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Bodil Drescher Anaya was working at the New York University Medical Center when she got a call from the physical therapy department there. They were working with a young woman who just would not straighten her arm, which was rigidly bent and held close to her body. So they called Anaya, the director of the center's horticultural therapy department.

Anaya put the young woman in front of a raised, indoor garden, wide enough that a person could reach to the middle from a seated position. When Anaya told the woman they would be planting the garden starting in the middle and working back toward her, she never hesitated, stretching out her hand to dig the hole. For Anaya, the episode captured the essence of horticultural therapy.

"It's camouflaged," said Anaya, a registered horticultural therapist recognized by the American Horticultural Therapy Association. "Her mind was not, 'I have to stretch my arm.' Her mind was 'I have to dig a hole to plant this plant.' It's not an exercise she's doing. She looked down at her arm and said, 'You tricked me.'"

Anaya and Karen Strand are the founders of Way to Grow, Inc. in Schuylerville, NY, a not-for-profit agency that trains potential horticultural therapists, a healing and therapeutic approach that has its roots in the earliest civilizations. The therapy employs gardening and other natural interaction to help people with physical or mental disabilities, at-risk youth, prisoners, the aged and substance abusers, among others.

"I always say that physical therapy takes care of the mechanics of your body," Anaya said. Horticultural therapy helps people learn to live with disabilities. "Making use of it is up to the occupational therapists. What we're trying to do is to reach the highest level of competency."


Role of the Garden

Long known as valuable healing art, gardening has only relatively recently been recognized as a therapeutic tool. In documents dating from the Sumerian empires around 2700 B.C., a garden is described as "luscious fruit, of imperishable beauty and whose inhabitants knew neither sickness, violence or aging," according to Anaya.

Archaeologists in Egypt found recommendations from physicians around 600 B.C. describing the curative powers of communing with nature. England has had horticultural therapy programs since the early 1800s and in 1879, the first known greenhouse for use by individuals with mental illness was built by the Pennsylvania's Friends Asylum for the Insane.

After World War II, the federal government began to establish veterans' hospitals for returning disabled soldiers, according to the AHTA. It was the beginning of horticultural therapy's use with the physically disabled as an army of garden club volunteers brought natural activities to the patients. The offspring of such gardens can be seen in Milton, N.Y. at the Unlimited Garden at the 4-H educational center, designed and built for people with disabilities.

In 1955, Michigan State University awarded the first undergraduate degree in horticultural therapy; the first graduate curriculum was established at Kansas State University in 1971. Horticultural therapists work with other health care providers, including occupational and physical therapists, psychologists, psychiatrists, doctors and others to improve the lives of their patients. Patients -- or clients as practitioners prefer to call them -- work in all phases of gardening, including design, cultivation, maintenance, even marketing and selling of the end product.


Many Benefits

The therapy works on a number of levels, Anaya said.

First, there is the physical element of gardening, the use of "every single muscle in your body" during the work of preparing the soil, planting, weeding, harvesting and displaying, she said. Beyond that, the therapy helps build confidence and self-esteem, allowing the patients to see tangible, positive results from their work.

"There are two very distinct educational aspects that come together," said Strand. "This is not just a gardening activity where people play with plants. There is a goal at the end of the activity more than just having entertained a client for an hour. The thing about HT is that because of the nature of it, it's not as clinical or cold as if they're sitting in a therapist's office.

"This is a living medium that depends on their care," Strand said. "A lot of disabled people have been dependent on somebody else's care their whole life: Doctors, nurses, family members. This is something that will live or die based on what they do." Horticultural therapy also can help people interested in a job working with plants.

"It's also a good medium to teach about death and dying," Anaya said, referring to her work with elderly people. "They see a plant lives and dies, and that's OK. It's not something that is dreadful. It's just part of the life cycle."

At Pilgrim Psychiatric Center in West Brentwood on Long Island, a 2-year-old horticultural therapy center hosts about 170 people a week, working at planting tables or in the 2½ acres of land around it. There, mentally ill adults grow flowers, herbs and vegetables for their own use and have designed an ornamental garden for everyone's enjoyment, according to Richard Betanzos, a recreational worker there.

"This therapy kind of works on many different types of mental illness," Betanzos said. "Depending on their individual needs, we try to put them in an area where they can work comfortably. Some like the solitude and quiet of the planting table, and others like the social aspect of working in a group.

"It's a very calming atmosphere we have here," Betanzos said. "And for people who have problems with self-esteem, they're able to grow something and produce something."

Kim Hagstrom, a senior occupational therapist at Pilgrim, said the skills learned in the garden prepare their clients for work outside the facility.

"It gives them some sort of control over their environment," she said. "We see some social skills enhanced and some general work skills. For example, being on time, listening to a supervisor. That can be carried over into any kind of job."

"We've got several people who have worked in various horticultural jobs, landscaping and such," Hagstrom said. "It's re-identifying a successful time in their lives. It's a good thing for them to experience."

The Schenectady County Association for Retarded Citizens also has a greenhouse at its Maple Ridge Day Treatment facility in Rotterdam for people with developmental disabilities.


Getting Started

Horticultural therapy is still a fledgling movement in this country, with only 900 registered therapists recognized by the American Horticultural Therapy Association. Eventually, therapists like Anaya and Strand would like to see some sort of state or national licensing of horticultural therapists.
To become a registered or a master horticultural therapist, a candidate must have a varied background with college course work in such areas as psychology, botany, entomology, anatomy, communications and business management, to name just a few.

Courses, such as the ones Way to Grow sponsors, offer those interested in horticultural therapy a glimpse at the profession and introductory courses that go toward recognition by the AHTA.

"We're really trying to promote our profession and educate those who want to be an HT," Strand said. Way to Grow conducted a four-day seminar last month at its 164 Broad St. headquarters, the first of three set for the next two months. There also are courses set most every month at convenient times.

As a registered not-for-profit agency, Way to Grow relies on grants and donations to stay in business, getting a grant from Janssen Pharmaceutica Research Foundation to produce a color pamphlet. Donations of office equipment or time to perform clerical duties are also needed. Call (212) 473-2271 in New York City or (518) 695-9672 in upstate New York for more information.