Rachel Freeman, lecturer in horticulture at Technological University Dublin frames the latest research on STH and explains why educational institutions need to lead the way


There is a need for educational institutions to lead the way in terms of supporting practitioners’ access towards best practice, through accessing the latest research, helping with evaluation of services and guidance on access to funding resources.

Social and therapeutic horticulture (STH) sits within an overall therapeutic framework called Green Care. Green Care encompasses therapeutic activities such as care farming, facilitated green exercise, animal-assisted therapy, ecotherapy, wilderness therapy, nature therapy and social and therapeutic horticulture. These activities are linked under the umbrella term Green Care through their use of nature and the natural environment in their interventions and active therapy processes within the areas of health, education and social settings.

Research indicates that green care or care in a green environment has the potential to improve existing therapeutic programmes and health service outcomes through the incorporation of green elements, with research demonstrating the wellbeing potential for use of green care settings.

Horticulturists working as STH practitioners in Ireland find themselves working in a relatively niche area. That said, health and wellbeing are big business and there are many options to use their skills, in and with nature through the broader scope of green care. Horticulturists interested in developing beyond STH can further their practice into green care, as interventions and activities not only occur in clinical healthcare settings but also in the areas of education, social and community.

The term Nature Assisted Practice (NAP) is used to describe the activities of practitioners actively using nature and green environments in their therapeutic practices. Growing numbers of practitioners from an array of backgrounds including healthcare (nursing, physiotherapy, occupational therapy and psychotherapy), community and youth development, social care, environment, creative arts are using elements of nature (plants and growing media) and nature-based settings in their interventions. These practitioners are seeing the benefits of joining forces with STH practitioners. They are working as part of a multidisciplinary team which includes horticulturists, particularly where clinically defined goals are set and a natural environment is the intervention setting.

Additionally, STH practitioners are becoming involved in nature assisted practice activities occurring in settings that provide education and experiences in nature. Here their focus may be to facilitate group work in an outdoor setting with the goal of fostering group cohesiveness. Activities of this type might include nature camps, forest school, scouts, and school environmental education. These programmes don’t necessarily need the input of a healthcare professional, and by their nature allow for a greater degree of flexibility and client/service user input. In urban settings such as Dublin, there is a growing demand for natural educational experiences in the outdoors for preschool and school-age children, provision for both within the scope of forest schools and also beyond. STH practitioners who enjoy working with this cohort and seeking to broaden their remit can consider this area.

Schools, both primary and second level, through the Heritage in Schools scheme, seek professionals to engage in a range of outdoor and nature-based skills and crafts within the school. Individuals must apply to join, and once requested by a school to come to visit, they are paid by the school (fees are subsidised by the Heritage Council). Currently, on the Heritage in Schools website, there is a whole page dedicated to the move away from the nature-based play for children; here is potential for STH practitioners to engage in this arena to the benefit of all (www.heritageinschools.ie).

NAP practitioners with a focus on environmental sustainability employ green strategies to enhance traditional health and social care practice and can apply ecological health theories to develop innovative education, health promotion and community development practice interventions. Therefore, within current community-based health care models, they are capable of providing opportunities for engagement at a local community level, promoting community inclusion by keeping service users within their communities, visible in the green spaces and horticultural activities, e.g. production and care of community window boxes.

Care of the local environment is also a key consideration of NAP health and wellbeing practices. STH practitioners and those engaging in these services often create their own opportunities, particularly where nature-based interventions and activities are linked with sustainability and local environmental issues. Those practitioners working in natural settings and service users and clients engaging in NAP for treatment are predisposed to care for their environment. They are therefore drawn to environmental activities such as a beach cleaning, contributing to park and woodland group plantings, community enhancement schemes, and community allotment growing. This is where care for the environment goes hand in hand with interventions providing health and wellbeing benefits. This is yet another opportunity for an environmentally attuned STH practitioner to further their practice.

Some STH practitioners are fortunate enough to come from farming circles, and here there is potential to combine their STH and agricultural skills, or partner with the farmer to develop and provide care farming services. Care farming or social farming is the practice of offering activity on family farms as a form of social support service and is relatively new in Ireland. Many of the day to day activities offered are within the scope of any horticulturist or STH practitioner. For more information see www.socialfarmingireland.ie.

In NAP there is much to be gained through a collaborative approach. Where clinical goals are set, it is often the best therapeutic practice for STH practitioners to be part of an active multidisciplinary healthcare team. Collaboration in other settings such as education, working with teachers, and social settings working with social workers and social care personnel, or with community volunteers and leaders, STH practitioners also benefit through the exposure to other approaches to practice.

Gaps in knowledge, training and experience mean that the opportunities outlined here will not suit all STH practitioners, clients or service providers. Experience, training and education are vital in this field working with people with healthcare needs and those who are vulnerable, as is the need for Garda vetting in order to gain the best possible outcomes for the individual or user groups engaged with.

In terms of best possible outcomes, evaluation is key to both determining the efficacy of the activities and return on investment for the funding provider. There is a need to critically evaluate practice and use of nature-assisted interventions employed to enhance health and wellbeing including STH. It is only through the evaluation outcomes that best possible outcomes are maintained for service users/clients, the respect of the profession is maintained (even raised) and funding continues to be provided for the provision of services. ✽

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Rachel FreemanRACHEL FREEMAN. Lecturer in Horticulture. Technological University Dublin – Blanchardstown Campus.