Article

Gardening as a mental health intervention: A review

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Abstract

Purpose - The number of gardening-based mental health interventions is increasing, yet when the literature was last reviewed in 2003, limited evidence of their effectiveness was identified. The aim of this review was to evaluate the current evidence-base for gardening-based mental health interventions and projects through examining their reported benefits and the quality of research in this field. Design/methodology/approach - Studies evaluating the benefits of gardening-based interventions for adults experiencing mental health difficulties were identified through an electronic database search. Information on the content and theoretical foundations of the interventions, the identified benefits of the interventions and the study methodology was extracted and synthesised. Findings - Ten papers published since 2003 met the inclusion criteria. All reported positive effects of gardening as a mental health intervention for service users, including reduced symptoms of depression and anxiety. Participants described a range of benefits across emotional, social, vocational, physical and spiritual domains. Overall the research was of a considerably higher quality than that reviewed in 2003, providing more convincing evidence in support of gardening-based interventions. However, none of the studies employed a randomised controlled trial design. Research limitations/implications - There is a need for further high-quality research in this field. It is important that adequate outcome measures are in place to evaluate existing gardening-based mental health interventions / projects effectively. Originality/value - This paper provides an up-to-date critique of the evidence for gardening-based mental health interventions, highlighting their potential clinical value.

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... Originally developed by Block et al. (2011), the food well-being (FWB) framework highlights the role of food to improve well-being for both individuals and society and uses a holistic approach to well-being (i.e., it includes for example spiritual and emotional dimensions in addition to nutritional health) [9,10]. However, this framework has largely been focused on food consumption activities, although a large body of literature shows the connection between growing food activities and well-being [3,7,[11][12][13]. Additionally, a growing body of literature has shown a positive relationship between sustainability or sustainable development and well-being [14][15][16][17][18][19][20], especially how environmentally sustainable practices can help support ecosystems services which have direct impact on human well-being [21,22], but also how prosocial behaviors and connection to nature are key elements of sustainable practices and directly enhance human well-being [23,24]. ...
... Previous research indicates that there is a strong connection between gardening and well-being. Studies have been conducted amongst people above 60 [38], school children [39,40], people with mental health [11], and leisure gardeners [8]. Some results indicate that gardening has positive impacts on mental health, reducing symptoms of depression and anxiety [11]. ...
... Studies have been conducted amongst people above 60 [38], school children [39,40], people with mental health [11], and leisure gardeners [8]. Some results indicate that gardening has positive impacts on mental health, reducing symptoms of depression and anxiety [11]. Some also linked gardening practices to an increased sense of connection to nature, or what is known as biophilia. ...
Article
“Life, Liberty and Pursuit of Happiness”, is what millions of Americans strive for. The onset of COVID-19 has highlighted the disparities that exist among Black, Indigenous and People of Color (BIPOC) communities, which are facing food access inequities. In this paper, we argue that engaging in growing food sustainably can improve food access, support food justice and enhance sense of purpose and well-being. We expand the notion of Food Well-Being (FWB) to include food producers—especially gardeners—and hypothesize that gardening has the potential to enhance FWB, regardless of the racial and socio-economic background. However, without policies tackling social and racial justice issues, structural barriers may hinder this potential. We use three studies to draw a rich profile of sustainable food gardeners in Arizona, USA and their well-being: (a) the children and teachers engaged in school gardens in the Phoenix metropolitan area; (b) sustainable gardeners and farmers in Phoenix and Tucson; (c) Arizona gardeners during the pandemic. The results show a connection between sustainable gardening and eudemonic well-being, and an impact on the five FWB dimensions (physical, intellectual, spiritual, emotional and social). However, without appropriate policies, funding and infrastructure, the impact might remain minimal, volatile and subject to tokenism
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... In-depth, semi-structured interviews were guided by open-ended questions. These questions related to the extent of participants' gardening background, motivations for involvement [10,13], the perceived values [9][10][11][12][13][14] and challenges [22,[46][47][48][49][50][51] of participation, and their understanding and experiences of wellbeing [17][18][19][20][21][22][23] and belonging [31,[40][41][42]45] through urban gardening. Greater insight was sought in these key areas through applying a broader theoretical analysis to that within existing community and gardening literature. ...
... Additionally, this research questions whether the identified benefits of community and allotment gardens apply to the understudied location of Melbourne, and seeks to identify the perceived values and benefits of these places within an urban setting, as well as to explore the challenges of sustaining the existence of community and allotment gardens in the context of population growth, urban densification [75] and economic considerations. It is argued that places such as Melbourne that are ethnically diverse [79] undergo increasing population growth and urban densification [75] with diminishing access to outdoor and green space [76], it becomes increasingly important to protect the potential benefits of community and allotment gardening [3,[5][6][7][8][9]11,12]. This is particularly the case as they may ameliorate identified health and wellbeing concerns of urban living [2][3][4]. ...
Article
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... A new initiative at one Australian rural community health setting was to enhance the TDR curriculum with an afternoon of therapeutic gardening (TG) in the Grow Hope Garden (GHG) once a week. The role of nature and TG has been recognised in the literature for enhancing the health and wellbeing of individuals and providing psychological benefit (Clatworthy et al. 2013;Marsh et al. 2018). Horticultural TG has also been known to be a meaningful therapeutic modality for veterans with substance abuse issues (Lehmann et al. 2018). ...
... The findings from this study found participants enjoyed doing activities in the garden, which they perceived as meaningful, and gave them a sense of achievement. This resonated with other studies where they found therapeutic gardening decreased the passivity and improved the occupational balance in their participants in various settings (Kam and Siu 2010;Clatworthy et al. 2013;Haith and Trenoweth 2015;Marsh et al. 2018). A key benefit of the GHG acknowledged by participants was that they enjoyed working together and building social connections during their time in the garden, as they found this outdoor activity relaxing. ...
Article
Therapeutic day rehabilitation (TDR) is a non-residential intensive structured program designed for individuals recovering from substance misuse. A weekly afternoon of therapeutic gardening was a new incentive initiated in a TDR program at one Australian community health service, designed to give participants the opportunity to spend time outdoors connecting with nature and each other. The aim of this study was to explore perceptions of participants enrolled in this program by employing a convergent parallel mixed-method design using qualitative individual, semi-structured interviews (n = 14) and longitudinal quantitative quality of life (QOL) data at three different intervals (n = 17). The analysis of the quantitative data showed that there was a statistically significant increase in the participants' QOL scores in three of four domains (physical health, psychological, social relationships) when comparing baseline and post completion of the TDR. These observed changes were maintained at the 4-week follow up. The key findings from the semi-structured interviews include positive effects for participants on social connectivity, structure and achievement, understanding of recovery and relaxation from contact with nature. This study shows that a combination of TDR and therapeutic gardening can improve participants' physical health, psychological health and social relationships.
... The physical act of gardening has been shown to improve mental health by reducing depression and anxiety in adults with clinical depression and increasing emotional well-being in the general population [29][30][31]. Several international studies have identified the positive impact of gardening on mental health during the COVID-19 pandemic; however, to our knowledge, there have been no studies on the impact of gardening and outdoor activities on anxiety during the COVID-19 pandemic across multiple states in the U.S [32][33][34][35]. ...
... The effectiveness of gardening as a mental health intervention has been explored by previous, and now emerging, studies amid the COVID-19 pandemic to determine whether positive effects, such as mood improvement, reduced anxiety, and trauma recovery are observed [23,30,66,67]. Participants of a study by Sunga and Advincula reported that their motivation to garden was to reduce stress, anxiety, and boredom brought on by the pandemic and that gardening improved their mood and behavior [66]. ...
The COVID-19 pandemic impacted mental health. Growing research has identified the mental health benefits of nature contact, including gardening. We used a cross-sectional survey to investigate the association between gardening and other outdoor activities with anxiety among U.S. adults. The RANG (Reducing Anxiety with Nature and Gardening) survey was distributed online from June-September 2020 through social media (Twitter and Facebook) and a national Master Gardeners listserv. Survey questions captured demographics, COVID-19 experiences, gardening, outdoor activities, and anxiety using the Generalized Anxiety Disorder 7-item scale. Data were analyzed using chi-square, Fisher's exact, and Kruskal-Wallis tests, as well as logistic regression. Among participants, 46% reported anxiety symptoms. Participants who had gardened ≥ 15 years and those gardening > 8 h over two weeks had lower anxiety scores. Spending more time outdoors on weekdays also decreased anxiety scores. After adjusting for covariates, lower odds of anxiety were identified for 50-69 and 70-89-year-olds vs. 18-29-year-olds; males vs. females; and Texas vs. Maryland residents. These findings confirm increased anxiety during the COVID-19 pandemic and suggest that sustained gardening and other outdoor activities could help reduce anxiety.
... The quality and availability of green spaces and other natural elements range within communities and neighborhoods. Engagement in green spaces has a positive impact on mental health and well-being (Choe et al., 2020;Kruize et al., 2020;Wendelboe-Nelson et al., 2019), and can elicit a variety of desirable responses for the participant including decreased stress, increased self-esteem, enjoyable sensory experience, and connectedness (Clatworthy et al., 2013;Hussein et al., 2013;Ibes et al., 2018;McFarland et al., 2008;Wendelboe-Nelson et al., 2019). Recent studies have defined the differences between active and passive use of green space, identifying active utilization as a key characteristic leading to higher ratings of positive emotions and quality of life (Holt et al., 2019). ...
