Introduction
Adolescents who experience difficulties adapting to school life are often exposed to social stigma and discrimination from both peers and teachers, which can intensify their emotional distress. In addition, academic challenges may contribute to a vicious cycle of low self-esteem and frustration (Han, 2023).
The causes of school maladjustment can be broadly classified into individual factors, including temperamental and psychological traits, and academic achievement, and environmental factors, such as family, school, and community contexts (Choi, 2023). Specific reasons for school dropout are commonly categorized as illness, family-related circumstances, expulsion, and school maladjustment, with school maladjustment accounting for the largest proportion (Ministry of Education and Korea Educational Development Institute, 2020). The number of students who drop out due to school maladjustment has steadily increased. In 2024, the number of high school dropouts reached 27,065 (2.1%), representing an increase of 1,150 students (0.1%) compared with the previous academic year (Ministry of Education, 2025).
Adolescents experiencing school maladjustment are at heightened risk of developing self-deprecating attitudes, emotional withdrawal, interpersonal difficulties, peer-related stress, and other complex problems. Therefore, there is a need for psychological and emotional support programs that facilitate self-expression and provide emotional support for these individuals (Jung and Lee, 2015).
Therefore, to promote emotional recovery and foster a positive self-concept among maladjusted adolescents, experiential therapeutic approaches are needed that extend beyond traditional counseling-based interventions and enable adolescents to experience achievement and self-expression through hands-on activities. In this regard, plant-mediated horticultural activities have been suggested as an effective means of enhancing the self-esteem and self-efficacy of adolescents experiencing school maladjustment.
From this perspective, horticultural therapy refers to a professional intervention that utilizes plant-based, various activities to promote social, educational, psychological, and physical adaptation, while supporting physical rehabilitation and psychological recovery (Son, 1997). Interactions with living organisms, such as plants, can provide adolescents with a sense of psychological stability. In particular, horticultural therapy may serve as an effective intervention for alleviating the emotional difficulties experienced by school-maladjusted students and fostering the development of a positive self-concept.
The purpose of this study was to develop and implement a tailored horticultural therapy program for second-year high school students experiencing school maladjustment in order to enhance their self-esteem and self-efficacy. To achieve this objective, Strengths-Based Cognitive Behavioral Therapy (S-CBT) was incorporated into the horticultural therapy program. S-CBT, proposed by Padesky and Mooney (2012), is a strengths-oriented cognitive therapeutic approach grounded in Beck’s (1976) cognitive behavioral therapy framework. It emphasizes the identification and amplification of clients’ strengths, promotes positive emotions and resilience, and supports the process of change through the effective utilization of these strengths.
Therefore, this study posited that a horticultural therapy program integrating S-CBT would be effective in improving the self-esteem and self-efficacy of adolescents experiencing school maladjustment. By helping adolescents recognize their positive strengths through S-CBT and reinforcing them through practical horticultural experiences, this approach was anticipated to support their psychological growth and development.
Research Methods
Research Participants
This study was conducted with second-year students enrolled in a specialized high school (U Specialized High School) located in U Metropolitan City who were identified as experiencing school maladjustment. Prior to participation, the students were provided with a detailed explanation of the program content and procedures, as well as the purpose of the study, the participation process, and the intended use of the collected data. Written informed consent was obtained from all students who voluntarily agreed to participate. A total of 20 students were selected and assigned to either an experimental group or a control group. The experimental group consisted of 10 students (5 males and 5 females) who voluntarily chose to participate in the horticultural therapy program. The control group consisted of 10 students (4 males and 6 females) who agreed to participate in the study but did not wish to participate in the horticultural therapy program. The individual characteristics of the participants are presented in Table 1.
This study was conducted in accordance with domestic and international ethical standards for research involving human participants. Participation was entirely voluntary, and all collected data were anonymized for research purposes and securely destroyed upon completion of the study.
