Horticultural Therapy Methods

Connecting People and Plants in Health Care, Human Services, and Therapeutic Programs, Second Edition

Rebecca L. Haller, Christine L. Capra, Rebecca L. Haller, Christine L. Capra

• Publisher: CRC Press
• Year: 2016
• ISBN:
  9781315352862
• Edition: 2
• Topic: Medicine
• Subtopic: Physiotherapy, Physical Medicine & Rehabilitation

Horticultural therapy has evolved from its use only by volunteer gardeners to become a recognized and respected therapeutic modality conducted by trained, registered professionals. Horticultural Therapy Methods is the first textbook to describe the processes and techniques used to provide horticultural therapy interventions and the rationale for their use. This book presents types of programs, settings, and goals in horticultural therapy. It outlines treatment planning; development of sessions to meet treatment objectives; motivation and behavior management techniques; documentation guidelines; practical approaches for wellness; and resources for activity ideas.

New to this Edition:

• Various useful examples of horticultural therapy in practice and strategically placed tips and resources.
• Additions to appendix on horticultural therapy treatment strategies.
• New chapter on session planning.
• Thirty-seven photographs demonstrating horticultural therapy in practice.
• Additional "HT Practice" examples and tips.

The book is used as a reference and a guide for students, educators, and those conducting horticultural therapy or therapeutic horticulture to guide them in constructing effective treatment programs. Health care and human service professionals use the reference in the therapy, treatment, and education of inmates, residents, patients, trainees, students, and other participants.

chapter one

The framework

Rebecca L. Haller

Contents

Introduction

Shaping a profession

Practitioners

Educators

Researchers

Professional associations

Volunteers

Regulators and employers

Clients/participants

Horticultural therapy defined

Program settings, types, and goals

Settings

Types

Goals

Understanding the people served

Horticulture as a therapeutic modality

Encourages human growth

Offers restoration

Addresses innate psychological needs

Offers versatility

Has meaning and purpose

Impacts others

Summary

References

Introduction

Whatever it is that calls the gardener to the garden, it is strong, primeval and infinitely rewarding.

Lauren Springer
The Undaunted Gardener, 1994

Horticultural therapy offers positive and rewarding experiences for program participants, therapists, and those who come into contact with the growing environment. People involved in these programs intuitively know the many benefits and joys derived from connecting with nature (Figure 1.1). The attraction to engage in horticultural therapy activities may stem from a deeper “pull,” in addition to the visible positive effects. Beneath the surface of this life-enhancing practice lie the conscious steps that are employed by the horticultural therapist to provide therapeutic programs. As an emerging profession, horticultural therapy continues to utilize the techniques practiced by many related health and human service fields—notably psychology, occupational therapy, vocational rehabilitation, social work, therapeutic recreation, and education. Much has been written about the reasoning and processes that are employed in these and other fields of human service. Theoretical bases for practice vary by setting, population, and therapeutic approach. However, the basic processes used are remarkably similar across disciplines. Horticultural therapy practitioners who adopt these accepted treatment procedures are able to positively impact the quality of their services and the profession as a whole.

Figure 1.1 Gardening offers a nature connection. Photo by Rebecca Haller.

This chapter provides a framework for discussion of the processes and techniques outlined in later sections of this manual. Included are systems and events that shape the horticultural therapy profession, a working definition of horticultural therapy, an overview of program types and the people served, and reflections on the significance of horticulture as a therapeutic medium.

Shaping a profession

The practice of horticultural therapy has progressed from an 1800s belief that working in the agricultural fields could benefit mental patients, to the use of gardening as activity and therapy for physical rehabilitation in the early 1900s, to the presence of many types of programming and settings in the 2000s. Entities that have influenced—and continue to shape—the profession of horticultural therapy include practitioners, educators, researchers, professional associations, volunteers, regulators, and employers, as well as clients or participants.

Practitioners

Since the mid-1900s, horticultural therapy has been used by mental health professionals, occupational therapists, physical rehabilitation specialists, and vocational service providers, as well as other human service providers. In some settings, horticultural therapists work closely, or co-treat, with allied professionals to maximize outcomes and benefits to clients. The profession is characterized by a prevalence of practitioners who are willing to share information freely and are open to new ideas and approaches. A healthy variety of program models results largely from the creativity and dedication of these diverse professionals.

Educators

Horticultural therapy education and training programs have led efforts to produce research, helped to define the profession through curricula content, and have been well-represented in establishing credentialing standards. Historically, and currently, most educational programs are based in horticulture or plant science departments of colleges and universities, or in horticultural therapy certificate programs. Seldom are they found in human science or health-care facilities. Future curricula with a balanced proportion of human services and social science courses are needed to reflect the interdisciplinary competencies required of horticultural therapists who wish to practice in health-care or social service arenas (Starling et al. 2014) (Figure 1.2).

Figure 1.2 Horticultural therapy education helps to shape the profession through curriculum and training. Photo by Christine Capra, Horticultural Therapy Institute.

