The Effects of Horticultural Therapy Based on Person-Centered Theory on the Emotional Competence and Concentration of Elementary School Students in Special Education Classes
Article information
Abstract
Background and objective
This study aimed to examine the effects of a horticultural therapy program based on person-centered theory on the emotional competence and attention span of elementary school students in special education classes (hereafter referred to as “SEC elementary students” or “SEC children”). Person-centered theory—rooted in the core principles of empathy, congruence, and unconditional positive regard—promotes personal development and fosters autonomy in emotional expression.
Methods
The program was implemented with six students from a special education class at an elementary school in D City. It was conducted once a week for 40 minutes per session, over a total of 10 sessions from April to June 2025.
Results
There was a statistically significant improvement in emotional intelligence, with scores increasing from a pre-test mean of 87.17 ± 21.01 to a post-test mean of 151.50 ± 37.30 (p = .028). Positive emotional responses significantly increased (p = .027), while negative emotional responses decreased (p = .028). Additionally, a session-by-session analysis showed a consistent improvement in emotional competence (p < .001). Attention scores decreased from 22.67 ± 3.98 to 9.17 ± 3.66 (p = .027), indicating improved attention span, as lower scores reflect better outcomes. These results suggest that horticultural therapy, based on person-centered theory, had a positive effect on both emotional competence and attention span. It is presumed that the therapeutic environment—characterized by empathy and autonomy—contributed to these positive changes among children with special educational needs.
Conclusion
This study demonstrates that horticultural therapy—founded on empathy and support for autonomy—is an effective intervention for improving emotional competence and attention span in SEC children. These findings support the potential application of horticultural therapy based on person-centered theory within school-based special education programs.
Introduction
Elementary school students in special education classes (hereafter referred to as “SEC elementary students” or “SEC children”) may experience psychological and emotional withdrawal when integrated into general education settings alongside their typically developing peers. This withdrawal may lead to issues such as anxiety, reduced concentration, and diminished self-esteem (Son et al., 2001). Moreover, as these students grow older, their awareness of their surroundings, intellectual curiosity, and desire for self-expression tend to increase. However, limitations in attention span and endurance, as well as a limited capacity for sustained engagement, often hinder their academic achievement. These challenges frequently lead to repeated experiences of failure, resulting in a decline in motivation to learn (Kim et al., 1993). These combined characteristics —emotional instability and difficulty in sustaining attention—can adversely affect various aspects of a child’s development, including academic learning, behavioral self-regulation, the formation of peer relationships, and adaptation to daily life. In the long term, such challenges may significantly undermine the development of self-esteem and the capacity to establish and maintain meaningful social relationships (Jo, 2005).
Various interventions have been implemented to support the psychological and emotional stability of SEC children and to address their difficulties with attention (Ha, 2017; Lee and Lee, 2019). However, many of these approaches remain primarily focused on academic instruction, often overlooking the emotional competencies and inner change (i.e., constructive personality change) of these children. In light of this, there is a growing demand within the educational field for experience-based, alternative therapeutic activities that engage multiple senses and promote emotional expression. Among such approaches, horticultural therapy is gaining increasing attention. It offers a holistic, sensory-rich experience through interaction with plants, fostering a sense of accomplishment and emotional stability through the nurturing of living organisms. Horticultural activities naturally stimulate the five senses, enhance concentration through task-focused engagement, and promote emotional relaxation. These effects can positively impact psychological, emotional, and behavioral aspects, ultimately supporting school adjustment (Choi, 2017). In particular, horticultural therapy can serve as an appropriate intervention for children with limited verbal expression or emotional competence, as it encourages nonverbal forms of self-expression.