Research Instruments
Program Implementation
The horticultural therapy program was conducted in the “Joyful Classroom” at U Specialized High School located in U Metropolitan City. The program comprised 10 sessions, each lasting 2 hours, and was conducted weekly on Fridays from March 15 to May 31, 2024. The Joyful Classroom was located on the second floor of Building 5 and was equipped with 20 tables and chairs. The classroom had a floor area of 67.5 m2 (20.4 pyeong), providing sufficient space for indoor horticultural activities. The room was south-facing, allowing adequate natural light and ventilation through its windows.
The program was administered by the principal investigators, who held Certificates of Teaching (Plant Resources and Landscaping, Grade 2) and Welfare Horticultural Therapist (Grade 2), with assistance from graduate students majoring in horticultural therapy.
Prior to program implementation, all participants received an orientation regarding the study purpose, program schedule, and safety guidelines.
S-CBT Model-Based Horticultural Therapy Program
The horticultural therapy program was developed based on the Strengths-Based Cognitive Behavioral Therapy (S-CBT) model and tailored for second-year high school students experiencing school maladjustment. The program incorporated cognitive-behavioral techniques using emotion cards and was designed primarily to enhance self-esteem and self-efficacy.
While the original S-CBT model consists of four stages —Search for Strengths, Construct a Personal Model of Resilience (PMR), Apply the PMR, and Practice Resilience—this study incorporated a Repetition stage, resulting in a five-stage framework as shown in Table 2. The intervention comprised 10 sessions, with two sessions allocated to each stage. Through repeated activities, students were encouraged to apply the PMR to real-life situations, thereby enhancing self-regulation and resilience.
During the Strength Search stage, participants identified and organized their personal strengths and weaknesses, fostering a positive self-understanding. In the Construction stage, they explored psychological difficulties encountered in daily life and learned strategies for managing and regulating them, thereby enhancing their control over stressors. The Application stage focused on utilizing the PMR to develop flexible thinking and problem-solving skills when confronting challenges. During the Practice stage, participants repeatedly applied the skills and strategies acquired in the previous stages within simulated stressful situations to reinforce resilience and facilitate its transfer to everyday contexts.
Lastly, the Repetition stage sought to generalize learned strategies and promote long-term behavioral changes through repeated application of the previous four stages. Particularly in instances of prolonged unresolved tasks, chronic problems, or persistent maladjustment stemmed from personality factors, this stage supported the formation of positive attitudes and relapse prevention by analyzing and modifying existing dysfunctional thoughts and behavioral patterns and applying new coping strategies.
The detailed contents of the horticultural therapy program are presented in Table 3.
Sessions 1 and 2 focused on rapport formation and identification of personal strengths. Participants planted English ivy (Hedera helix) in clay pots and observed its rooting and growth, fostering feelings of stability and accomplishment. These experiences facilitated rapport building with the researchers. In addition, participants engaged in a flower arrangement activity for self-reflection, selecting and arranging floral materials that represented their personal characteristics. Through the “Search for My Strengths” activity and comparison of self-and peer-perceptions, participants identified previously unrecognized strengths and expanded their positive self-awareness from the perspectives of others. These experiences formed the foundation for subsequent emotional and behavioral changes in later sessions.
Sessions 3 and 4 focused on facilitating emotional awareness by helping participants clarify emotions encountered in daily life and explore their emotional reactions to stressful situations. Through the use of emotion cards, participants practiced identifying and labeling their feelings more specifically, which helped them recognize differences among the emotions they experienced. During the dish garden activity, participants created a miniature garden by arranging plants of varying sizes and textures within a single container, visually expressing the complexity of their internal emotional states. As they adjusted the placement and spacing of the plants to achieve a balanced arrangement, participants engaged in a process of objectively viewing the relationships among their chaotic emotions and establishing psychological order. This process helped them understand that a wide range of emotions exist, including not only uncomfortable feelings but also productive forms of tension associated with goal attainment. Furthermore, participants had opportunities to practice reinterpreting situations from different perspectives. Additionally, in the centerpiece flower arrangement activity, participants enhanced visual enjoyment and experienced positive emotions through the aesthetic composition of flowers, utilizing their diverse colors and shapes. At the same time, principles of floral de-sign—including balance of plant size, spatial arrangement, height variation, proportion, and color harmony—were incorporated into the activity. By creating a visually balanced composition and reducing the tension that can arise from visual imbalance, participants were encouraged to experience a sense of psychological stability. This experience of stability was intended to provide an emotional foundation for subsequent exploration of strategies to cope with and alleviate negative emotions encountered in stressful situations.
