Rachel Freeman, assistant lecturer in horticulture at the Institute of Technology Blanchardstown, shares her knowledge of the social and therapeutic benefits of horticulture
There is a renewed interest in horticulture and the outdoors, this time with the fresh perspective: gardening is good for your health. Reports in print and social media extol the virtues of time spent outdoors, gardening, growing your own food, and the benefits of green space in our immediate environment.
This comes at a time when much of society is experiencing a significant disconnect with our environments. A report published in the UK earlier this year showed that three-quarters of UK children spend less time outdoors than prison inmates.
Societal changes, particularly those in the last 200 to 300 years, have given rise to a number of changes such as urbanisation, increased use of technology and a more sedentary lifestyle, all of which means we spend increasing amounts of time away from plant filled natural environments. In 1984 Edward O Wilson coined the term ‘biophilia’
and defined it as the ‘connections that human beings subconsciously seek with the rest of life’. Wilson believed that as humans we have deep subconscious affiliations with other living things as a product of our evolution. Early man needed to define his environment, knowing which plant provided food or a source of water. As a result, an evolutionary affinity with plants was developed which still exists today.
20 odd years ago, this was an emerging area of horticulture, the body of research available providing an evidence base for practice was limited. Back then, the odd time I mentioned horticulture therapy, I got one of two reactions: ‘Hmmmm, yes, interesting’ and ‘Sorry, what’s that?’ The situation has changed as a result of increased interest and greater dissemination through mainstream media, and most people are aware of the benefits of contact with plants and natural environments.
HORTICULTURE FOR HUMAN HEALTH
Through publications and associated research, it is evident that contact with plants has demonstrated positive outcomes with a wide array of conditions and situations, for example, intellectual and physical disability, visual impairment, dementia, post-traumatic stress disorder, depression, anxiety, stress, autism, deprived communities, and reducing unemployment, child development to name but a few.
Until recently, the dearth of consumer articles on the subject could fool one into thinking this is a new phenomenon but the use of horticulture to improve human health and wellbeing is nothing new; centuries-old evidence offers examples of the healing benefits of plants and use of the outdoors for improvement in human health.
Healing places of ancient Egypt, Greece and Rome, monasteries and early hospital settings along with their grounds were highly regarded as medicinal places. In ancient Egypt for example, the pharaoh’s physician prescribed ‘a spell in the palace gardens for those troubled of mind’. Gardens and outdoor space were considered as restorative and medicinal; these facilities were often set in scenic countryside locations with substantial grounds surrounding each establishment, with features such as central atriums, courtyard gardens and monastic cloister gardens being key components of the medical and restorative services offered. This construct of facility and garden as one unit gave easy access to plants and the outdoors for fresh air, light exercise, or simply for a view.
Horticulture activities were part of the treatment processes. Asylum records noted ‘Male patients shall be employed in gardening and husbandry… to promote cheerfulness and happiness’. Dr. Benjamin Rush, a late 18th-century American psychiatrist, found that ‘Field labour in a farm setting had curative effects on people who were mentally ill’.
Historically this therapeutic value of horticulture was understood and widely used. This connection was lost through societal and demographic changes, and modernisation of medicine, particularly during the late 19th and 20th centuries.
However, things are coming full circle, and increasingly horticultural practices and green spaces around the world are used medicinally in healthcare and community settings as a means of treating conditions and promoting wellbeing in its broadest sense.
DEFINING THE TERMS, NOT THE PRACTICE
The use of horticulture for human health has a range of contexts and is used with a diverse range of individuals and communities. These practices are known by many different terms: therapeutic horticulture (TH), or horticulture therapy (HT) and increasingly the more all-encompassing term, social and therapeutic horticulture (STH).
They are broadly defined as follows:
Social and therapeutic horticulture is the purposeful use of horticultural activities and the outdoors to promote health and wellbeing and facilitate social inclusion.
