Dig deep: The benefits of gardening
Healthcare Counselling and Psychotherapy Journal, October 2025

In the garden, the simple act of watching plants grow, feeling soil between the fingers, noticing the change in light, hearing the birds or smelling herbs can offer a sense of grounding and calm that is all too often lost in our modern world. At a time when our mental health services are stretched thin and growing numbers of people are struggling with anxiety, depression, trauma and burnout, many practitioners are beginning to look for additional ways to support recovery. Social and therapeutic horticulture (STH)¹ is one approach that is gaining ground.

For people whose inner worlds feel chaotic, disconnected or exhausted, the garden can offer structure, connection and a chance to feel part of something alive. STH builds on these benefits, using facilitated horticultural activity in carefully designed settings to support emotional wellbeing, increase confidence and foster social interaction.Ìý

STH is particularly compelling in the context of counselling and psychotherapy, because it can reach people who might find traditional approaches inaccessible or overwhelming. STH offers a different kind of therapeutic space that is active, group based and rarely focuses on health conditions or personal reflection. Clients are instead invited into a process of doing, observing and tending.Ìý

STH can significantly reduce symptoms of depression and anxiety, improve mood and concentration and enhance overall wellbeing.² STH also aligns with the growing push for more preventative, holistic, person-centred care in our health system. As social prescribing initiatives expand and the NHS seeks to integrate more non-clinical approaches into care pathways, STH offers a practical, scalable and cost-effective option that complements rather than competes with conventional therapy.Ìý

But STH remains underused and under-recognised.³ I believe it deserves a more prominent place in our thinking and practice. STH supports recovery through action, presence, physical activity and the small victories of growing and creating something real.Ìý

There’s a growing body of evidence that STH can make a real difference to people’s mental health.⁴ At its heart, STH supports emotional wellbeing – helping to build confidence, restore self-esteem and foster resilience and hope. But its impact goes even further. Studies have shown it can help reduce symptoms of stress, depression, anxiety, loneliness and social isolation.⁵ It’s also been used to support the management and stabilisation of a range of mental health conditions, with no known negative side effects.Ìý

Each week, thousands of people access STH projects across the UK,⁶ so we’re beginning to see the scale of its potential more clearly. Research is also starting to catch up with what practitioners and participants have long observed: that being in a garden, engaging with living things and working with others in a meaningful way can be life-changing.Ìý

A project I recently visited was using STH within a secure mental health unit. Staff spoke about the difference it was making, not only to residents but also to the wider service. The sessions, led by a trained practitioner, gave patients something to look forward to and talk about throughout the week.Ìý

Conversations that began in the garden often continued long after the session had ended, offering a thread of connection. The physical activity was welcomed, and the act of planning and planting brought a sense of purpose. Interestingly, staff also noted a positive shift in their own wellbeing.Ìý

A key route into STH is through green social prescribing, a model that recognises people’s needs cannot always be met by medication or clinical intervention alone. Green social prescribing connects individuals with non-clinical services in their local communities, including therapeutic gardening programmes. It’s a model that’s gaining traction. In fact, 87% of clinicians perceive improvements in mental health to be a benefit among patients referred to green social prescribing. Of those surveyed, 91% said they would refer for depression and 89% for anxiety. Other reasons for referral include grief and bereavement, trauma or persistent stress.^7Ìý

A cross-government evaluation shows just how transformative green social prescribing can be: over two years, more than 8,300 people engaged in nature-based activities (such as gardening, conservation or outdoor exercise) and saw meaningful benefits for mental health. On standard Office for National Statistics wellbeing scales, participants’ happiness scores jumped from 5.3 to 7.5 (surpassing the national average), life satisfaction rose from 4.7 to 6.8 and a sense of life’s worthwhileness climbed from 5.1 to 6.8. Anxiety levels also dropped from 4.8 to 3.4, bringing participants close to the national benchmark. Significantly, more than half of those involved came from socio-economically deprived areas, with 21% identifying as from ethnic minority backgrounds, highlighting how green social prescribing can help tackle health inequalities.^8Ìý

