Occupational Therapy News OTnews January 2019 | Page 43
HORTICULTURAL THERAPY FEATURE
Cipriani et al (2018) conducted a qualitative
study to investigate the value and meaning of a
horticultural therapy programme incorporated into
occupational therapy interventions at an adult
inpatient psychiatric facility (north-eastern United
States), and its impact on recovery goals. Individual
semi-structured interviews were conducted with
occupational therapists (n=2) and programme
participants (n=8) and analysed using a modified
version of the empirical, phenomenological,
psychological (EPP) method. Two main themes
emerged, relating to the essence of the programme
and the personal growth of participants. The
authors explore the results, and identify a
number of benefits of the programme including:
opportunities for socialisation, development of work
skills and experiencing a vocational role.
benefits from a beautiful garden, landscaped by Tony Danford over
20 years ago, and still tended by him today.
Since the ARU opened five years ago, the occupational therapy
team has worked hard to establish occupation-based groups to
support patients to engage in meaningful activities as part of their
rehabilitation.
From listening to our patients’ feedback on their leisure pursuits
and self-identified goals, we developed a gardening group therapy
session that appeals to both inexperienced and experienced
gardeners.
Led by our advanced rehabilitation assistant Joe Scoble, the
group started as a simple table top session, with patients repotting
plants, growing strawberries and tending to tubs, however we had
dreams of turning it into something greater.
The feedback we received from patients about the group
was overwhelmingly positive, with reports that they enjoyed the
opportunity to be outdoors, to gain confidence in completing
gardening tasks as a wheelchair or prosthetic limb user and to learn
new skills.
The evidence in the literature that supports horticultural therapy
as part of holistic rehabilitation is also widespread (Detweiler et
al 2015; Wise, 2018), including both physical and psychological
benefits to those who have sustained a traumatic or life changing
event.
In addition to the patient feedback and the evidence base, our
rehabilitation assistant Joe also completed a horticultural therapy
training course and this, coupled with his background in landscape
gardening and rehabilitation expertise, helped us to put together a
successful bid for charity funding to allow us to develop our table
top gardening group into a bigger project.
Since then, the garden group has evolved into the hub of the ARU
for our patients. With support from gardener Tony, garden volunteers
and patients supporting the design process, we have created a new
vegetable and herb garden in a previously unused part of the garden,
that is managed and tended by the ARU patients.
The different height beds allows us to grade the activities being
completed to meet the patients’ individual needs and abilities; our
wheelchair users have access to beds for seated gardening tasks,
while with our higher level prosthesis users can complete digging
and heavy lifting while standing in the lower beds.
For our upper limb patients, the group provides an opportunity
to develop skills in gripping, grasping and manipulating objects, as
well as to develop greater confidence to use their residual limb in
functional ways previously not trialled.
Projects so far have included planting, propagation and growing
vegetables, herbs and salad plants, which we have begun to use in
our cooking groups.
We have seen that providing horticultural therapy as part of our
rehabilitation programme offers our patients wide-ranging benefits. It
gives them an opportunity to share experiences and form friendships,
while also providing a space away from the ward re-connect with
the outside world again and reflect after what has often been several
months of being in the acute hospital environment.
Cipriani J, Georgia J, McChesney M, Swanson
J, Zigon J, Stabler M (2018) Uncovering the
value and meaning of a horticulture therapy
program for clients at a long-term adult inpatient
psychiatric facility. Occupational Therapy in
Mental Health, 34(3), 242–257
From a practical perspective, the therapy sessions also help
patients to improve wheelchair skills and safety awareness, while
also improving their dynamic balance and functional strength.
The group also gives staff an opportunity to talk about the topic
of health promotion, and encourages exercise, healthy eating and
social interaction, all of which are vital in supporting the key NHS
initiative of promoting self management and self care
(www.england.nhs.uk/2017/11/encouraging-people-to-embrace-
self-care-for-life/).
We are able to use our garden as a tool for both learning and
healing, and the ability to truly use occupation as rehabilitation has
helped the occupational therapy team to reconnect with the core
values of our profession.
References
Detweiler, MB, Self, JA, Lane S, Spencer L, Lutgens B, Kim DY, Halling
MH, Rudder TC, Lehmann LP (2015) Horticultural therapy: a pilot
study on modulating cortisol levels and indices of substance craving,
post-traumatic stress disorder, depression, and quality of life in
veterans. Alternative Therapies in Health and Medicine, 21(4): 36-41
Wise J (2018) Digging for victory: Horticultural therapy with veterans for
post-traumatic growth. London: Routledge
Sophie Cook, occupational therapist, and Joe Scoble,
advanced rehabilitation assistant, Amputee Rehabilitation Unit.
Email: [email protected]
OTnews January 2019 43