Survey of Horticultural Therapy Programs in Tennessee

Author(s): Jenny C. Pfeffer, Dennis E. Deyton and J. Mark Fly

Source: Journal of Therapeutic Horticulture , 2009, Vol. 19 (2009), pp. 24-44
Published by: American Horticultural Therapy Association

Stable URL: https://www.jstor.org/stable/44025121

JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide
range of content in a trusted digital archive. We use information technology and tools to increase productivity and
facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.

Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at
https://about.jstor.org/terms

American Horticultural Therapy Association is collaborating with JSTOR to digitize, preserve

and extend access to Journal of Therapeutic Horticulture

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
Survey of Horticultural Therapy
Programs in Tennessee

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
2009: XIX JOURNAL OF THERAPEUTIC HORTICULTURE 25

SURVEY OF HORTICULTURAL THERAPY

A study was conducted to identify
PROGRAMS IN TENNESSEE
horticultural therapy programs in
Horticulture is recognized as a treatment modality for
Tennessee and types ofpeople institutions,
suffering from a wide range staff,
of diseases and
activities, and clientele involved in the
limitations. Horticultural therapy is the mix of two fiel
horticulture and therapy It is a profession that uses
programs. An internet web-based survey
horticulture or the act of working with plants as a tool
was used in 2007 to therapy
survey to improve outcomes of the cognitive, social,
emotional, and physical aspects of patients. The terms
representatives of member institutions in
horticultural therapy and therapeutic horticulture are
the Tennessee Hospital
frequentlyAssociation and
used interchangeably. The American
the Tennessee Association of Homes
Horticultural Therapy and
Association (AHTA) currently d
horticultural therapy as ". . . the engagement of a client
Services for the Aging ; directors of
horticultural activities facilitated by a trained therapist
botanical gardens ; and members
achieve specific and documented of thegoals" (AHT
treatment
Tennessee Master Gardeners. The
2008a, p.l). The organization survey
defines therapeutic hortic
as ". . . a process that uses plants and plant-related activ
indicated that programs were
through which participants strive to improve their wel
individualized depending
through active on the
or passive type(AHTA,
involvement" of 2008a,
client served, funding,
This surveyinstitution, and
used the term horticultural therapy in all
questions except for one that asked if the individuals
therefore, the resources available for the
therapeutic horticulture; definitions of horticultural th
program. The survey and found the most
therapeutic horticulture were included on the sur
common purpose of(see horticultural
Methodology section for definitions).

therapy was to " improve mood" of

Horticultural therapy programs are found in hospitals,
clients, followed by nursing
" social interaction,
homes, rehabilitation centers, prisons,"and ma
"stress reduction, " and "motor skill
facilities for developmentally and physically disabled p
A survey in 1968 by Rhea McCandliss of 500 psychiatr
development." Most respondents (91%)
hospitals in the United States found a considerable pre
felt there was a need for more
of horticultural therapy programming, interest in prog
development,
professional horticultural therapy and a deficiency in the number of
professionally trained horticultural therapists available
training and a Tennessee Horticultural
meet the existing demand (McCandliss, 1972). Very litt
Therapy Association (86%).
information is available about the presence of horticul
therapy programs in Tennessee, characteristics of the
programs, and needs of the staff (e.g. horticultural the
resource information, professional training, state profe
society, etc.).

LITERATURE REVIEW
Origins and Present Situation of Horticultural
Therapy in the United States
Horticultural therapy is a relatively new profession
developed by early practitioners who used gardening
activities to improve the well-being of their patients or
clients, and saw beneficial changes in people. It is also one of
the oldest disciplines; people in early history had the need
for connection with the beauty of natural environments
(Lewis, 1996). The ancient civilizations accepted this as a
natural part of their existence. In fact, many different tribes

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
26 JOURNAL OF THERAPEUTIC HORTICULTURE 2009:XIX

of Native Americans in the United

In thisStates saw their
psychiatric gardens gar
institution,
and food crops as a central part of an
were their spiritual
integral partheritage
of the treatm
(Buchanan, 1997). Historically, plants have
patients. been
Lewis associated
stated in his book
with healing. Most indigenous people of the
Foundation has American
remained a leader
Indians, African tribes, and Australian aboriginals
horticultural viewed
therapy in the
the Unite
earth as their Mother, and saw a very spiritual connection
between themselves and the plants
In the that surrounded
1940s, and
occupational therapi
were accessible to them. They also knew
members the
used medicinal value
horticultural activi
of many plants (Lewis, 1996).veterans of World War II restore t
psychological, and social well-be
In Egypt in the times of the McCandliss
Pharaohs, depressed and horticult
was an early
was using
mentally ill members of the courts gardening
were taken on courses
walks by 1
through the royal gardens (Shepard,
Hospital 1967). European
at Topeka, monks
Kansas. She lat
built monastic gardens for meditation,
Foundation asas
did monks
their in Tibet.
horticultural t
Royalty throughout time expended
therapygreat
was sums
first of
usedmoney and
by Richard
(Sullivan, 1979) and in 1948
effort on the creation of calming gardens, from the hanging Ruth
gardens of Babylon to the courts
phrase
of horticultural
Europe. In medieval
therapy (Olsz
times in Spain it was noticed that impoverished hospital
Another
patients who worked in the gardens to horticultural therapy
pay their bills had pi
a psychiatric
better recovery rates than the socialwho
wealthy patients worker and oc
did not
spend time in the gardens (Davis, 1994).
together Physically
with Eleanor and
McCurdy in
mentally wounded soldiers inprograms
WWII were helpeddesigned
specially in their as "ho
recovery with "garden therapy" (Bruce,
1950s 1999).
(Lewis, 1996). This took plac
Hospital in Michigan. In 1955, O'R
Horticultural therapy has been growing
among in range
the first and to examin
authors
importance since the late 1700s when
as a it was
therapy forrecognized that
psychiatric patien
2003).
the involvement with plants and They recorded
gardening hurriedthat
the when t
recovery of psychiatric patients
as a (Tereshkovich,
tool in therapy,1975).
they observed
personal
Horticultural therapy professional appearance
origins and the
came from hygiene,
increased
observation of the therapeutic communication,
effects of people-plant reduced
interactions, not from scientific studies
social (Lewis, 1996). Dr.
functioning.
Benjamin Rush is often described as the father of
horticultural therapy by starting
The the first
first program
textbook in the
in the field of h
United States in Philadelphia Therapy
in 1798 (Sempik
through& Becker,
Horticulture , w
2003). While a professor of medicine at the University
Alice Burlingame of
in collaboration
Pennsylvania, he concluded from his observations
Michigan that labor
State University's Horti
on a farm and horticultural activities improved
(Lewis, 1996). the health
Gradually, of
professio
mentally ill patients (Hefley,developed
1973). Also
and
in horticultural
Philadelphia, thera
the
During
Friends Hospital created the first the 1970s
private several other un
psychiatric
institution in 1817. The hospital created shaded
horticultural walks,
therapy as anpaths,
option
graduate
and open spaces for their patients degree
to walk, andprograms
involved (Shoem
their
patients with vegetable gardens and State
Kansas fruitUniversity
trees. The established
hospital
still has healing gardens and aundergraduate program in cooper
very strong horticultural
therapy program (Shoemaker,
Foundation.
2004). In the same year, a U
student received a M.S. degree in
The Children's Aid Society, under
Therethe
are leadership of Helen
currently two universit
Campbell, used gardening in offering
1896 as a bachelor's
way to helpandthe
master's d
disadvantaged young people living in and
therapy Newone
York City s low
university (Unive
income areas. Mrs. Campbell noted the'spositive
bachelor effect
degree in of
landscape ho
plants on children who had exposure
horticultural
to thetherapy
greenhouse
concentrati
and
plants in it (Lewis, 1996). In 1919, C.F. Menninger
certificate and online
programs; one his h
son created the Menninger Foundation in Topeka,
program; and Kansas.
13 other colleges or