... Sensory modulation includes the understanding that an individual will actively seek out the types and duration of stimuli needed in order to adapt to challenges and respond successfully to the environment with a sense of well-being (Brown et al., 2019;Fisher et al., 1991). The active engaged use of outdoor therapeutic garden green spaces (ie, sensory gardens, wellness gardens, therapeutic zen gardens) have been found to decrease feelings of stress, anxiety, and social isolation (Adevi et al., 2018;Adevi and Martensson, 2013;Adevi and Lieberg, 2012;Clatworthy et al., 2013). ...
Article
Green spaces serve as environmental sources to improve physical, mental and social health and wellbeing. Studies indicate that university students, when actively engaged in the use of green spaces, experience improved health and well-being. This study highlights the lived experience of two student participants and investigates student perceptions of a university campus therapeutic sensory garden on the quality of life based on the utilization of the green space. Quantitative and qualitative measures were used to assess student use of the therapeutic sensory garden as well as student perceived quality of life related to social, mental, and physical well-being. Quantitative results included varied responses regarding the number of hours spent in the garden, number of visits to the garden, and types of sensory elements utilized in the garden. Qualitative results on student perception of quality of life identified three themes between the two participants: 1) connectedness, 2) positive emotional responses, and 3) active engagement sensory responses. The findings resulting from quantitative and qualitative analysis of the lived experiences of two student participants are consistent with that of current evidence literature indicating a positive association between time spent in a green space/natural environment and student perceptions of quality of life. These pilot study findings present structure and hypotheses related to time utilization, anticipated outcomes, and active ingredients for therapeutic sensory garden intervention with larger sampled groups of University students.
... Clatworthy et al carried out a meta-analysis of gardening-based interventions for adults experiencing mental health difficulties [23]. Of the studies reviewed, four focused on individuals with depression, one studied those with schizophrenia and the remaining five report either 'mixed' diagnoses or do not provide any details. ...
... Multiple systematic reviews [17][18][19]23] on social prescribing interventions in adults have found a positive impact on depression and anxiety symptoms. Affective disorders make up a significant proportion of all referrals to CAMHS; however, there is often a wait for appropriate therapeutic treatment. ...
Article
Full-text available
The use of social prescribing interventions for common mental health issues is expanding as clinicians seek to diverge from the traditional medical model of treatment. This intervention allows for the referral of patients to a nonclinical social activity via a link worker. Evidence for the benefits of social prescribing is growing. Most evidence is based on adults; however, a smaller number of studies involving children and young people have produced encouraging results. This evaluation reports on data routinely collected by the Linking Leeds service between 9 January 2019–11 January 2020. Linking Leeds provides Social Prescribing for people aged 16 years and above; however, the current paper focuses on service users aged between 16 and 25. Their aim is to connect people to services and activities in their community in order to benefit overall health and mental wellbeing. This evaluation of the Linking Leeds program supports the growing body of evidence to support the benefits social prescribing can have on young people’s mental health. Two main mechanisms were identified which underpin social prescribing in young people: social connectedness and behavioural activation.
... Mrs T mentioned in Lebo's Term 1 report of Year Two, that Lebo still needs to be reminded to be polite, and say 'please' and 'thank you' (T1R2:L7-9). Studies have shown that working in the garden provided benefits across the social and emotional and physical domains (Clatworthy, Hinds, & Camic, 2013). Working in the garden may reduce the symptoms of anxiety and depression (Clatworthy, Hinds, & Camic, 2013). ...
... Studies have shown that working in the garden provided benefits across the social and emotional and physical domains (Clatworthy, Hinds, & Camic, 2013). Working in the garden may reduce the symptoms of anxiety and depression (Clatworthy, Hinds, & Camic, 2013). ...
Research
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Severely prematurely born children, born before the gestational age of 28 weeks, are at an increased risk of developmental delays, which may manifest as physical difficulties, learning disabilities, attention deficits, hyperactivity, and behavioural and social problems. These present demanding challenges for teachers which are further intensified by large class sizes, and limited resources in many South African schools. In diverse classrooms it is difficult to differentiate the content and the pace of the curriculum. This study explored the psycho-educational support needs of Lebo (pseudonym), who was born severely premature. The study was conducted in a special needs class in a mainstream primary school in the south of Johannesburg. Data were collected over a period of a year from semi-structured interviews with the teacher and parents, and a researcher’s observation journal. Further information was collected from the educational psychologist’s report, learner’s school reports and extracts of schoolwork. Thematic content analysis revealed that Lebo needed assistance in all domains of development: motor and physical; communication; social and emotional; adaptive and cognitive. The teacher ensured that Lebo and other learners had access to appropriate concrete resources, in the classroom and outside play areas to assist learning. Learners were placed in ability groups where they were challenged, yet could cope. This allowed for careful differentiation and targetted adaptation of the curriculum to meet the needs of each individual child.
... (Arifin et al., 1998). Those activities were believed to have a positive influence in maintaining and increasing the immunity of the human body both physically and psychologically (Clatworthy et al., 2013;Buck, 2016;Soga et al., 2017;Corley et al., 2021). Because of that, the pekarangan, as the closest landscape unit in the house, was considered to be the best choice for doing those activities. ...
Article
Full-text available
Pekarangan is a typical Indonesian home garden. This article aimed to look at biophysical conditions of pekarangan between Sundanese migrants and non-migrants. A total of 40 pekarangans in Selajambe and Ciomas Rahayu villages, West Java, were chosen as representative locations for the Sundanese non-migrant population (native Sundanese), and 40 pekarangans in Tegal Yoso and Tanjung Kesuma villages, Lampung, were chosen as representatives of the Sundanese migrant population. Research has been carried out in the period 2019–2021. To measure the biophysical conditions of pekarangans , we analyzed the pekarangan area, pekarangan size, number of species and individual of pekarangan plants, vertical diversity and horizontal diversity of plants, and the relationship between the pekarangan area and number of species and individual plants. The results showed that the difference in conditions of the pekarangan was indicated by the difference in the area and size but not by the diversity of the plants. Both types of pekarangans have the same level of diversity, as indicated by the number of individual plants that are almost the same in number per 100 m ² . In addition, a strong and positive correlation (0.69–0.88) between the area of pekarangan and the number of individual plants indicated that the small to medium size or large pekarangan sizes had almost the same diversity of plants. The difference lied in the type of plant that is cultivated. Migrant pekarangans are dominant in cultivating food crops, while non-migrant pekarangans are dominant in cultivating ornamental plants. The selection of plants that have important and valuable functions can be a solution in maintaining the area of the pekarangan . Choosing plants with a variety of functions can be an option for a small to medium pekarangan size. To improve the biophysical conditions of the pekarangan was also inseparable from the involvement of economic, social, and cultural aspects in the pekarangan .
... Também a jardinagem e horticultura têm sido usadas como terapia em vários contextos e envolvendo diferentes grupos de indivíduos, como forma de promoção da saúde e bem-estar (Davis, 1998;Rappe, 2005;Sempik et al., 2006). Uma revisão sistemática evidencia os efeitos positivos da jardinagem na saúde mental e benefícios nos domínios emocional, social e espiritual (Clatworthy et al., 2013). Os indivíduos estudados, portugueses seniores, não apresentavam demência, nem tão pouco se encontravam institucionalizados, mas os nossos resultados indicam claramente que a presença de plantas, no espaço residencial e as atividades que estas proporcionam, promoveram o bem-estar e o coping durante o confinamento dos participantes neste estudo. ...
... Finally, participants reported other home-based practices that that were perceived as protective for participants health and well-being, including meditation, telehealth therapy, gardening and creating art, all activities that have been shown (with varying efficacy) to improve mental health and/or well-being (Clatworthy et al., 2013;Goyal et al., 2014;Stuckey & Nobel, 2010;Zhou et al., 2020). All told, these practices are likely to act as protective strategies for improving and supporting the mental health and well-being of trans individuals and thus deserve further study for how they may specifically benefit trans and nonbinary individuals, including by affirming gender identities, and coping with stigma and resulting stress. ...
Article
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Since the onset of the COVID-19 pandemic, global research has suggested that the pandemic has negatively affected lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) populations, including by limiting health care access. There is little research on the impact of COVID-19 among transmasculine persons and men assigned female sex at birth (AFAB) in the United States, who face unique health care challenges outside of the pandemic context. Between May and June of 2020, 20 transmasculine individuals and AFAB men who have sex with men participated in semi-structured interviews about their experiences during the early months of the COVID-19 pandemic. Participants were asked how the pandemic affected their access to health care, overall health, and well-being. Interviews were analyzed using an inductive, thematic approach. Participants reported reduced access to in-person health care, which in some cases meant overdue hormone-related bloodwork and unmet health care needs. Most participants reported that they were able to maintain their testosterone regimen, although some were concerned about future access, citing anxiety about potential shortages. Three participants reported canceled or deferred gender-affirming procedures, which they were uncertain would be rescheduled soon. Participants generally reported that the expansion of telehealth improved access to care, particularly for gender-affirming psychotherapy that was otherwise inaccessible or inconvenient prior to the pandemic. Other salient themes include the pandemic’s impact on health behaviors and daily routines. Although the COVID-19 pandemic created new challenges for maintaining health, it also expanded access to gender-affirming health care, largely through the expansion of telehealth. Our findings provide new insights for supporting the health of transmasculine individuals and AFAB men.