Sessions 5 and 6 involved exploring emotional responses to everyday stressors and discussing perceptions and coping strategies in stressful situations. The Broom (Cytisus scoparius) planting activity provided participants with an opportunity to recognize feelings of tension and discomfort commonly experienced in daily life through the process of pruning and regulating plant branches. Through this process, they became more aware of how stress influences emotional states and contributes to emotional change. Subsequently, the Mosaic Plant (Fittonia albivenis) topiary creation activity was designed to present participants with unexpected situations that required problem-solving. Within this process, participants were encouraged to utilize their personal strengths to address challenges. The activity also provided opportunities to discuss different ways of interpreting stressful situations and to explore the practical application of various coping strategies.
Sessions 7 and 8 focused on transforming negative emotions into positive experiences and strengthening resilience. Through creating gift flower baskets, participants experienced emotional stabilization while selecting and arranging floral materials. Sharing the completed arrangements with others promoted positive social interactions and provided an opportunity for positive emotional transformation. The subsequent Sweetheart Hoya (Hoya kerrii) planting activity encouraged participants to express their emotions through the symbolic use of a heart-shaped plant. As they recalled stressful situations from their daily lives, they reflected on their emotional responses and practiced reframing negative thoughts from a more positive perspective.
Sessions 9 and 10 focused on promoting the generalization of strategies acquired in previous stages so that they could be applied in daily life. Along with the Chrysanthemum (Chrysanthemum morifolium) planting activity, participants engaged in role-playing exercises that simulated stressful situations commonly encountered in everyday life. Through these activities, they practiced applying previously learned coping strategies. In the hanging garden creation activity, participants incorporated representations of their strengths into a circular structure, reminding themselves of personal resources identified earlier in the program, and exploring ways to utilize them in their future lives.
Through these experiences, the program focused on maintaining positive behavioral and emotional changes beyond its completion.
The program was designed based on the “stepwise application” framework of the S-CBT model, with each session emphasizing the core objectives of a specific stage. Unlike conventional cognitive behavioral interventions, this approach enables the systematic and sequential development of resilience-related competencies through stage-specific horticultural activities.
Assessment Instrument
Rosenberg Self-Esteem Scale (RSES)
Self-esteem refers to the extent to which individuals positively evaluate and accept themselves. To assess self-esteem, this study employed the Rosenberg Self-Esteem Scale (RSES) developed by Rosenberg (1965) and adapted into Korean by Jon (1974). The scale measures individuals’ degree of self-respect and pattern of self-acceptance and consists of 10 items rated on a 4-point Likert scale, including five positively worded and five negatively worded items. Positive items are scored from 1 (“rarely”) to 4 (“always”), whereas negative items are reverse-scored. Total scores range from 10 to 40, with higher scores indicating greater self-esteem. The reliability of the Korean version was reported as Cronbach’s α = .790 in Jon’s (1974) study.
To accommodate the comprehension level of adolescents experiencing school maladjustment, the phrasing of several items was simplified while preserving the original meaning and core concept of the scale. For example, the term “disposition” was replaced with “personality” to enhance readability. These modifications were made by consensus among the researchers. Although such revisions may have slightly reduced the scale’s reliability, they were deemed acceptable considering the characteristics of the target population. In the present study, the Cronbach’s α for the scale was .656.
