Cultivating Hope through Horticulture-Based Strategies for Addressing Trauma: Findings from a Systematic Scoping Review

Background:

Research has demonstrated that horticulture-based approaches have been effective at addressing anxiety, depression and rumination (Gonzalez et al., 2010) while improving social functioning (Harris, 2017). Case reports have also suggested that horticulture-based approaches may be particularly appropriate for treating trauma, research in this area is limited (Detweiler et al., 2015). Notwithstanding, trauma has been on the rise since the COVID-19 pandemic, and it is possible that horticulture-based therapy could offer a safe, distanced space to process trauma. Accordingly, a systematic scoping review was conducted to explore current state of research on farm and garden-based interventions for trauma, particularly among at-risk populations, to determine potential appropriateness for addressing trauma. The findings from this review are relevant to our present pandemic context, the needs of at-risk nondominant populations and how horticulture-based approaches can be used to attend to these needs.

Methods:

A multi-data base systematic scoping review was conducted to offer an overview of the current state of research on farm and garden-based approaches for addressing the impacts of trauma, as well as (b) current needs and (c) recommendations for preventing and addressing trauma, particularly among at-risk populations. Peer-reviewed scholarly and grey source literature was identified using the following search terms: “PTSD” OR “posttraumatic” OR “post-traumatic” OR "mental trauma" OR "psychological trauma" or "trauma* event" AND “animal assisted” OR “care farm*” OR “farm*” OR “garden*” OR "horticulture" OR “nature-based” AND "healing” OR “prevent*” OR “recommendation*.” Included were (a) peer-reviewed and grey source literature that reported findings from primary qualitative, quantitative and mixed methods research, (b) in the English language, (c) that examined farm and/or garden-based approaches for addressing trauma as well as (d) current needs and recommendations for practice, policy and research, chiefly when working with at-risk populations.

The search returned 226 potentially relevant cases. Of these, 31 were preliminarily screened in for full text reading, with 16 screened in for thematic analysis, to uncover themes from available research.

Findings:

Several overarching themes were identified, including the affordability of horticulture-based approaches, their efficacy in complementing existing traditional forms of therapy through offering a holistic multisensory experience, and various physiological, psychological, spiritual and social-ecological benefits, such as improved mental health, decreased posttraumatic stress, assistance with processing grief and loss, and increased social supports. This is noteworthy, as perceived social support is a critical component for both preventing and addressing posttraumatic stress.

Implications:

Timely multi-level implications have been identified for future practice, research, policy, and education. For example, growing spaces should be considered in refugee camp design and further research is needed on horticulture-based strategies for addressing severe mental health disorders in addition to trauma, particularly experimental studies involving larger sample sizes. Further implications, including during the pandemic, will be discussed.