... Nature-based interventions, such as horticultural therapy, gardening, and the Japanese practice of Shinrin-yoku ("forest bathing"), have received increased attention internationally and are being introduced as methods of treating ill mental health (Clatworthy et al., 2013;Cipriani et al., 2017;Kotera et al., 2020). Talking therapy in natural, outdoor spaces has also become increasingly popular. ...
Article
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Few studies have explored outdoor therapy when facilitated by clinical psychologists within an inpatient mental health service. In the present study, outdoor psychology sessions were introduced after service users (SUs) expressed a desire to return to face-to-face working during the COVID-19 pandemic. This study aimed to explore SUs’ and clinical psychologists’ perspectives on the feasibility of conducting outdoor therapy within the service. A mixed-method approach was underpinned by critical realist philosophy. Three psychologists maintained reflective diaries following outdoor therapy sessions with 16 SUs. A subsample of 14 SUs completed scales measuring therapeutic alliance and comfort during outdoor sessions. A subsample of eight SUs participated in semi-structured interviews. Data was analysed using descriptive statistics and thematic analysis. Quantitative and qualitative data demonstrated high SU satisfaction with therapeutic alliance and comfort outdoors. Six themes were identified: utilising a person-centred approach; the value of multi-disciplinary team support; enhancing therapeutic engagement; the benefits of time away from the ward; managing confidentiality; physical health and safety. This feasibility study demonstrated the introduction of outdoor psychology sessions within an inpatient mental health service to be a viable response to COVID-19. The findings suggest outdoor therapy can be an effective and safe mode of therapy, and can offset the challenges of indoor working, providing certain risk factors are considered and managed. The limitations of this study and implications for clinical practice are discussed. Further research is now required to support future integration into clinical practice.
... Politically, gardening as a low-risk, inclusive form of PA (Thomson, 2018), has demonstrated its contribution to reductions in healthcare costs, through reductions in mental ill-health (Liu et al, 2014) including depression (Clatworthy et al, 2013), prevention of later life susceptibility to disease (Infantino, 2004), and facilitating positive cardiovascular health outcomes for older adults 4 (Park et al, 2011) through both moderate and lower intensity tasks (Bellows et al, 2008), despite downsides including musculo-skeletal injuries (Buck, 2016). ...
Thesis
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In recent years there has been considerable reporting of a range of physical and psycho-social benefits derived from ‘green exercise’, a term which describes a myriad of nature-based activities, including gardening, walking, climbing, and running in natural surroundings. Extant literature has largely focused upon exploring these benefits in respect of specific physical and psycho-social health and wellbeing outcomes, including positive impacts upon mood states, enhanced social connectedness, and improvements in recovery rates for patients in physical rehabilitation programmes. However, numerous gaps existed within the research beyond a focus on outcome measures: firstly, articulating the essential influences (mechanisms and processes) potentially driving these impacts. Secondly, insufficient qualitative investigations, particularly longitudinal ones. Third, a lack of innovation in researching green exercise, especially in respect of ethnographic studies. Fourth, and relatedly fifth, a need for more granular focused research upon specific population groups and settings, and utilising specific modes of green exercise - gardening, horticulture, and conservation activity - that had hitherto been under-investigated. The work consists of findings from six published papers that not only confirm that green exercise promotes positive enhancements to physical and psycho-social health and wellbeing for participants, but also offers possible explanations as to why and how these are derived, drawing upon relevant theories and concepts. The investigations were based upon a pragmatic overarching research approach employing ethnography to research participant experiences within four distinct contexts: a purpose-built garden within a medium secure NHS unit; a conservation project in an urban park; a woodland project outside formal mental health service provision; and a corporate health setting. Combined, these small-scale ‘case studies’ of GE offer important insight into the value of GE for specific groups and contexts and enable the development of a suggested socio-ecological model that emphasises a ‘green transformative ripple effect’ can be achieved delivering benefits not only for individuals, but also at group and community level. The latter is further evidenced through local ‘social impact’, demonstrating potential for the adoption of green exercise initiatives by practitioners and policymakers involved in social prescribing and community development as part of a more comprehensive health improvement strategy within communities.
... Gardening activities can be psychologically and aesthetically therapeutic for gardeners and promote self-sufficient food consumption to enhance satisfaction in life (Clatworthy et al. 2013). In this study, gardening activities are collectively referred to as horticultural activities performed in private areas, such as home gardens and verandas, to improve personal living conditions. ...
Book
Faced with the growing demand for nature in cities, informal greenspaces are gaining the interest of various stakeholders - residents, associations, public authorities - as well as scientists. This book provides a cross-sectorial overview of the advantages and disadvantages of urban wastelands in meeting this social demand of urban nature, spanning from the social sciences and urban planning to ecology and soil sciences. It shows the potential of urban wastelands with respect to city dwellers’ well-being, environmental education, urban biodiversity and urban green networks as well as concerns regarding urban wastelands’ in relation to conflicts, and urban marketing. The authors provide a global insight through case studies in nine countries, mainly located in Europe, Asia and America, thus offering a broad perspective. -------- https://link.springer.com/book/10.1007/978-3-030-74882-1
... The women also talked of the garden as being a place that "provided (them with) a respite from life's stresses" and took "their mind off the difficult times they were experiencing" (Stuart et al., 2002, p12). Although not specifically horticultural therapy, this study echoes other findings from the literature on the benefits of horticultural therapy which include an greater feelings of self-worth, letting go of aggression and hostility, mutually beneficial management of the environment and themselves (Adevi, Uvnäs-Moberg, & Grahn, 2018;Clatworthy, Hinds, & Camic, 2013;Kamioka et al., 2014;Kim, 2003;Oh, Park, & Ahn, 2018;Relf, 2005). Additionally, learning from experiences in the garden there are opportunities for choices, socialization, the use of helpful coping skills, intellectual stimulation Presence in the garden can be an amazing experience, from the sounds of the birds singing and rustling in the leaves on the ground, the scents of plants such as roses and mint, to watching the plants pushing their way to the soil surface, to the different textures of leaves, soil, stones, flowers and fruits, to the ripe strawberries eagerly picked and eaten. ...
Article
Attachment Theory suggests interaction with caregivers in childhood impacts relationships and health throughout our lives (Bowlby, 1965, 1969, 1971), leaving many who have experienced insecure attachment with an inability to form healthy relationships or cope with stressors throughout their lifespan (Holmberg, Lomore, Takacs, & Price, 2011). Horses have interacted with humans for over 12,000 years (Hintz, 1995), holding multiple roles in human society, most relying on observation by humans of equine behavior, and formation of a human-equine bond (Hamilton, 2011). More securely attached humans tend to more readily decipher non-verbal cues, positively affecting their felt security and internal working model of Attachment (Bachi, 2013). Interacting with horses, who provide significant non-verbal cues, may provide an opportunity to enhance this process, providing useful feedback and insight. This study aimed to evaluate if a single ground-based encounter with a horse could bring about changes in women participants’ reports of Attachment and Emotion Regulation. It was hypothesized that participants would move towards more secure dimensions of Attachment and Emotion Regulations after the encounter with the horse and that behavioral interactions with the horse would differ for those with differing dimensions of Attachment or Emotion Regulation. This study incorporated a repeated measures mixed methods design, one twenty-eight year old Standardbred mare, “Wicky” Long Wick, interacted with 22 female university students with minimal prior equine experience aged 18-30. Participants completing a demographic and screening questionnaire along with the Experiences in Close Relationships –Revised (ECR)(Brennan, Clark, & Shaver, 1998) and Emotion Regulation Questionnaires (ERQ)(Gross & John, 2003) at baseline, then the ECR and ERQ again both immediately prior to and immediately following encounter with the horse. The encounter was videotaped and included meeting, grooming, leading, and goodbye. Statistical analyses were completed using SPSS including paired t-tests and correlations. Videotape was evaluated, coded, and included in both quantitative and qualitative data analyses. Participants were recruited and participated in the study over the period of one calendar year. A significant decrease in Attachment anxiety was shown after encountering the horse (t(21)=2.915, p=.008 (M .237364, SD= .381941)), and significantly less time was spent between the horse and participant at goodbye than at meeting (t (21)=2.751, p=.021 (M 42.045, SD= 71.67)), particularly for those with insecure dimensions of Attachment (t (15)= 2.814, p=.013 (M= 45.75, SD=65.03)). Participants with insecure dimensions of Attachment showed significant increases in cognitive reappraisal after encountering the horse (t(14)= -3.732, p=.002 (M -.411, SD= .4266)), and the greatest decreases in Attachment Anxiety (t(14)=3.364, p=.005 (M .307, SD= .354)). The findings suggest interaction between horses and people differs along Attachment dimensions and show some support for positive changes in humans for both Attachment and Emotion Regulation dimensions after interaction with a horse.