Horticultural therapy is the use of plants by a trained professional as a medium through which certain clinically defined goals may be met.
Therapeutic horticulture is the process by which individuals may develop wellbeing using plants and horticulture. This is achieved by active or passive involvement.
These definitions are all broadly similar, focussing on differences and limiting practice on these differences is neither useful nor progressive.
This is a niche and comparatively young sector of horticulture. It is developing apace as the role of nature in relation to human health is better understood through research studies and practice evaluations. These terms, definitions and their scope will no doubt change, as the use and practice of horticulture for human health advances; let’s not get too hung up on a name.
THE RESEARCH
Horticulture’s potential in a therapeutic context is gaining credibility and prominence. It is used as a prescription for ill health. One of its most prominent supporters is the pediatrician Robert Zarr in Washington USA, who prescribes time and activities in a park setting as a treatment. (www.theatlantic.com/magazine/archive/2015/10/the-nature-cure/403210) But horticulture treatments and therapies are not without their critics.
The naysayers and traditional researchers have a paradigm bias within which qualitative research is not favoured, and randomised controlled trials (RTC) are considered gold standard. Admittedly, much of the early research in this area was qualitative, coming from a wide range of disciplines, not just horticulture/healthcare. The findings were mainly correlational in nature, thus failing to clearly demonstrate a cause and effect outcome in the way an RTC can, and this was the basis for their issue.
Qualitative research is rich in information, giving a depth of understanding to a subject that quantitative trials cannot obtain. As part of a wider research community working together in a mixed methods research paradigm, there is a wealth of information that is and can be in the future, obtained to offer clear evidence on the benefits of horticulture to human health.
A growing body of research is emerging, particularly in the areas of mental health, addiction and recovery, and in child development, with sound findings to support the theory that gardening is good for you.
PRACTITIONERS AND QUALIFICATIONS
Using horticulture to improve human health and wellbeing is nothing new; research evidence shows that at its most basic level a connection with nature is beneficial, even vital for health. Increasingly horticulture is used around the world in health care and community-based settings as a means of promoting health and wellbeing for a variety of individuals and communities in a range of different contexts, with many horticulturists at the helm. It exists to improve human health and wellbeing, it emphasises the process over the outcome or productivity, and truly celebrates the person served. It is driven by a client centred approach, respecting the individuality and creativity of those choosing to use it. This is the essence of all programmes which use horticulture to benefit human health. In many cases, horticulturalists have taken extra or post-qualifying training to improve practice.
Whatever term is used to describe the practitioner, they are all qualified and trained to address the needs of those seeking benefit from horticulture through planned and organised programmes, using plants, horticulture practices and natural surroundings for a positive outcome with both individuals and groups.
ACCESS TO TRAINING IN IRELAND
Provision for training in Ireland in this area is poor. Many of the horticulture colleges provide a comprehensive module in the subject, but this does not take the place of a recognised, accredited professional training programme.
Thrive, a national UK charity, working in conjunction with Sonairte, fills a gap in the Irish market, providing one and two-day introductory workshops to STH. This gives an opportunity to interested individuals to gain insight and begin to map an entry route to the sector.
In the UK, Thrive, working with in conjunction with some well-known colleges provides a range of accredited undergraduate courses. In addition, Coventry University, one of Thrive’s main partner colleges, offers an undergraduate BSc Level 8 and postgraduate MSc at Level 9 in social and therapeutic horticulture. As I understand it, the only other accredited programmes available are those offered by the American Horticulture Therapy Association.
EDUCATIONAL AND STH
One of the more interesting and innovative STH initiatives I have been involved with is the DOC project. http://frontlineireland.com/service-users-from-the-daughters-of-charityservice-attend-the-institute-of-technology-blanchardstown.