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
2009 : XIX JOURNAL OF THERAPEUTIC HORTICULTURE 27

Horticultural
least one course in horticultural therapy.Therapy The
in Europe
AHTA lists 21
programs in the United States
Gardening
and has four
a long in
tradition
Canada
in Europe.with
A survey in the
internship opportunities (AHTA,
United Kingdom
2008b). (UK) described the health benefits of
"green exercise activities" such as gardening and exploring
local
A professional association, the woodlands (Peacock,
National Hine & Pretty,
Council for 2007). Their
Therapy
and Rehabilitation through Horticulture (NCTRH),
survey indicated that being was and some
outside with nature
established in 1973 to promoteform
theof exercise
horticultural
were important fortherapy
the well-being of more
than 88% of respondents.
profession as a therapeutic intervention and Byrehabilitative
the year 2020, one-third of the
medium (Shoemaker, 2004). Itpopulation
became of thethe
UK willAmerican
be of retirement age and the
Horticultural Therapy Association (AHTA)
importance in longer
of people staying 1987 and
in their own home
instead of healthcare
membership within the Association facilities is becoming
and annual more widely
conferences
were established. accepted (Marsden & Spurgeon, 2008). The garden was
described as the most visible part of a home and a source of
The Interdisciplinary Research Team of the Office of pride for many people and a concern for the elderly staying
Consumer Horticulture (IRTCH) wąs established in 1988 at in their homes. Charitable organizations in the UK have
Virginia Tech University. The IRTCH emphasized the actively provided gardening information and opportunities to
human aspects of horticulture, but there was no elderly, disadvantaged, and disabled people. A national
documentation or research to support the contribution of horticultural charity, Thrive, strove to make gardening safer
horticulture to stress-reduction or improvement of human for older people living in their own home in the UK
behavior, human health, or interaction within communities. (Marsden & Spurgeon, 2008). The non-profit charity The
The first symposium of IRTCH, "The Role of Horticulture Sheltered Work Opportunities Project (SWOP) provided
in Human Well-Being and Social Development," took place horticultural work for elderly and disabled people in a
in 1990. It was so successful, that The People-Plant Council nursery and garden maintenance program in the UK.
(PPC) was formed and the Council has since held a Researchers concluded from a survey that the organization
symposium every two years. The Ninth International People- contributed to successful therapeutic rehabilitation in mental
Plant Symposium took place at the 27th International health care (Galvin, Sharpies, Hume & Dumbrell, 2000). A
Horticultural Congress and Exhibition in Seoul, Korea in survey was recently conducted of patients in a German
August of 2006. The People-Plant Council News is a psychiatric hospital and in a psychiatric after-care facility
quarterly publication linking horticulture with human well- (Neuberger, 2008). The survey showed that gardening in a
being, and increasing plant interaction awareness in many therapeutic setting could restore awareness,
countries. communicational skills, and body functioning.

Research in the United States during the past three decades

Universities in England, Scotland, The United Kingdom,
has shown the benefits to humans from interactions with Germany, Italy, Norway, Sweden, Denmark, and Finland
plants (Lohr & Pearson-Mims, 2008). Research at Southern
have included horticultural therapy courses in their
Illinois University-Carbondale showed that indoor educational programs (Evers, 2000). Horticultural therapy
horticulture activities over a seven week period produced an
has been increasing in Finland with new initiatives in school
increase in psychological well-being of older people in a gardening, environmental education, gardening in training
long-term care facility (Barnicle & Midden, 2003). Recent programs for disabled people, and in therapeutic
research showed that even simple horticultural activity can environments in hospitals and institutions (Evers, 2000;
have positive impact on quality of life of persons in an Evers, Linden & Rappe, 2000). The University of Reading
assisted living facility (Collins & O'Callaghan, 2008). was the first in the UK to develop courses in social and
Research conducted at the Rusk Institute (Wichrowski, therapeutic horticulture within the horticulture degree. The
Whiteson, Haas, Mola &, Rey, 2005) concluded that Royal National Orthopaedic Hospital NHS Trust near
horticultural therapy improves mood and is an effective London provided patients ". . .with gardening therapy to
component of cardiac rehabilitation. Recent research (Parkbuild up their physical strength, increase movement and
& Mattson, 2008) showed that patients in post-surgery help maintain balance, posture and co-ordination" (Exley,
hospital rooms that had plants or flowers had lower systolic2008, p.91). Research at the Danderyd Hospital
Horticultural Therapy Garden in Sweden showed that
blood pressure and heart rate, lower ratings of pain, anxiety,
and fatigue, and more positive feelings than patients in horticultural therapy improved cognitive and/or sensory
control groups. motor functions, well-being, and life satisfaction of clients as
well as increased social participation. However, the authors