... Gardening activities can be psychologically and aesthetically therapeutic for gardeners and promote self-sufficient food consumption to enhance satisfaction in life (Clatworthy et al. 2013). In this study, gardening activities are collectively referred to as horticultural activities performed in private areas, such as home gardens and verandas, to improve personal living conditions. ...
Chapter
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In urban areas, many wastelands deriving from former industrial activities may contain degraded and polluted soils. When reconversion of these wastelands is included in a renaturation project, it opens the way to more extensive approaches in favor of biodiversity and ecosystems. The designers of a future brownfield redevelopment projects must therefore think upstream about the clean-up strategy that is least harmful to biodiversity. The stated objective is to breathe new life into degraded soils while designing a new landscape based on the dynamics and resilience of ecological systems. Choices are not easy to make insofar as projects do not have the same time horizon as the dynamics of ecological systems. While ecosystem services can structure projects, we show that the renaturation of polluted wastelands is a very complex subject because it also comes up against the complexity of urban territories and the diversity of ways of thinking, which causes tensions and sometimes incomprehension about the future of the environment that is to be built. It is therefore necessary to gather feedback from in situ experiments carried out in projects for the phytomanagement of formerly polluted wastelands.
... Substantial evidence indicates that gardening and other nature-based therapies are effective mental health interventions. [109] For instance, one randomized controlled trial found horticultural therapy to be as effective as cognitive-based therapy for treatment of stress-related conditions. [110] However, most theories on the mechanisms underlying these mental health benefits rely heavily on visual experience, discounting other potential modes of action, such as exposure to soiland plant-associated microbial communities. ...
Article
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The complexity of the human mind and its interaction with the environment is one of the main epistemological debates throughout history. Recent ideas, framed as the 4E perspective to cognition, highlight that human experience depends causally on both cerebral and extracranial processes, but also is embedded in a particular sociomaterial context and is a product of historical accumulation of trajectory changes throughout life. Accordingly, the human microbiome is one of the most intriguing actors modulating brain function and physiology. Here, we present the 4E approach to the Human Microbiome for understanding mental processes from a broader perspective, encompassing one's body physiology and environment throughout their lifespan, interconnected by microbiome community structure and dynamics. We review evidence supporting the approach theoretically and motivates the study of the global set of microbial ecosystem networks encountered by a person across their lifetime (from skin to gut to natural and built environments). We furthermore trace future empirical implementation of the approach. We finally discuss novel research opportunities and clinical interventions aimed toward developing low‐cost/high‐benefit integrative and personalized bio‐psycho‐socio‐environmental treatments for mental health and including the brain‐gut‐microbiome axis. The 4E approach to the Human Microbiome understands mental processes broadly, encompassing body physiology, microbiome dynamics, and environment throughout lifespan. We pursue mechanistic network models in the form of embedded gut‐brain‐behavior interactomes, reaching convergence of methods and analyses and public policy and novel evidence‐based clinical interventions coupled with patients’ lifestyle.
... Through direct engagement with the physical world, gardeners also build attachment to place; experience "overall feelings of joy, pride, purpose, peace, and awe" and report reduced stress (Alaimo et al., 2016, p. 305). Through all these processes, gardens shape key determinants holistically of physical and mental health: diet, physical activity, community connections, stress levels, and connection to nature, which can lead to therapeutic benefits (Genter et al., 2015;Marsh et al., 2018;Ong et al., 2019); improvements in overall physical health (Park et al., 2017;Bail et al., 2018;Litt et al., 2017;Soga et al., 2017a,b;Howarth et al., 2020) and psychological wellbeing (van den Berg and Custers, 2011;Clatworthy et al., 2013;Cipriani et al., 2017;Chalmin-Pui et al., 2020). ...
Article
Gardening has the potential to improve health and wellbeing, especially during crises. Using an international survey of gardeners (n = 3743), this study aimed to understand everyday gardening experiences, perspectives and attitudes during early stages of the COVID-19 pandemic in 2020. Our qualitative reflexive thematic and sentiment analyses show that during the first months of the COVID-19 pandemic, gardening seemed to create a safe and positive space where people could socially connect, learn and be creative. Participants had more time to garden during the pandemic, which led to enhanced connections with family members and neighbours, and the ability to spend time in a safe outdoor environment. More time gardening allowed for innovative and new gardening practices that provided enjoyment for many participants. However, our research also highlighted barriers to gardening (e.g. lack of access to garden spaces and materials). Our results illustrate the multiple benefits of gardening apparent during COVID-19 through a lens of the social-ecological model of health.
... Resilience is improved when a person engages in doing gardening activities because it evokes feelings of calmness and pleasure which is conducive for stress restoration. For instance, literature discussed the embracing of the environment through gardening-related activities act as a form of therapy which aids in addressing depression and self-improvement (Beyer et al., 2014;Clatworthy et al., 2013). Other scholars have likewise discussed the role of gardening helped in building personal resilience during life crisis situation and the pandemic and its effect on psychological distress and lockdown exhaustion (Camps-Calvet et al., 2021). ...
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Aim: This study is aimed to assess the health and well-being benefits of gardening between gardeners and non-gardeners. Methods: A total of 400 respondents participated in the study which was equally sampled between gardeners and non-gardeners. Criterion sampling was utilized in the participant selection. The study utilized standardized questionnaires and was conducted in Central Philippines. The study utilized a quasi-experimental post-test only design. T-test of independent samples was utilized in the analysis. Results: Results revealed that gardeners have considerably higher reports of good health (M=3.40, SD=0.48), higher resilience (M=3.82, SD=.51) and displayed significantly higher reports of coping (M=3.82, SD=.56) than non-gardeners. Non-gardeners on the other hand showed to be more fearful of COVID-19 than the gardener group (M=3.26.SD=.63). Conclusion: Gardening activity is beneficial in maintaining a person’s perceived health and well-being especially in times of distress and social isolation. People who engage in gardening activities are better at adapting to change, making them more resilient and adjusted from grief and loss of a loved one. It is recommended to incorporate gardening as an adaptive means in improving the public’s health and well-being especially at times of health crises. KEYWORDS: Gardening, Fear of COVID-19, Perceived Health, Resilience, Bereavement Coping, Psychological Well-being, Philippines
... 49 Although the mechanisms of how the natural environment affects PTB remain unclear, there might be several possible pathways linking greenness to PTB. 28,29,52 First, the biophilia hypothesis indicates that humans are close to nature instinctively, which could enhance psy-chological or physiological restoration. 53,54 Increasing evidence suggests that poor maternal mental health during pregnancy may be related to an increased risk of PTB. 51,55 Previous studies indicated that pregnant women were more likely to have fewer depressive symptoms when exposed to greater greenness. ...
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Exposure to greenness may lead to a wide range of beneficial health outcomes. However, the effects of greenness on preterm birth (PTB) are inconsistent, and limited studies have focused on the subcategories of PTB. A total of 3,751,672 singleton births from a national birth cohort in mainland China were included in this study. Greenness was estimated using the satellite-based Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) within 500-m and 1,000-m buffers around participants’ addresses. The subcategories of PTB (20-36 weeks) included extremely PTB (EPTB, 20-27 weeks), very PTB (VPTB, 28-31 weeks) and moderate-to-late PTB (MPTB, 32-36 weeks). Gestational age (GA) was included as another birth outcome. We used logistic regression models and multiple linear regression models to analyze these associations throughout the entire pregnancy. We found inverse associations between greenness and PTB and positive associations between greenness and GA. Specifically, an increase of 0.1 NDVI exposure within a 500-m buffer throughout the entire pregnancy was significantly associated with decreases in PTB (OR 0.930, 95% confidence interval [CI]: 0.927 to 0.932), EPTB (OR 0.820, 95% CI, 0.801 to 0.839), VPTB (OR 0.913, 95% CI, 0.908 to 0.919), MPTB (OR 0.934, 95% CI, 0.931 to 0.936), and an increase in GA (β 0.050, 95% CI: 0.049 to 0.051 weeks). These results suggest the potential protective effects of greenness on PTB and its subcategories: MPTB, VPTB, and EPTB in China.
... Gardening activities can be psychologically and aesthetically therapeutic for gardeners and promote self-sufficient food consumption to enhance satisfaction in life (Clatworthy et al. 2013). In this study, gardening activities are collectively referred to as horticultural activities performed in private areas, such as home gardens and verandas, to improve personal living conditions. ...
Chapter
Urban spaces are dotted with various interstitial spatial areas from very narrow spaces between buildings or structures to huge spaces between parcels. These in-between spaces are filled with plants that represent the surrounding nature, partly or entirely. In urban areas with past human interference, can we thus consider or recognize this quasi-nature as urban green space? This research begins on the premise that the role of urban green space is important in supporting the combined well-being of urban residents. We thus review the potential of vacant lands as urban wastelands in the context of the state of affairs in Japan, which is undergoing a paradigm shift in urban green policy. We surveyed Ichikawa City (Japan) as an example of a city that has already been or is currently being urbanized. The survey combined field surveys and perception surveys to identify vacant lands and to understand residents’ perceptions. The quantity of vacant lands observed corresponds to about 1.43% of Ichikawa City. Residents with higher exposure to traditional green space in their daily lives were more aware of the existence of vacant lands. In addition, respondents who see vacant lands as an urban green space show a positive and active attitude toward existing urban green space and urban nature. Moreover, they respond more strongly to the issue of the non-sustainability of vacant lands than to the issue of private property. As a result, vacant land may have a high tendency to be perceived by residents as an intimate, local space, suggesting usability. We finally highlight that vacant lands can serve an alternative or supplementary role in cities with limitations to creating new urban green space.