Beginning in 2009 with a pilot scheme, a number of intellectual disability learners were integrated into third-level education at ITB. This initiative was designed to address the lack of post-secondary level options available to learners and piloted under the Education for Persons with Special Educational Needs Act 2004. Joining horticulture they skilled up alongside horticulture students. This opportunity supports learners to achieve through a specially designed FETAC programme, acquire new vocational and personal skills, and ultimately prepare for work.
Students enjoy the interaction with the learners and the hands-on experiential learning in the use of horticulture as a therapy. But the real benefit is in the development of soft skills, sometimes referred to as emotional intelligence. These are those all-important attributes that all employers seek. Emotional intelligence skills enable students to perform effectively in professional and social settings, converse with a client or customer in a difficult situation and remain engaged, focused and professional.
“Increasingly horticultural practices and green spaces around the world are used medicinally in healthcare and community settings as a means of treating conditions and promoting wellbeing in its broadest sense”
When hiring it’s easy to find a graduate with suitable qualifications and experience but much harder to find one who is a savvy communicator, can work creatively and effectively, and in particular, one that can work as part of a team, contributing and motivating others towards a shared goal.
From an education perspective the technical horticultural skills are straightforward teaching, the emotional intelligence skills less so; a realistic opportunity for practice supports and enables a rich and tangible teaching methodology.
For students taking this STH module, emotional intelligence is key to remaining client centred. All students complete a basic first-year module in personal and professional skills which include among other things, communications, presentation and IT. Working with the DOC learners and similar groups requires students to use and adjust these skills with individual learners; students must be patient, display enthusiasm, communicate effectively, search for nonverbal cues, enable individual participation to its fullest, creativity, plan meticulously (and have plan B, C, D…), and be calm under pressure. These skills are valuable, and hugely transferrable, to industry practice on graduation.
A recent ITB graduate outlined the value of the STH module; horticulture is only one part of the work, and you have to think, so what if the weeding doesn’t get done today. Studying STH and in particular, working with the group from the Daughters of Charity group was a great hands-on experience. It trains you to read a situation, make adjustments, or go to Plan B. That’s invaluable. The clients don’t always say what’s going on and you have to be able to pick up on what’s happening for them, and plan accordingly.
IMPORTANCE OF STH TO INDUSTRY
Enthusiasm for horticulture, plants, and the outdoors is always good for the industry. Regardless of where that interest comes from or what drives it, it can be capitalised on. Business is all about making hay while the sun shines.
For business, there is always a trickledown effect from such a trend. A more knowledgeable gardening general public as a result of social and community horticulture initiatives will drive plant and associated product sales. The more knowledgeable the participants become, the more likely they are to be successful and continue to be motivated to be involved. As communities and individuals become more aware of definitive beneficial effects through involvement in horticulture, this motivation and involvement will continue. All of which can only serve to be positive from the industry’s perspective.
WHERE TO FROM HERE FOR IRISH PRACTITIONERS?
There is much to be gained through collaboration and networking, and with a significant number of experienced horticulturalists working in the area, there is a rich body of knowledge to be exploited.
A database of organisations and individuals who would share ideas, activities, practice experiences, educational opportunities, would elevate standards of practice further, leading to a broadening recognition and mainstream acceptance of the profession. There is also a huge opportunity for cross-disciplinary working and research. A grouping would serve to strengthen and grow the profession, particularly in terms of helping to inform and shape national policy, thereby further increasing employment opportunities for graduates.
In addition, development of links to the UK, where established organisations such as Thrive and the Association of Social and Therapeutic Horticulture practitioners have been networking successfully for many years, would provide sound organisational experience and guidance.
I am starting a network, if you are interested in creating it please contact me at rachel.freeman@itb.ie ✽
 Rachel Freeman is an assistant lecturer in horticulture at the Institute of Technology Blanchardstown, where she is also year-two course and placement coordinator. In addition to teaching practice, Rachel is also completing an MSc in Social and Therapeutic Horticulture at Coventry University, UK. She can be contacted at rachel.freeman@itb.ie |
