Horticultural Therapy Session Plan (Activity Programming)

Plan ID: [Unique identifier]

Version/Date: [Version number] — [Date last updated]

Author: [Name, credentials, role]

Organization/Program: [Organization or program name]

Session Date: [Planned date]

Time: [Start time] to [End time] (Duration: [minutes])

Session Type: [Individual / Group]

Location: [Specific setting] (e.g., greenhouse, therapeutic garden zone, indoor room, bedside, community plot)

Expected Participants: [Number expected] (For groups: min [#] / max [#])

Participant/Group Context

[Participant name and identifier per facility policy] (Include for individual plans only; omit for group plans.)

[Target population description with functional needs and inclusion/exclusion criteria] (For group plans only; do not include individual identifiers.)

Referral Source & HT Role: [Referring discipline/service] — [How horticultural therapy integrates with the interdisciplinary plan]

Linked Goals from Plan of Care: [Relevant goal titles this session addresses] (List only goals explicitly targeted by this session.)

Relevant Functional Considerations: [Mobility/positioning, upper extremity function, cognition/attention, sensory needs, communication supports] (Include only items that directly impact the planned activity.)

Precautions & Restrictions (Safety-Critical): [Falls risk status] [Lifting/weight-bearing limits] [Immunocompromised status affecting soil/compost handling] [Wound/skin precautions] [Allergies: latex, plant/pollen, food, fragrances, insect stings] [Behavioral restrictions: sharp tool eligibility, elopement risk, self-harm risk] (This section must not be blank. If any item is unknown, use "Not yet assessed—must verify before participation" or "Unknown—screen at check-in: [brief screening plan]." Never infer or assume allergies or restrictions.)

Therapeutic Targets & Session Objectives

Primary Therapeutic Targets: (Select only those being addressed this session.)

• Physical: [ROM / strength / coordination / endurance / fine motor]
• Cognitive/Executive: [attention / sequencing / memory / problem-solving]
• Psychosocial: [social participation / communication / self-efficacy]
• Affective/Behavioral: [distress tolerance / mood regulation / engagement]
• Sensory: [tactile tolerance / olfactory tolerance / modulation]
• Vocational/Functional: [task persistence / work behaviors / safety compliance]

Session Objectives: (State 1–3 measurable objectives. For each, include observable behavior, permitted assistance level, success criteria, and data source.)

[Objective: Participant will [observable behavior] with [allowed assistance level], within [time/accuracy criteria], with [safety criteria]. Data source: [specified tool or method].]

Clinical Rationale: [1–3 sentences explaining why this activity is therapeutically indicated for these targets at this time]

Activity Overview

Activity Name: [Planned horticultural activity]

Theme/Meaning: [Seasonal relevance, cultural significance, or participant-chosen topic]

Therapeutic Mechanism: [Specific mechanisms targeted] (e.g., graded bilateral UE use, sequencing practice, social reciprocity in shared task, mindfulness via sensory focus. Specify mechanisms rather than generic benefits.)

Session Flow: Introduction (~[#] min) → Demonstration (~[#] min) → Guided practice (~[#] min) → Independent practice (~[#] min) → Reflection/cleanup (~[#] min)

Choice/Autonomy Points: [Where participants can exercise choice: plant type, pot color, role, location] (Note accommodations for participants with cognitive or communication needs.)

Task Analysis

Procedure: (List step-by-step instructions with time estimates. Mark critical safety steps. Write clearly enough that another staff member could run the session safely.)

• [Step 1] (~[#] min)
• [Step 2] (~[#] min)
• [SAFETY] [Critical safety step, e.g., tool handling, hand hygiene]
• [Additional steps as needed]

Task Demands:

• Motor: [Pinch/grasp, bilateral coordination, standing/sitting tolerance, reach requirements]
• Cognitive: [Attention, sequencing, working memory, problem-solving demands]
• Sensory: [Textures, sounds, odors, temperature exposures]
• Social: [Turn-taking, requesting help, collaboration requirements]

Anticipated Skilled Actions: [Where therapist will apply clinical reasoning: graded cueing, task modification, behavioral support, adaptive equipment selection]

Grading & Adaptations

Grade Down Options: [Pre-measured materials, larger seeds/tools, fewer steps, seated option, templates/jigs, simplified instructions]

Grade Up Options: [Smaller seeds, higher accuracy requirements, dual-tasking, time constraints, peer-leader roles]

Adaptive Tools & Supports: [Built-up handles, ergonomic tools, one-handed adaptations, positioning aids (raised beds, lap trays, anti-slip mats), communication supports (picture steps, color-coded bins), sensory accommodations (glove options, quieter zones)]

Stop Rules: [Criteria for pausing or modifying: pain, fatigue, shortness of breath, agitation escalation, unsafe tool use] (Define threshold for switching to backup activity.)

