The gardening program was based in a small building in the garden, attached to the hospital, where the patients loved to go for a chat. It was their time to be “far” from the ward for a while, their sanctuary. Being outdoors in the garden, invited them to share their feelings and thoughts. They socialized and felt less isolated. Some of them weren’t actively involved in gardening activities but appreciated and praised the hard work of their peers. Together we improved the entire garden area, flower and vegetable beds, and fed the birds (squirrels as well), all of which attracted wildlife in the garden … it was heaven!
The hospital is in a small village and the neighbours were not happy with its presence. They had a very negative idea about the hospital and its patients, so part of my job was to develop strategies to reduce that stigma. We worked with the local parish council in order to keep and maintain the hospital’s surroundings. I remember one person, a neighbour, passing by clapping his hands and saying “thank you” when we were planting new flowers. We also sold part of our garden produce (everything was organic) to the local hotel and all the money we earned was invested in our garden. I also asked my colleagues to donate unused gardening tools in order to get them involved. We decorated the hospital’s entrance with pots so that everyone could see them. The patients took on the role of picking up litter as part of the onsite Real Work Opportunities. All these actions helped to reduce the amount of neighbours’ complaints.
I can happily say that all the patients I have worked with have left the hospital asking to live in a place with a garden or keep growing vegetables. These outcomes make you value being a 2018_ Co-founder of the Spanish Horticultural Therapy Association. For more information go to www.vitaminaverde.es
Dear Leila,
I appreciate your insightful contribution to the discourse on Horticultural Therapy. My exposure to this therapeutic modality stems from my enrollment in a Sustainable Urban Food Systems course. As a clinician working with foreign-born survivors of torture in the United States, I am consistently seeking innovative and culturally relevant therapeutic approaches.
Considering your expertise, I am curious if, over the course of your experience in the field, you have observed a growing receptiveness among mental health professionals toward embracing Horticultural Therapy and acknowledging its efficacy. Silva-Rodriguez Bonazzi’s recent work (2022) underscores the motivational and stress-coping benefits of horticultural interventions, particularly their positive impact on PTSD symptom reduction. Emerging research suggests that survivors of trauma may find solace in therapeutic modalities involving physical movement, deviating from traditional talk therapy. This observation resonates with my experiences in working with refugees and immigrants, where cultural nuances often pose barriers to traditional therapeutic interventions.
The holistic nature of Horticultural Therapy, recognizing both the physiological and nonverbal dimensions of a survivor’s experience and the psychological dimensions, made this modality stand out immediately. This approach seems to offer a natural trajectory for healing, potentially addressing PTSD and displacement trauma in the refugee and immigrant populations. Your discussion of reducing stigma between community members, patients, and the mental health rehabilitation unit through incorporating Horticultural Therapy was also particularly compelling. Given the communal aspects inherent in this therapeutic approach, I am optimistic about its potential to mitigate societal stigma surrounding refugees and immigrants in the communities where they resettle.
Reports show that Spain has received a record number of claims for refugee status and international protection in 2022 (O’Mahony, 2023) due to Russia’s war in Ukraine, conflicts in Africa, and the political crises taking place in Latin America. With that in mind, in your opinion, would offering Horticultural Therapy to this population be beneficial in the treatment of any mental health conditions they may arrive with or develop? Additionally, would this approach be accepted and supported by funding? Spain has historically been known for having more welcoming attitudes towards refugees than many other countries, which made me wonder if this would be an ideal location to implement such programming to serve as an example of its benefits to the international community. In my research on utilizing Horticultural Therapy for this population, I found little to no programming available—with most programs geared towards gardening as a pathway to the labor market versus a path to increased mental health.
Your post also touched on the importance of introducing fresh fruits and vegetables into the diets of the individuals you served. I found this to hold an interesting and dichotomous connection with the immigrant and refugee population, as they often come from cultures where fresh produce is a mainstay in their diets and, upon resettling (at least in the United States), end up having much poorer diets which then contribute to physical health issues that can also exacerbate existing mental health issues. Sastre et. Al (2015) reports, “Resettlement guidelines place refugees near grocery stores and public transportation; however, these stores are often not appropriate for the cultural or religious food preferences and practices of many groups… The high prevalence of food insecurity cited in other studies and the preferences and skills to grow and eat fresh foods reported here may support the need for improvements to ensure access to green spaces for refugees resettled in US urban environments.” As food holds such cultural importance, the absence of culturally relevant foods in their diet also affects their mental health. While some movements have called for initiatives where individuals can grow their own food, I have also seen extreme opinions against allowing individuals to grow food from their country of origin, stating it poses a danger to the indigenous plants in the areas where they resettle. I would be very curious to hear your perspective on this issue.
I look forward to your insights on this topic and any additional reflections you may offer on the evolving landscape of Horticultural Therapy within the mental health domain.