Research & Evidence

We have collected studies of therapeutic gardening into a Research Library which can be used to find evidence to support your therapeutic gardening work and funding applications.  As further research studies into the benefits of gardening come to our attention we will list them in the Research Library and highlight some of them on this page in the Research Digest. 

Research Digest

In July 2016, a visit to the Trellis office from Maxel Ng of the National Parks Board , Singapore and currently a member of the Visiting Staff at Royal Botanic Garden Edinburgh, brought us news of studies being carried out there, including The Effects of Horticultural Therapy on Asian Elderly’s Mental Health . So far the results are significantly positive - we’ll link to the full research paper, when it’s published. Singapore has adopted a strategic approach to therapeutic gardening, with direct government investment in gardening projects across the country, see the wealth of gardening and greenspace in Singapore’s culture at


Gardening and well being

Therapeutic Gardening: theory and evidence
A summary of the main studies relevant to gardening therapy Word | pdf

Trellis Annual Conference 11th March 2016 : Dr Rachel Bragg, Development Coordinator, Care Farming UK, delivered an animated and enlightening overview of therapeutic gardening, its place within green care and evidence of how it supports health and wellbeing. To open the presentation please right click on the link and select 'open in new window' . This is the accompanying research paper.  

AIPH International Green City Conference: Growing Green & Healthy Places
Sir Richard Thompson KCVO, DM, President of the Royal College of Physicians in his conference paper  Why and How Green Environments are Better for Your Health   (please right click on the link and select  'open in new window') at the AIPH International Green City Conference,  1st April 2014

Gardens and health: Implications for policy and practice
A useful new publication, 2016,  making the case for increased use of gardening in health services, and rounding up some good research references about the health benefits of gardens and gardening.

Forward to Nature: Why a Walk in the Woods Could Calm ADHD, Make Your Family Happier and Deliver Your Kid to Harvard. Research shows getting kids in nature can increase intelligence, creativity, and well-being, as well as solving a host of other psychological and physical illnessess.

Longitudinal study of older people in Sweden highlighting the importance of non sport based physical activity in cardio vascular health.
The importance of non-exercise physical activity for cardiovascular health and longevity, Ekblom-Bak, E. et al.,Br J Sports Med: 28th October 2013

Green spaces deliver lasting mental health benefits. Analysing data that followed people over a five year period, the research has found that moving to a greener area not only improves people’s mental health, but that the effect continues long after they have moved. Article:.

PubMed: Healing gardens and cognitive behavioral units in the management of Alzheimer's disease patients: the Nancy experience.
Healing gardens: recommendations and criteria for design.
What Is the Evidence to Support the Use of Therapeutic Gardens for the Elderly?.


Physical Activity and the Prevention of Depression: A Systematic Review of Prospective Studies
George Mammen and  Guy Faulkner, PhD shows evidence that any level of physical activity including low levels (e.g., walking or  gardening  <150 minutes/weeks), can prevent future depression. From a population health perspective, promoting physical activity  may serve as a valuable mental health promotion strategy in reducing the risk of developing depression. Published in the
American Journal of Preventive Medicine Volume 45, Issue 5 , Pages 649-657, November 2013

The Growing Healthy Older People in Wales (GHOP) research programme reveals that allotment and community gardening reduces stress, boosts self-esteem and enhances feelings of happiness and well-being, particularly for women see the report at[web].pdf

ecotherapy benefits for mental health and wellbeing
Mind (the mental health support charity in England and Wales) recently released Feel Better Outside, Feel Better Inside - a report showing the many benefits of ecotherapy for mental wellbeing. Ecotherapy involves activities such as gardening, food growing and conservation work in natural environments. The report demonstrates that ecotherapy improves mental health, boosts self-esteem, helps people with mental health problems return to work, improves physical health and reduces social isolation. It also calculates the savings to the public purse from engaging people in ecotherapy activities.see report at  
also see Mind's report Ecominds effects on mental wellbeing: an evaluation for mind at

Allotment gardening and health: a comparative survey among allotment gardeners and their
neighbors without an allotment,  van den Berg et al. Environmental Health 2010,

Di Blackmore PhD postgraduate student at the University of Stirling gives an update on her research into the health effects of therapeutic gardening.