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
28 JOURNAL OF THERAPEUTIC HORTICULTURE 2009:XIX

concluded that more research was needed

Horticultural Therapy in the (Soderback,
Oceania Region
Soderstromat & Schalander, 2005).
The OceaniaA review
region is composedin The of Australia,
principally
Netherlands concluded that different studies
New Zealand, New in different
Guinea, Melanesia, Micronesia, and
countries showed that people-plant interactions
Polynesia. In Australia and New Zealand, promoted
the therapeutic
human well-being but little research had
benefits of gardening werebeen
noticed asdone on
early as the how
19th
working with plants was beneficial (Elings,
century in mental institutions 2006).
and farm hospitals (Aldous,
2000). Oceania has organizations such as the Horticultural
Horticultural Therapy in Asia Therapy Association of Victoria, the Horticultural Therapy
Interest in horticultural therapy varies from country to Society of New South Wales, Inc., and the Banksia Centre in
country in Asia but can be found in India, Indonesia, Iran,the National Botanic Garden of Canberra, specifically
Israel, Japan, Korea, Pakistan, People s Republic of China, interested in human-horticulture research. There has been a
and Saudi Arabia. Horticultural therapy research was significant shift in the last decade in Australia and New
reported to be more advanced and interest more widespreadZealand in the attitude towards disadvantaged people and
those with disabilities (Aldous & Kidd, 2008). Thus, Aldous
in Korea and Japan than the other countries (Matsuo, 2000).
Horticultural therapy has become more popular in South and Kidd (2008) reported that the prospects were good for
Korea since its introduction by Kwack at Korea Universitycontinued
in growth in horticultural therapy, especially in the
the early 1980s through lectures and publications (Sim & healthcare area. They reported that 54% of adults older than
Kwack, 1995; Matsuo, 2000). Horticultural therapy programs 65 years in New Zealand practiced gardening. A distance
have been implemented in hospitals, psychiatric hospitals, education course in horticultural therapy has been offered at
rehabilitation centers, and special education schools Massey University in New Zealand since 2001 (Kidd, 2008).
(Matsuo, 2000). Korea also has the Korean Horticultural Spinoffs from the course included the establishment of a
Therapy Association and the Korean Society for Plants, second course in 2004 and a web site of people-plant
People, and the Environment (Kwack & Reif, 2002). Likeprojects and therapeutic gardens in New Zealand. Research
many other industrial nations, Korea has the fastest increase in horticultural therapy at Massey University has focused on
in the elderly portion of its population. A research trial in "the therapeutic benefits of gardening and the contribution
Korea showed that horticultural therapy can improve of plants to the well-being of residents of rest homes"
psychological sociality of demented elders, especially if the(Aldous & Kidd, 2008, p.97).
patients were paired in a buddy system (Han, Lee, Kim &
Suh, 2008). PURPOSE OF STUDY

This study was conducted to determine: 1) the awa

Universities in Japan have actively researched the effects
plants have on human well-being during the last decade.
Japan is another developed country with a rapid increase in
elderly adults (Asano, Takaesu & Matsuo, 2008).
Approximately 40% of the Japan s population is engaged in
horticultural activity (Matsuo, 2008). Matsuo noted that
humans have two types of needs: biological/physical and
spiritual/emotional. It was summarized that horticulture
stimulated and satisfied both types of needs, promoting a
sense of healing. A survey of elderly adults found that hours
of horticultural activity correlated highly with health related
scores, especially of vitality and mental health (Yamane &
Adachi, 2008). Researchers at Hokkaido University
measured physiological and psychological effects of an
outdoor horticultural activity of picking apples (Furuhashi,
Hirata, Tanaka, Suzuki & Oosawa, 2008). The physical
activity caused a decrease of the activity of the
parasympathetic nervous system, an index representing
relaxation, during the work. Their survey found a decrease of
negative feelings (mood) and an increase of positive feelings
in subjects after the work.
Tennessee of horticulture as a tool in therapy; 2) t
prevalence of horticultural therapy programs in th
the types of institutions, staff, activities, and client
involved in those programs; 4) the influence of fun
source on the type of horticultural therapy program
the need to provide professional education for hor
therapists.
METHODS
Pilot Survey
A pilot survey was sent to six knowledgable people in
horticultural therapy who had years of experience in
horticultural therapy for their review and suggestions.
Adjustments in wording and structure were made to the
survey form before it was sent to the public.
Survey Participants
The survey was sent to member institutions of the Tennessee
Hospital Association and the Tennessee Association of
Homes and Services for the Aging. The web link and
requests to participate in the survey were sent by the
associations instead of by the University of Tennessee. Since

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
2009 :XIX JOURNAL OF THERAPEUTIC HORTICULTURE 29

Horticultural
horticultural therapy is also used in varioustherapy is a organizations
structured therapy
program that
such as those involved in social care, uses plants and plant
vocational activities as a and
training,
therapeutic tool to in
botanical gardens, requests to participate improve
the the body mind and were
surveys
spirit In a of
sent by the researchers to directors horticultural
the therapy program ,
Cheekwood
participant
Botanic Garden in Nashville, Ijams goals are identified,
Nature Center resultsin
documented and
Knoxville, Memphis Botanic Garden, , and assessments are made for
the Sertoma Day
participant
Center in Knoxville (an institution improvement with
working These programs usually
special-
needs individuals). A web-based take
list-serv
place in hospitals , rehabilitation settings ,of the
of members
Tennessee Master Gardener program was
nursing homes, etc. available through
the University of Tennessees Department of Plant Sciences,
and the Master Gardener Coordinator sent requests
Therapeutic horticulture to
is not a formal therapy
program, and
participate in the survey to members toit does not require
solicit that goals are
their
identified and
responses and to increase the survey addressed. The pleasure
population. Thethat comes
number of web survey requests from
sent beingout
close towas
plants and natural
1,318,
distributed as follows: 95 members of the
environments Tennessee
is emphasized for the enjoyment they
Association of Homes and Services for
bring to clients the Aging;
and patients. It is often129
applied to
members of the Tennessee Hospital Association;
settings such as courtyards, indoor three
plants, growing
herbs, director
directors of botanical gardens; one indoor and outdoor
of gardening, etc.
the Sertoma
Center; and 1,090 members of the Master Gardener
Program. There was no information in the survey responses to identify
the person completing the survey. If respondents indicated
Survey Methodology they wanted to receive survey results or had an interest in a
A 32-question survey was distributed using the internet and professional directory, then the contact information they
a computer web-based system (Appendix A). The University provided was collected in a separate computer file.
of Tennessee Office of Internet Technology (OIT) Customer Therefore, the researchers could not connect survey
Tech Support distributed and collected the data for the webparticipants to their survey responses.
survey An initial e-mail was sent on May 30, 2007 by the
leadership of each of the three organizations (Tennessee Survey Response Rates
Hospital Association, Tennessee Association of Homes and Of the 1318 survey sample population, 284 people started to
Services for the Aging, and Tennessee Master Gardeners) take the survey through the internet and 202 of those (70%)
completed it. Thus, 15% of the total population completed
directly to their members requesting participation in the web
survey. Similar e-mails were sent to directors of the Sertomathe survey. The population was divided into four groups with
Center, Cheekwood Botanic Garden, Ijams Nature Center, response rates listed as follows:
and Memphis Botanic Garden. The e-mail explained the
purpose of the survey as well as provided the link to the Hospitals: 34 of the 129 members of the Tennessee
survey. E-mails were sent a week later by the sources Hospital Association invited to participate in the web-
reminding the recipients to participate in the survey. survey completed the survey (26% response rate).