Meanwhile, to maximize the effectiveness of horticultural therapy, it is essential to move beyond the mere provision of horticultural activities and apply theories that facilitate psychological growth and inner change. This study applies Carl Rogers’ (1902–1987) person-centered theory as a foundational framework for horticultural therapy. Grounded in three core therapeutic elements—unconditional positive regard, empathy, and congruence—person-centered theory fosters inner growth and supports the restoration of autonomy and self-expression in participants. This approach is expected to enhance emotional stability and attention span (Choi, 2017). Moreover, it has been shown to help children in special education settings become more self-directed, autonomous, and confident (Kim, 2008). However, there is a lack of empirical research in South Korea examining the effectiveness of horticultural therapy programs based on person-centered theory for SEC children. To address this gap, this study developed and implemented an indoor horticultural therapy program grounded in person-centered theory for SEC children. By analyzing pre- and post-program changes, we evaluated its effects on emotional development and attention span. Based on these findings, we sought to suggest the potential of horticultural therapy as a non-pharmacological, sensory-based intervention that can support the emotional and psychological development of SEC children in need of therapeutic support.
Research Methods
Participants
This study aimed to investigate the effects of a horticultural therapy program grounded in person-centered theory on the attention span and emotional abilities of SEC children. The participants were students in grades 1 through 6 enrolled in special education classes at an elementary school in D Metropolitan City. Six children were selected, with priority given to those officially identified as requiring special education services and additional support. The selection criteria for participation were as follows. First, children were required to be enrolled in special education classes and deemed eligible for participation in the program. Second, the cooperation and informed consent of both guardians and homeroom teachers had to be obtained. Children who were unable to participate due to physical limitations or other constraints were excluded from the study. Furthermore, prior approval was obtained from the school administration, and participants were selected in collaboration with special education teachers. Guardians of the selected children were provided with a detailed explanation of the study’s purpose, procedures, duration, anticipated outcomes, right to withdraw, and privacy policy. Written informed consent was then obtained. In addition, the program’s content and procedures were thoroughly explained to the children in age-appropriate language to ensure their understanding, and verbal assent was also secured.
This study was conducted in accordance with both domestic and international ethical standards for research involving human subjects. Participation was entirely voluntary, and all collected data were anonymized, used solely for analysis, and securely destroyed upon completion of the study. Moreover, the program was carefully designed to minimize any physical or emotional burden on the participants, with consideration given to the individual characteristics of each child. Detailed information on participant characteristics is provided in Table 1.
Participant characteristics
Research tools
Horticultural therapy program
A horticultural therapy program grounded in person-centered theory necessitates a therapeutic environment that fosters the following core conditions: (1) Unconditional positive regard—accepting all of the child’s expressions and emotions as they are, and offering encouragement without judgment of failures or mistakes; (2) Empathy—carefully attuning to the child’s emotional state and level of engagement with plants and activities, and building a warm, empathetic relationship; and (3) Congruence—creating opportunities for the therapist to authentically express their own emotions and engagement, thereby fostering genuine connection with the child (Lee et al., 2005). This study incorporated horticultural activities as therapeutic interventions designed in accordance with these three foundational principles of person-centered theory.
First, the therapeutic intervention of unconditional positive regard was implemented by offering positive feedback regardless of the children’s behavior or level of achievement during the activities. The children received generous praise and encouragement, even for minor accomplishments, and responses to mistakes remained supportive and nonjudgmental. In doing so, the intervention fostered a psychologically safe environment in which children could engage freely in the activities without fear of failure—emphasizing effort and participation over outcomes.
Second, empathy was applied by accepting and validating the children’s emotions and behaviors throughout the horticultural activities. Active empathic responses were provided in relation to a range of emotional experiences— such as joy, interest, curiosity, frustration, and disappointment—that emerged during interactions with flowers and plants. By acknowledging and verbally reflecting these emotions, the intervention supported the development of the children’s emotional self-awareness and expressiveness.
Third, congruence was fostered by maintaining an authentic and consistent demeanor in interactions with the children throughout the program. For example, when a plant failed to thrive, the researcher expressed genuine emotion by saying, “I’m a little disappointed that this plant isn’t growing well either. But if we work together, it can grow beautifully again.” By openly sharing personal feelings and engaging in the horticultural experience alongside the children, the intervention helped to build trust and strengthen the therapeutic relationship.
The program implemented in this study was reconstructed based on a case study on horticultural therapy for children with intellectual disabilities (Choi, 2017), with particular attention to the behavioral characteristics of the target population (Joo, 2012). Its structure was further guided by the national elementary special education science curriculum for both lower and upper grades (Korean Ministry of Education, 2022), which emphasizes values and attitudes such as respect and consideration for nature and life, as well as age-appropriate levels of difficulty and engagement (Korean Ministry of Education, 2022). The final program was organized into three phases: Early Stage (Building Mutual Trust), Middle Stage (Self-Expression), and Late Stage (Inner Exploration) (Kim, 2024).