The main application of the research will be to raise awareness and convince service managers, funders and policy makers in organisations such as national government, local authorities, health and environmental agencies, of the value delivered by such projects.

Green space and Health

Ground-breaking research into the impacts of greenspace, blue space and urban environments on individual and population health was reported at the GreenHealth conference in Edinburgh in March. The conference, organised by greenspace scotland on behalf of the GreenHealth research partnership heard from speakers including Prof George Morris, Prof Richard Mitchell of Glasgow University, Prof Catharine Ward Thompson of the OPENspace Research Centre and Prof David Miller of the James Hutton Institute. In the final session delegates proposed key recommendations for policy, practice and further research. The recommendations, together with the presentations are now available at greenspace scotland


Trellis Research Work

We aim to collate new research relevant to therapeutic gardening so that it's accessible to practitioners in one central place. We also work in partnership with researchers to encourage more studies that will help build the evidence base that demonstrates the benefits of therapeutic horticulture initiatives.


Latest Research

  • The Social and Economic Costs

  • Understanding the mechanism of physical activity…

  • Benefits of a gardening project for people with dementia in nursing homes

    McClellan J
    Nursing Times [online]


    Gardening and garden-related activities can be a fun way of getting nursing home residents more physically active and engaged. For residents with dementia, they can provide opportunities to be involved, express themselves and interact with others. Gardening can also be a way of getting all members of the nursing home community involved in a common project. This article describes a gardening project undertaken at two nursing homes in Scotland, where it was found to have numerous benefits for all involved.