The opening section of the survey contained some ice-
breaker questions concerning general interest in gardening.
Responses to those questions are not included in this report.
The next section served to gather general information about
the institution where the survey participants were employed.
The third section asked questions about their horticultural
therapy programs (if present). The fourth section dealt with
demographic information of clients served by horticultural
therapy programs (if present), and the fifth and last section
asked for respondents' opinions about horticultural therapy
in Tennessee in general. People responded to the survey by
marking the most appropriate answer. The survey form
included the following definitions:
Nursing Homes/Assisted Living: 22 of the 95
members of the Tennessee Association of Homes
and Services for the Aging invited to participate in
the web-survey completed the survey (23%
response rate). Nursing homes and assisted-living
home responses will be discussed as one group
because of the low number of horticultural
programs reported by each group.
Botanical Gardens and Sertoma Center: Four of
four directors of the Sertoma Center, Cheekwood
Botanic Garden, Ijams Nature Center, and
Memphis Botanic Garden completed the survey
(100% response rate).

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
30 JOURNAL OF THERAPEUTIC HORTICULTURE 2009:XIX

Master Gardeners: 142 of the

nursing 1,090 members
homes/assisted of the
living, botanical gardens, Master
Tennessee Master Gardeners completed
Gardeners) the
the respondents were survey
associated.
(13% response rate).
The results of the survey indicated a lack of understanding or
Survey Data Analysis appreciation within the survey group of horticultural therapy
The data were analyzed using the Statistical Package for the
activities. This supports a previous report (Reif, Shoemaker
& Matsuo, 2004) which concluded there needs to be
Social Sciences (SPSS 15 for Windows). Descriptive statistics
were performed on the response variables (categorical data)
increased public awareness of the psychological, sociological,
to provide mean values for responses. This data is considered
physiological, economic, and environmental effects of plants
exploratory in nature. The data lacked statistical significance;
on people.
therefore, standard deviations and frequency distributions
are not presented. Prevalence of Horticultural Therapy Programs
in Tennessee
RESULTS AND DISCUSSION Question 2, "Does your institution have a horticultural
Survey results are presented in the following therapy
section based
program?" was asked to determine the prevale
on the study objectives and listed as research horticultural
questions withtherapy programs in Tennessee. The surv
their corresponding results. sent to more than 200 hospitals, nursing homes/assisted
living facilities, and botanical gardens and 60 facilities
Awareness of Horticulture as a Tool in Therapy responded. Only 12 of the 60 institutions (20%) had
Question 1, "How familiar are you with the use of horticultural therapy programs (Table 1). Thus, there
horticulture as a tool for therapy?" was asked to determine probably many opportunities and needs for horticultur
the awareness of horticulture as a tool in therapy. The meantherapy programs in Tennessee.
response value for the 202 participants completing the
survey was 2.85. Comparing the mean to the original five Types of Institutions Involved with
point scale, where the minimum value (1) was "not at all Horticultural Therapy, Clientele Served, and
familiar," (3) was "somewhat familiar," and the maximum Activities Offered in the Programs
value (5) was "very familiar," 2.85 was interpreted as the Question 3: How would you describe your institution ? The
participants being "little to somewhat familiar" with the use 12 horticultural therapy programs were distributed in the
of horticulture as a tool for therapy. Since the survey was following institutions: two programs were in assisted living
designed to maintain the respondents' anonymity, we were facilities, one program in a nursing home, one program in a
not able to determine with which group (e.g. hospitals, hospital, and eight programs in what was listed on the survey
as "Other Institution Types" (Table 1). These eight programs

TABLE l:Type of institution or program with TABLE 2: Years of operation of horticultural

horticultural therapy program. therapy program.

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
2009: XIX JOURNAL OF THERAPEUTIC HORTICULTURE 31

TABLE 3: Age of clients served in horticultural

therapy programs (n= 1 2).

were in the following institutions: botanic garden, CCRC

institution (nursing home, assisted living, and independent
living together), community provider, park program, and
technical school. Three programs considered themselves not
TABLE 4: Horticultural activities utilized in
applicable.
program (n= 1 2).
Of the 34 hospitals that responded (out of 129 contacted),
there was only one horticultural therapy program reported
program had been in operation for less than one year, five
(3%). In a survey of the American Horticultural Therapy
programs between one and five years, one program between
Association members, only 3% of 116 respondents worked in
six and ten years, and five programs more than ten years
general hospitals (AHTA, 2002). Only four of the 22 (18%) of
(Table 2). There is a great need to increase the awareness of
nursing homes/assisted living facilities that responded to this
hospitals, nursing homes, and assisted living administrators
survey had horticultural therapy programs. AHTA (2002)
of the physiological, psychological, and sociological benefits
reported that 26% of surveyed members worked in nursing
of horticultural therapy on clients.
homes/assisted living facilities, the largest group in their
survey Of the three botanical gardens and the Sertoma
Question 5: What are the demographic characteństics of the
Center there were two horticultural therapy programs. The
clients served? The most common age group of clients
authors are not aware of other recent surveys to determine
served by the horticultural therapy program was in the "Ove
what percentage of hospitals or nursing homes/assisted living
50 years-old" group. Ten out of the 12 programs in
institutions had horticultural therapy programs. A future
Tennessee worked with clients in this age group (Table 3).
survey should ask why hospitals (and other institutions) do
Most of the programs worked with more than one age group
not have horticultural therapy programs. It would be helpful
of clients. It was also found that 65% of the clients served in
to know if institutions without horticultural therapy
these 12 programs were female and 35% were male.
programs are aware of the associated health benefits, do not
appreciate the benefits, or do not consider the horticultural
There are currently 76 million people age 50 and over in th
therapy programs cost effective, among other reasons.
United States (Senior Journal, 2008) and the number is
undoubtedly increasing as baby boomers enter this age
Question 4: How long has your horticultural therapy
group and people have longer life spans. Thus, the
program been in operation? The survey indicated that of the
population primarily served by horticultural therapy
12 established horticultural therapy programs, only one

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
32 JOURNAL OF THERAPEUTIC HORTICULTURE 2009:XIX

TABLE 5: Purpose of horticultural therapy

program (n= 1 2).

programs in this country and most developed countries is

increasing significantly. The U.S. Department of Health &
Human Services (2008) reported that by 2020 half of
Americans will be at risk for fractures and that about 20% of
TABLE 6: Major disabilities of patients treated by
individuals with a hip fracture will end up in a nursing home
horticultural therapy program (n=l2).
within a year.

