What is Green Care?
Green Care is a structured and facilitated intervention led by a trained practitioner that takes place in natural surroundings, recognising the instinctive connection between nature and health. The term includes therapeutic, social or educational interventions involving farming; farm animals; gardening or general contact with nature. Green Care can be viewed as an umbrella term summarising a wide range of activities and targeted beneficiaries, ranging from health promotion (targeted to a general population), disease prevention (accessible to a general population, but typically targeted towards more vulnerable individuals or groups) and therapeutic interventions which include targeted therapeutic or treatment/ rehabilitation interventions for addressing specific needs.
Green Care Programmes are designed, structured and facilitated for individuals with a defined need to achieve clear patient-orientated outcomes and use a person-centred approach to increase the benefits and ensure safety. The programmes involve the active and regular engagement of the individual with meaningful nature-based activities delivered by trained practitioners to create a sense of achievement, personal responsibility and self-confidence and offer opportunities to learn new skills. There are a wide range of nature-based activities that can be used in these programmes, including horticulture and food growing, farming and animal assisted services, and environmental and wildlife conservation.
Unlike casual outdoor recreation, Green Care involves trained professionals, clinical or therapeutic goals, and systematic program design. The main building blocks of Green care activities are nature contact, meaningful activities and social interaction.
Origins & lineage
Historically, Green care farms were associated with hospitals, psychiatric departments and other health institutions. Today, most Green care projects involve community gardens, city farms, allotment gardens and farms. The approach can be traced back to earlier traditions within Europe and North America where hospitals and psychiatric institutions used farms and gardens as therapeutic interventions for people with mental health problems.
The contemporary Green Care movement emerged most robustly in Northern Europe. Green Care Finland ry, established in 2010, works to coordinate, develop and promote the use of nature and animal assisted methods in combination with wellbeing and health services in Finland. The Green Care Coalition was established in 2016 to promote the commissioning and use of Green Care services, and to give voice to the many organisations in the UK who are committed to delivering or supporting the delivery of high quality and cost-effective Green Care services. In Norway Green Care refers to adapted and quality-assured welfare services on farms.
The intellectual framework consolidated in the 2000s. Key figures include researchers Joe Sempik, Rachel Hine, and Marjolein Elings, who contributed foundational conceptual work defining the field. The term “Green Care” itself gained traction across the Nordic countries and the Netherlands in the early 2000s as social and healthcare systems sought nature-based alternatives for rehabilitation and care.
How it’s practiced
All Green Care activities in Finland are conducted by trained professionals. Practitioners may come from backgrounds in occupational therapy, social work, horticulture, nursing, or animal-assisted therapy, and many receive specialized Green Care training.
Activities are as diverse as the settings. Farm animal-assisted therapy can include caring or and interacting with a number of animals including cows, goats, chickens, etc. in order to provide a therapeutic benefit to an individual. Therapeutic horticulture involves caring for plant-life as an intervention strategy. Participants may plant seedlings, tend livestock, harvest vegetables, mend fences, or walk forest trails—all under therapeutic supervision.
Most of the literature from Sweden described therapeutic horticulture for people out of work due to stress-related or burnout diseases. The Danish papers described both services based on horticulture and farm work for young people out of work or school, whereas in Finland, we found one article about horticulture for people with mental health problems. In Norway, there were several studies describing Green Care services on farms for people with mental health problems, animal-assisted interventions and therapeutic horticulture on farms.
Sessions typically last between 20 and 90 minutes. The most effective interventions were offered for between 8 and 12 weeks, and the optimal dose ranged from 20 to 90 min. Participants attend regularly—often multiple times per week—creating rhythm and routine.
Green Care today
While many countries have embraced Green Care, and research-based evidence supports its efficacy in a variety of therapeutic models, it has not yet gained widespread popularity in the United States. Green Care could prove to be an effective approach to providing mental health care in the U.S., particularly in rural areas that are typically underserved by more traditional mental health facilities, but have an abundance of farms, livestock, and green spaces where care might be effectively provided.
In Europe, Green Care is institutionalized. In some countries, [it is] a fully reimbursed, clinically validated healthcare model serving tens of thousands of people annually. Care farms operate as formal partners to health and social care systems, receiving referrals from physicians, psychiatrists, and social workers.
Social prescribing of nature therapy “green social prescribing” facilitates access to local nature-based activities that improve biopsychosocial wellbeing outcomes, are affordable, accessible, and can be adapted to context. In the UK, general practitioners may prescribe Green Care as they would physical therapy. Finland distinguishes between Green Care (in Finnish, Luontohoiva) [which] typically include vulnerable groups such as the elderly, immigrants, mentally and/or physically disabled, [and] Green Empowerment (in Finnish, Luontovoima) [which] include activities supporting the overall mental and physical wellbeing of all people.
In North America, the field remains nascent but growing. Community gardens with therapeutic programming, equine-assisted therapy centers, and care farms appear sporadically, often funded through grants or private pay rather than integrated healthcare.
Common misconceptions
Green Care is not gardening class. It requires trained practitioners, therapeutic goals, and systematic assessment. A hobby gardener and a horticultural therapist work with fundamentally different intentions and methods.
Green Care is not simply “being outside.” Many nature-based activities are available in the daily life of the general population, such as taking ‘green’ exercise (eg running, walking, cycling in the countryside or green spaces), interactions with animals (eg horse riding and dog walking), gardening/horticulture (including growing food), farming, forestry and environmental conservation. People usually make a conscious decision to incorporate these ‘Everyday Life’ activities into a healthy lifestyle. Green Care, by contrast, is intervention, not recreation.
Green Care is not exclusively rural. The Green4C project focuses on a) forests and other natural and semi-natural rural spaces; b) agricultural lands; c) urban and suburban green spaces as the geographical spaces where Green Care activities are or can be carried out. Urban community gardens, rooftop farms, and city allotments all serve as Green Care settings.
Green Care is not one modality. Green Care is an umbrella term used to describe a broad spectrum of health promoting interventions that all use both biotic and abiotic elements of nature. Therapeutic programs that are currently considered green care programs include animal-assisted therapy, horticultural therapy, wilderness therapy, care farming, and green exercise. The term encompasses significant methodological diversity.
How to begin
For practitioners: Seek training through organizations such as the American Horticultural Therapy Association (AHTA), Green Care Finland, or the UK’s Green Care Coalition. Many universities now offer modules or certificates in nature-based interventions.
For individuals seeking services: Inquire whether your physician or mental health provider offers social prescribing or green prescribing. In the United States, search regional care farm networks or therapeutic horticulture programs. In Europe, contact your municipal health authority for Green Care referrals.
For researchers: Consult the seminal 2010 report “Green Care: A Conceptual Framework” by Sempik, Hine, and colleagues, and examine the Nordic Green Care research network outputs from workshops held in Trondheim (2012) and later gatherings. Key journals include Journal of Therapeutic Horticulture, Society & Animals, and Anthrozoös.
For farm owners or land stewards: Contact national Green Care organizations to understand quality standards, insurance requirements, and training pathways. In Finland, quality labels (LuontoHoiva and LuontoVoima) guide professionalization. The Netherlands offers models for integrating care services into existing agricultural operations.