Effectiveness of social and therapeutic horticulture for reducing symptoms of depression and anxiety: a systematic review and meta-analysis
Published evidence indicates that therapeutic horticulture can significantly reduce symptoms of depression and anxiety in adults with symptoms or at risk of these symptoms. However, according to the authors of a recent systematic review, Wood et al 2025, more rigorous data are required for the full potential for therapeutic horticulture to be realised in the UK.
In their research, Wood et al identified 17 studies reporting on the effects of therapeutic horticulture on anxiety and depression. Most studies (14) included comparisons – either before or after therapy or with a usual treatment. Importantly, for inclusion, therapy had to primarily involved horticultural activities, with sessions lead by a practitioner training in therapeutic horticulture, whereas setting and duration of therapy were not defined. In addition, all studies used validated scales to measure the impact of therapy on anxiety or depression.
The relevant studies were published between 2010 and 2023. Nine of the studies were performed in Korea, 3 were performed in other SE Asian countries or Japan and only 3 involved western populations. All but 4 involved less than 50 participants, even when a comparator group was included, and the clinical conditions varied considerably between studies (e.g. patients with chronic back pain, elderly nursing home residents, outpatients with chronic depression).
A meta-analysis of data from the studies demonstrated statistically significant improvements in symptoms of anxiety or depression following the defined programme of therapeutic horticulture compared with comparator treatment or comparing before and after therapy. However, only a few individual studies showed a statistically significant effect, possibly because of the small numbers of participants. These included three Korean studies – one involving hospitalised stroke patients, another in patients with depressive symptoms and another in women aged 40-59 years without depression – and a Japanese study of elderly nursing home residents.
Their findings suggest the potential of therapeutic horticulture to support existing treatments for anxiety and depression. The publication of UK studies would help enable more wide-spread use of therapeutic horticulture in the UK.
Wood CJ, Barton J, Wicks CL. Effectiveness of social and therapeutic horticulture for reducing symptoms of depression and anxiety: a systematic review and meta-analysis. Front Psychiatry. 2025;15:1507354
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