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Horticultural Therapy in Practice

By Nicole Miedema

Children have their own way of learning, playing and experiencing the world around them. They have their own unique way of expressing difficult feelings and dilemmas. Horticultural therapy provides a new, special way of to obtain growth in the emotional lives of damaged children.

Children learn by playing and therefor get a grip on the world around them. By playing keek-a-boo games we have learned that mommy is not really gone when she disappears behind a tablecloth. Through theme-games like ‘mom & dad’, fireman, ticketcollector, we obtain grip on our environment, parents and adults.

In games children can work through difficult and fearful emotions and play out the feelings that they cannot yet comprehend. Being outdoors and gardening in a playground children can experience all kinds of feelings. Gardening is working with unique material that lives: it sprouts, grows, bears fruit, dries out, dies and sprouts again, etc. One can project feelings on plants. One can love them, take care of them or tease them. The different seasons offer a broad scale of activities.

Children with development problems are inhibited in their growth. In HT growth can be brought into motion again, just like plants. They can grow under the right circumstances: the right temperature, enough fertilizer, water and light.

Youth Village ‘De Glind” is a residential institute for assistence for children from 0 to 18 years of age. There are different types of clusters: groups of children with several ‘groupleaders’ and families with foster-parents who take children into their care. Research shows that children who are placed in ‘De Glind” often have complicated development problems. HT has been added to the treatment program in order to enlarge the possilibities to help these clients.

HT uses the same means and conditions for help/assistance as the projects on “Agriculture and care”*, but it concentrates on individual therapeutic treatment.

* In Holland the number of projects on therapeutic farms is growing rapidly. The Dutch organization that brings together the interests of these projects is called the ‘Platform for Agriculture and Care’.


In which growth are these children inhibited? For these kids, it’s difficult to comprehend normal things, like awareness of regulation and time. They want all kinds of things but are restrained by ill developed functions as motor retardation, lack of carrying-capacity and internal control. Because of their fear of failure they often tend to avoid difficult situations. The way they do this is mostly not adequate, for instance due to behavioral problems, self-overestimation, rigid behavior etc.

HT is used in these cases to set going development and change-processes. Mostly the choice goes out to individual therapy, because during the confrontation with peers stress and problematic behavior come up. In a private environment it’s safer to be confronted, to play, to learn and to experiment at a level that fits the potential possibilities.

And how is growth brought into motion again in HT? Diverse methods can be used: The vision of the institute on treatment and the type of children determines which method is chosen. In this case-study the ego-supportive method is used. Young children or children with a lack of carrying-capacity need protection from too much tension. In a ego-supportive therapy the specific assimilation-processes can be dosed . The therapist has a supporting role that reduces and intercepts tension, impulses, frustrations and fear. He functions as a kind of huge container for things that the child cannot yet comprehend. The therapist appoints the complicated emotions, clearly places them into perspective and therefor helps obtain clarity. He seeks connection to the areas where growth is possible. The following case-study shows how this method can be put in practice.


Paul is 10 year old boy. He is described as an impulsive, hyperactive child that is easily distracted. A lot of his behavior is owing to early neglect and insecurity. Therefor he lacks internal structure and unsafe attachment. Paul needs the safety of grownups around him, though he seeks for a symbiotic relationship with them. He has a low average IQ, a strong will and a tendency to provoke conflicts and shows opposite behavior. His mood is fearful. The foster parents describe him as an uninhibited and hyperactive child. He has trouble controlling himself and situations seem to befall him. Paul has difficulty sharing the attention in the foster home, he wants to have exclusive attention. He is described as a boy who unintentionally sucks the energy out of people. During the day and night Paul sometimes suffers from fearful fantasies that take a hold of him and that have to do with death: the end of living. He needs o lot of structured and predictive situations in the foster home, otherwise behavioral problems start up.

At school Paul constantly needs a grownup to not fall into chaos. Especially in ‘lose’ settings he is seems very uninhibited. Paul shows aggressiveness verbally as well as behaviorally and has trouble getting along at school.

For a long period of time, Paul showed little development or change in his behavior. The development problems at school and in the group were disturbing. An observation period was started by using HT.

Observation Period

After an observation period of four sessions it comes out that Paul has a childlike and impulsive way of working. He explores the world around him like a toddler: with his hands, nose and ears. He puts things into his mouth and grasps all kinds of things with his hands. He seems to have no internal control and easily falls into chaos. Selecting and determining during the activities is difficult. New activities he mostly rejects: “I don’t want that!”.

At those moments Paul gets rigid and stubborn. The cause of the rigid behavior seems to be fear. Can I really do this? And how should I do that? This is never going to work? When the therapist walks away a bit and Paul has the feeling he will be left alone, he always follows the therapist. During thunderstorms Paul gets too frightened to go home alone. Certain objects fascinate, but also frighten him. He asks for instance; “If I step into the water-butt, will I be able to get out again?” “If I stand in cement, will I be able to get out again?”

Paul has affinity with gardening. Because it is easy to influence him, taking part in the activities and the interaction with the therapist, development is possible. Paul is able to learn in circumstances in which a limited amount of materials is offered. Besides that a certain prognostication is necessary and the stimuli from the surroundings must be reduced. In such a situation Paul is able to let go of his rigidness.

He presents a boy who is curious and wants to discover the world in a playful manner. This observation leads to new therapy goals. After consulting the orthopedagogue, the therapy commences.

Movement Goal

The general goal: to give Paul more control over himself by making the world clear and structured. And to diminish the fear of separation by working from symbioses toward autonomy.