    Jeanette McClellan is a retired nurse helping to deliver on the Standards of Care for Dementia in Scotland in residential care settings.
Year Published by Where Abstract Link Pages Notes Pages
RIVASSEAU-JONVEAUX Thérese (et al) Healing gardens: recommendations and criteria for design 2012 Gériatrie et Psychologie Neuropsychiatrie du vieillissement The French Alzheimer plan anticipates new specialized structures for cognitive rehabilitation and psycho-behavioural therapy of Alzheimer's patients: the cognitive-behavioural units as follow-care units, the units of reinforced hospitalization inside the long term care units and the adapted activities units. this plan indicates the need to make healing gardens integral parts of these units. The benefits of green space in urban environments has been demonstrated with regards to physical, psychological and sociological effects and similarly studies in hospitals have revealed objective and measurable improvements of patients well being. Although green spaces and gardens are available in many French care units, they are rarely specifically adapted to the needs of Alzheimer's patients. For the garden "art, memory and life" a specific concept guided by a neuropsychological approach was developed, complemented by an artistic vision based on cultural invariants. It is already used in the frame of non-pharmacological therapies to improve symptoms such as deambulation, sleep disorders, apathy and aggressive behaviors. Based on the literature, and our experience and research, recommendations for the design of such gardens dedicated to Alzheimer's patients can be proposed. Beyond taking into account obvious aspects relating to security, allowing for free access, a careful design of walk-ways and a conscious choice of plants is needed. A systematic analysis of the existing green spaces or garden must be conducted in order to pinpoint the weakness of the space and identify the potential for developing it into a real healing garden. Evaluation of adapted questionnaires for users and professionals allow to establish a list of requirements combining both user requests and therapeutic needs as basis for the design of the garden as well as to evaluate during the course of the project, whether the needs of the various stakeholders have been met or if adjustments are necessary. 245-253 245-253
PRINGUEY Dominique, PRINGUEY-CRIOU France The healing garden, therapeutic resource: Psychopathological and phenomenological aspects, therapeutic implications 2015 L’Encéphale 197-201 197-201
PRINGUEY-CRIOU France Healing garden: Primary concept 2015 L’Encéphale 41 Since ancient times the relationship between mankind and plants occupies medicine and philosophy. From the first tablets of herbal medicine to Asclepius gardens, those of cloisters and bimaristans to cosmological gardens in Asia, from the largest public park to asylum institutions of the nineteenth century, the garden is proposed as a place of care, a promoter of restoration of the human being. If the advent of technology and drugs have for a time relegated it to the level of empirical care, results in neuroscience ultimately provide it on a scientific basis. The early evolutionary theories, the Savanah theory from Orians, the biophilia hypothesis from Wilson, are relayed by the famous Ulrich’ study showing the positive influence of a view of nature through the window on the recovery of in patients. Mechanisms leading stress regulation, level of attention and organisation, focus and fascination, are recognized at the origin of restoration processes. Human capacities to respond to the recuperating function of a natural environment connect to grounded behaviour for adaptation to natural selection process and survival. The mechanisms of our immune system are essential to maintain our vitality. Phyto-resonance, felt or unconsciously perceived in appearance, according to Shepard is an emotion that structures well beyond the archaic behaviour. Recovery, in terms of phenomenological experience of the presence, is a philosophical demonstration of the environmental i.e. multisensory, spatial and temporal approach. Its emotional and affective experience connects to the vitality and creativity. The phyto-resonance hypothesis according to the Konrad Neuberger's point of view induces strategies catering to all levels of the organisation of the human being. It confirms the multidisciplinary nature of hortitherapy and places the mechanism of relationships between man and plant at the centre of discipline. It is also a source of inspiration and inexhaustible work for caregivers. The phenomenological approach of the therapeutic garden is an art of hospitality, human relationships and care. The garden opens the door to our interiority and prepares the interpersonal meeting. The experience of presence, mobilizing internal resources, is an opening to the possibilities of the living world, allows entry into a slow but promising time. The reintroduction and rehabilitation of the garden setting in residential care is necessary. These benefits are open to all for a better efficacy of care. 454-459 454-459
