“The glory of gardening: hands in the dirt, head in the sun, heart with nature. To nurture a garden is to feed not just the body, but the soul.” – Alfred Austin

When Alfred Austin, poet laureate of Great Britain from the late 1800s to the early 1910s, wrote those words in 1894, he was doing so much more than using poetic licence to rhapsodize about the joys of horticulture.

Research has shown that the benefits of gardening extend well beyond growing vegetables and fruit for sustenance and flowers and trees for aesthetic appeal. There is something about digging in the dirt while being outside, about communing with nature, that is therapeutic.

“We can use plants to calm the nervous system,” Amy Bruzzichesi says. “There's actually an autonomic nervous response. When we are around plants, we engage the part of the parasympathetic nervous system that lets us calm down and assess the situation more calmly.”

Bruzzichesi is NC State Extension’s statewide program manager for therapeutic horticulture, a position she has held since 2024. She provides resources to Extension agents throughout the state who are interested in creating or improving therapeutic horticulture programming in their counties, including four online courses.

In the following Q&A, Bruzzichesi provides insight into the program and her passion for using horticulture for human well-being.

Every few months people ask me questions about how to take care of their plants. I do know how to do those things, but that's not what therapeutic horticulture is. In a nutshell, it is facilitating a people-plant connection in a therapeutic setting so participants can move toward their wellness goals by being more connected to plants and nature. It has a trained facilitator. We use plants and plant-related activities to maintain people's health and enhance their well-being.

We tend to choose plants that have sensory properties so they'll have something that is interesting to touch. Or maybe it's chocolate mint that we can break some off and try it for the brave people who want to have that wonderful experience of the chocolate mint exploding in their mouth. It's all about getting people to use their senses to be more connected to nature.

It's not a clinical practice — that's horticultural therapy — but it's a wonderful way to help people maintain their mental health and maintain a focus on wellness when they're in a situation that maybe doesn't naturally lend itself to that.

Plants are not going to fix whatever is causing anxiety. They don't make the exam go away. They don't make the job problems any different. But what they do is allow us to approach those problems from a different perspective once we've been able to calm down. You are different when you have had the therapeutic experience. Plants can be really, really helpful in getting our nervous systems to respond more calmly and rationally. Research has shown that interacting with plants reduces stress markers, decreases blood pressure, and calms the nervous system.

If we are working in a nursing facility with older folks, we might be doing a tabletop activity where we're planting sunflower seeds that will go out into the raised-bed gardens. We might be doing a flower-arranging activity, which is also a tabletop activity so that people with mobility issues or other physical constraints can participate. If we're working with a more able-bodied population, we might be breaking up a plot of grass and creating a garden for the growing season.

We might be doing a plant identification stroll through a botanical garden and understanding how all the different elements combine to create a pollinator-friendly space.

Preschool children all the way up to ... The oldest person I've worked with was 103, 104, and still a dedicated, passionate gardener. So truly across the lifespan and the ability span. There are people that need different accommodations to participate, but we're absolutely delighted to make sure they're included as well.

As practitioners, we approach that as a really exciting challenge to find ways to help people, whether it's a tool that works or a position that's comfortable or any type of adaptive equipment. Helping everyone participate in gardening is incredibly rewarding.

Therapeutic horticulture is an evidence-based practice. A group of people gardening together and a group in a therapeutic garden might look identical, but there are different objectives. The people gardening, their focus is on the plants. In our therapeutic setting, we're also focusing on the plants, but the practitioner's focus is on the people. Is this person improving their ability to stand from 10 to 15 minutes? Is this other person having a social interaction? Is that person improving their sensory tolerance by putting their hands directly in the soil instead of using tools all the time? We use the body of evidence to choose specific activities that we know will help them move toward their goals.

Last year there was a pilot program working with students at UNC-Chapel Hill who were experiencing some mental health issues from the pressures of being a student. The program ran for 12 weeks. They had two cohorts of 18 students and did a pre- and post-test. The results showed that just being together and being with plants and having time to decompress helped them manage better.

They felt like the plants were their friends and they had made new friends in the group. Just being able to have a place that was low-stress, that could foster those connections and teach those coping skills, made all the difference in the world.

It really did. We had heightened anxiety. None of us had been through a pandemic before, and there was just the human instinct to go outside. For some people, that evolved into having a connection with plants and gardening, and with growing some of their own food and flowers. And it blossomed into, "Hey, wait a minute, I feel a lot better. I feel even better than I thought I was going to feel." That was one of my motivations for formalizing my connection with therapeutic horticulture. I took advantage of the extra time to get more training and to become proficient.

Part of Extension's mission is to promote wellness. It's a natural fit to have therapeutic horticulture as part of that. It is something that we can use across all North Carolina communities.

One of the natural routes toward that is through the NC State Extension Master Gardener program. When I started two years ago, I was delighted to find there were several programs already happening across the state. Wake County has provided therapeutic horticulture outreach through the Extension Master Gardener program for years. They've had a group of dedicated volunteers going out into the community and taking plant-based activities into nursing facilities, assisted living centers, schools and hospitals.

Where Extension can really make an impact is to help people overcome those barriers and find ways to maintain their wellness no matter where they live.

My outreach is to all 100 counties in North Carolina. I am available to do Zoom calls or to travel anywhere through Extension that I can help an agent set up a program, or to speak to their Master Gardener volunteers to do advanced training so they feel confident developing a new program to meet a need in their community.

I've also done outreach beyond North Carolina. I've spoken via Zoom in Ohio, Louisiana, Mississippi, South Carolina and a couple of other states to teach about therapeutic horticulture and to help them understand how it can benefit their Extension programs. I am the administrator and co-instructor for the four therapeutic horticulture online certificate courses. We take people from interest to proficiency. At the end, they have a certificate in therapeutic horticulture in partnership with the North Carolina Botanical Garden.

It comes from a lifetime of feeling a connection and solace from being outside and around plants. My father was a landscape architect and my mother was a clinical psychologist, so it's sort of a natural melding of those two skill sets.

My mom was in graduate school when I was a baby. She told my dad to take the baby outside so she could learn the names of everything. What my mother had in mind was bird, tree, dog. What my dad did was give the Latin names of plants. I learned to speak English in horticultural Latin. I’ve had this mental catalog my whole life. When I see a plant, it'll pop into my brain. As I got older, I asked questions and helped in the garden. And my great-grandfather owned a plant nursery, so it's been in my genetics for a very long time. This was a natural progression. Even though I landed in social work, plants were going to get in there one way or another.