The Early Stage aimed to promote positive interactions through active participation, thereby fostering mutual trust between the therapist and the children and establishing a sense of group stability. The Middle Stage focused on encouraging emotional expression by providing unconditional acceptance and empathic understanding. During this phase, creative activities were also introduced, allowing children to make choices freely. The Late Stage was designed to enhance emotional competence and attention span by facilitating self-exploration through immersive experiences (Table 2).
Horticultural therapy program for each session to achieve the therapeutic goal of this study
Program implementation
A horticultural therapy program in this study was conducted every Wednesday from April 2 to June 4, 2025, for a total of ten 40-minute sessions. The sessions took place in the special education classroom (Class H) at S Elementary School, located in D Metropolitan City. Class H, approximately 63 m2 in size, was furnished with six tables and chairs, a whiteboard, and an electronic whiteboard. The program was led by the researchers, who served as the primary instructors, with support from the special education (SE) homeroom teachers and staff teachers acting as assistant instructors. The observation logs were collaboratively completed by the researchers, special education homeroom teachers, and staff teachers. Prior to the implementation of the program, the researchers visited the school to explain the purpose of the study, the schedule, and safety precautions to the participating students and SE teachers.
Assessment tools
In this study, we used two instruments to evaluate emotional competence: the Emotional Intelligence Rating Scale for Preschool Children (EIRSPC; Kim, 1998), a teacher-rated scale, and the Horticultural Therapy Efficacy Scale (HTES; Psycho-Emotional Evaluation Indices; Im, 2010) to assess the effects of horticultural therapy. Both instruments were administered as pre- and post-tests. Both instruments were administered as pre- and post-tests. The EIRSPC was selected to accommodate SEC children who were unable to read or complete self-report questionnaires in Korean, as most existing scales for children are self-administered. Therefore, the EIRSPC was considered appropriate based on the mental age of SEC children with intellectual disabilities. Developed by Kim (1998), the EIRSPC consists of 50 items, each comprising a pair of positively and negatively worded statements. Responses are rated on a 5-point scale, with higher scores indicating stronger positive emotional competence. The scale has demonstrated high internal consistency (Cronbach’s α = .96) and good pre-post test reliability (r = .87). In this study, the EIRSPC also showed strong reliability, with a Cronbach’s α coefficient of .970. Furthermore, the HTES (Psycho-Emotional Evaluation Indices) developed by Im (2010) to assess the effects of horticultural therapy, was originally designed for a self-measurement tool so it could be applied to all horticultural therapy participants (Im, 2010). However, considering the study participants were SEC elementary students, this research utilized the scale through teacher observation logs to compensate for the limitations inherent in self-report measurements. The HTES consists of 24 items: 13 assessing positive emotions and 11 assessing negative emotions. Positive emotions refer to the overall enhancement of emotional well-being through horticultural activities, including aspects such as self-esteem, stability, satisfaction, a sense of accomplishment, relaxation (stress relief), interest, joy, composure, patience, passion, and hope. Items are rated on a 5-point scale ranging from 1 (very poor) to 5 (very good), with higher scores indicating stronger positive emotional effects. Negative emotions represent the degree to which negative emotional states are expressed during activities, including depression, anger, anxiety (instability), withdrawal, alienation, fear, frustration (discouragement), despair, worry, rejection, and resignation. These items are also rated on a 5-point scale, from 1 (very severe) to 5 (no problem), with higher scores indicating lower levels of negative emotional expression. The scale demonstrated high internal consistency, with a Cronbach’s α of .965. In this study, the Cronbach’s α was .804 for the positive emotion subscale and .697 for the negative emotion subscale, indicating acceptable reliability.
