Unearthing the Theoretical Underpinnings of "Green Care" in Mental Health and Substance Misuse Care: Theoretical Underpinnings and Contemporary Clinical Examples

Nurturing mental health and well-being using ordinary farms

Purpose

This practice piece aims to review an occupational therapy led pilot programme – social farming as an intervention option in an adult community mental health setting in Ireland. It will also reflect on the practical implications of delivering the natural surroundings based programme through the COVID-19 pandemic and plans for the future development of such programmes in adult mental health services.

Design/methodology/approach

The Occupational Circumstances Assessment Interview Rating Scale (OCAIRS) was used to measure occupational participation (Forsyth, 2005). This was administered with participants’ pre and post their participation in the 10-week programme. An internal questionnaire was developed to further capture both the participant and farmer experiences of the social farming programme.

Findings

Whilst improvements were noted in a number of OCAIRS domains, it was difficult to identify small changes over a short period of time. The main domains of change were habits, roles, interests and personal causation. The success of the social farming placements was also reflected in the internal questionnaire. The pilot programme has resulted in the further development of the social farming programme and securing of funding for placements for five years.

Originality/value

It would be beneficial to consider other standardised assessments that assess quality of life and occupation for future placements. It is also beneficial to consider practical implications in delivering a social farming programme, particularly to those with barriers to transport. It is hoped this paper will contribute to the growing knowledge of social farming as a meaningful therapeutic intervention in mental health occupational therapy practice.

Experiences of an Equine-Assisted Therapy Intervention among Children and Adolescents with Mental Illness in Sweden - A Nursing Perspective

Mental illness among children and adolescents is increasing globally, and prescription of psychiatric drugs for children and adolescents with mental illness is increasing worldwide, including Sweden. Holistic health-promoting interventions have shown promising long-lasting significant health benefits in young individuals with mental illness, but holistic health-promoting mental health interventions are often disregarded due to a lack of systematic theory-based knowledge. Consequently, the lack of scientific knowledge thwarts implementation of equine-assisted therapy as an established intervention in mental health nursing for children and adolescents with mental illness. The purpose of the study was to better understand experiences of equine-assisted therapy among children and adolescents with mental illness. The study adopted an inductive approach and data was collected using photovoice methodology. Six young persons, 7-18 years of age, referred by a psychologist to the equine-assisted intervention due to mental health issues, were included in the study. Data was analyzed using qualitative content analysis. The results could be summarized by an overarching theme, a physical, emotional, and social milieu for growth, consisting of three subcategories: feeling relief from everyday stress and anxiety; nurturing self-esteem in a mutual friendship; and strengthening self-reliance through synchronized interplay. The results indicate that equine-assisted therapy has essential values closely related to the goals of mental health nursing. Further research should strive to attain even gender distribution in study samples and focus on how equine-assisted therapy could be thoroughly integrated into established nursing intervention for children and adolescents with mental illness.

Evaluating the effects of a Therapeutic Day Rehabilitation program and inclusion of gardening in an Australian Rural Community Health Service

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 play’s the thing’: A creative collaboration to investigate lived experiences in an urban community garden

Presenting the backstage story of a non-traditional qualitative research project, I illustrate how a creative approach can stimulate participant dialogue and encourage researcher reflexivity. Working with an award-winning playwright and the staff and volunteers at a community garden, I explored the meanings of connections between people and nature, and how these connections impact well-being, through a collaborative performance ethnography. The aim of the study is to stimulate discourse around the role of community gardens in enacting social and environmental change for well-being. This article is an exploration of how the creative approach we adopted, incorporating arts-based inquiry and performance as method, contributed to every aspect of the research process. First, it facilitated relaxed communications with the members of the community organisation who participated. Their interest was immediately piqued by the idea of being involved in the development of a play, which led to relaxed, playful discussion. Second, the creative approach provided new perspectives on the collection and analysis of data. It expanded my thinking, in developing my methodological approach to the research and in working towards a radical reflexivity. I suggest that creative approaches are applicable to many areas of organisational research.

The Social Provisions Scale: psychometric properties of the SPS-10 among participants in nature-based services

PURPOSE

This article analyses the psychometric properties of the Social Provisions Scale 10-items version.

METHODS

The Social Provisions Scale was analysed by means of the polytomous Rasch model, applied to data on 93 young adults (16-30 years) out of school or work, participating in different nature-based services, due to mental or drug-related problems.

RESULTS

The psychometric analysis concludes that the original scale has difficulties related to targeting and construct validity. In order to improve the psychometric properties, the scale was modified to include eight items measuring functional support. The modification was based on theoretical and statistical considerations.

CONCLUSION

After modifications the scale showed not only satisfying psychometric properties, but it also clarified uncertainties regarding construct validity of the measure. However, further analysis on larger samples are required. Implications for Rehabilitation Social support is important for a variety of rehabilitation outcomes and for different patient groups in the rehabilitation context, including people with mental health or drug-related problems. Social Provisions Scale may be used as a screening tool to assess social support of participants in rehabilitation, and the scale may also be an important instrument in rehabilitation research. There might be issues measuring structural support using a 10-items version of the Social Provisions Scale but it seemed to work well as an 8-item scale measuring functional support.

Considering the Contemporary Issues and Unresolved Challenges Facing Therapeutic Communities for Clients with Alcohol and Substance Abuse

Alcohol and substance abuse remain significant public health problems in many parts of the occidental world. Some facilities that provide treatment for such abuse often refer to themselves as "Therapeutic Communities" (TCs). However, fundamental compositional differences in TCs present unresolved issues and as such, create significant implications for research, practice, education, and substance/alcohol care policy. Accordingly, this paper examines the heterogeneity and efficacy of TCs; the treatment approaches of harm reduction and abstinence; the training of TC staff and workers; and the recommended length of stay for individuals seeking recovery.