Journal of Therapeutic Horticulture 27.1 - 2017


An Exploratory Study on the Effect of Horticultural Therapy for Adults with Intellectual Disabilities
Claudia K. Y. LAI, PhD, RN, FAAN, Lily Y. W. Ho, MN, RN, Rick Y. C. Kwan, MSc, RN, Connie Y. Y. Fung, RSW, HTR, Yim Wah MAK, PhD, RN

Horticultural therapy (HT) has been shown to lead to various positive health outcomes. However, the effect of HT on adults with intellectual disabilities (ID) has not been extensively studied. This single group pre- and post-test study aimed to examine the effect of a 12-week HT program on the self-efficacy and quality of life (QOL) of 12 adults with ID at pre- (T0), immediately post- (T1), and 12 weeks post-intervention (T2) using the Glasgow Social Self-Efficacy Scale (GSSES) and the Chinese Quality of Life Questionnaire - Intellectual Disabilities (CQOL-ID). The participants’ experiences were assessed using the Non- Pharmacological Therapy Experience Scale after sessions 1, 6 (mid-intervention), and 12 (end of intervention). Statistical significance was observed in the GSSES score at T1 (z= -2.139, p=0.032) and in the competence dimension of the CQOL-ID scale at T2 (z= -2.671, p=0.008). No significant changes were found in other dimensions of the CQOL-ID. The participants’ experience improved at session 6 (z= -2.046, p=0.041), but this effect was not sustained to the end. In conclusion, HT improved the social self-efficacy of the participants during the intervention period and promoted the competence dimension of QOL. It was a pleasurable intervention for the participants.

The Impact of Green Exercise on Volunteers’ Mental Health and Wellbeing – Findings from a Community Project in a Woodland Setting
Mark Alan Christie, MA and Fiona Cole, MSc

An increasingly robust evidence base supports the therapeutic value of nature on mental health and wellbeing. The rise in reported mental ill-health across the world has major implications for the effective use of healthcare budgets, as well as economic consequences. Health practitioners may need to consider going beyond traditional mental health service provision and look to more widespread engagement with community-based interventions. This is especially important given that the structured nature of service provision may present significant challenges for some people with mental ill-health (MIND, 2016). Thus, this study explored the experiences of volunteers with mental health problems attending an unorthodox center in a woodland setting within the North West of England, which seeks to promote health and wellbeing through green exercise.

An ethnographic approach, involving the use of fieldwork diaries and photographs, explored the center’s informal and unique physical and socio-cultural environment. Formally researching as outsiders on participants was deemed incongruent with the empowering ethos of the center. Following a six-week relationship building period, in which the researchers immersed themselves in the practical activities, individual fieldwork interviews were conducted with each of the volunteers (n=11). 

Transcribed data revealed three key themes underpinning the self-reported positive impacts on personal mental health and wellbeing. The importance of the physical and social environment was paramount, whereby volunteers recognized the restorative effects of the natural environment, but also stressed the flexible, informal and ‘no nonsense’ ethos of the center, combined with the social support, as major factors in delivering positive health outcomes. The clear sense of purpose and meaning underpinning activity choice participation, and the feeling of togetherness this fostered, were also major influences. Using existing skills and developing new ones demonstrated the power of occupational engagement in enhancing enjoyment, achievement and overall contribution.

Recognition of the influence of the context and structure of services on people’s ability to engage in therapeutic activities is therefore crucial in order to enable people to access support in their mental health recovery.

Case Study - Michelle
Melissa Bierman, MS, HTR, MHT

The following case study is based on a clinical intervention with an 18-year-old female during a 4-month inpatient stay at a behavioral health intensive care unit in the Portland, Oregon area.

Case Study - Harry
Kate Bodin, MEd, HTR

Harry was referred for horticultural therapy services shortly after his move into foster care. Previously he lived in a secure residential facility for eight years. All horticultural therapy clients receive clinical assessments, comprised of two clinical horticultural therapy sessions, and interviews with staff, caregivers and family. Kate worked with Harry for a year before transferring his sessions to another HTR on staff.

Case Study - Master D.
Sushama Ramachandran, Clinical Psychologist. MA. (Psychology), MPhil. (Clinical Psychology), EMDR

This case study is based on the observation of a 12 year old boy in my private clinic. He was referred to a pediatrician for a thorough evaluation to rule out the existence of any other medical conditions. This is a basic practice in India to seek the help of other medical professionals to rule out the existence of other co-morbid conditions to avoid complications during non-pharmacotherapy. The child was diagnosed as purely autistic, cross –referred to me for psychological management and rehabilitation.

Case Study - Dorothy
Jennifer Sloan, BA, AD, HTR

Dorothy is a senior living in long term care who is experiencing vision loss. A highly social senior, Dorothy was referred to the horticultural therapist for participation in Garden Club which proved to be excellent meaningful activity by utilizing therapeutic modifications for low vision and encouraging a natural tendency towards leadership.

Lighthouse Community School: A Case Study of a School for Behaviorally Challenged Youth
Jonathan Trauth EdD, LISW-S

In the 1999-2000 fiscal year, Lighthouse Community School was established in Cincinnati, Ohio to address maladaptive behaviors of middle and high school youth within the urban school district. In the school’s first year, sixty students were enrolled who exhibited severe behavioral and substance abuse issues, as well as difficulty maintaining attendance. Intervention was necessary in order to steer youth away from a path leading toward juvenile detention and negative involvement within the criminal justice system.

Lighthouse Community School is a charter school and began as an extension of Lighthouse Youth Services (LYS). Lighthouse Youth Services was established in 1969 and is dedicated to advancing the dignity and wellbeing of children, youth, and families in need ( LYS has received national recognition as a highly effective social service agency (Moore, 2011). The program provides a broad range of services, including early childhood intervention, behavioral health and psychiatric services, home-based help for families, services for at risk youth, community residential treatment facilities, foster care and adoption, independent living arrangements, and also opportunities through education.

Book Review: Grow It, Heal It: Natural and Effective Herbal Remedies From Your Garden or Windowsill
Christopher Hobbs & Leslie Gardner. New York: Rodale. 2013. 230 pp. ISBN 987-1-60961-570-3
Reviewed by Lesley Fleming, MA, HTR