... Through the involvement of many members of the local community, community gardens can also improve the overall health of an area, by enabling broader neighbourhood issues to be addressed (Armstrong 2000). Gardening is increasingly recognised as an important contributor to improved mental health (Clatworthy et al 2013;Frumkin 2001). People with dementia, for example, can benefit from specifically-designed gardens that provide 'therapeutic activities designed to maximise retained cognitive and physical abilities and lessen the confusion and agitation often associated with the condition' (Alzheimer's Australia SA Inc 2010, p. 4), while people living with mental health challenges were shown to benefit from a targeted program that focused on social inclusion through gardening (Whatley 2012). ...
Technical Report
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02) 9635 7764 ABN: 65 003 487 965 ACN: 003 487 965 | Culture, community and sustainable food practices: a study of community gardens in Blacktown LGA
... Further benefits of contact with nature include mental restoration, cognitive and intellectual stimulation, reduced risk of developing stress-related illness and improved mood. Finally, people may benefit from social interactions such as a stronger sense of unity and belonging and decreased risk of dementia (Sugiyam and Thompson, 2005;Clatworthy et al., 2013;Wolf and Housley, 2016). Currently, more research has been conducted on the impact of the natural environment on the health and well-being of older people. ...
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The global population of older people grows systematically and with age, the physical and cognitive abilities of people decline. The amount of evidence that gardening may provide substantial health benefits and enhance the quality of ageing is increasing. This paper presents a systematic review of the therapeutic effects of horticulture and gardening on clients aged ≥60 years. It encompasses articles published in English between January 1, 2010, and December 31, 2021. The literature survey shows that the interest in the topic has grown significantly in recent years as over half of the published studies are from 2019 to 2021. Most of this work was done in Asia (60%), America, Europe, Australia and New Zealand. The most commonly used interventions were active horticultural therapy programs or gardening, but 20% of the studies explored the passive connection of being outside. The fitness of the elderly was measured using 33 psychological tests, 32 physiological and functional parameters and different kinds of self-developed questionnaires and interviews. The most commonly used psychological tests were the Geriatric Depression Scale, Self-rated Health and Quality of Life, Mini-Mental State Examination, Friendship Scale, Lubben Social Network Scale, and the Attitudes to Ageing Questionnaire. The physiological and functional parameters included heart rate variability, blood pressure, electroencephalography, brain nerve growth factors, and different types of biomarkers. The study outcomes demonstrated positive results of horticultural therapy on human health and well-being, particularly in a psychological dimension and to a smaller but still significant extent physiological aspect.
... There is an increase in the number of people with mental health problems resulting from forced migration, domestic violence, chronic illnesses, caregiving burden, and other environmental stressors in lowand middle-income countries (LAMICs) (Patel, 2007).The mental health challenges are further exacerbated by food and water insecurity (Perkins et al., 2018) and under-resourced mental health systems (Molodynski, Cusack, & Nixon, 2017).This increasing burden of mental health problems will require innovations in the provision of low-threshold and culturally-relevant mental health interventions. Studies from highincome countries have suggested mental health benefits accruing from involvement in various forms of gardening (Clatworthy, Hinds, & Camic, 2013;Thompson, 2018). In Addition, other studies have cited mental health benefits of gardening and improvement in dementia symptoms (Gonzalez & Kirkevold, 2014;Murroni et al., 2021) and school children self-regulation (Weeland et al., 2019). ...
Article
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There is increasing awareness among researchers and health practitioners from high income countries about the potential mental health benefits of participating in gardening activities and spending substantial time in green spaces. However, this phenomenon is not well established in low- and middle-income countries. In this commentary, we discuss the evidence base surrounding the potential mental health benefits of participating in gardening activity and spending substantial time in a green space. We hope to stimulate discourse about incorporating these activities into mental health prevention in low- and middle-income countries.
... Last but not least, it provides fresh, healthy, and low-cost food. Research has shown how horticultural interventions that are intentionally designed to meet people's needs can be effective in helping individuals in institutions manage mental health issues such as depression and anxiety (Clatworthy et al., 2013;Grinde & Patil, 2009;Moeller et al., 2018), and PTSD (Annerstedt & Währborg, 2011). Evidence of the effects of therapeutic gardens goes well beyond a correctional context. ...
Article
Ecotherapy and gardening have gained popularity in corrections, with most interventions focusing on prison settings. This paper briefly describes the authors’ experiences developing a gardening program in a community corrections facility for women, describing a pilot research program and preliminary results. Findings indicate that gardening is an effective, low-cost programming option for community residential settings that improve clients’ mental health and nutritional awareness, fosters community partnerships, and promotes camaraderie among clients and staff.
... There is indeed something about gardening that appeals to human biological functions, suggesting the desire is innate-so much so that it is a successful treatment for mental health issues (Clatworthy et al., 2013). However, it is unclear exactly which aspects of gardens improve biological functioning: the exercise, interaction with plants, fresh air, or all of the above? ...
Article
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Gardening is a popular practice despite the abundant and affordable food at the grocery store, suggesting gardening is more than just a way to obtain food. The purpose of this article is to explore these other motivations. Evolutionary and pragmatic motivations are first explored, and then discarded, in favor of a values-driven approach. Gardening is depicted as both a form of art and a hobby. As an art form, the writings of iconic philosophers such as Immanuel Kant, Arthur Schopenhauer, and Martin Heidegger—as well as modern philosophers—are used to articulate the meaning of gardening as an aesthetic experience. As a hobby, gardening is a socially approved form of leisure and productive play. The conclusion is that, in addition to obvious physiological benefits such as food and exercise, gardening helps us acquire higher needs, such as self-actualization and transcendence. Why do we garden? No simple answer can suffice. Gardening, like many interests, is performed both for an end product and for the process itself. Gardeners can hardly be expected to be able to articulate their reasons, just as sports fans would have difficulty articulating why they watch football, or music lovers explaining why songs mesmerize them. When pressed, their answers will be mostly a tautology (e.g., I simply like it). However, this does not mean we cannot make progress in understanding the motivations for gardening. Gardening is a form of exercise, it is a hobby, and is performed for aesthetic pleasure, and research on motivations for all three of these exist—especially that regarding aesthetics.
... Horticultural therapy (HT) has been reported to have human health benefits, such as alleviating pressure from stress and anxiety, stabilizing mood changes, establishing self-esteem, increasing the sense of community and improving physical health 1 . The American Horticultural Therapy Association (AHTA) defined HT as an intervention involving indoor or outdoor planting and gardening activities proven to have therapeutic value by reducing stress, decreasing blood pressure and enhancing self-confidence 2 through stimulating the five senses (visual, sound, taste, tactile and smell) to result in better mental and physical health. ...
Article
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Horticultural therapy (HT) has been reported to be beneficial to mental and physical health. This study investigated the effects of HT on the psychological status and mucosal immunity of elderly individuals. Twenty-four participants aged 70–93 were recruited from residential facilities and adult day-care services. Six different HT activities were designed and guided by licensed instructors who performed saliva collection and helped the participants complete the questionnaires before and after each activity. The sleep quality scores were collected during the 6 weeks of HT activities. Saliva was collected and analyzed to determine the concentrations of immunoglobulin A (IgA), lactoferrin, chromogranin A (CgA), α-amylase (AA) and total protein (TP). Comparisons of the questionnaire scores between preactivity and postactivity showed that feelings of satisfaction and happiness were significantly enhanced after each activity. In addition, sleep quality was significantly improved after the 6-week course of HT activities. Regarding mucosal immunity, the preactivity IgA and IgA/TP were significantly increased at week 3 and week 6; in addition, the ratio of lactoferrin/TP was significantly decreased at week 6 compared to week 1. The postactivity AA and CgA levels were significantly enhanced at weeks 2, 3 and 5 compared to the corresponding preactivity levels. In conclusions, HT activities significantly improved the happiness, satisfaction, well-being and sleep quality of the elderly. Moreover, mucosal immunity proteins, including IgA, lactoferrin, CgA and AA, were significantly increased.
... Accordingly, natural environments as well as urban greenery have a remarkable impact on reducing mental stress and improving mental health [44,75,[94][95][96][97][98]. "Psycho-physiological stress reduction theory" and "Attention Restoration Theory" provide the theoretical basis for the restorative effect of interaction with the natural environment as well as urban greenery [99]. ...
