Horticultural Therapy and Acquired Brain Injury: A Mixed Methods Systematic Review

Background: Urbanisation drives reduced interactions between humans and nature, which has been suggested to negatively impact human health. Nature-Based Interventions are increasingly popular, and Horticultural therapy may improve depression, quality of life and cognition for people with acquired brain injuries. No systematic reviews of horticultural therapy and acquired brain injury have been conducted.
Methods: A mixed-methods systematic review was used to gather all available evidence. Theoretical supplementary searches were conducted to identify the relevant theories for horticultural therapy for the acquired brain injury population. A sequential exploratory approach to synthesis was adopted.
Results: 3522 records were identified through searches across seven database and. 14 studies were included in the final synthesis, five qualitative and nine quantitative. A logic model was developed, and the outcomes were tested using the quantitative studies.
Discussion: HT suggested to be effective for improving symptoms of depression and quality of life with mixed evidence for its effect on anxiety and cognition. Mechanisms of change include social interactions, restorative effects of nature and increasing self-efficacy. Future research should focus on high-quality quantitative research and consistent reporting of information. Clinicians should consider using HT alongside traditional rehabilitation for ABI and ensure the environment is accessible for all.