Horticultural therapy: the 'healing garden'and gardening in rehabilitation measures at Danderyd Hospital Rehabilitation Clinic, Sweden.

OBJECTIVES Objectives were to review the literature on horticultural therapy and describe the Danderyd Hospital Horticultural Therapy Garden and its associated horticultural therapy programme. DESIGN The literature review is based on the search words 'gardening', 'healing garden' and 'horticultural therapy'. The description is based on the second author's personal knowledge and popular-scientific articles initiated by her. The material has been integrated with acknowledged occupational therapy literature. SETTING The setting was the Danderyd Hospital Rehabilitation Clinic, Sweden, Horticultural Therapy Garden. PARTICIPANTS Forty-six patients with brain damage participated in group horticultural therapy. RESULTS Horticulture therapy included the following forms: imagining nature, viewing nature, visiting a hospital healing garden and, most important, actual gardening. It was expected to influence healing, alleviate stress, increase well-being and promote participation in social life and re-employment for people with mental or physical illness. The Horticultural Therapy Garden was described regarding the design of the outdoor environment, adaptations of garden tools, cultivation methods and plant material. This therapy programme for mediating mental healing, recreation, social interaction, sensory stimulation, cognitive re-organization and training of sensory motor function is outlined and pre-vocational skills and the teaching of ergonomical body positions are assessed. CONCLUSION This study gives a broad historic survey and a systematic description of horticultural therapy with emphasis on its use in rehabilitation following brain damage. Horticulture therapy mediates emotional, cognitive and/or sensory motor functional improvement, increased social participation, health, well-being and life satisfaction. However, the effectiveness, especially of the interacting and acting forms, needs investigation.