Article
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More than one hundred and fifty cities around the world have expanded their emergency cycling and walking infrastructures to increase their resilience in the face of the COVID-19 pandemic. In addition, the role of mobile apps is prominent in respect to developing a smart city during this pandemic, which raises the questions of how mobile apps contribute to the improvement of walking/cycling behavior and how such a relationship is influenced by the situation imposed by COVID-19. The role of mobile apps in the three relevant fields of physical activity, transport, and urban planning are reviewed. Next, the associations between walking/cycling behaviors and their contributing factors and the impacts of the COVID-19 pandemic on these relationships are reviewed. Studies on physical activity have emphasized the role of motivational social factors in improving the function of mobile apps. In regard to transport, mobile apps have the potential to facilitate data collection in macroscale environments. In addition, mobile apps may facilitate people’s recognition of positive/negative environmental aspects, and this may in turn lead to greater pedestrian/cyclists’ awareness and better organization of their walking/cycling behavior. Moreover, based on a participatory approach, the classification of current mobile apps and certain suggestions on the development of future mobile apps are presented. Finally, complementary suggestions are provided for maintaining and improving the use of mobile apps to improve the level of walking/cycling.
... The high heterogeneity across studies, as also being noted in other previous reviews, (Clatworthy et al., 2013;Kamioka et al., 2014;Nicholas et al., 2019), has prevented a metaanalyses, and thereby a general effect size of HT's therapeutic potential on older adults' psychosocial wellbeing cannot be calculated. It is natural that the programme structures would depend heavily on site resources, such as the size of gardening space and local weather. ...
Article
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Aim: This systematic review aims to evaluate changes in Chinese older adults’ psychosocial wellbeing after receiving horticultural therapy, and examine existing evidence regarding horticultural therapy’s effectiveness in a Chinese setting. Method: Intervention studies measuring relevant outcomes amongst older adults and conducted in China were identified from ASSIA, CIHAHL Plus, PsycINFO, EMBASE, MEDLINE, SCOPUS, Web of Science Core Collection and CNKI. Cochrane risk of bias assessment tools were used to appraise study quality. Result: 16 studies were selected, among which four were published in English and 12 in Chinese. Findings suggested that after receiving horticultural therapy, older adults’ psychosocial wellbeing is generally improved, but causal relationships between improvements and horticulture therapy were less clear. Conclusion: Features of horticultural therapy conducted in China is with its cultural and social uniqueness. Existing evidence supports the post-intervention benefits on completion of horticultural therapies, but the limitations in programme design, sample representativeness and methodological robustness limited the quality of the evidence.
... This has been criticised before, concerning health benefits of nature in other settings and target populations [4,20,77]. Studies that examined nature-based therapeutic approaches, e.g., horticultural therapy and greenspace interventions, were excluded here but have already been reviewed [78][79][80]. They concluded that nature-based approaches can be effective for MH but also found inadequate methodological quality of the included studies. ...
Article
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The environment in healthcare facilities can influence health and recovery of service users and furthermore contribute to healthy workplaces for staff. The concept of therapeutic landscapes seems to be a promising approach in this context. The aim of this qualitative meta-analysis is to review the effects of therapeutic landscapes for different stakeholders in psychiatric care facilities. A systematic literature search was conducted in the four data bases PubMed, PsycInfo, CINAHL, and Web of Science. Thirteen predominately qualitative studies were included in this qualitative meta-analysis. The methodological quality of these qualitative studies was assessed, using an adapted version of the Journal Article Reporting Standards for Qualitative Research, and a thematic analysis was conducted. The results were categorised into the three main themes of the physical (built and natural), social, and symbolic dimensions of the therapeutic landscape. Given the heterogeneity of the summarised data and an overall methodological quality of the included studies that can be rated as medium, the results should be interpreted with caution. Current findings are based almost exclusively on qualitative studies. Therefore, there is a need for quantitative study designs that investigate the relationship between specific environmental elements and mental health outcomes for different stakeholders in psychiatric facilities.
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Background: School-based green space activities have been found to be beneficial to the physical activity level and lifestyle habits of adolescent students. However, their effects on green space use and satisfaction, mental health, and dietary behaviors required further investigation. This study aimed to investigate the effects of school-based hydroponic planting integrated with health promotion activities in improving green space use, competence and satisfaction, healthy lifestyle, mental health, and health-related quality of life (QoL) among early adolescent students in secondary schools. Methods: This study adopted a three-group comparison design (one control and two intervention groups). Secondary school students ( N = 553) of grades 7–9 participated in either ( 1 ) hydroponic planting (two times per week for 8 months) integrated with health promotion activities; ( 2 ) only health promotion activities (one time per week for 6 weeks); or ( 3 ) control group. Outcomes assessed by questionnaire included green space use and satisfaction, life happiness, lifestyle, depressive symptoms, and health-related QoL. Results: After adjusting for sex and school grade, the scores in “green space distance and use” and “green space activity and competence” were significantly better in the intervention groups than in the control group. Hydroponic planting integrated with health promotion activities was also associated with better scores in dietary habits and resistance to substance use. Intervention groups had a higher score in “Green space sense and satisfaction” and life happiness when compared with the control group. Conclusions: Our study shows that the school-based hydroponic planting integrated with health promotion activities were feasible and, to a certain extent, useful to improve green space use and competence, dietary habits, and resistance to substance use among early adolescent students in secondary schools in urban areas. Future studies should address the limitations identified, for example, designing a randomized controlled trial that could fit school schedules to generate new evidence for physical and mental health in adolescent communities.
Article
Refugees and the displaced experience challenges which can lead to mental health illnesses, including depression. In this study, the effectiveness of gardening in reducing depression and improving the lives of displaced Syrian women in Lebanon was explored. Considering that the displaced had limited outdoor space and no access to land, vertical gardening units were used. Forty-four participants residing in four displaced communities in North Lebanon joined the 6-months gardening programme, which was designed as a quasi-experimental exploratory study. Data on depression scores were collected at the preparatory phase and at 24 weeks post-intervention using the Beck Depression Inventory (BDI-II) and analysed using a paired t-test. Results revealed that participants were less depressed at the end of the gardening programme, with depression scores significantly lower than preparatory phase scores. Group interviews were also conducted to assess women’s perception of gardening halfway through the intervention phase. Women’s engagement in gardening activities was also reflected by estimating yields. Participants indicated that they joined the programme because they saw it as a stress relief activity, they were interested to learn about vertical gardening, they enjoyed the aesthetic value of plants, they wanted to produce food and they felt that gardening provided an opportunity to socialise. Our findings suggest that aid organisations may consider vertical gardening as a therapeutic and social activity in situations where displaced women are confined to limited open spaces.
Article
Gardening activities can offer a sense of calm, purpose, and self-worth and help improve physical and mental health, but research on these benefits within veteran populations is limited. In collaboration with a local garden, this Veterans Affairs (VA) program evaluation explored perceived benefits of gardening for veterans from two VA programs. Focus groups and photovoice methods revealed four main benefits of participation: supporting mental and emotional wellbeing, improving socialization and comradery, nurturing life and identity, and learning new skills. Findings align with VA's Whole Health (WH) approach, and support collaborations between community gardens and the VA to benefit veteran populations.
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COVID-19 was declared as a global pandemic on 11 March 2020 by the World Health Organization, but the world is already going after it. From China, cases spread rapidly across the world, driving world policymakers’ stringent steps to separate cases and restrict the virus transmission. The main supportive foundations of the modern world economies have been torn up by these strategies as multinational trading and collaboration resulted in nationalizing and fighting for limited stocks. The epidemic in COVID-19 greatly influenced the growth of infrastructure and the global economy. Global reactions are underway to rapid disruptions in main markets and industries in infrastructure. One remedy is to return to the physical and building environment (BE) to reduce the effect before medications for an outbreak are created. Due to the fear of illness, epidemics have changed our world. In several past studies of infectious pandemics, advances in the BE have been seen to help more to deter infection transmission. Architecture and urbanism would also never be the same following the COVID-19 outbreak. In encouraging environmental health interventions and reducing chances of diseases, BE has an important role to play. Although the ongoing worldwide outbreak is a threat at all levels of the developed environment, implementing an antivirus paradigm can take time to minimize future threats or deter the virus from spreading. This paper presents how the world produced by virus looks on the basis of the lessons learned and the value of a stable and safe environment. Many questions unanswered need further multidisciplinary research. This paper looks at the future COVID-19 steps to gradual and systemic improvements in varying time frames and sizes, which enhance air quality and less energy use, or the use of materials that eventually fulfil the sustainability objectives. This challenges us to reconsider buildings and urban areas and eventually use sustainable solutions for win–win results.
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Men with health problems refuse to participate in rehabilitation programmes and drop out of healthcare offerings more often than women. Therefore, a nature-based rehabilitation programme was tailored specific to men with mental health problems, and long-term illnesses. The rehabilitation programme combines the use of nature, body, mind, and community spirit (NBMC) and is called the 'Wildman Programme'. The presented study was designed as a matched-control study with an intervention group participating in the Wildman Programme (N = 114) compared to a control group receiving treatment as usual (N = 39). Outcomes were measured at baseline (T1), post-intervention (T2), and 6 months post-intervention (T3). The primary outcome was the partici-pants' quality of life measured by WHOQOL-BREF, which consists of four domains: physical health, psychological health, social relationships, and environment. The secondary outcomes were the level of stress measured by the Perceived Stress Scale (PSS), and the participants' emotional experience in relation to nature, measured by the Perceived Restorativeness Scale (PRS). The intervention group improved significantly in the physical and psychological WHOQOL-BREF domains and in PSS at both follow-ups. The participants' interest in using nature for restoration increased significantly as well. The only detectable difference between the control group and the intervention group was in the WHOQOL-BREF physical domain at the 6-month follow-up. For further studies, we recommend testing the effect of the Wildman Programme in an RCT study.