The Short-form Conners Rating Scale (CRS; Conners, 1970), adapted by Kim (2008), was used as a pre- and post-test to evaluate attention capacity. This scale assesses behavioral characteristics commonly associated with attention-deficit/hyperactivity disorder (ADHD) in children. It is a 10-item abbreviated version, originally revised by Goyette et al. (1978) for use by teachers and parents, based on Conners’ original 93-item scale. In this study, we utilized the Korean adaptation of the CRS, which was translated by Oh and Lee (1989). The reliability of the adapted scale was previously reported with a Cronbach’s α of .82 (Oh and Lee, 1989). The CRS uses a 4-point Likert scale (0 to 3), with total scores ranging from 0 to 30. Higher scores indicate more pronounced problem behaviors, with 16 points generally considered the cutoff score (Lee et al., 2005). In this study, the CRS demonstrated good internal consistency, with a Cronbach’s α coefficient of .867.
Data analysis
All statistical analyses were conducted using SPSS (version 19.0, IBM, USA, 2012). The Wilcoxon Signed-Rank Test was used to compare pre- and post-test data for the EIRSPC (Kim, 1998), the HTES (Psycho-Emotional Evaluation Indices; Im, 2010), and the short-form CRS (Kim, 2008). Additionally, the Friedman Test was employed to analyze HTES scores across each session in order to examine patterns of change among participants throughout the program.
Results and Discussion
Changes in emotional competence before and after the horticultural therapy program
The Wilcoxon Signed-Rank Test was applied to assess changes in emotional intelligence, as measured by the EIRSPC (Kim, 1998). Results indicated a significant increase in posttest scores (151.50 ± 37.30) compared to pretest scores (87.17 ± 21.01) (Z = −2.201, p = .028). This demonstrates a statistically significant improvement in children’s emotional competence following participation in the horticultural therapy program. After assessing children’s emotional intelligence using the HTES (Psycho-Emotional Evaluation Indices; Im, 2010), changes were analyzed using the Wilcoxon Signed-Rank Test. The results revealed a significant increase in positive emotion scores from pretest (28.00 ± 7.72) to posttest (54.67 ± 9.99) (Z = −2.207, p = .027), indicating that the program effectively enhanced children’s positive emotions. Meanwhile, negative emotion scores were significantly higher at posttest (47.00 ± 8.00) compared to pretest (24.17 ± 3.82) (Z = −2.201, p = .028). Given that the scale ranged from 1 (very severe) to 5 (no problem), with higher scores indicating lower levels of negative emotions, this result suggests that the horticultural therapy program had a positive effect in reducing children’s negative emotions (Table 3).
Changes in emotional competence before and after the horticultural therapy program
These results suggest that horticultural therapy, grounded in person-centered theory, offers more than simple recreational activities; it provides a psychologically safe environment for children. Within this setting, children’s expressions evolve from basic reactive responses to include richer forms of self-expression, heightened self-awareness, and more positive emotional experiences. Notably, the finding that expressive activities involving natural materials enhance emotional openness and foster a more positive self-perception is consistent with previous research indicating that horticultural interventions support emotional regulation and self-expressive capacities (Lee et al., 2010; Kim, 2023; Park et al., 2024).
Fig. 1 illustrates the session-by-session changes in the mean scores of emotional competence, measured using the HTES (Psycho-Emotional Evaluation Indices; Im, 2010). A Friedman test conducted to assess changes in positive emotion scores across sessions revealed a significant upward trend, with scores increasing steadily from 27.33 ± 7.82 at Session 1 to 54.50 ± 9.29 at Session 10 (χ2(9) = 51.62, p < .001). This suggests that, as the program progressed, the therapeutic intervention—rooted in person-centered theory—consistently fostered opportunities for joy, a sense of accomplishment, and self-expression, resulting in a marked improvement in the children’s positive emotional states. Notably, a sharp increase was observed after Session 4, which may reflect the children’s growing acclimation to the therapeutic environment and the formation of a trusting relationship with the researchers. Negative emotion scores also demonstrated a significant change, rising from 24.83 ± 4.84 at Session 1 to 47.33 ± 6.02 at Session 10 (χ2(9) = 51.35, p < .001). A higher score on the negative emotion scale reflects lower levels of negative affect, signifying greater emotional stability and a more positive emotional state. Based on this criteria, the slight increase observed up to Session 4 likely reflects initial tension and anxiety related to unfamiliar surroundings and interactions with the researchers. However, the continued rise in scores during the latter half of the program is attributed to the therapists’ consistent use of person-centered approaches, which contributed to enhanced psychological stability and the development of trust among the children. This result indicates that the change in negative emotion levels across sessions was statistically significant, suggesting that the program was effective in reducing negative emotions.