In terms of hard evidence, one landmark piece of research came in 2022, when Hung-Ming Tu published the first meta-analysis of randomised controlled trials (RCTs) focused on therapeutic horticulture.¹⁰ The findings were clear: participants in the horticultural therapy groups experienced significantly better mental health outcomes than those in control groups. The authors concluded that therapeutic horticulture should be considered a viable therapeutic option in healthcare settings.Ìý

A 2025 systematic review and meta-analysis in Frontiers in Psychiatry focused on the impact of STH on depression and anxiety.¹¹ The authors reviewed 17 studies, including four RCTs, and found large, statistically significant benefits for depression, and moderate and statistically significant improvements for anxiety, among participants in STH interventions compared to control groups.Ìý

The findings were encouraging. STH was shown to be a viable alternative to traditional treatments, but also highly effective when used alongside them. Importantly, the review highlighted STH’s potential to help address inequalities in access to care, particularly for people who might face barriers to engaging with conventional services.Ìý

STH was also found to support physical health, foster social connection and reduce feelings of loneliness, making it especially valuable for people living with complex comorbidities across physical, mental and social domains. With minimal side effects and the flexibility to be used preventatively, as well as during recovery or relapse, STH offers a compelling option for a system that is increasingly looking for person-centred, adaptable, holistic approaches. Ìý

In her written evidence to the Health and Social Care Select Committee,¹² Dr Carly Wood argues persuasively that STH is grounded in rigorous academic research, yet remains insufficiently woven into mental health care pathways.Ìý

Every day at Thrive, we see the impact of STH on people and communities. Supported by their GP, a client reached out to Thrive after they struggled to cope with day-to-day life and needed time off work. They felt very low most days; depression had taken over. By joining Thrive’s Pathway Group, a programme for adults living with mental ill health, they experienced the positive impact of both gardening activities and being part of a group. The programme gave them a focus and a sense of hope, igniting a passion to be outdoors and learn new things, supporting their return to work. They were also able to form connections with others who understood their struggles.Ìý

Thrive delivers STH at its three centres in Reading, London and Birmingham. The charity also runs outreach programmes in schools, hostels, hospitals, care homes and other community settings in the UK. We run targeted programmes to support people experiencing mental ill health, which act as both recovery and early interventions.Ìý

The Growing Out programme for adults with mental health needs, such as anxiety and depression, provides a chance to be active outdoors, socialise, learn gardening, gain confidence and improve wellbeing. We know that people who are experiencing disability, social isolation or long-term health conditions are at greater risk of developing mental ill health,¹³ so positive mental health outcomes are part of a wider agenda for all our programmes.Ìý

STH practitioners tailor the activity to meet the specific needs of each person. They develop a strong rapport with their clients and nurture a positive social environment, as well as tending to the plants and wildlife in the garden. Tasks can be varied and include sowing seeds, pruning and watering. When arranging activities, practitioners consider factors such as severity of mental ill health and personal or vocational goals. Practitioners can also adjust the programme if the needs of the client change.Ìý

Thrive is collaborating with like-minded organisations, individuals, academics and public bodies to increase the use of STH, often by providing training in a range of settings. Bex Warrilow graduated from the Thrive Diploma in 2024 and currently works as an occupational therapy assistant at an NHS adolescent hospital. She uses STH as a therapeutic intervention and runs year-round, weekly STH groups. Bex says: ‘We know the benefits of nature are really positive and I’ve witnessed improvement in emotional regulation. Even when someone isn’t feeling very good, they know through our sessions that going outside will help them. Engaging in therapeutic horticulture has helped them have conversations they haven’t necessarily felt able to have in the hospital’s clinical setting, because they feel more comfortable outside, while engaged and connected with nature and experiencing the physiological benefits.’Ìý