Article
Background: There is increasing interest in the association between nature, health and wellbeing. Gardening is a popular way in which interaction with nature occurs and numerous gardening projects aim to facilitate wellbeing among participants. More research is needed to determine their effectiveness. Aim: To systematically evaluate the effectiveness of group-based gardening interventions for increasing wellbeing and reducing symptoms of mental ill-health in adults. Methods: A systematic review of Randomised Controlled Trials was conducted following the protocol submitted to PROSPERO (CRD42020162187). Studies reporting quantitative validated health and wellbeing outcomes of the community residing, adult populations (18+) were eligible for inclusion. Results: 24 studies met inclusion criteria: 20 completed and four ongoing trials. Meta-analyses suggest these interventions may increase wellbeing and may reduce symptoms of depression, however, there was uncertainty in the pooled effects due to heterogeneity and unclear risk of bias for many studies. There were mixed results for other outcomes. Research limitations/implications: Heterogeneity and small sample sizes limited the results. Poor reporting precluded meta-analysis for some studies. Initial findings for wellbeing and depression are promising and should be corroborated in further studies. The research area is active, and the results of the ongoing trials identified will add to the evidence base.
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The research results in the last two decades show the important role of pekarangan as a micro-scale landscape unit in providing space for growing various types of plants, i.e., multi-layers from the grasses to the trees, livestock, and fish. Pekarangan is defined with distinctive spatial patterns and elements as a representation of the harmonious relationship between the owner and the ecological character. Perceptions and preferences based on different social, cultural, and environmental factors shape the pekarangan pattern and function to become more diverse as a form of community local wisdom. The important role of pekarangan needs to be deeper elaborated in efforts to increase community immunity during the Covid-19 pandemic. Pekarangan has great potential to be developed as a mitigation and rehabilitation space by providing a variety of medicinal plants as well as outdoor activity spaces with a healthy environment quality. This research was designed for three years with three main approaches: (1) inductive method, which focuses on building theory from practices that have been known and carried out for generations, (2) implementation as an effort to actualize local knowledge, (3) multiplicative for the benefit of the important value of pekarangan . Studies start from basic research of pekarangan ; research on the development of spatial planning and elements forming pekarangan ; research on nutritional content contributed from pekarangan products. Data were obtained through pekarangan mapping, structured questionnaires at four selected locations in Cisadane, Citarum, Kali Progo, and Brantas Watersheds. The results of this research are expected to be implemented in public spaces on a meso scale and macro scales.
Chapter
Alcohol use disorder is by far the most prevalent substance use disorder in the general population and is a major contributor to disease worldwide. Recovery from the disorder is a dynamic process of change, and individuals take many different routes to resolve their alcohol problems and seek to achieve a life worth living. Total abstention is not the only solution and robust recovery involves more than changing drinking practices. This volume brings together multidisciplinary research on recovery processes, contexts, and outcomes as well as new ideas about the multiple pathways involved. Experts chart the individual, social, contextual, community, economic, regulatory, policy, and structural influences that are vital to understanding alcohol use disorder and recovery. The book recommends new approaches to conceptualizing and assessing recovery alongside new avenues for research, community engagement, and policy that constitute a major shift in the practice and policy landscape.
Article
Alcohol use disorder is by far the most prevalent substance use disorder in the general population and is a major contributor to disease worldwide. Recovery from the disorder is a dynamic process of change, and individuals take many different routes to resolve their alcohol problems and seek to achieve a life worth living. Total abstention is not the only solution and robust recovery involves more than changing drinking practices. This volume brings together multidisciplinary research on recovery processes, contexts, and outcomes as well as new ideas about the multiple pathways involved. Experts chart the individual, social, contextual, community, economic, regulatory, policy, and structural influences that are vital to understanding alcohol use disorder and recovery. The book recommends new approaches to conceptualizing and assessing recovery alongside new avenues for research, community engagement, and policy that constitute a major shift in the practice and policy landscape.
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Introduction : La réadaptation à l’effort dans le cadre de l’activité physique adaptée (APA) a un impact positif sur l’amélioration de la qualité de vie des patients douloureux chroniques [1]. La pandémie à Covid19 nous a contraints à proposer une formule APA avec télé‑coaching à la place des groupes d’APA habituels. L’objectif de l’étude était d’évaluer l’adhésion des patients aux séances et leur satisfaction, ainsi que de décrire l’évolution des symptômes dans le temps selon les groupes. Méthode : Nous avons réalisé une étude rétrospective en incluant les patients suivis au Centre d’évaluation et de traitement de la douleur du CHU de Toulouse et ayant bénéficié de la mise en place d’un programme d’APA de 4 semaines avec télé‑coaching ou en autonomie, pendant la période du 01/01/2021 au 31/03/2021. Le télé‑coaching a été réalisé en groupe avec l’interface Starleaf®. La satisfaction et l’adhésion des patients ont été recueillis à 1 mois. La performance physique, par l’intermédiaire du Short Physical Performance Battery (SPPB [2]), l’intensité des symptômes douleur, anxiété‑dépression, catastrophisme et kinésiophobie ont été mesurées à l’initiation du programme et à 1 mois. Résultats : 31 patients ont été inclus dans notre étude, 14 ont bénéficié d’un programme d’APA avec télé‑coaching et 17 d’un programme en autonomie. Notre échantillon est constitué à 87,1 % de femmes. L’âge moyen est de 44,5 (±11) ans. Les pathologies les plus représentées sont la fibromyalgie (48,4 %) et les céphalées (25,8 %). 9 (29 %) patients ont été perdus de vue (dont 2 dans le groupe avec télé‑coaching). Concernant l’adhésion des patients, elle est renforcée dans le groupe en télé‑coaching avec plus de patients ayant pratiqué au moins 2 séances hebdomadaires en moyenne (71 % vs. 35 %, p=0.045). La satisfaction des patients est meilleure dans le groupe télé‑coaching (EVN=8.6±2.2 vs. 6.7±2.5, p=0.03). L’évolution de la performance physique à 1 mois est meilleure dans le groupe télé‑coaching (ΔSPPB=1.6±2.2 vs 0.0±0.7, p<0.01). Il en est de même pour l’évolution de l’anxiété (ΔHADSanx= ‑2.9±3.9 vs ‑0.4±2.2, p=0.04) ou de la dépression (ΔHADSdep = ‑1.9±4.2 vs 0.3±3.0, p=0.047). L’intensité de la douleur, la kinésiophobie et le catastrophisme évoluent de manière similaire. Discussion : Les résultats de notre étude témoignent de l’adhésion et de la satisfaction des séances de télé‑coaching en groupe dans le cadre d’une APA chez les patients atteints de syndrome douloureux chronique. L’évolution dans le temps suggère un bénéfice de cette approche sur la performance physique, l’anxiété et la dépression par rapport à des programmes réalisés en autonomie. Des études prospectives sont nécessaires pour valider nos observations.
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Increasing urbanization has resulted in urban stress, which not only has affected the cognitive development of children in schools but also adults at workplace. Various research studies have been conducted in this field, and many computational tests were showcased to prove the facts. Still there is a huge gap while designing the school campus and workplace. This study is based on comprehensive portrayal of greenness at both these spaces. The findings of the study shall provide an insight to policymakers and architects with evidence for feasible and attainable besieged interventions such as improving green spaces not only outdoors but also integrating them with inside spaces at school campus and at workplace.
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Objective Despite growing awareness of the importance of engagement with the natural world for people living with dementia, little is known about the impact specifically for people living independently in their own home. This review identifies, analyses and synthesises existing research, incorporating first-person narrative accounts of the benefits and potential challenges experienced in forging meaningful connections with the natural world. Methods Six databases were searched from February 2000 to February 2021. Relevant organisations and authors were contacted, and a hand search of included study reference lists was conducted. The findings of included studies were synthesised using a thematic analysis approach. Findings Sixteen studies were included: 13 qualitative and three mixed methods. Eight themes and three sub-themes were identified, revealing how contact with the natural world held a significance for people living with dementia, associated with a sense of pleasure, comfort, stimulation, freedom and meaning. Support and the use of adaptive strategies afforded opportunities for continued engagement with meaningful outdoor activities and the promotion of identity, independence, social interaction, enhanced wellbeing and quality of life for people living independently with dementia. Conclusion Meaningful connections with the natural world offer far more than a ‘breath of fresh air’. When support mechanisms are in place, engaging with the natural world can be a valuable arena for enablement and continuity, providing a sense of connectedness to self, place and others.
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The Expressive Terrarium is a new intervention tool in the field of ecological arts therapy. The terrarium is a glass bowl containing plants and other objects from nature, art materials, as well as miniature and found objects. Quantitative and qualitative data were collected from a sample of students and administrative staff from the same college to better understand the experiential process for future use as a clinical intervention tool. The findings showed that both groups had high positive attitudes toward the terrarium experience. The qualitative data showed that the participants experienced feelings of enjoyment and a sense of calm while engaged in building and tending their terrariums. The terrarium was perceived as enabling self-expression and as a symbolic-narrative-oriented personal space. Thus, this preliminary mixed-method study suggests that the Expressive Terrarium could be implemented in individual and group therapy or as a community-based intervention in schools and academia.