POMMIER Romain (et al.) Approche qualitative de l’éprouvé au Jardin de Soins. Une étude exploratoire en Psychiatrie de l’Adulte 2018 Annales Médico-Psychologiques In Adult Psychiatry, the Healing Garden seems today an innovative therapeutic mediation aimed likely take part in the recovery of severe patients. The therapeutic effect would depend on several bound mechanisms, in keeping with our fundamental relation with the natural environment and socio-relational purposes supported by a nonintrusive support of low complexity. Formal scientific clinical studies began in psychiatry in reactive disorders. We want to consolidate the clinical impressions accumulated in practice care in the suffering hospitalized adult of a severe pathology, through a pilot study of a qualitative type using the content analysis of interviews in a short form. The method consists of exploring elements of their comments through a feedback of personal experiences within a small group of patients to identify recurring and shared issues. Then, a structural synthesis of central elements of described experience aims at understanding the patient unique experience meanwhile and perceive the meaning for them. We began the investigation with 7 patients. The clinical evaluation was based on a semi structured interview lasting 20–30 minutes with the help of an interview guide collecting experience. The personal experience of the patient once re-written has been analyzed. The first step of qualitative data confirms the assumption of a device of care supporting the process of recovery, the benefit in a reduction of perception of symptoms of the disease, the impression to get back on their feet, the interest of a differently perceived relation with caregivers, the advantage of a resumption of the power to act, and the recognition of the importance of the support from others. Therefore patients state a re-start of their physical or psychic energy. It can be understood with the support of the group as well as the direct effects of the vegetal, or more, with discovering new possibilities to enable them to rebound back into daily life. Then, they can describe that whenever the caregiver goes to the same level as the patient in charge, and that he agrees to be taught and surprised by what the other knows, he restores on a making-together method a failing self-esteem. This feeling of self-efficiency, highlighted by human interaction with a newly renamed caregiver, enables people to get past feeling stigmatized even if this feeling is unfortunately deeply buried in the person. If the feeling of worthlessness and impossibility to change give way to a slightest action, a dynamic settles down. It enables the patient to get aware that it can act and influence on its environment, like the others. As a result, the feeling of inadequacy decreases and even the slightest result enable to recover self-confidence thanks to a positive environment. It doesn’t take much for them to realize they can act and widen their experience to other areas of their lives. The feeling of the ability to act by themselves comes back. Finally the relationship with others seems a key element in the Healing Garden. It can be shared between peers, between caregivers and patients, between the relationships of these people with the rest of society. The matter is the acceptance of its own abilities even if they are diminished. This perspective cannot be separated from the above mentioned elements: The achievement is team work and overtake individual boundaries. It allows the patient. It is the feedback of society over creation and work performed. The feeling of self-efficiency created by the pride they can feel is reward and may lead to other achievement. To conclude, we propose to consider the thematic emergence of the experience of the concept of vitality as spring action in the real in front of others as echo in a psychopathologic tradition dedicated to the existential comprehension of disorders. The implementation of a healing garden in the psychiatric fields comes as a response of our survey and sustains the patients differently. The originality is in that patients acquire resources from the environment, in a dynamic recovery. So we suggest offering this mediation as soon as possible to curb the spread of their illness. We would like to see this pilot survey taking part in structuring relevant dimensions and new researches. 150-156 150-156
Sin-Ae Park, Ki-Cheol Son, Weon-Keun Cho Practice of Horticultural Therapy in South Korea 2012 Acta Horticulturae 954 Horticultural therapy (HT) in Korea has seen rapid growth over the past 15 years. The Korean HT and Well-Being Association has been playing a crucial role in developing Korean HT. There are four levels of HT certification including Advanced HT, HT Level 1, HT Level 2, and Horticultural Well-being provided by the Korean HT and Well-Being Association. At present, the number of qualified horticultural therapists stands at approximately 2,000 and HT is offered at about 1,700 facilities such as social welfare organizations, job rehabilitation facilities, hospitals, public health centers, schools, etc. for various people. The practice of HT includes four phases: diagnosis and preparation, planning, implementation, and evaluation. Currently, endeavors are underway to obtain state certifications for HT certifications and to ensure medical insurance coverage. 179-185 179-185