General Self-Efficacy Scale (GSES)
Self-efficacy refers to an individual’s belief in their ability to successfully perform tasks in a given situation. To assess self-efficacy, this study employed the General Self-Efficacy Scale (GSES) developed by Schwarzer and Jerusalem (1995) and adapted into Korean by Ko and Kim (2011).
The scale, designed to assess individual self-efficacy, consists of 10 items rated on a 4-point Likert scale ranging from 1 (“strongly disagree”) to 4 (“strongly agree”). Higher scores reflect higher levels of perceived self-efficacy. Ko and Kim (2011) reported a reliability coefficient of Cronbach’s α = .920 for the Korean version of the scale.
To enhance readability for adolescents experiencing school maladjustment, several items were modified using synonymous expressions while preserving the fundamental concept of the scale. For example, the term “composure” was replaced with “calmness.” These revisions were made by consensus among the researchers. Although these modifications may have resulted in a slight reduction in reliability, they were deemed appropriate for the target population. The internal consistency of the scale in the present study was Cronbach’s α = .650.
Data Analysis
To examine the effects of the tailored horticultural therapy program on the self-esteem and self-efficacy of students experiencing school maladjustment, all collected data were coded using Microsoft Excel and subsequently analyzed using IBM SPSS Statistics version 24.0. For each assessment instrument, mean item scores were calculated by dividing the total score by the number of items, and these values were used for statistical analyses.
Since the sample size of each group consisted of only 10 participants, nonparametric statistical methods were employed to address the possibility that the assumption of normality was not satisfied. To examine baseline homogeneity and identify any pre-intervention differences between the experimental and control groups, the Mann-Whitney U test was conducted. Changes between pretest and posttest scores within each group were analyzed using the Wilcoxon signed-rank test.
Results and Discussion
Baseline Homogeneity Test
The baseline homogeneity test conducted between the control and experimental groups yielded p-values of .684 for self-esteem and .529 for self-efficacy. As no statistically significant differences were identified between the two groups, they were considered homogeneous at baseline (Table 4).
Changes in Self-Esteem and Self-Efficacy
Changes in self-esteem and self-efficacy among the control and experimental groups are presented in Table 5.
For the self-esteem scale, higher scores indicate a more positive self-evaluation. The control group showed a statistically significant decrease in self-esteem, with scores declining from 3.05 ± 0.14 at pre-test to 2.78 ± 0.18 at post-test (p = .011). In contrast, the experimental group exhibited a statistically significant improvement, with scores increasing from 3.08 ± 0.13 at pre-test to 3.66 ± 0.16 at post-test (p = .005).
Similarly, for the self-efficacy scale, higher scores reflect a more positive self-evaluation. The control group’s self-efficacy score decreased slightly from 1.84 ± 0.18 at pre-test to 1.81 ± 0.16 at post-test; however, this change was not statistically significant (p = .317). Conversely, the experimental group demonstrated a statistically significant increase in self-efficacy, with scores rising from 1.77 ± 0.13 at pre-test to 2.20 ± 0.23 at post-test (p = .005).
These findings may be interpreted in relation to the seasonal context during which the study was conducted. The research period, spanning from March to May, coincides with a time when students commonly experience heightened academic and interpersonal stress associated with adapting to a new semester, establishing peer relationships, and preparing for midterm examinations. Since adolescents with school maladjustment tend to possess fewer coping resources for managing stress compared with their peers, environmental stressors are likely to accumulate in the absence of targeted psychological interventions or support systems, potentially contributing to a decline in self-esteem. Previous research has suggested that successful school adjustment serves as an important foundation for the development of problem-solving abilities and social functioning in later life (Khu, 2012). In contrast, academic stress and difficulties in peer relationships are highly likely to lead to decreased self-esteem (Lee and Choi, 2012). These findings underscore the need for intervention programs designed for adolescents experiencing school maladjustment and provide an important context for interpreting the effectiveness of the horticultural therapy program implemented in the present study.