Question 6: What kinds of activities are offered in the

stress reduction (50%), motor skill development (50%), and
horticultural therapy programs? The most common
body flexibility improvement (42%). Horticultural therapy
horticultural activity among the programs was the growing of
was used less for pain relief (25%).
annual plants, with 83% of the programs utilizing this activity
(Table 4). The growing of perennials (75%), flowers (75%),
These reported uses echo findings that horticultural therapy
and herbs (67%) were also common activities in the
could improve social involvement for older individuals (Han
programs. The fourth most common activity did not involve et al., 2008), reduce stress (Wichrowski et al., 2005), and
growing plants but instead the arrangement of flowers
improve physical development (Söderback, Söderström &
(42%). Several programs (33%) included "Other" activities
Schälander, 2005; Exley, 2008). Other researchers reported
such as gardening for food, landscape design, propagating,
significant improvements in psychological well-being among
repotting, and horticulture related crafts. All the programs
the elderly who participated in a structured three-month
used a variety of horticultural activities.
gardening project (Heliker, Chadwick & O'Connell, 2000).

Question 7: What are the main purposes of your horticultural

Question 8: What are your clients major disabilities? The
therapy program? The use of horticultural therapy to
elderly and physically disabled were the client groups most
"improve mood" of clients was the most commonly reported
often served by horticultural therapy programs (67%) (Table
objective of programs (67%) (Table 5). Many programs also
6). Six programs (50%) served clients with developmental
used horticultural activities for social interaction (58%),
disabilities and five programs (42%) served clients with

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
2009 : XIX JOURNAL OF THERAPEUTIC HORTICULTURE 33

were very low for horticultural th

12 programs (42%) had annual bud
Four programs had budgets betwe
Respondents for the remaining th
the budget amounts. The research
reports of budgets for horticultur

Question 11: Is your program link

Most of the programs (58%) were
of program (Table 7). Three of th
associated with therapeutic recrea
programs (17%) were linked with
and two programs (17%) to an art
program was associated with occu
with music therapy.

Question 12: Do you use volunteer

therapy program? Seven of the 1
therapy programs used volunteer
volunteers in each program varied
limited budgets available for horti
the use of therapy
TABLE 7: Linkage of horticultural volunteers is obviously
programs to other types programs.
of therapies at the
institution (n=l 2).
Type of Ownership of Institution Involved in
Horticultural Therapy Programs
Question 13: How
visual disabilities. Three programs (25%)would you characterizeclients
served the ownership who
of
your institution? Six of the
were emotionally or mentally ill, and three programs (25%) 12 programs (50%) were operated
by privately owned institutions
served clients with hearing disabilities. Thus,(e.g. hospitals,of
most companies
the
owning nursing home and assisted
horticultural therapy programs served clients in multiple living facilities). Five of
the programs
disabilities groups. Clients who were wereculturally
operated by non-profit institutions (42%).
Two programs
disadvantaged, substance abusers, or were self-owned
had by individuals
injuries ofor families.
the
Only one
spine were not typically served by program
these was funded by the state government.
programs. Two
AHTA (2002)
institutions specified that their reported that of
programs 105 members surveyed,
worked with13% clients
with Alzheimers disease. worked for private institutions, 14% for-profit, 21% public,
and 51% not-for-profit. A survey by AHTA (Harvey, 2003)
reported
Question 9: What is the average non-profit institutions
length of time had the most horticultural
spent by a
therapy programs and employed
client in your horticultural therapy program? Responses the most horticultural
therapists.
varied greatly concerning how long clients stayed in their
horticultural therapy programs. In three of the 12 programs,
Therapeutic
clients spend between one and three Horticulture
months. and its
InPrevalence
two in other
Tennessee
programs, clients stay between four and six months.
Respondents from four of the Question 14: Do you use did
12 programs therapeutic horticulture at y
not know
institution?
how long their clients stayed. The length Seventeen
ofpercent
time(31 of the 202) of
in
respondents (including Master Gardeners)
horticultural therapy varied in the three remaining programs. indicated th
The authors assumed the staysusedwere
therapeutic
muchhorticulture.
shorter Sincein
only 12 responde
used horticultural therapy, there
hospitals than in nursing homes/assisted living facilities, was more use of ther
but
this could not be determined horticulture
from the than horticultural therapy by various
survey.
participants. Due to the organization of the survey, w
not identify of annual
Question 10: What is the approximate which group the users for
budget of therapeutic
horticulture were members.
your horticultural therapy program? The reported budgets

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
34 JOURNAL OF THERAPEUTIC HORTICULTURE 2009:XIX

TABLE 8: Need for professional horticultural therapy

Tennessee.

■Response 2 was not assigned a description but was assumed to be intermediate to response I and 3.
2Response 4 was not assigned a description but was assumed to be intermediate to response 3 and 5.

Question 15: How do you use plants in therapeutic state (Table 8). Focusing on those that said that there
horticulture as a tool to improve the well-being of your some need to high need, it can be inferred 86% of t
clientsPThe results indicated the most commonly used respondents perceived the need for an association in
therapeutic horticulture activity was the use of outdoor state. Only 14% of the respondents felt there was no
gardens as a tool to improve the well-being of their clients. for an association in Tennessee. Due to the organizati
The second most common activity was the use of indoor the survey we could not identify to which group the
gardening. Other programs grew herbs and/or vegetables, respondents belonged.
and some made flower arrangements
Need for a Directory of People Involved with
Need to Train Horticultural Therapists in Horticultural Therapy in Tennessee
Tennessee Question 1 7: If the survey results indicate a need to compile
a directory
Question 16: To what extent is there a need for of the horticultural therapy programs in
professional
horticultural therapy training in Tennessee? Tennessee
The mean , would
scaleyou like to be part of this directory?
Seventy-eight
value of the 202 responses to the question was 3.68, percent of the 198 respondents indicated they
indicating most people felt there was a need wanted to receive the results of the survey. However, only
for professional
30% of 8).
horticultural therapy training in Tennessee (Table those people were interested in being part of a
Only
3% of respondents felt there was no need for directory.
training, Thus,
andwhile most respondents felt there were
needs forMany
91% felt there was at least some need for training. professional horticultural therapy training and a
respondents (30%) indicated there was a great need for state organization, and they wanted to receive a
professional
horticultural therapy training in the state. copy of directory of people involved in horticultural therapy,
most did not want to be listed in the directory.
Approximately
Question 1 7: To what extent is there a need for 60 respondents were interested in being
a professional
listed
horticultural therapy association in Tennessee? Thein mean
the directory, which is the same number of
responses
scale value of the 202 responses was 3.47, meaning from was
there hospitals, nursing homes/assisted living, and
Botanical
"somewhat a need" for a professional organization in Gardens/Sertoma
the Center groups. We cannot