Researchers

Many benefits of horticultural therapy have been portrayed anecdotally in publications over the past 50 years. Research that documents outcomes and efficacy also exists but is much less plentiful. The need for strong research as a base for the profession cannot be overstated. Practitioners, educators, and researchers from relevant disciplines must team together to carry out and publish research that employs sound social science methods. This is critical for future funding, employment, and excellence in practice.

Professional associations

In the United States, the American Horticultural Therapy Association (AHTA) and its regional networking groups have focused on information dissemination through publications, conferences, and networking. In order to advance the practice of horticultural therapy and expand employment options, future efforts must include strong advocacy and the promotion of the profession to health-care and human services providers as well as regulatory and insurance leaders (Haller 2003).

Another important activity of AHTA is to create and manage a credentialing system—currently a voluntary professional registration system based on interdisciplinary education and a supervised internship. This system has recognized the scarcity of university degrees in horticultural therapy and has formerly given credit for a wide array of education and experiences. AHTA plans that future standards will include a certification exam based on job knowledge and skills (Starling et al. 2014).

Similar associations exist across the globe, including in Canada, Japan, Australia, the U.K., and others.

Volunteers

Since the mid-1900s, volunteers have brought gardening activities to residents of prisons, hospitals, long-term care, and others—usually at no cost. Garden club members and master gardeners have been especially active in developing programs utilizing their training and experience in horticulture. Health-care or human services education is seldom required, resulting in programs of varied therapeutic value. Distinguishing between horticultural therapy programs and articulating a monetary value for volunteer services can help to eliminate the confusion that exists among administrators and potential employers. When volunteers serve as resources for programs led by trained horticultural therapists, optimum conditions for sustainability and effectiveness exist.

Regulators and employers

Employers commonly look to supplemental funding bases to operate horticultural therapy programs. Private donations of money, materials and labor, self-earned income from sales of plant products, and program grants are frequently vital to the provision of program funding. In health care, insurance companies regard horticultural therapy services as reimbursable only when they are framed within strict guidelines such as for training or co-treatment.

In order for the practice of horticultural therapy to be regarded as effective and fundable by administrators, insurance companies, and regulators, the following nationally coordinated actions must be taken: build a strong research base, apply standard treatment procedures to practice, develop a rigorous credentialing system, and advocate for the profession.

Clients/participants

The people serving in horticultural therapy programs play a role in how programs evolve. With a trend toward client-centered care, those involved may direct treatment plans and choose therapies, placements, and pursuits in which to be engaged. As more consumers understand the benefits of using horticulture as a tool for therapy and rehabilitation, they are more likely to choose the organizations that offer this service. For example, an individual may prefer to live in an assisted-living or long-term care facility that has a gardening program as an option for ongoing activity. This may give the organization a competitive edge and the motivation to continue or expand horticultural therapy programming.

Horticultural therapy defined

As might be expected for a relatively young profession with diverse applications, a full spectrum of published definitions of horticultural therapy exists. Definitions encompass strict portrayals of horticultural therapy in health-care terminology as well as those that broadly include any beneficial horticultural experience (Dorn and Relf 1995). Recent authors have generally defined horticultural therapy more narrowly while using alternate terminology for the positive effects that gardening and passive garden exposure can have on the general population (Matsuo 1992, Sempik et al. 2003, Diehl 2007). In 2007, the AHTA described four types of horticultural therapy programs, including horticultural therapy, therapeutic horticulture, social horticulture, and vocational horticulture (Diehl 2007). Some horticultural therapists now refer to their programs as therapeutic horticulture, particularly those that include active and/or passive involvement with plant-related activities that do not focus on clinically defined treatment goals. Thrive, an organization in the U.K., uses the terms “social and therapeutic horticulture” to describe a full range of program types and purposes for health and well-being (Thrive 2015).

The following definition is also presented to describe horticultural therapy in its many forms:

Horticultural therapy is a professionally conducted client-centered treatment modality that utilizes horticulture activities to meet specific therapeutic or rehabilitative goals of its participants. The focus is to maximize social, cognitive, physical and/or psychological functioning, and/or to enhance general health and wellness.

This definition includes three elements as described by Dorn and Relf (1995): the clients served, therapy goals, and treatment activities. They describe horticultural therapy as a practice that serves defined client groups (those with identified therapeutic or rehabilitati...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Foreword
• Preface
• Acknowledgments
• Editors
• Authors
• Contributors
• Chapter 1 The framework
• Chapter 2 Goals and treatment planning: The process
• Chapter 3 Activity planning: Developing horticultural therapy activities and tasks
• Chapter 4 Working with program participants: Techniques for therapists, trainers, and program facilitators
• Chapter 5 Planning horticultural therapy treatment sessions
• Chapter 6 Documentation: The professional process of recording treatment plans, process, and outcomes
• Appendix I
• Appendix II
• Appendix III
• Appendix IV
• Index