Materials, Tools & Safety

Materials List: (Itemize with quantities per participant plus buffer. Include substitution options for seasonal items.)

• [Material] — Qty per participant: [#], Buffer: [#], Substitution: [alternative if unavailable]

Tools:

• Non-sharp: [Scoops, watering cans, spray bottles, trowels, etc.]
• Sharp: [Pruners, scissors, knives, etc.] (If used, complete Tool Safety Procedure below.)

Tool Safety Procedure: [Sharps eligibility criteria] [Pre-issue safety briefing points] [Count-out/count-in procedure: starting count [#], issued to [roles], end-of-session reconciliation] [Locked storage location] (This field must not be blank if sharp tools are used. If no sharp tools: state "No sharp tools planned.")

PPE & Hygiene: [Gloves (including non-latex options)] [Eye protection if indicated] [Hand hygiene supplies and protocol] [N95 availability for immunocompromised participants if dusty activity]

Chemicals: [No chemicals planned] OR [Chemical type; storage location; dilution procedure; disposal procedure; SDS location]

Environmental Setup & Emergency Readiness

Setting: [Indoor / Outdoor] — [Specific location] (Accessibility features: [raised beds, wide paths, seating, shade structures])

Layout: [Participant station arrangement] [Staff positions] [Tool distribution point] [Traffic flow plan] [Defined boundaries] (Boundary definition especially important for participants with dementia or impulsivity.)

Conditions Plan: [Temperature/hydration plan] [Sun/shade management] [Lighting/glare mitigation] [Noise level] [Pest/insect precautions]

Emergency Readiness: First aid kit: [location] | Eyewash: [location or N/A] | Sharps container: [location or N/A] | Phone/radio: [access point] | Egress route: [nearest exit] | Incident reporting trigger: [criteria] (This field must not be blank. If any item not yet verified: "Not yet verified—confirm before session start.")

Seasonality & Contingency

Seasonal Fit: [Current season constraints and opportunities: plantable/harvestable items, relevant sensory elements]

Post-Session Care: [Who handles watering/maintenance] [Storage plan for participant projects]

Weather/Indoor Contingency: [Alternative indoor activity targeting same therapeutic domains] Criteria for moving indoors: [temperature threshold, precipitation, air quality index]

Backup Plan: [Plan B activity for supply shortages, attendance variations, or if primary activity becomes unsafe]

Staffing & Supervision

Staff Roster: Lead clinician: [Name, credentials] | Support staff: [Names and roles of assistants/aides/volunteers]

Role Delineation: Skilled intervention (grading, cueing): [staff] | Setup/materials: [staff] | Data collection: [staff] | Sharp tool authorization: [staff]

Supervision Requirements: [Supervision method: direct observation points, check-in frequency] [Staff-to-participant ratio for sharp tool activities] [Coverage plan if staff must leave area]

Data Collection Plan

Minimum Dataset: [Attendance/participation duration] [Level of assistance (specify scale used)] [Task completion metrics] [Safety behavior observations]

Target-Linked Measures: [Measures aligned to session objectives: fine motor counts/accuracy, sequencing errors/prompts, social initiations, pre/post ratings] (Select only measures directly linked to stated objectives.)

Measurement Definitions: [Operational definitions for cue, assist, initiation, safety violation, etc.] Timing: [baseline / during / end of session] Assessor: [who collects data]

Data Storage: [Where data are recorded: EHR, program log] [Privacy considerations]

Pre-Session Verification Checklist

[Items requiring confirmation at session start: unknown precautions/restrictions, tool eligibility checks, environmental safety verifications, consent/attendance confirmations] (Distinguish these from finalized planned elements.)

Variance Note

[Brief documentation of any deviation from plan and reason] (For post-session use only if session could not proceed as planned. This is not a progress note.)