The role of horticultural therapy in the clinical rehabilitation of patients with depression: A scoping review

Horticultural therapy is a plant-based therapeutic intervention that has shown promise in alleviating depressive symptoms and supporting clinical rehabilitation. This scoping review synthesizes current evidence on the use of horticultural therapy for individuals diagnosed with depression. A systematic search across eight Chinese and international databases identified 1044 studies, of which 18 met the inclusion criteria. These studies were conducted in diverse settings, including hospitals, nursing homes, schools, and community centers. Interventions ranged from active participation (e.g. planting and floral arrangement) to passive engagement (e.g. nature walks). Outcomes included psychological indicators such as depression and anxiety levels and physiological markers such as salivary cortisol and cardiovascular response. Most studies reported positive effects on mood and quality of life. However, variations in intervention design, duration, frequency, and facilitator qualifications limited comparability. This review highlights horticultural therapy as a promising complementary approach for depression rehabilitation while emphasizing the need for standardized protocols and culturally adapted applications in future research.