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
2009 : XIX JOURNAL OF THERAPEUTIC HORTICULTURE 35

internet.
identify from which group the 30% Arespondents
telephone survey could then be used
interested into scr
forbut
being part of a directory came, institutions
will with and without
make programs.and
a directory The remain
make it available to the public.questions could be asked over the phone or a correspon
survey could be sent by mail to the appropriate person
each institution. The four-wave Dillman method could be
CONCLUSIONS used to maximize response rates for mail surveys (Dillm
Smyth
The elderly population is the group primarily served & Christian, 2008).
by
horticultural therapy programs in the United States and most
Futureis
developed countries. That segment of the population surveys of associations offering horticultural th
predicted to increase significantly in the U.S. asshould
well asidentify
other to what group the respondent belongs,
developed countries such as the UK, Japan, andasKorea.
hospitals,
The nursing homes, and assisted care facilities
Master
results of this survey indicate few of the hospitals and Gardeners were not originally a target survey g
in this
nursing homes/assisted living facilities in Tennessee study, but were added due to concerns of the
practice
population
horticultural therapy. Only 20% of the 60 hospitals, size of the study. It is suggested that survey
nursing
this type
homes/assisted living facilities, and botanical gardens trying to identify horticultural therapy not in
that
Master
responded to the survey had horticultural therapy Gardeners. We feel their responses were more
programs.
aligned with therapeutic horticulture.
Three percent of the 34 hospitals and 18% of nursing
home/assisted living facilities surveyed had programs. There
is a current need for more horticultural therapy programs in
Tennessee and probably in the United States and there will
be an increasing need for programs in the future. Gathering
more information, such as found in this survey, will help
demonstrate the need for more horticultural therapy
programs and training of horticultural therapists.

Research in many countries is showing benefits to the

general population and especially to the elderly and disabled.
The elderly and those with physical disabilities were the
client groups in Tennessee most frequently served by
horticultural therapy programs The most common goal of
the horticultural therapy programs in this survey was to
improve client mood, but more than 50% of institutions also
used horticultural therapy to improve social interaction,
reduce stress, develop motor skills, and improve body
flexibility. Most programs in Tennessee had small budgets
with few volunteers. Horticultural therapy programs need
higher funding in order to serve more clients with a higher
level of care.

Because of budget constraints, the researchers used the

internet to conduct the survey as opposed to more expensive
mail or telephone surveys. The use of the internet as a survey
tool was satisfactory and may be useful for other researchers.
A limitation of this survey was that each organization was
concerned with the privacy of their members and would not
provide the researchers access to their mailing lists. Thus
each organization sent mailings of introduction and
reminders to their members. The researchers were limited
by the reliance on the organizations to contact the proper
representative and to send reminders. Names, addresses,
and telephone numbers can be purchased from a survey
sampling company or other list providers or found on the

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
36 JOURNAL OF THERAPEUTIC HORTICULTURE 2009:XIX

REFERENCES Evers, A.M., Linden, L. & Rappe, E. (2000). A review of human

Aldous, D. & Kidd, J. (2008). Horticultural therapyissues in horticulture in Finland: Urbanization motivates a
perspectives in
Australia and New Zealand. In E. Matsuo, P.D.renewed
Reif & appreciation
M. for plants and nature. HortTechnology
Burchett (Eds.), VIII International people-plant10(1), 24-26.
symposium
Exley, L. (2008). and
on exploring therapeutic powers of flowers, greenery A description of the program of horticultural
nature (pp.93-100). Awaji, Japan: International therapy
Society at the
forRoyal National Orthopaedic Hospital N.H.S.
Horticultural Sciences. Trust. In E. Matsuo, P.D. Reif & M. Burchett (Eds.) VIII
Aldous, D. (2000). Present status of human-horticulture International people-plant symposium on exploring
relationships research: Australia, New Zealand and the South therapeutic powers of flowers, greenery and nature (pp.83-91).
Pacific. In O. Verdonck, A. Mathe, P.D. Reif, E. Matsuo, G.D. Awaji, Japan: International Society for Horticultural Sciences.
Groening & J. Rammeloo (Eds.), XXV International Furuhashi, S., Hirata, M., Tanaka, E., Suzuki, T. & Oosawa, K.
Horticultural Congress, part 13: New and specialized crops (2008). Monitoringautonomic nervous activity of workers
and products, botanic gardens and human-horticulture harvesting apples, using a portable electrocardiograph. In E.
relationship (pp. 115-121). Brussels, Belgium: International Matsuo, P.D. Reif & M. Burchett (Eds.), VIII International
Society for Horticultural Sciences. people-plant symposium on exploring therapeutic powers of
American Horticultural Therapy Association (AHTA) (2002). 2002 fìowers, greenery and nature (pp. 225-229). Awaji, Japan:
Salary survey. Denver, CO: AHTA. International Society for Horticultural Sciences.
American Horticultural Therapy Association (AHTA) (2008a). Galvin, K., Sharpies, A., Hume, S. & Dumbrell, A. (2000). Users'
Defìnitions and positions. Retrieved December 10, 2008, from perspectives of work rehabilitation with horticultural therapy.
http://www.ahta.org/documents/FinalHTPositionPaper.pdf British Journal of Therapy and Rehabilitation 7(6), 1.
American Horticultural Therapy Association (AHTA) (2008b). Han, K.H., Lee, S.M., Kim, H.S. & Suh, J.K. (2008). A study on
Universities, colleges and organizations offering education or interpersonal relations of demented elders through therapeutic
training in horticultural therapy Retrieved December 10, horticultural activities of buddy system. In E. Matsuo, P.D.
2008, from http://www.ahta.org/education/colleges.cfm Reif & M. Burchett (Eds.), VIII International people-plant
Asano, F., Takaesu, Y. & Matsuo, E. (2008) Surveillance study on symposium on exploring therapeutic powers of flowers,
healing landscape: Meaning of existence of plants especially in greenery and nature (pp.133-137). Awaji, Japan: International
landscape. In E. Matsuo, P.D. Reif & M. Burchett (Eds.), VIII Society for Horticultural Sciences.
International people-plant symposium on exploring Harvey, G. (2003). Salary survey highlights areas of need and
therapeutic powers of flowers, greenery and nature (pp. 193- potential growth for HT profession. AHTA News
198). Awaji, Japan: International Society for Horticultural (July/August), pp. 1-3.
Sciences. Hefley, P.D. (1973). Horticulture: a therapeutic tool. Journal of
Barnicle, T. & Midden, K.S. (2003). The effects of a horticulture Rehabilitation 39(1), 27-29.
activity program on the psychological well-being of older Heliker, D., Chadwick, A. & O'Connell, T. (2000). The meaning of
people in a long-term care facility. HortTechnology 13(1), 81. gardening and the effects on perceived well being of a
Bruce, H. (1999/ Garden for the senses: Garden as therapy. gardening project on diverse populations of elders. Activities,
Altamonte Springs, FL: Winner Enterprises. Adaptation, and Aging 24, pp.35-56.
Buchanan, C. (1997). Brother crow, sister corn: Traditional Kidd, J. (2008). Horticulture and human well-being: A growing
American Indian gardening. Berkeley, CA: Ten Speed Press. field of interest for distance teaching in New Zealand. In E.
Collins, C.C. & O'Callaghan, A.M. (2008). The impact of Matsuo, P.D. Reif & M. Burchett (Eds.), VIII International
horticultural responsibility on health indicators and quality of people-plant symposium on exploring therapeutic powers of
life in assisted living. HortTechnology 18(4), 611. flowers, greenery and nature (pp.145-150). Awaji, Japan:
Davis, Stephen. "Horticultural Therapy. Senate Russell Onice International Society for Horticultural Sciences.
Building, Ninth Annual Congressional Initiatives Award Kwack, H.R & Reif, P.D. (2002). Current status of human issues in
Ceremonies. Washington, DC. April 1994. horticulture in Korea. HortTechnology 12, pp.415-419.
Lewis,
Dillman, D.A., Smyth, J. & Christian, L.M. (2008). Internet mail C. (1996). Green nature/human nature: The meaning of
and mixed- mode surveys: The tailored design method. plants in our lives. Urbana, IL: University of Illinois Press.
Hoboken, NJ: John Wiley Co. Lohr, V.l. & Pearson-Mims, C.H. (2008). Peoples response to
Elings, M. (2006). People-plant interactions. In Hassink, J. & Dijk, discomfort in the presence of interior plants or art. In E.
M. (Eds.), Farming for health (pp.43-55). Netherlands: Matsuo, P.D. Reif & M. Burchett (Eds.), VIII International
Springer. people-plant symposium on exploring therapeutic powers of
Evers, A.M. (2000). Activities in human issues in horticulture in flowers, greenery and nature (pp. 173-178). Awaji, Japan:
Europe among people-plant council news addresses. In O. International Society for Horticultural Sciences.
Verdonck, A. Mathe, P.D. Reif, E. Matsuo, G.D. Groening & J. Marsden, D. & Spurgeon (2008). Safer gardening in older age:
Rammeloo (Eds.), XXV International Horticultural Congress, Supporting people to Uve in their own homes. In E. Matsuo,
part 13: New and specialized crops and products, botanic P.D. Reif & M. Burchett (Eds.), VIII International people-
gardens and human-horticulture relationship (pp. 123-128). plant symposium on exploring therapeutic powers of flowers,
Brussels, Belgium: International Society for Horticultural greenery and nature (pp. 199-203). Awaji, Japan: International
Sciences. Society for Horticultural Sciences.

