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Dream Practice: My Dream Horticultural Therapy Job

by Lorraine Brisson, MS, HTM

When I was asked to write an article about my dream horticultural therapy (HT) job, I did not hesitate to accept the offer.  For the past twenty years, I have been fantasizing about the components that would encompass a dream job in HT. I am slowly approaching that ideal, but will never totally achieve it.

You are probably asking yourself: What is HT? When I tell people what I do, I get a myriad of responses such as: Do I give therapy to sick plants? My response is that I provide therapeutic services to people with special needs using plants as a medium.  The American Horticultural Therapy Association (AHTA) definition of HT is: The engagement of a client in horticultural activities facilitated by a trained therapist to achieve specific and documented treatment goals.

Although the acceptance of HT as a science is fairly new, the use of plants and gardens to treat a variety of ailments is documented as far back as 2000BC in Mesopotamia. Today, HT is used in many different locations such as hospitals, nursing homes/assistive living facilities, schools, correctional facilities, municipal and state programs. Populations receiving HT programming include elderly, physically and developmentally challenged, psychiatric, veterans, substance abusers, Alzheimers, abused, youth at risk and many more.
My program is located at a veterans’ medical center in western Massachusetts and as fortunate as I am to have the facilities, funding and good pay that I do, I consider this to be somewhat of an exception. So, as I describe my dream job, I believe that I speak for the majority of HT practitioners.

Let’s start with why we choose HT-because we love it! The rewards of using the healing power of plants to enable others, combines two of the most rewarding professions-horticulture and human service.  I don’t know a single HT who is in it for the money. Unfortunately, because insurance companies don’t recognize HT as a legitimate treatment modality, employers do not receive third party re-imbursement for services rendered. Because of this, demand for good paying HT jobs is much greater than the supply. So, the first thing I would do is convince insurers that HT is a treatment modality deserving of third party re-imbursement. This would translate into wages that are commensurate with our allied professionals such as occupational, recreational, music and art therapies.
Currently, AHTA provides professional registration through a peer review process. I would take this a step further and require HTs to pass a state certification exam. This would put us on par with our allied professions and dispel the perception of HT as simply gardening activities. To obtain the education needed to become a certified HT, there would be plenty of educational opportunities throughout the country at colleges, universities and HT certificate programs accredited by AHTA.

So, now we have a pool of qualified HTs; what components are we looking for in an HT program? First, the facilities; if we are growing plants, we need a greenhouse.  This greenhouse would be handicapped accessible. It would have wide aisles and benches to accommodate a variety of situations. It would have all of the adaptive devices needed to serve the population with which I am working.. The greenhouse heating and cooling systems would be fully automatic. Attached to the greenhouse would be the potting areas so that participants don’t have to go outside travelling from one area to the other. Everything would be designed for comfort and accessibility. Outside, the gardens would have raised beds of different levels. There would be both sunny and shady areas for working and socializing. The gardens would have plants and ornaments that stimulate all the senses-touch, sight, smell, taste and hearing. Ornamental features would include water fountains and/or pools, birdhouses and feeders, chimes, an assortment of chairs and benches, tables with umbrellas and much more. It would be an oasis.

Now that I have the perfect facilities, I need participants. First, I need a referral process. This would be accomplished through a process by which a participants’ primary care provider, mental health clinician, social worker or other designated provider would initiate a referral directly to the HT program. I would contact the individual and make an appointment for an intake. The intake would consist of a detailed assessment that would insure individualized services to best meet the needs of the participant. After a brief period of time, an Individualized Service Plan would be established. During the course of the individuals’ participation, reviews would be conducted within an established time frame and adjustments made as needed.

Support would be provided by a treatment team consisting of mental health clinicians, physicians, recreational and occupational therapists, clerical, dieticians etc. who would meet regularly. Everyone would always be present and on time. Additionally, the maintenance crew would quickly respond to maintenance requests, and administrative staff would always be there to answer inquiries and requests for administrative needs. Equally important, the HT program would have adequate staffing. It would never be short-staffed due to vacations or illness. I would have a pool of volunteers too. They would be knowledgeable and dependable. They would interact well with the participants and contribute to the overall success of the program.

HT programs are not cheap to operate. Greenhouses need to be heated and maintained, and plants and materials need to be purchased. Funding for all this would be provided by the institution which would allocate the necessary funds in the annual budget. It helps if the CEO is a gardener! Too often when cuts have to be made, HT programs are the first in line. This would no longer be a concern because all staff would have an understanding of the benefits of HT programming not only to the participants, but to the institution as well, through beautification of the grounds.

As a professional, I would strive to maintain an ongoing training regimen. This would be achieved through in-house training and 100% financial support for attending training from related service organizations such as AHTA and the Northeast Chapter, AHTA.

So, now I have created my dream job. Best of all, is my satisfaction in knowing that the population I am serving will be the equal beneficiary of my dream job! 

Lorraine Brisson, MS, HTM
President NEAHTA

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