Animal Assisted Interventions in the Green Care Framework: A Literature Review

Characteristics of natural environment use by occupational therapists working in mental health care: a scoping review

OBJECTIVE

The objective of this review was to identify and characterize the use of the natural environment/outdoor space by occupational therapists working in mental health care. This included consideration of the characteristics of the environment used, interventions, mental health conditions being treated, and the outcomes being used.

INTRODUCTION

Research has demonstrated the link between human health and the environment. The benefits appear to be particularly relevant to people with mental health conditions. Occupational therapists already consider the environment when assessing and developing interventions, and therefore are well placed to consider and use the natural environment in mental health practice. However, the use of the natural environment by occupational therapists working in mental health is unclear.

INCLUSION CRITERIA

The scoping review included any publication relating to the use of the natural environment/outdoor space in mental health occupational therapy practice. All forms of the natural environment or outdoor space were included, such as hospital gardens and local parks. There were no geographical, gender, or age restrictions. All mental health diagnoses were eligible for inclusion.

METHODS

Seven databases were searched: Embase (Ovid), Emcare (Ovid), MEDLINE (Ovid), PsycINFO (ProQuest), AMED (Ovid), Trip Database, and CINAHL (EBSCOhost). Gray literature was also searched using a selection of websites and digital repositories. Papers written in English were searched, with no time limit set on publication. Titles and abstracts were screened by 2 independent reviewers for assessment against the inclusion criteria, followed by a full-text review and data extraction. Data were extracted using the data extraction tool developed by the authors. Findings were presented in a tabular format, accompanied by a narrative summary describing how the results relate to the review objectives and question.

RESULTS

Of peer-reviewed publications, 7 papers used qualitative methods and 7 used mixed methodology. The remaining sources included conference abstracts, unpublished works, a book chapter, and a website article. The environments used included forests, beaches, gardens, and parks. A variety of interventions were delivered in these environments, including gardening and nature-based activities, physical activities, and animal-assisted interventions. Such activity-focused interventions are largely delivered in a group context, thus providing a social element. A diverse range of mental health conditions were treated. Several methods were used to consider the outcomes on the individual, including both qualitative measures and quantitative outcome measurement tools.

CONCLUSIONS

The review highlights many characteristics of how the natural environment is being used across mental health services by occupational therapists. A variety of conditions are targeted for such interventions, and several outcome measures have been used to understand impact. This review can support further development and implementation of nature-based approaches in mental health occupational therapy.

The feasibility of wildlife immersion experiences for Veterans with PTSD

Introduction

Animal-assisted interventions (AAI) offer potential physical and psychological health benefits that may assist Veterans with post-traumatic stress disorder. However, more feasibility studies are needed regarding intervention details, adverse events, reasons for study withdrawal, and animal welfare.

Methods

This mixed methods feasibility trial involved a modified crossover study in which Veterans with PTSD/PTSD symptoms were provided a series of 8 nature and wildlife immersion experiences to evaluate feasibility and preliminary efficacy. The sample included 19 Veterans with PTSD/PTSD symptoms who were followed for a mean of 15.1 weeks. The intervention was comprised of a baseline forest walk, assisting with wildlife rehabilitation, observation in a wildlife sanctuary, and bird watching. Post study bird feeders were provided for sustainability.

Results

This AAI nature/wildlife immersion intervention was feasible, acceptable, and safe to administer to Veterans with PTSD/PTSD symptoms with appropriate support. Logistical and relational facilitators were identified that supported the wildlife immersion activities. Participants reported greatly enjoying the activities. Attention to animal welfare and care was an important ethical foundation that also contributed to feasibility.

Discussion

AAI immersion experiences with wildlife are feasible and can safely be administered to Veterans with PTSD/PTSD symptoms. Logistical and relational facilitators are important to support nature and wildlife immersion activities.

Sharing the space of the creature: Intersubjectivity as a lens toward mutual human-wildlife dignity

Human-wildlife coexistence is critical for sustainable and healthy ecosystems as well as to prevent human and wildlife suffering. In this paper, an intersubjective approach to human-wildlife interactions is proposed as a lens toward human decentering and emergent mutual evolution. The thesis is developed through a secondary data analysis of a research study on wildlife care and philosophical analysis using the work of Bernard Lonergan and Edmund Husserl. The study was conducted using the theory of transcendent pluralism, which is grounded in human and ecological dignity, including the dignity of beyond-human beings. Deeper interpretation of the original data suggests that human-wildlife interactions are mutually conscious, embodied, and hold spatial-temporal dimensions. The affective realm is an integral dimension of human-wildlife intersubjectivity. These findings inform an approach toward human-wildlife relations in which human persons and the beyond-human multitude can all flourish in dignity.

Challenges and Perspectives of Social Farming in North-Eastern Italy: The Farmers’ View

In the European framework of multifunctional agriculture, Social Farming (SF) has constantly been spreading. In Italy, these practices are legally connected to Animal Assisted Interventions (AAI), creating new perspectives and challenges for farmers and their territories. In this paper, we report the results of a pilot study conducted in the Veneto Region to understand farmers’ opinions about the opportunities and challenges of SF and AAI. Participants were convened by the Italian farmers’ trade organization Coldiretti. All of them provide social/healthcare services on their farms, including human–animal interaction, and have attended the regional training courses for Social Farming providers. Data were collected during two focus groups that were videotaped and subsequently analyzed by two researchers to categorize and dope out relevant topics. Results show a mismatch between what is stated by national and regional laws and the current situation reported by farmers. They are faced with many economic challenges as well as barriers in their relationship with traditional healthcare services. However, farmers have a strong motivation and believe in the benefits that AAI and SF offer to society in rural and urban areas.