Participants’ changes in positive and negative emotions across sessions. ***p < .001 by Friedman test.
These changes demonstrate that horticultural therapy grounded in person-centered theory was effective in enhancing children’s emotional competence, with improvements in positive emotions and reductions in negative emotions occurring in a mutually complementary way.
Moreover, given that higher average scores reflect increased positive emotions and decreased negative emotions, the significant difference in mean scores from the first to the tenth session indicates that the program was effective in reducing children’s psychological anxiety and enhancing their emotional stability. These results align with previous studies showing that horticultural activities can positively influence the development of emotional competence (Lee and Kim, 2010; Hyun et al., 2010; Jang, 2012; Choi et al., 2015; Woo et al., 2015).
In the early stage of the program, the children exhibited limited verbal and behavioral expression, likely due to the unfamiliarity of both the activities and the presence of the researchers. They tended to follow instructions passively and expressed their emotions with hesitation. During this phase, the consistent application of unconditional positive regard played a critical role. Regardless of the children’s performance or the outcomes of their activities, the researchers offered consistent positive feedback, thereby allowing the children to experience acceptance and respect for their intrinsic worth. Consequently, their fear of failure was mitigated, enabling them to gradually engage in the activities within a state of psychological stability. Furthermore, with the introduction of specific horticultural activities— such as cooking and planting—all participants, with the exception of Participant E, began responding positively to the researchers, and instances of verbal emotional expression were observed.
In the middle stage of the program, as the children’s engagement and immersion in activities such as flower arranging and plant-based crafts increased, their emotional expressions became more nuanced, and the frequency of verbal expression rose noticeably. In contrast, negative responses—such as anxiety, refusal, and avoidance—were reduced. During this phase, empathy emerged as a central therapeutic element. The researchers attentively observed the children’s verbal and behavioral responses and reflected them using empathic language, which supported the children in recognizing and articulating their own emotions. For instance, Participant A expressed a personal emotion by stating, “I love my mom, so I think I’d feel good giving her a gift.” The researcher responded reflectively: “Your love for your mother is truly warm. So, you feel that when you give her a gift, your mother will be happy, and that makes you feel happy too.” This empathic reflection facilitated the child’s emotional awareness. Moreover, through the process of emotional sharing with peers and the researchers, the children gradually expanded their capacity for self-expression.
In the later stage of the program, most of the children began to actively express their emotions, both verbally and behaviorally, during the horticultural activities. At this stage, congruence played a central role. The researchers shared their own emotions with authenticity during the course of the activities, which encouraged the children to express their own feelings with greater freedom and creativity. For example, when Participant D looked at a figurine inside the terrarium and remarked, “I think it would be fun to play with a friend,” the researcher responded with genuine feeling: “I think it would be great fun to play with a friend too. When you say that, it makes me happy.” Even Participant E, who had frequently refused to engage in previous phases, gently stroked a succulent plant and affectionately said, “My friend~.” In response, the researcher expressed an authentic emotional reaction: “When you call the succulent your ‘friend,’ I imagine the plant must feel truly happy. I can also feel the warmth in your words.”
Taken together, the program sequentially fostered psychological safety through unconditional positive regard in the early stage, facilitated emotional recognition and expression through empathy in the middle stage, and promoted opportunities for self-exploration by cultivating trust and open communication grounded in congruence during the later stage. This therapeutic progression was evidenced not only by quantitative changes—specifically, significant increases in positive emotions and decreases in negative emotions as measured across sessions—but also by qualitative shifts, including heightened engagement and a broader range of emotional expression. These findings suggest that horticultural therapy, grounded in person-centered theory, constitutes an effective intervention for enhancing both emotional stability and self-expression capacity in SEC children.
Changes in attention span before and after the horticultural therapy program
In this study, a Wilcoxon signed-rank test was conducted to examine changes in attention span before and after participation in the horticultural therapy program. The results indicated that the pre-test score (22.67 ± 3.98) was significantly lower than the post-test score (9.17 ± 3.66) (Z = −2.207, p = .027; Table 4). Since higher scores reflect lower levels of attention, the significant reduction in scores after the program suggests a marked improvement in the children’s attention span.