Post-Test Verification of Between-Group Effects
To evaluate the effectiveness of the horticultural therapy program tailored for adolescents experiencing school maladjustment, post-test mean scores were compared between the experimental and control groups. The post-test mean self-esteem score was 2.78 in the control group and 3.66 in the experimental group. The experimental group scored 0.88 points higher than the control group, and the difference between the groups was statistically significant (p < .001). For self-efficacy, the post-test mean score was 1.81 in the control group and 2.20 in the experimental group. The experimental group scored 0.39 points higher than the control group, and this difference was also statistically significant (p < .001).
The post-test comparison presented in Table 6 suggests that the program’s structure—designed to facilitate strength recognition and coping strategy practice according to the stages of the S-CBT model, while accumulating experiences of achievement and emotional stability through horticultural activities—may have contributed to improvements in self-esteem and self-efficacy among participants in the experimental group.
This study investigated the effects of a horticultural therapy program based on the S-CBT model on the self-esteem and self-efficacy of second-year high school students experiencing school maladjustment. The results revealed that the control group experienced a significant decrease in self-esteem, whereas no significant change was observed in self-efficacy. These findings suggest that environmental stressors—including academic pressure during the semester and interpersonal difficulties—may have adversely affected the adolescents’ emotional stability and self-concept. In contrast, the experimental group demonstrated significant improvements in both self-esteem and self-efficacy. These findings suggest that the program may facilitate positive changes in psychological recovery and the development of positive self-awareness among adolescents. Adolescence is a developmental period characterized by various conflicts and stressors arising from physical changes, increasing independence from parents, and the establishment of personal values. Such challenges are highly likely to lead to school maladjustment (Ha, 2013). Therefore, in addition to family and social support, the importance of psychological interventions such as horticultural therapy programs has been emphasized (Kim, 2023).
The present findings are consistent with those of previous studies. Jung et al. (2022) reported that a horticultural activity program applied to middle school students experiencing emotional difficulties related to school maladjustment resulted in behavioral changes and positive psychological effects. Similarly, horticultural therapy has been reported to improve self-esteem and school adjustment while reducing impulsivity and stress among adolescents (Son, 2015). Furthermore, Koo (2016) suggested that identifying areas in which students can achieve through strengths-based programs, sharing successful experiences, and recalling feelings of accomplishment contribute to the development of self-esteem.
During the Strength Search stage of the present program, participants were provided with opportunities to recognize their internal strengths and develop a more positive self-concept. In the Construction stage, they reviewed strategies for identifying and managing psychological difficulties encountered in daily life, thereby establishing a foundation for self-regulation. In the Application stage, the Personal Model of Resilience (PMR) was utilized to encourage creative thinking and promote resilient responses to assigned tasks. During the Practice stage, repeated utilization of resilience-building strategies provided participants with opportunities to maintain a positive self-concept. Finally, in the Repetition stage, the preceding experiences were integrated and applied to establish a foundation for sustaining behavioral and psychological changes.
This program distinguishes itself by integrating the structured and sequential framework of the S-CBT model with the emotional stability benefits of horticultural activities. Through this approach, participants were encouraged to identify their positive resources and utilize them in addressing problematic situations. Traditional cognitive behavioral therapy (CBT) typically follows a stepwise process involving problem identification, restructuring of distorted cognitions, and maintenance of these changes through behavioral modification. In contrast, problem-solving decisions within the present program were guided by participants’ active choices. Participants restored their sense of self-efficacy through positive emotions and strengths cultivated during horticultural activities and were encouraged to utilize these strengths as resources for problem-solving. In other words, rather than relying solely on externally directed intervention, the problem-solving process in this program is differentiated in that it guides participants to establish proactive coping mechanisms grounded in the emotional stability and awareness of personal strengths acquired through horticultural activities.
