Horticultural therapy can be individualized or used in a group setting.  Studies show that group horticulture therapy has a greater impact on rehabilitation and self-esteem.  In group settings, people can watch one another and learn.  A great deal of encouragement can be used among the group raising confidence.  A sense of accomplishment and self esteem is felt when the group sees their accomplishments.  Group therapy also develops social skills that also enhance self esteem.

Physical handicaps can be used as an advantage rather than a handicap.  For example, people with Parkinson's disease sometimes have symptoms of "tremors" or "shakes".  These "tremors" or "shakes" can be used as an advantage to sow seeds during the planting of a garden.

With lifelong illnesses and debilitating injuries, there are certain barriers that will be frustrating for the patient at times.  Keeping in mind that horticulture therapy is designed to enable the person, one must be mindful of special needs.  We want to challenge an individual, not make them frustrated.

Here are some helpful ways to avoid some of the frustrations:

	Raised, narrow beds for wheelchair bound people to make it easier to work in a garden without using special tools.
	Cardiac patients need to do activities that will not raise the stress levels and blood pressure.  They should not perform overly strenuous activities such as hauling dirt.
	Conserving energy is an important part of horticulture therapy since most of the activities are done outside.  Teaching energy conservation techniques will help patients during other daily activities.
	Amputees should exercise unaffected body parts and learn to use prosthetics.  Teaching them techniques such as holding gardening tools with a prosthetic arm will strengthen self confidence.
	Spinal cord injuries can vary dramatically in levels of disabilities.  The patient should be able to tell the therapist the level of assistance that they need.  These are very individualized cases.

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