The sub-goals are:

  • observe the experiences of the body
  • contact the body by sense-activation
  • structure the surroundings
  • experiencing the ego· fence off the ‘self’ and the ‘other’

The order of the sub-goals indicates the phases of the therapeutic process. In the case-study 8 of the 13 sessions are described that took place within a few months. Because the background information indicates that it is difficult tot consolidate the experiences, the therapist decides to increase the frequency to two sessions a week. In this case-study the most important events of the therapy are described and the means that are used to stimulate growth.

a Step by Step Plan

During the observation period Paul shows interest in all kinds of materials and has difficulty chosing. The hammer and the axe fascinate him the most. The therapy is held at a fixed place with predictable materials and a fixed order .

First the needed materials are obtained, then the wood is chopped and the fire is lit. The last ten minutes of the session there is time for cleaning up and a cup of tea. The first session Paul feels a bit strange, but after that Paul knows exactly what to do. A fireplace is built, the therapist brings in tiles to break. The pieces are used as an bottom layer. Paul starts chopping wood in an enthusiastic way, he makes the kindlings as small as possible. There are different kinds of wood with variable hardness. Paul tries them all and tells the therapist which kinds split easily and which don’t.

Exercises having to do with physical activity appeal to Paul. He shows interest in certain materials. The therapist uses this information to offer a suitable exercise, namely building a fire. Lighting a fire is an exercise that takes place in a fixed spot. Paul has made a fireplace in ‘his’ little garden. It’s a clearly defined area to work on. Building a fire requires a limited number of materials, namely an axe, wood, lighting fluid and matches.

Paul almost automatically focuses on the fire, therefor most of the stimuli from the surroundings are shut out.

By offering materials with a variety of hardness, Paul can discover his power in a structured and functional way. He has to use his whole body. By fixed actions the exercise becomes predictive. Paul can learn to experience continuity. The therapist makes a step by step-plan and uses visual examples if necessary to create an overview. The following sessions different sensorial exercises are offered while sitting by the fire. There are games for physical strength, visual observation, scents, defining taste and sounds. The following describes these sessions.

Consious experienceewust beleven

During the session thick and thin branches are offered to Paul for him to cut to pieces. The therapist asks him: “Are you left or right-handed?”. Paul doesn’t really know and tries both hands. He discovers that he is right-handed. “Now it’s your turn.” Paul shouts. They both try out how long they can cut with either left or right hand. “If I can learn how to cut with my left hand, I can do something else with my other hand!”. The therapist also asks Paul which foot he puts first. They play balancing-games while sitting by the fire.

Paul is fascinating by the fickle forms of the fire. He takes the right precaution regulations that were agreed upon at the beginning of the therapy sessions. There are substances that have special effects when thrown into the fire, like powder milk. Flames light up, they appear to fly up. When the flames die down, Paul looks if the fire is out yet. He turns over the wood and studies the glowing coals. It’s snowing, Paul tries to put out the fire with snow. With water and sand he tries out other ways of extinguishing it.

During the fire-making Paul is consciously using his whole body. He listens to sounds, observed different forms of appearance of the fire, tasted herbs and other substances like bread and onion. He has also experienced his muscle power during the chopping of wood and pruning. By the therapist’s interventions these became conscious experiences. For instance by playing a game sensorial game: blindfolded Paul sensed several substances and the therapist asked concrete questions about his observations. By learning body-awareness it’s possible to create a sense of Self. These are my hands, legs, ears and nose.

After a few sessions Paul’s reactions show he is more sensitive and is more aware of his body. He says to the therapist: “Do you also think my hands smell of horses?”. Paul becomes more aware of his posture and shows the therapist what he does when it’s cold. He pulls up his shoulders and rubs his hands. During the wood chopping he discovers the difference in the position of his arm when holding the axe either in the left or right hand. For him a logical explanation develops: the right arm is strong enough to keep the straight, the left arm is crooked. For an adult this seems logical, but for Paul this is as good as a scientific discovery.

Seculed Garden

Every time Paul comes into the room, he looks into the water-butt. Sometimes the barrel is empty, when it rains a lot, it is totally full. When it freezes, it becomes ice and he tries to measure the thickness by breaking it. This fascinates him so much that he immediately asks the therapist: “Is the barrel full?” and “How thick is the ice now?”.

Paul already asked during the observation period how deep the barrel really was and if he could stand in it. This time the therapist takes the water out and puts Paul into the barrel. Standing there, he realizes that he fits into the barrel. He crouches and ducks away. “Now you can’t see me anymore, can you?”. The therapist lifts Paul out of the barrel again.

The whether circumstances are different every time and offer new experiences. The rain barrel seems to fascinate Paul, but it’s also very scary. If you look into it, it’s a dark hole. By emptying the barrel and standing in it, Paul experiences physically what goes in and what can come out of the barrel. Paul is wondering about ‘containment’ and the question whether one can also get out again.

The therapist expands this subject into an exercise in which this can be physically experienced, namely digging a secluded garden to sit in.

The first sessions are very intense and a deep hole in the ground develops. Paul makes a fire in the hole and sits close to the therapist. The next time the therapist will set more boundaries, she proposes to dig two separate sitting holes into the side wall. She makes


Activities where used which would trigger the different senses. Physical exercise is the first step to get a feeling of an ego fence. The second step was to make the fence more concrete, which made it possible for Paul to experience this. A shared sitting hole with seperated places to sit would give a symbolistic feeling about being together but stil apart from eachother. Placing a sign would indicate an active border between the Ego (I) and the rest of the outerworld. Paul's development by this threatment wil be, in short, the awakening of the experience of "Me" (ego) and the border with the surroundings.


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