Gardening as an Occupation: A Critical Review
York, Michelle, Wiseman, Tania, British Journal of Occupational Therapy
The relationship between occupation and wellbeing is far from a new concept in occupational therapy (Wilcock 2006). Therapeutic use of occupations underpins the philosophy of the profession, with occupations such as gardening being the very essence of the profession's fabric (Holder 2001). Gardening is widely reputed for providing an array of therapeutic benefits to wellbeing, under themes such as increased social inclusion, physical exercise, self-esteem and a spiritual connection (Sempik et al 2005a). Gardening is the occupational form used in social and therapeutic horticulture. Often located within local communities, social and therapeutic horticulture shares similar practices with psychology, social work, occupational therapy and vocational rehabilitation, and is gaining increasing respect and credibility (Fieldhouse and Sempik 2007, Parkinson et al 2011).
The link between occupation and health has been well established through research and is an integral element of several government papers and health guidelines; for example, Occupational therapy interventions and physical activity interventions to promote the mental well-being of older people in primary care and residential care (National Institute for Health and Clinical Excellence [NICE] 2008a) and Mental health and social exclusion (Social Exclusion Unit 2004). Research findings support engagement in occupations that promote physical exercise, social inclusion, life satisfaction, purpose and skill mastery. Research into occupational engagement and health is recognised by the College of Occupational Therapists (2007) as an urgent research theme for informing practice.
Historically recorded therapeutic benefits of gardening span back to the 1800s, with the belief that working in agricultural fields enhanced life for people with mental health issues, through to the use of gardening as activity and therapy for mental and physical rehabilitation in the 1900s to the current 2000s, with gardening used in many contexts (Simson and Straus 2003). A number of previous studies have highlighted the sparse exploration and documentation for the therapeutic benefits of gardening as an occupation (Johnson 1999, Sempik et al 2003, Relf 2005, Stein 2008).
The lack of sound research into gardening was seen as a major hindrance to its viable application as a therapy (Relf 2005). Johnson (1999) found that, from an occupational perspective, studies often regarded gardening in a vocational context, as opposed to a therapeutic one, with lack of consideration of elements such as social, cultural, spiritual and psychological. Stein (2008), in a review of the literature concerning community gardens and health promotion, found significant links to the promotion of physical activity and of psychological wellbeing. These factors were identified as positive influencers against illness and diseases, such as diabetes and colon cancer, and were seen as a strong agent in health promotion.
Sempik et al (2003) conducted a major literature review to pool studies and explore the wider meanings and contexts within gardening as an occupation. Their search stretched from 1970 to 2003. Overwhelmingly, although the literature clearly espoused the therapeutic benefits of gardening, they found studies to be subjective in nature, with poor or ill-defined research designs. Within their literature review, Sempik et al (2003) identified a significant lack of synthesis among published studies. The most recent previous literature review regarding the therapeutic benefits of gardening that they uncovered was by Markee and Janick (1979), which also found poor quality research and lack of synthesis.
After conducting a comprehensive search of the literature, this study has identified four high quality research papers, published since 2003, which explore the therapeutic benefits of gardening. However, there still remains a lack of synthesis within this area of research since Sempik et al (2003). …