Van Den Berg AE, Custers MH Gardening promotes neuroendocrine and affective restoration from stress 2015 Epub 2010 Jun 3. Journal of Health Psychology Stress-relieving effects of gardening were hypothesized and tested in a field experiment. Thirty allotment gardeners performed a stressful Stroop task and were then randomly assigned to 30 minutes of outdoor gardening or indoor reading on their own allotment plot. Salivary cortisol levels and self-reported mood were repeatedly measured. Gardening and reading each led to decreases in cortisol during the recovery period, but decreases were significantly stronger in the gardening group. Positive mood was fully restored after gardening, but further deteriorated during reading. These findings provide the first experimental evidence that gardening can promote relief from acute stress. 3-11 3-11
Mick Marston Life near a city park can be as healthy as out in the country 2008 Federation of city farms and community gardens Newcastle upon Tyne
Miss S.A. Gibson Horticulture as a Therapeutic Medium 1996 Glasgow Caledonian University British Journal of Therapy and Rehabilitation
McClellan, J Benefits of a gardening project for people with dementia in nursing homes 2018 Nursing Times [online]; 114: 2, 38-40
Nancy Gerlach-Spriggs, Richard Enoch Kaufman, Sam Bass Warner, Jr Restorative Gardens: The Healing Landscape 1998 Yale University Press,+Vince.&ots=__AioyEfNp&sig=Vd8fUQvnzVIs7f_vmXn2bI8_A3I#v=onepage&q=Healy%2C%20Vince.&f=false
NHS National Institute for Health and Clinical Excellence Physical activity and the environment 2008 National Institute for Health and Clinical Excellence
NHS Scotland Hospitals Health benefits of Greening the NHS Estate 2011 pdf file
Nina Morris Cultivating Urban Greenspace 2010 University of Edinburgh Report on symposium
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Part II Structure of the lifestyle horticultural industry Horticultural Science Focus Chronica Horticulturae
Part III Well being benefits Horticultural Science Focus Chronica Horticulturae
Penny Wark A simple therapy that is down to earth yet uplifting 2008 The Times
Pretty J, Peacock J, Hine R, et al. Green Exercise in the UK 2007
Prof Les Firbank Carbon in the garden Internet
R Jepson PhD, F Thackeray Exploring the health effects of horticulture 2010 Word File
R Jepson PhD, F Thackeray Research & Evidence Working Group Word file by Trellis
R Jepson PhD, F Thackeray Research & Evidence Event 2008 Trellis
R Jepson PhD, F Thackeray Minutes of Research and Evidence event 2008 Trellis
R Jepson, R Robertson, L Doi Audit of exercise referral scheme activity in Scotland 2010 NHS Health Scotland University of Scotland
R Simpson Credits Small word file Stirling University
R Whear, J Thompson, A Bethel et al. What is the impact..for dementia 2014 Elsevier JAMDA
R Whear, R Garside Gardens crucial for dementia 2014 University of Exeter
Raymond Duncan Seeds of "garden scotland" should be sown 2006 Scottish Allotments and Gardens Society Third Force News
Roger S Ulrich Health Benefits of Gardens in Hospitals 2002 Texas A & M University
Roger S Ulrich, Marcus, M. Barnes Effects of gardens on health 1999 John Wiley & Sons Publishers Healing Gardens: Theraputic Benefits and Design Reccomendations
Roger S. Ulrich, Ph.D Health Benefits of Garden in Hospitals 2002 Texas A & M University Center for Health Systems and Design
Roger S. Ulrich, Ph.D View through a window may influence recovery from surgery 2009 American Association for the advancement of science
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S. Shimmen, H. Biggs, S. Rawcliffe Food, mental health and wellbeing 2010 Scottish Development Centre for Mental Health
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Scottish Arts Council Briefing, Arts and Health Scottish Arts Council
Scottish Government Mental health strategy for Scotland Respondent Information Form
Scottish Natural Heritage Health and the Natural Heritage 2009 SNH
Simon Bell; Val Hamilton; Alicia Montarzino; Helen Rothnie; Penny Travlou; Susana Alves Greenspace and quality of life: a critical literature review 2008 Greenspace Scotland Stirling
Sin-Ae Park, C Shoemaker, M Haub Physical and Psychological… 2009 HortScience journal
Sparcoll and BHF National Centre Five year review... 2009 NHS Scotland Executive Summary
Stephanie T. Broyles, PhD, Andrew J. Mowen et. Al Integrating Social Capital Into a Park-Use and Active living framework 2011
Stephen Adams Allotments really are good for your health 2010 Internet
Stephen Adams Allotments really are good for your health 2010
Sustainable Development Commission Health, place and nature
Tim Spurgeon Therapeutic Horticulture - Growing for optimum well being 2001 Positive Health
Tina Bringslimark , Terry Hartig , Grete G. Patil The psychological benefits of indoor plants 2009 Journal of Environmental Psychology
TJ Littlejohns, W Henley et al. Neurology 2014 American Academy of Neurology
Trellis Flow diagram for research Internet
V. Lohr, C Pearson-Mims Physical discomfort may be reduced in the presence of interior plants 2000 Hortechnology International Human Issues in horticulture
Van den Berg Health impacts of healing environments 2005 Groningen University Hospital Groningen
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Understanding the mechanism of physical activity… 2011 Elsevier
Ekblom-Bak, E. et al. The importance of non-exercise physical activity for cardiovascular health and longevity 2013 Abstract: British Journal of Sports Medecine Longitudinal study of older people in Sweden highlighting the importance of non sport based physical activity in cardio vascular health.