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
2009 : XIX JOURNAL OF THERAPEUTIC HORTICULTURE 37

Matsuo, E. (2000). Overview of human-horticulture

Sullivan, M. (1979). Horticultural therapy: Therelationships
role gardening plays in
Africa and Asia, especially in Korea in healing.
andAmerican Health Care Association
Japan. In O.(May), pp.3-8.
Verdonck,
A. Mathe, P.D. Reif, E. Matsuo, G.D. G.Groening
Tereshkovich, & J.
(1975). Horticultural therapy: A review. National
Rammeloo (Eds.), XXV International Council forHorticultural Congress
Therapy and Rehabilitation through horticulture ,
part 13: New and specialized crops lectureand
and publication
productsseries. February, 1(1),
botanic
1-4.
gardens and human-horticultureU.S. Department of Health & Human(pp.129-132).
relationship Services (2008). By 2020,
Brussels, Belgium: International one
Society for
in two Americans Horticultural
over age 50 will be at risk for fractures
Sciences. from osteoporosis or low bone mass. Retrieved November 7,
Matsuo, E. (2008). Humanity in horticulture - Healing and 2008, from http://www.hhs.gov/news/press/2004pres/
pleasure. In E. Matsuo, RD. Reif & M. Burchett (Eds.) VIII 20041014.html
International people-plant symposium on exploring Wichrowski, M., Whiteson, J., Haas, F., Mola, A. & Rey, M.J.
therapeutic powers of fíowers, greenery and nature (pp.39-34). (2005). Effects of horticultural therapy on mood and heart rate
Awaji, Japan: International Society for Horticultural Sciences. in patients participating in an inpatient cardiopulmonary
McCandliss, R.R. (1972). A career in horticulture therapy. rehabilitation program. Journal of Cardiopulmonary
Menninger Perspective (June-July 1972). Rehabilitation 25(5), 270-274.
Neuberger, K. (2008). Some therapeutic aspects of gardening in Yamane, K. & Adachi, M. (2008). Roles of daily horticultural
psychiatry. In E. Matsuo, RD. Reif & M. Burchett (Eds.) VIII activities in physical and mental QOL for elderly adults. In E.
International people-plant symposium on exploring Matsuo, P.D. Reif & M. Burchett (Eds.) VIII International
therapeutic powers of flowers , greenery and nature (pp.83-91). people-plant symposium on exploring therapeutic powers of
Awaji, Japan: International Society for Horticultural Sciences. fíowers, greenery and nature (pp.165-171). Awaji, Japan:
Olszowy, D.R. (1978). Horticulture for the disabled and International Society for Horticultural Sciences.
disadvantaged. Springfield, IL: Thomas.
Park, S.H. & Mattson, R.H. (2008). Effects of flowering and foliage
plants in hospital rooms on patients recovering from
abdominal surgery. HortTechnology 18, pp. 563-568.
Peacock, J., Hine, R. & Pretty, J. (2007). The mental health benefits
of green exercise activities and green care. Mind Week Report ,
February 2007, pp. 1-18.
Reif, D., Shoemaker, C.A. & Matsuo, E. (2004). The evolution of
the People-Plant Council: An assessment of the first twelve
years. In D. Reif (Ed.), XXVI International Horticultural
Congress: Expanding roles for horticulture in improving
human well-being and li fe quality (pp. 89-96). Toronto,
Canada: International Society for Horticultural Sciences.
Sempik, J. A. & Becker, S. (2003). Social and therapeutic
horticulture: Evidence and messages from research. Reading:
Thrive.
Senior Journal (2008). 4 in 10 Americans over 60 will experience
poverty. AARP Study Retrieved November 7, 2008 from
http ://senioijournal . com/N E W S/F eatures/05-23-
lAARPStudy.htm
Shepard, P. (1967). Man in the landscape: A historic view of the
esthetics of nature. New York: Alfred A. Knopf.
Shoemaker, C.A. (2004). Horticultural therapy: Comparisons with
other allied therapies and current status of the profession. In
D. Reif (Ed.), XXVI International Horticultural Congress:
Expanding roles for horticulture in improving human well-
being and life quality ( pp. 173-178). Toronto, Canada:
International Society for Horticultural Sciences.
Sim, W.K. & Kwack, B.H. (1995). Psychological effects of
ornamental plants on mental health in Korea. In E. Matsuo &
P.D. Reif (Eds.), Horticulture in human life , culture , and
environment (pp. 261-264). Kyoto, Japan: International Society
for Horticultural Sciences.
Söderback, I., Söderström, M. & Schälander, E. (2005).
Horticultural therapy: The 'healing garden' and gardening in
rehabilitation measures at Danderyd Hospital Rehabilitation
Clinic, Sweden. Pediatric Rehabilitaion 8(3), 235.