We know it will be challenging to provide STH equitably at scale and low cost. We also recognise that not everyone wants an in-person service. We recently launched the Cultivating Wellbeing app, which is a great way for people to get started with gardening and gain the many benefits of spending time in nature.Ìý

The data show that Cultivating Wellbeing is helping users incorporate gardening and time in nature into their routines and enhance their knowledge, skills, self-confidence and passion for gardening. Users of the app are more aware of the benefits of gardening and its impact on their health and wellbeing. Initial findings showed that, after 12 weeks, there was a 15.4% increase in users who knew how to incorporate gardening for the benefit of their wellbeing and a 38.5% increase in gardening activities. Users’ life satisfaction mean score increased by 0.6 points (out of 10) and their nature connectedness mean score increased by 10.5 points (out of 100).¹⁴ In time, we hope we will be able to make the app available to many more people as a complementary offer, primarily for those experiencing or at risk of anxiety or depression.

Anyone can benefit from gardening; it’s great for all of us. But when does someone need a guided intervention and how can therapists know that the organisation they are referring to can meet the needs of their clients?Ìý

When we think about nature’s role in health, it helps to imagine it working on three interconnected levels. First, there’s everyday contact with nature, such as a walk in the park, sitting under a tree or tending a small balcony garden. These everyday experiences offer gentle, ongoing support for wellbeing, helping people feel grounded and connected. The next layer is nature-based wellbeing initiatives, community programmes that use gardens, green spaces or outdoor activities to promote mental and social health, building on everyday nature exposure but adding intentional group support. At the most intensive level, we have nature-based therapy, including STH, which is carefully designed and led by trained practitioners to support people with diagnosed health conditions. Each layer plays a vital role, but the type of activity a person needs can vary depending on their circumstances and whether they are looking to prevent ill or worsening health or seeking recovery and relapse support.Ìý

The report, Aligning Therapeutic Gardening Approaches to Five Levels of Mental Health and Wellbeing,⁹ provides a structured framework that maps gardening practices to the NHS’s five-level mental health model. It clearly explains how various gardening activities (from self-directed gardening to horticultural therapy) can be used to meet specific mental health needs. By categorising interventions based on the level of support required, the report aids health and social care professionals in assessing and referring to appropriate nature-based interventions, ensuring that individuals receive the right type of support at the right time, reducing the risk of inappropriate or unsafe referrals. It not only enhances the effectiveness of therapeutic gardening but also provides clarity, enabling it to integrate more seamlessly into existing mental health care pathways.Ìý

Of course, people’s mental health and needs can fluctuate, and it’s incumbent on practitioners, referrers and organisations at all levels to consider whether the provision remains the right support for the individuals they are working with.Ìý

As STH gains momentum, the question naturally arises: what next? The evidence tells us that STH is a powerful, versatile approach that supports mental health across the spectrum, from prevention to recovery. Yet, for its full potential to be realised, STH must move from the margins to become a mainstream, integrated part of health and care in the UK.Ìý

A pivotal development is the upcoming formation of a UK Association for Social and Therapeutic Horticulture (ASTH). A joint venture between Trellis and Thrive, it’s a crucial step towards uniting practitioners and providing a consistent UK-wide standard, bringing confidence to referrers, patients and practitioners.Ìý

STH is poised to grow rapidly. It offers an accessible and effective way to support mental health at a time when demand for compassionate care has never been higher. As the ASTH grows, and as the NHS integrates green social prescribing more fully, the time is ripe for healthcare professionals to champion this approach.Ìý

Whether you are a counsellor, psychotherapist, social prescriber or mental health advocate, there are concrete steps you can take today: promote STH within your networks, make referrals where appropriate, encourage clients to explore the Thrive app and consider further training in therapeutic horticulture. Together, we can help ensure that the incredible power of nature is not only recognised but fully realised for the benefit of those we serve. And, of course, don’t forget to get gardening, too!Ìý