Horticultural therapy: Are there benefits to guided gardening?

The Bottom Line

  • Horticultural therapy involves gardening-related activities—such growing flowers and vegetables—conducted under the supervision of a trained therapist.
  • In older adults, horticultural therapy may improve physical functioning, mood, and quality of life, and reduce body mass index.
  • Those interested in horticultural therapy should consider location, format, and cost when thinking about engaging in this activity.  

Gardening is a popular leisure time activity amongst older adults. Be it planting colourful flowers to ring in the summer, nurturing the seeds of soon-to-be delicious fruits and vegetables, or re-potting and arranging plants to enhance the look of an outdoor or indoor space, there is no denying the unique feeling of getting your hands dirty and bringing your vision to life. The beauty of gardening is that it can be done in various settings, such as at home, in the community, or in an aged care facility. This means that even if you do not have a front yard or backyard, there are different ways to access garden environments.

When it comes to gardening, we often talk about it as a self-guided practice. But did you know that garden-related activities—such as growing flowers, vegetables, and fruits—can be guided by trained therapists? This type of practice is called horticultural therapy (1-3). It is “rooted,” no pun intended, in achieving specific goals associated with a person’s treatment plan. For example, if someone is working towards reducing the symptoms of a particular disease or disorder, their horticultural therapy would aim to attain these results (1;4). Patients, trained horticultural therapists, and health care providers all have a role to play within the horticultural therapy team. So, communication between these parties is essential.

What benefits can horticultural therapy yield? A recent systematic review looked at its effects on the general health of older adults (1).

What the research tells us

Horticultural therapy is often promoted as a practice that anyone can engage in (5). The studies within the review align with this messaging, as they were comprised of various populations. For instance, some studies included all types of people. In contrast, others focused on specific populations, such as healthy people, cancer survivors, folks who had experienced a stroke, those with depression, or people living with dementia and mild Alzheimer’s disease. The review found that horticultural therapy has the potential to produce positive effects on a few physical and emotional health outcomes. Overall, some older adults may see improvements in physical function, mood, and quality of life, as well as reductions in body mass index (BMI). In particular, enhancements in mood were specific to the feeling of happiness in healthy people, while boosts in quality of life were specific to those with mild Alzheimer’s disease.

Most of the studies included in the review engaged participants in horticultural therapy for 60 to 120 minutes per week and a duration of 1.5 to 12 months. However, a concrete recommendation around optimal session length and program duration remains unclear.

Overall, the evidence was of moderate quality meaning the findings could change as more research emerges. More rigorous studies are needed to solidify and build on these promising results (1).

Food for thought!

If you are interested in participating in a horticultural therapy session or program, here are some considerations:

  1. Location: Horticultural therapy is delivered in various settings, including private homes, community centres, community gardens, and residential aged care facilities (long-term care homes, retirement homes, assisted living facilities, etc.). Consider factors such as your current location, preferences, transportation, mobility issues, and cost when assessing if and where to access this service (5).     
  2. Format: Horticultural therapy can be conducted in a one-on-one or group format. Consider whether you prefer more personalized and private programming or being able to socialize and connect with others (5).    
  3. Cost: Horticultural therapy may or may not be associated with a fee. The cost is dependent on how you are accessing the program. For instance, are you seeking this service from a privately owned horticultural therapy business or a not-for-profit organization offering such programming for free?        

You do not need a green thumb to enjoy gardening-related activities and reap the potential positive effects they can have on your health. Whether gardening on your own at home or engaging in guided garden-related activities, remember to put safety first. Use the right equipment, be aware of your environment and fall hazards, practice sun safety, and adapt activities to meet your needs and physical limitations.    

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Author Details


  1. Wang Z, Zhang Y, Lu S, et al. Horticultural therapy for general health in the older adults: A systematic review and meta-analysis. PLoS One. 2022; 17(2):e0263598. doi: 10.1371/journal.pone.0263598.
  2. Wichrowski M, Whiteson J, Haas F, et al. Effects of horticultural therapy on mood and heart rate in patients participating in an inpatient cardiopulmonary rehabilitation program. J Cardiopulm Rehabil. 2005; 25(5):270-274. doi: 10.1097/00008483-200509000-00008.
  3. Flournoy RL. Gardening as therapy: Treatment activities for psychiatric patients. Hosp Community Psychiatry. 1975; 26(2):75-76. doi: 10.1176/ps.26.2.75.
  4. Gonzalez MT, Hartig T, Patil GG, et al. Therapeutic horticulture in clinical depression: A prospective study. Res Theory Nurs Pract. 2009; 23(4):312-328. doi: 10.1891/1541-6577.23.4.312.
  5. Root in Nature. Horticultural Therapy. [Internet] n.d. [cited July 2022]. Available from  https://www.rootinnature.ca/horticultural-therapy

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of new and old blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with changing public health recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.