Seeds of Recovery

Horticultural therapists cultivate the curative power of gardening.

Mark Wexler
Nature and Health
Apr 01, 2021

Residents of a senior living facility tend plants as part of a program to connect elders with the healing power of nature. Therapist Joel Flagler (below, at left) shows a recovering stroke survivor how to use adjustable planting tools.

WHEN JOEL FLAGLER TAKES ON new clients, many are dubious at first. “They haven’t had gardening experience, and they’re sure that any seed we give them won’t grow,” says the Rutgers University horticultural therapy professor. But as their seeds germinate and develop into thriving plants, “it demonstrates that a person’s actions can make a difference,” he says. “Having success with plants, we find, can help our clients deal better with other issues in their lives,” including cancer, strokes and addictions.

Flagler is among a growing number of professionally registered specialists who are applying elements of botany, biology, physiology and psychology to prescribed gardening activities for debilitated people in retirement facilities, hospitals, schools, prisons and private homes. Their therapeutic settings often include colorful native plants as well as fragrant herbs. “These gardens provide intentional opportunities for users to enjoy powerful stimuli from nature,” says Patty Cassidy, a horticultural therapist who works with elderly patients in Portland, Oregon.

Therapist Joel Flagler demonstrates the use of adjustable planting tools to a recovering stroke victim

Medical professionals have long touted the health benefits of gardening, and several studies confirm that cultivating plants can lessen the effects of a wide range of human disorders. In one study, Swiss researchers reported that people with extreme muscle, tendon and bone soreness who took part in a four-week garden program showed significant improvement in their ability to live with chronic pain. In another, Norwegian scientists found that patients with clinical depression who participated in therapeutic gardening activities for three months experienced reduced depression and increased attentional capacity that lasted at least three months after the program had ended.

“Horticultural therapy doesn’t make a problem go away, but it’s an intervention that helps bring about positive change,” says Flagler. Like his colleagues, he designs specific activities for different groups that enable him to evaluate their improvement, based in part on clinically defined goals established by the nonprofit American Horticultural Therapy Association.

To encourage behavioral changes in veterans suffering from post-traumatic stress disorder, for example, Flagler conducts group therapy sessions in quiet, nonthreatening outdoor locations where the former soldiers can share their stories while performing simple gardening tasks.

“Horticultural settings provide an atmosphere in which it may be easier for people to relate to one another,” says Cassidy, who helps clients with memory problems by having them grow plants they recall from their pasts. Digging in dirt also can stimulate the production of serotonin, sometimes called the “happy chemical” for its upbeat effects on people. “All of us can benefit from digging in the soil,” Flagler says.

That includes people confined in prisons. “A lot of individuals who are incarcerated come to our program thinking soil is dirty and dangerous and that all bugs are bad,” says Hilda Krus, a horticultural therapist who directs the nation’s longest-running prison-gardening program on Rikers Island in New York City. The project began in the mid-1980s as a job-training program, but soon Krus and her colleagues realized the therapeutic potential of their work. “We consistently noticed positive mood changes in the men and women who spent time in the gardens,” she says.

On New York's Rikers Island, inmates participate in the nation’s longest-running prison-gardening program.

“Predictable rhythms”

To help participants overcome fear of bees and other wildlife, Krus teaches them about the animals’ ecological roles in the native-plant habitats they are creating. After COVID-19 forced authorities to temporarily close the prison’s seven gardens last spring, Krus and her team continued doing therapy remotely via computer. According to a Columbia University study, detainees who participated in the program had a 40 percent lower reconviction rate than Rikers’ general population.

Because plants native to a gardener’s region require relatively little maintenance, they are especially appropriate for debilitated clients—while at the same time attracting more wildlife than nonnative species. Wheelchair users or people with mobility issues, meanwhile, can grow pollen-rich plants at a comfortable level by using rectangular raised garden beds with adjacent seats. “The height can vary, but the width should be about an arm’s length so you won’t lose your balance reaching across the bed,” says Cassidy. People who need to work standing up to reduce pressure on their lower backs or knees can lure hummingbirds and other wildlife to their yards and decks by cultivating fruiting or flowering native vines (such as trumpet creeper) vertically on trellises, fences or walls.

As they grow, says Flagler, “plants provide certain predictable rhythms that are very comforting to us, particularly during these uncertain times.” As the pandemic and its aftermath grind on across the country, he adds, cultivating gardens “can help stabilize us when we’re feeling down and shaky.”

Mark Wexler is editor-at-large.