Disability, Disadvantage and Distress

“self-compassion offers clear advantages over self-esteem when things go wrong, or when our egos are threatened”
Dr. Kristen Neff


Disability Studies has come into its own in the academic world as more and more physically and mentally challenged individuals talk openly and write explicitly, sometimes militantly about their pathologies or those of loved ones.

The work of understanding quality of life reclamations has its proponents at many governmental, nongovernmental and intergovernmental agencies, starting with the UN.

As Horticultural Therapists it is useful to become familiar not only with the specific nature of certain limitative insults or pathologies in order to appropriately design therapeutic activity, but it can be useful to understand the developmental and psychological dynamics at play when someone is challenged by disability or disadvantage.

Reducing the disability gap and bringing differently abled people closer –especialy caregivers and doctors so that the clinical concern does not totally overshowdow the humanity of the person with functional limitations– also depends on how the disability is framed.  The WHO has developed a series of criteria worth understanding because the framework makes clear that disability is just as much a concern expressed in systemic environmental limitations and hurdles (sidewalks, kneeling buses, aural/vocal pedestrian lights) as it is personal issue. Furthermore, as disabled persons and some researchers of disability will argue the ways in which the disabled are framed, has an effect on the attitudes in the helping services. For example medical student attitudes towards persons with dementia was significantly altered after discovering that alzheimers patients, while suffering from the frustrations of memory loss,  were none the less able to engage wholeheartedly in creative storytelling.


The Horticultural Society of New York has made available a number of guides in PDFs format for using horticulture therapeutically to address the needs and issues of the mentally ill, incarcerated or institutionalised individuals, inner city children. These useful guides can be found here

Although less specific to any certain special needs group, this handy guide by the NJcooperative gives a good overview of the types of possible approaches to creating a programme.

Texts and Textbooks around pathology

On neuro-rehabilitation and annexe issues, here are a number of concise French language guides, presentations and documents. This is a wealth of information, a goldmine for helping to think about how to tailor Nature based and horticultural therapy activity.

A few texts I have found important as I learned to navigate Issues surrounding illness came in the form of work by this anthropologist of medicine specializing in oncology

There are generalist approaches and seminal texts as well as texts on the physical and psychosocial implications  of certain specific types of challenges, based on the medical insult or congenital condition.

For example here is a wonderful qualitative research article on stroke victims and here a good webpage that resumes what to expect after stroke.

Ongoing research

Neurotrack has developed an online test that helps to detect Alzheimers in its earliest stages. Thet also are passionat about brain health. Check out their brain games.

Clinical Environment

The clinical environment can be a challenging place to work for the horticultural therapist. Learning as much as is pertinent about pathology and disease for designing appropriate therapeutic activities is important. Becoming comfortable with clinical reasoning also demands familiarity with medical terms encountered. As an intern at NYU Rusk Rehabilitation I proposed a glossary of terms/abbreviations encountered in conference, in medical documentation, in everyday professional expressions as part of a research requirement. The glossary, as any living dictionary, remains incomplete at a mere 400+ terms, but can be consulted  here.

Witnessing and experiencing

Besides the clinical There are many eye witness or first hand narratives of living with disability. Either from the affected person or from the members of the close intimate circle of caregivers, family, friends.

Here are a number of writers I have found enlightening and inspiring for the therapist to read providing an almost ethnographic account, from the natives point of view, that may help with building empathy. Here are only a few examples.


prof Sandy Bern, feminist



Eve Ensler

Grisedis Real

Locked-in syndrome

Scaphandre et papillon

Mental Health and developmental disability

the disabling affects of depression

Darkness Visible remains a stalwart account by a modern writer

Prison populations and Substance Abuse

Healing fields

A good curiccula available at the Hort


Digging for Victory, Joanna Wise

A masters thesis on gardens for war veterans. Link here

Stroke and physical disability

My stroke of insight written by a stroke survivor who was also a neuroscientist is an exemplary account. This Ted talk is a good place to start until you get your hands on the book.

Diane Ackerman


Social and therapeutic gardens may be extraordinary vectors in community building.

Refugees, Asylum seekers and Primo Immigrants

Defiant Gardens

Innner city children and young adults or at risk youth

Curricula available at the Hort

Independent diasabled adults


Stress related health issues have been pinpointed by the WHO as the malaise of the 21st century.  This epidemic has started to catch our attention as we tailor our wellness and preventive health programmes to include information, education, and pratical approaches to stress.

Horticultural Therapists, like many other complementary allied health professionals are being included in integrative health teams or supported for blooming where they are planted programming which adressed this very modern health concern.

Burn out, bore out, psychique fatigue, uninterupped work flow due to cyber lifestyles…the impacts are far reaching while creeping up on us insiduously. But without necessarily reading a scholarly article that provides a series of models, we can more easily note that there are a few key charateristics, here is a cheat sheet or shorter article listing the issues succinctly

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