National Eating Disorders Association
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Implementing Horticultural Therapy in Eating Disorder Recovery

Brad E. R. Smith, MD

This blog post is sponsored by Rogers Behavioral Health.

Being out in nature, enjoying the warmth of a greenhouse, and working with plants all have a positive effect on someone’s mood and can also reduce anxiety. Because of this, horticultural therapy has been a valuable component of care across a variety of treatment settings, and is an especially good fit in eating disorder recovery.

Anxiety from contamination is a symptom that appears in those struggling with both eating disorders & OCD and related disorders. Horticultural therapy is a natural exposure that can be used to reduce anxiety and fear.

If someone has challenges with contamination, they might avoid getting dirty or exposing themselves to germs, bugs, and plants. Horticultural therapy can be used as part of their exposure hierarchy to have an activity that will continue to challenge them, resulting in fewer obsessions and compulsions.

For someone with an eating disorder, being involved from the beginning when a seed is planted, all the way to harvesting and preparing food, will also reduce anxiety about what is in their food. It can help people look at food in a positive light instead of being fearful.

This is also a great example about how to care for your body, just as you need to care for a seed or plant. The horticultural therapy process is an excellent way to demonstrate the symbolism of taking care of another living being, just as we need to take care of ourselves.

What is horticultural therapy?

While horticultural therapy and tending a garden at home appear to be similar, the difference is in the purpose and method of each. Gardening can be a relaxing hobby and can provide other benefits like having fresh fruits and vegetables. Horticultural therapy involves gardening or other plant-based activities but is goal-oriented and takes place under the direction and guidance of a professionally registered horticultural therapist, according to Jonathan Irish, MA, coordinator of horticultural therapy at Rogers.

“Patients are able to practice giving plants what they need to thrive through consistent care, nurturing, and purpose while working to get their own life back,” says Jonathan. “They are encouraged to challenge an unhealthy relationship to the food they eat by developing a different relationship to food they grow. While engaging in client-centered activities, they experience the metaphorical power of working with plants in a farm-to-table approach, a sense of community, and a belief in their own self-worth. Additionally, horticultural therapy activities can provide patients with unique opportunities to utilize cognitive behavioral therapy (CBT) skills, such as exposure therapy and behavioral activation.”

Brad Smith, MD, medical director, Oconomowoc campus and Eating Disorder Recovery Care for Rogers Behavioral Health. Brad E. R. Smith, MD, is a full-time psychiatrist and serves as the medical director for Rogers' Oconomowoc campus as well as the medical director of Eating Disorder Recovery. He is board-certified in adult psychiatry and forensic psychiatry, specializing in the assessment and treatment of eating disorders and other complex or multiple mental health diagnoses. Dr. Smith joined Rogers in 2011, seeing patients in the inpatient, residential, partial hospitalization, and intensive outpatient programs, helping patients learn evidence-based techniques for building resilience for recovery.