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
38 JOURNAL OF THERAPEUTIC HORTICULTURE 2009:XIX

APPENDIX A
Web Survey Questionnaire of Horticultural Therapy Programs in Tennessee

The University of Tennessee Institute of Agriculture Department of Plant Sciences

Thank you for your participation in our study This survey is part of my degree requirements at The University of Tennessee
The purposes of this study are to determine the awareness of the use of horticulture as a tool in therapy, to identify the
horticultural therapy programs already in existence, and what type of institutions, staff, clientele, and activities are involved
these programs in Tennessee. We assure you all your answers will be kept completely confidential and will not be associated
with your name or organization. Answering the survey will constitute your informed consent to participate. We greatly
appreciate you taking the few minutes necessary to complete and return your survey.

Gardening is an activity- the art and craft of growing plants like flowers, vegetables, herbs, and fruits- with a goal of creatin
beautiful environment and/or food.

Do you have a current interest in gardening?

How often do you garden?

What do you grow in your garden? (Please check all that apply)

Are

Please list the gardening related organizations o

How familiar are you with the use of horticultu

Verv familiar

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
2009 : XIX JOURNAL OF THERAPEUTIC HORTICULTURE 39

The following questions concern information about the institution where you are employed.

How would you characterize the ownership of your institution? (Please check all that apply)

_ State

How

How

Horticultural therapy is a structured therapy program that uses plants and plant activi
body, mind and spirit. In a horticultural therapy program, participant goals are identif
assessments are made for participant improvement. These programs usually take plac
nursing homes, etc. Therapeutic horticulture is not a formal therapy program, and it d
and addressed. The pleasure that comes from being close to plants and natural environ
they bring to clients and patients. It is often applied to settings such as courtyards, in
outdoor gardening, etc.
Does your institution have a horticultural therapy program?

Do you use therapeutic horticulture at your ins

How do you use plants in therapeutic horticultu

apply):

To what ext

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
40 JOURNAL OF THERAPEUTIC HORTICULTURE 2009:XIX

How long has your horticultural therapy program been in ope

What are the main purposes of your horticultural therapy program? (Please check

Wh

_ $1,000 to $4,999
_ $5,000 to $9,999
_ $10,000 to $25,000

What is the number of full-time staff involved in your horticultur

Please list the number of staff by the highest degree each has r

Number

I ligi i School Diploma /CKD

' bcational/Technical Training

Associate degree

College degree

Post-( Graduate degree

What are the prof

that apply).

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
2009 : XIX JOURNAL OF THERAPEUTIC HORTICULTURE 41

How many part-time staff are involved in your horticultural ther

Please list t
Number

High Scho
' ( )cat i ( )i i aI/T

Associate de

College degree

Post-Graduate degree

What are the profe

that apply).

Do you use

What is the average length of time spent by a clie

Which of the following resources are available for your horticultur

_ Flower Garden

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
42 JOURNAL OF THERAPEUTIC HORTICULTURE 2009:XIX

What activities are involved in your horticultural therapy pr

Is your pro

The following questions are about the demographics of clients served in your horticultural therapy
program.

What is the
None 1 to 10 10 to 25 26 to 50 51 to 75 Over 75

20 wars old or Younger

21 to 30 Years old

31 to 40 Years old

41 to 50 Years old

Over 50 ' ears old

What is the percent distribution of your clients by gender?

Percent

Females

Males

What are your client's major disabilities? (Please check all that apply).

_ Injury of the spine

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
2009 : XIX JOURNAL OF THERAPEUTIC HORTICULTURE 43

Now, I would like to ask your opinion about horticultural therapy in Tennessee in general.

To what extent, is there a need for professional horticultural therapy training in Tennessee, if at all.

To what extent, is there a need for a professional horticultural therapy associat

If you have comments you would like to share about horticultural therapy in

Please click the NEXT button to submit your responses. You will then be take
into the drawing for two $50.00 gift cards for Home Depot, to receive the resu
of horticultural therapy programs in Tennessee. All responses on the registrati
registration page is totally separate from the survey questions so your contact
responses in any way.

Would you like to be entered into the drawing for two $50.00 gift cards for

Would you like to receive the results of this survey?

If the survey results indicate a need to compile a directory of

to be part of this directory?

Please enter your contact information, such as your name an

saved in a separate database from your survey responses to e
connected with the survey responses in any way.

Name:

E-mail:

Phone:

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms
44 JOURNAL OF THERAPEUTIC HORTICULTURE 2009:XIX

ACKNOWLEDGEMENT

We are grateful to Esther Hisle from the Tennessee

Association of Homes and Services for the Aging; Chris
Clarke from the Tennessee Hospital Association, and Beth
Babbit, the Master Gardener Coordinator from the
University of Tennessee, for distributing the web-survey to
their groups. Special gratitude is given to Cary Springer of
the University of Tennessee Office of Internet Technology
Customer Tech Support for her assistance with the
construction and managing the statistical data of the web-
survey.

Jenny C. Pfeffer was born in Caracas, Venezuela. She

completed her B.S. in Ornamental Horticulture and
Landscape Design at the University of Tennessee and
returned to Venezuela for ten years. She completed an M.S.
in 2007 in the Department of Plant Sciences at the
University of Tennessee and worked on the horticultural
therapy survey reported in this article as well as the design of
a therapeutic rooftop garden for the Senior Behavior Center
at the Parkwest Medical Center, Knoxville. She currently is
employed as Horticultural Therapy Master at the Sertoma
Center in Knoxville.

Dr. Dennis E. Deyton received his B.S. and Ph.D. in

horticulture from North Carolina State University and M.S.
in horticulture from Michigan State University. He is a
professor in the Department of Plant Sciences at the
University of Tennessee. He conducts research primarily on
fruit crops and teaches courses in horticulture.

Dr. J. Mark Fly received his B.S. and M.A. at Middle

Tennessee University in psychology and M.S. and Ph.D. in
the School of Natural Resources at The University of
Michigan. He is a professor in the Department of Forestry,
Wildlife and Fisheries at the University of Tennessee. He is
Coordinator of the Wildlife Recreation Concentration, B.S.
Forestry Program, and Director of the Human Dimensions
Research Lab.

This content downloaded from

89.164.208.9 on Wed, 22 Feb 2023 17:52:54 UTC
All use subject to https://about.jstor.org/terms