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Argues that evolutionary heritage underlies humans' consistent preference for stimuli from the natural environment and that research on affective and aesthetic responses is needed to understand human interaction with the environment. It is noted that the rapidly expanding empirical record concerning aesthetic and affective responses to natural environments is in need of a well-developed theoretical foundation. An integrated conceptual framework to address this theoretical lack, drawing on recent theory and research on emotion, is proposed. This framework explains how affects arise in the natural environment; postulates their functions; and links them to cognition, activity in physiological systems, and behavior. The present author, in developing the framework, questions the view that feelings result from cognitive processes, asserting that feelings (not thoughts) are the initial response in environmental encounters. The observer's initial feeling reaction shapes subsequent cognitive events. The relative sequence of feeling and thinking in environmental encounters represents a fundamental issue in understanding human interaction with the environment. (98 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Between-group outcome research is a scientific approach to evaluating the effectiveness of psychotherapy and the mechanisms of change associated with those treatments for psychological disorders. This area of research is replete with important methodological issues that need to be considered in order for investigators to draw the strongest, most specific cause-and-effect conclusions about the active components of treatments, human behavior, and the effectiveness of therapeutic interventions. In this chapter, we present the various methodological considerations associated with these experiments. The chapter begins with a description of the different experimental designs from which investigators may choose in designing a therapy outcome study. These designs include the no-treatment and common factors comparison designs, as well as the dismantling, additive, catalytic, and parametric designs. We also present the methodological, client/participant, and therapist concerns that must be taken into account in the design stage of a treatment outcome investigation. Following this, we discuss the measurement of change, starting with the considerations surrounding dependent variables and ending with methods of analyzing data and assessing clinically significant change. Finally, after a presentation on small-N experimental designs, we discuss the importance of scientific research in naturalistic settings. Keywords: design; methodology; naturalistic; outcome; psychotherapy; therapy
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The point of departure of this chapter is to view nature-based settings as an important asset for improvement and promotion of health. During the last decades the concepts of healthy nature-based settings and accompanying treatment programs have been referred to by many names, making the subject difficult to interpret. Here the development of the theoretical framework and the research area are described. The second part of the chapter focuses on the structure of a therapy program and the health design of the nature-based setting. From the theories and experiences, including both research as well as best practice presented, the chapter ends with recommendations for future aims of research projects within this area.
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Ecotherapy is an umbrella term for a gathering of techniques and practices that lead to circles of mutual healing between the human mind and the natural world from which it evolved. It includes horticultural therapy, wilderness excursion work, time stress management, and certain kinds of animal-assisted therapy. This article provides an overview of research into ecotherapy's treatment efficacy and argues for a psychology of place designed to reconnect people psychologically with the world a place at a time.
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In most cases, therapy is addressed as an indoor, verbal, and cognitive activ- ity, with the relationship between therapist and client at its center (McLeod, 2003). This article presents an alternative approach to therapy, conducted in creative ways in nature, addressing the environment not merely as a setting but as a partner in the process. The article includes examples of work that took place with different clients, in varied settings. It aims at presenting basic con- cepts from this young framework that will inspire other practitioners to "open the doors" and explore these ideas with their clients in nature.
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Introduction The use of horticulture in mental health settings is widespread. Moreover, its effectiveness is supported by a body of qualitative evidence. Aims The investigators in this research study sought to determine those aspects of their horticultural projects that conferred the greatest therapeutic benefit to their clients. They used outcome measures to rate the responses of participants, paying particular attention to the participants' expressed motivation. Method Qualitative and quantitative methods were used to evaluate six horticultural projects. Ten participants were interviewed, using an adapted version of the Work Environment Impact Scale (WEIS) to rate factors that supported their motivation. Fifty participants were assessed, using the Volitional Questionnaire (VQ) to observe and rate the extent of their motivation. Findings The therapeutic value of horticulture arose from a complex interplay of personal factors, including gender-based preferences, individual interests and social needs. Conclusion The benefits of engaging in horticultural activity are not automatic. The external environment provides challenges, which can be graded by the facilitators to maximise the therapeutic benefit.
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The needs of people with serious mental health problems are frequently not met by services and service users' difficulties are further compounded by social isolation and exclusion. Clients attending a community mental health team horticultural allotment group described the importance that they attached to social contact in the group. This study aimed to develop an understanding of how this experience came about so that it could be harnessed more effectively. A qualitative approach was used to explore the subjective experience of meaning that had underpinned regular attendance by nine group members. Qualitative interviews and a focus group generated data, which were examined in the light of concepts drawn from the literature on therapeutic horticulture, social networking and meaning in occupation. The participants described the restorativeness of the allotment setting, a resurgent destigmatised identity and attachment to a highly valued social network. The study concludes that there are particular qualities of the plant-person relationship that promote people's interaction with their environment and hence their health, functional level and subjective wellbeing. The embeddedness of allotments within communities means that they have great potential as media for occupational therapy and as mechanisms for social inclusion.
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ABSTRACT– A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
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Directed attention plays an important role in human information processing; its fatigue, in turn, has far-reaching consequences. Attention Restoration Theory provides an analysis of the kinds of experiences that lead to recovery from such fatigue. Natural environments turn out to be particularly rich in the characteristics necessary for restorative experiences. An integrative framework is proposed that places both directed attention and stress in the larger context of human-environment relationships.
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Nature's potentially positive effect on human health may serve as an important public health intervention. While several scientific studies have been performed on the subject, no systematic review of existing evidence has until date been established. This article is a systematic evaluation of available scientific evidence for nature-assisted therapy (NAT). With the design of a systematic review relevant data sources were scrutinised to retrieve studies meeting predefined inclusion criteria. The methodological quality of studies and abstracted data were assessed for intervention studies on NAT for a defined disease. The final inclusion of a study was decided by the authors together. The included studies were heterogeneous for participant characteristics, intervention type, and methodological quality. Three meta-analyses, six studies of high evidence grade (four reporting significant improvement), and 29 studies of low to moderate evidence grade (26 reporting health improvements) were included. For the studies with high evidence grade, the results were generally positive, though somewhat ambiguous. Among the studies of moderate to low evidence grade, health improvements were reported in 26 cases out of 29. This review gives at hand that a rather small but reliable evidence base supports the effectiveness and appropriateness of NAT as a relevant resource for public health. Significant improvements were found for varied outcomes in diverse diagnoses, spanning from obesity to schizophrenia. Recommendations for specific areas of future research of the subject are provided.
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Including exercise for the prevention and treatment of mental disorders is a promising area of research for exercise scientists since data indicate that many of these disorders are not treated at all, and there is a significant delay in treatment. This review provides an appraisal of the recent use of exercise to prevent and treat specific mental disorders and provides a recommended framework for future progress of this research. More research is needed to overcome methodological issues to demonstrate the efficacy and effectiveness of exercise and to integrate mental and physical healthcare for widespread dissemination.
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Clinically depressed persons suffer from impaired mood and distortion of cognition. This study assessed changes in depression severity and perceived attentional capacity of clinically depressed adults (N=18) during a 12-week therapeutic horticulture program. The Beck Depression Inventory (BDI) and Attentional Function Index (AFI) were administered at baseline, twice during (4 and 8 weeks), and immediately after the intervention (12 weeks), and at a 3-month follow-up. Experiences of being away and fascination related to the intervention were measured at 4, 8, and 12 weeks. The mean BDI score declined 9.7 points from pretest (27.3) to posttest (p < .001) and were clinically relevant (deltaBDI > or =6) for 72% of the cases. The mean AFI score increased 10.2 points from pretest (68.8) to posttest (p = .06). The greatest change in BDI and AFI scores occurred in the initial weeks of the intervention. The reduction in BDI scores remained significant and clinically relevant at the 3-month follow-up (N=16). The decline in depression severity during the intervention correlated strongly with the degree to which the participants found that it captured their attention. Therapeutic horticulture may decrease depression severity and improve perceived attentional capacity by engaging effortless attention and interrupting rumination.
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A summary of the main findings of a review of the literature on social and therapeutic horticulture – the use of horticulture and gardening to promote health, well-being and social inclusion among vulnerable people.
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This evidence paper summarises the findings of the third and final phase of the Growing Together study of the use of social and therapeutic horticulture (STH) as a form of health and social care provision for vulnerable adults. The first phase of the research, a review of the literature, has already been published (Sempik et al, 2003) and summarised in Evidence Issue 6. The second phase, findings from a survey of STH projects showing the level of activity and participation in the UK were summarised in Evidence Issue 8. Full details of these findings have recently been published (Sempik et al, 2005). In order to study the effects of participation in STH, 24 garden ‘projects’ were examined in depth. Interviews were recorded with 137 clients, 88 project staff and carers, and 11 health professionals. The findings show that STH is an effective form of social care which promotes social inclusion and well-being for people with a wide range of social, mental and physical problems, including those with mental ill health, learning difficulties, challenging behaviour, physical disabilities and others.
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While institution-bound programs in horticulture therapy were appropriate for the era in which long-term hospitalization was the primary mode of psychiatric treatment, the supported employment paradigm updates this mode of treatment for the current era of community psychiatry.