Changes in attention span before and after the horticultural therapy program
Following the completion of the program, negative behaviors—such as leaving their seats, becoming distracted, making unnecessary verbalizations, displaying inattentive actions, and prematurely abandoning tasks—that had been observed before and during the horticultural activities decreased. Additionally, the overall duration of the children’s engagement in activities increased. These results suggest that the horticultural therapy program, grounded in person-centered theory, had a positive impact on improving the attention span of SEC elementary students. Especially, it indicates that therapeutic interventions—such as the researchers’ active listening and support, empathy for the children’s emotions, and respect for their choices—along with the plant-caring process, fine motor activities through task engagement, and visual stimulation, contributed to positive changes in sustaining the children’s attention. The core elements emphasized in person-centered theory—namely, fostering autonomy through unconditional positive regard, encouraging self-expression through empathy, and facilitating the realization of potential through the therapists’ congruence—may have fostered the children’s spontaneous participation, thereby enhancing their attention span. This finding is consistent with previous studies indicating that programs grounded in person-centered theory can effectively enhance children’s attention span (Kim, 2010; Oh, 2010; Kim and Lee, 2025; Choi and Choi, 2019).
Changes per participant based on observation logs
The quantitative results presented above indicate that the horticultural therapy program, grounded in person-centered theory, is an effective intervention for holistically enhancing children’s emotional competence and attention span, extending beyond mere sensory stimulation. Moreover, this study holds significance in demonstrating the applicability of horticultural therapy within special education contexts, while also affirming that person-centered theory can serve as a theoretical foundation for child-focused horticultural therapy interventions. To further explore the effects of the program from the participants’ perspectives, observation logs were maintained. Changes in the emotional and behavioral characteristics of each participant are summarized in Table 5.
Changes in participants’ emotional and behavioral characteristics based on observation logs
In this way, the horticultural therapy program based on person-centered theory went beyond simple horticultural activities, providing children with opportunities to develop self-understanding and positive self-acceptance. The core intervention components of person-centered theory thus functioned as key factors in enhancing the children’s attention span and emotional competence.
Conclusion
This study empirically investigated the effects of a horticultural therapy program—grounded in person-centered theory—on the emotional competence and attention span of SEC children in elementary school. Following ten sessions of horticultural activities, participants exhibited increased emotional stability, characterized by enhanced emotional abilities, a rise in positive emotions, and a reduction in negative emotions. Attention span also significantly improved, demonstrating the program’s effectiveness not only in emotional domains but also in enhancing attention span. These findings suggest that integrating horticultural activities with core principles of person-centered theory—namely, unconditional positive regard, empathy, and congruence—can offer emotional support and foster self-expression among children with special educational needs. This, in turn, may enhance their emotional competence, engagement, and attention span. Notably, nature-based interventions appear to stimulate children’s spontaneity and intrinsic interest, thereby contributing to their psychological well-being.
Therefore, this study demonstrates that horticultural therapy, utilizing person-centered theory, can serve as a practical intervention and a meaningful alternative for enhancing emotional abilities and attention spans in SEC children. Future research that considers a wider range of disability types, age groups, and program durations will contribute to the development of a more systematic horticultural therapy model.
The findings of this study confirm that a horticultural therapy program grounded in person-centered theory is effective in enhancing the emotional abilities and attention span of SEC children in elementary school. However, the following recommendations are proposed to improve the applicability of this program in future research and educational settings.
First, as this study involved a short-term program with a small sample of SEC children, its generalizability is limited. Therefore, future research should adopt a long-term approach and include a broader range of disability types and age groups.
Second, the collection and analysis of qualitative data—such as observations of children’s responses—are also necessary to systematically examine how the core counseling elements of person-centered theory function within actual program settings.
Third, future studies should extend the scope of effects beyond emotional abilities and attention span to include broader psychosocial factors such as self-esteem, sociability, and learning motivation. This would allow for a more comprehensive evaluation of the multifaceted impact of horticultural therapy programs.