Unlike conventional horticultural therapy programs, which have primarily focused on emotional stabilization and the provision of positive experiences, the present program was designed to promote adaptive behaviors in school life through cognitive restructuring based on strength exploration. From this perspective, the program may have provided adolescents experiencing school maladjustment— who are often exposed to repeated negative feedback— with opportunities to re-evaluate their abilities and potential and apply them in real-life situations.
Conclusion
This study implemented a 10-session horticultural therapy program based on Strengths-Based Cognitive Behavioral Therapy (S-CBT) as an emotional support intervention to enhance the self-esteem and self-efficacy of second-year high students experiencing school maladjustment. The baseline homogeneity analysis revealed no statistically significant differences between the experimental and control groups, confirming their baseline equivalence.
Following the program, the control group’s self-esteem decreased from a pretest mean score of 3.05 to a posttest mean score of 2.78, whereas the experimental group’s self-esteem increased from 3.08 to 3.66. Both the decrease observed in the control group (p = .011) and the improvement observed in the experimental group (p = .005) were statistically significant, indicating a significant difference between the two groups. This positive change in self-esteem appears to be primarily attributable to the Strength Search and Construction phases of the S-CBT model incorporated into the program.
In particular, during the dish garden and centerpiece creation activities conducted in the early sessions, participating students independently determined the harmonious arrangement of plants. Through this process, they visualized their complex emotions while experiencing a sense of control and psychological order. For students who had withdrawn due to accumulated negative feedback, these activities provided an opportunity to reconstruct positive self-perceptions, thereby contributing to enhanced self-esteem. These findings suggest that horticultural therapy programs incorporating S-CBT may effectively promote self-awareness among adolescents experiencing school maladjustment.
With regard to self-efficacy, the control group showed a slight decrease from a pretest mean score of 1.84 to a posttest mean score of 1.81, which was not statistically significant (p = .317). In contrast, the experimental group demonstrated a statistically significant increase from 1.77 to 2.20 (p = .005).
This improvement may be attributed to the Application and Practice phases implemented during the middle and later stages of the program. Through activities such as creating mosaic plant (Fittonia albivenis) topiaries and participating in role-play exercises, students encountered unexpected challenges and stress-inducing situations. By drawing upon their personal strengths to complete horticultural tasks and botanical artworks, they accumulated successful mastery experiences. These repeated problem-solving experiences appear to have strengthened their confidence in task performance, thereby enhancing their self-efficacy. The findings indicate that horticultural therapy programs based on the S-CBT model can also contrib ute to improving adolescents’ self-efficacy.
The emotional support and positive feedback cycles facilitated through horticultural activities may help alleviate the effects of repeated negative experiences within the school environment and promote psychological recovery. Accordingly, the present program demonstrates practical value as a psycho-emotional intervention for adolescents experiencing school maladjustment.
Nevertheless, this study has the following limitations. Due to the small sample size and the limited duration of the intervention, caution should be exercised when generalizing the findings, and the long-term effects of the program could not be fully verified.
Based on the findings and limitations of this study, the following recommendations are proposed.
First, building upon the potential demonstrated in this study, future studies should employ larger sample sizes to further examine and validate the long-term effectiveness of the program.
Second, systematic, hierarchical, and individualized psycho-emotional and social support programs should be developed to address the specific characteristics and needs of students experiencing school maladjustment.
Third, future research should incorporate qualitative methodologies that enable teachers and counseling professionals to comprehensively observe and analyze participants’ behavioral and emotional changes, thereby providing a more in-depth evaluation of program effectiveness.
Fourth, since the present study was limited by a relatively small sample size (N = 20), the analysis focused primarily on overall changes in participants’ self-esteem and self-efficacy using total scale scores. Therefore, future studies should recruit larger samples and conduct more detailed analyses of subscale dimensions, such as positive and negative self-esteem, in order to elucidate the specific mechanisms through which the program exerts its effects.
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