Mamen, G. Faulkener, G. Physical Activity and the Prevention of Depression: A Systematic Review of Prospective Studies 2013 American Journal of Preventive Medicine Volume 45, Issue 5 , Pages 649-657 Abstract: Context Given its high prevalence and impact on quality of life, more research is needed in identifying factors that may prevent depression. This review examined whether physical activity (PA) is protective against the onset of depression. Evidence acquisition A comprehensive search was conducted up until December 2012 in the following databases: MEDLINE, Embase, PubMed, PsycINFO, SPORTDiscus, and Cochrane Database of Systematic Reviews. Data were analyzed between July 2012 and February 2013. Articles were chosen for the review if the study used a prospective-based, longitudinal design and examined relationships between PA and depression over at least two time intervals. A formal quality assessment for each study also was conducted independently by the two reviewers. Evidence synthesis The initial search yielded a total of 6363 citations. After a thorough selection process, 30 studies were included for analyses. Among these, 25 studies demonstrated that baseline PA was negatively associated with a risk of subsequent depression. The majority of these studies were of high methodologic quality, providing consistent evidence that PA may prevent future depression. There is promising evidence that any level of PA, including low levels (e.g., walking <150 minutes/weeks), can prevent future depression. Conclusions From a population health perspective, promoting PA may serve as a valuable mental health promotion strategy in reducing the risk of developing depression
A E Van den Berg, HG Custers Gardening promotes neuroendocrine.. 2010 Journal of Health Psychology, June 2010
A S Poobalan, L S Aucott, A Clarke et al. Physical activity attitudes… 2012 BMC Public Health
A. van den Berg, M.van Winsum-Westra et al. Allotment Gardening and Health 2010 Environmental Health
Adrian Lee How Happy Bug May Ease Depression 2007 Bristol University Bristol University
Alison Bowes , Alison Dawson et al. Physical activity for people with dementia 2013 BMC Geriatrics
Alison Ryan Why Horticulture? 1997 Growth Point, Horticultural Therapy, Somerset Growth Point, Spring 1997 Horticultural Therapy, Somerset
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Andea Thompson Got Nature? You need to get out 2009 LiveScience LiveScience April 2009
Mediaeval Quotation 2004 Ashgate 2004 Health, Sickness, Medicine and the Friars
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Anita Unruh, Susan Hutchinson Embedded Spirituality: Gardening in Daily Life and Stressful life Experiences 2011 Scandanavian Journal of Caring Sciences , January 2011
Anne Jepson Therapeutic Gardening Research & Evidence Event 2009 Trellis Trellis , February 2009
Aye Maung Therapeutic Horticulture, Wellbeing and quality of life
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D. A. McLaughlin Social and Therapeutic Horticulture
DANNY DAY and BOB HAWKINS Getting Back to the Garden 2007 American Institute of Biological Sciences
David A. McLaghlin Social and Therapeutic Horticulture Scottish Agricultural College
David Malakoff What good is community greening 2002 American Community Gardening Association
Deborah Smith Horticultural therapy: The garden benefits everyone 2007 Internet Journal of Psychological Nursing and Mental Health Services
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Di Blackmore Phd record of first meeting 2010 Stirling University Office of R Jepson
Di Blackmore Edinburgh symposium 2011 University of Edinburgh
Di Blackmore Record of meeting between PhD… 2011 Trellis Perth
Di Blackmore Exploring the health effects of horticulture and gardens on general and vulnerable populations 2011 PhD Progress Report
Diane Relf Horticulture a Therapeutic Tool Journal of Rehabilitation
Diane Relf and Sheri Dorn Horticulture: Meeting the needs of Special Populations 2002 Internet
Dianne Anderson Grow to Care 2009 The Horticulturist Askham Bryan College, York
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K.C. Son, J.E. Song, S.J. Um, J.S. Lee, H.R. Kwack Effects of Visual Recognition of Green Plants on the Changes of EEG in Patients with Schizophrenia 2004 International Society for Horticultural Science
Ki-Cheol Son, Sin-Ae Park, Kwan-Suk Lee Determining Exercise Intensities of Gardening Tasks as a Physical Activity Using Metabolic Equivilents in Older Adults 2011
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McClellan J Benefits of a gardening project for people with dementia in nursing homes 2018 Nursing Times [online] Gardening and garden-related activities can be a fun way of getting nursing home residents more physically active and engaged. For residents with dementia, they can provide opportunities to be involved, express themselves and interact with others. Gardening can also be a way of getting all members of the nursing home community involved in a common project. This article describes a gardening project undertaken at two nursing homes in Scotland, where it was found to have numerous benefits for all involved. 38-40 Jeanette McClellan is a retired nurse helping to deliver on the Standards of Care for Dementia in Scotland in residential care settings. 38-40