An Exploratory Study of Horticultural Therapeutic Community Gardens in Fresno CountyJeremy BrownsteinDepartment of Social Work Education

Fresno County , Behavioral HealthHorticultural Therapeutic Community Center Gardens

Contract approved in March 2011Funded by MHSA; Prevention and Early Intervention (PEI) component8 garden sites under three contracted providersTarget groups: refugee and immigrant populationsSoutheast Asian, Native American, Mexican American, African American, Eastern European, and Punjabi communitiesFocused on prevention and addressing the early onset of mental health issuesNon-traditional means of service delivery

Fresno County , Behavioral HealthTherapeutic Horticultural Garden Centers

Opportunities to clientsHarvest a piece of landAccess to a natural spaceFoodSocial interactionsMeeting place for community membersPlatform for discussion on mental health wellness and education

ProblemOutcomes

GeneralClose ended

Limitation for expansionPotential loss of fundingFew studies that support gardens in such a capacity

HistoryHealing Gardens

In Mesopotamia, dating as far back as 2000 B.C., lush agricultural plots that lay in the fertile river valleys provided inspiration for the first designed gardens in this otherwise very arid landscape *Across cultures, nature has traditionally held an important role in health, vitality, and spirituality

• *Jellicoe, G. & Jellicoe, S.(1995). Landscape of man (2nd ed.). London: Thames and Hudson, 1995

History contd.Europe around the Middle Ages, developed gardens and courtyards at hospitals and monasteries for the sick and insane which served as places for reflection, growing food and herbs for consumption and medicinal use, and growing flowers for use in ceremonies *

* Tyson, Martha M. (1998). The Healing Landscape: Therapeutic Outdoor Environments. New York: McGraw-Hill.

History contd.In 1812 Dr. Benjamin Rush, known for his role in the development of modern psychiatry and a founding father of the United States, published a book titled, “Medical Inquiries and Observations Upon Diseases of the Mind” *Rush stated that “digging in a garden” was one of the activities that distinguished those male patients who recovered from their mania from those who did notFirst instance of nature assisted therapy in psychology

*Rush, B. (1812). Medical inquiries and observations upon diseases of the mind. Philadelphia: Kimber & Richardson. Retrieved September 22, 2013 from http://deila.dickinson.edu/theirownwords/title/0034.htm

Theoretical FrameworkRoger Ulrich

Stress Reduction Theory Rachel and Stephen Kaplan

Attention Restoration Theory

Stress Reduction Theory

Roger Ulrich in his paper “Visual Landscapes and psychological well-being” noted that urban scenes tended to bring about fear and sadness, where nature landscapes elicited friendliness, playfulness and elation *Development of the Psychological Stress Reduction Theory

Individuals are predisposed to find non-threatening interactions with natural stimuli relaxing and that exposure has a substantial impact upon the parasympathetic nervous system, which contributes to feelings of relaxation and enhanced wellbeing

* Ulrich, Roger. (1979). Visual Landscapes and Psychological Well-being

Ulrich (1984)“View through a window may influence recovery from surgery” studyFoundational in that it showed a connection to the restorative ability of nature, even when individuals are not in direct contact with the environment

Attention Restoration TheoryRachel and Stephen Kaplan

Environmental PsychologistsAttention Restoration Theory *

Asserts that individuals who spend more time in nature will have better cognitive functioning

* Kaplan, R., & Kaplan, S. (1989). The experience of nature: A psychological perspective. New York: Cambridge University Press.

Comparative LiteratureClatworthy (2012) explored the relationship between suburban allotment gardening and wellbeing by utilizing an Interpretative Phenomenological Analysis (IPA) approach with six gardeners, found seven main themes emerge: fundamental importance of food, protection and safety, feeling connected, esteem, pleasure of being in nature, development and values.

Current StudyExploratory Study

How do clients describe their lived experience as a participant in a horticultural therapeutic community center garden? In what ways do clients believe their participation has affected them?

Utilizing a phenomenological approachFocused on the lived experiences of individuals in order to develop a lived and existential meaning from their experiences

MethodStructured interview instrument (24 questions)Method

Flyers distributed at each siteVolunteer participationTranslators

Data Collection / Analysis8 interviews collectedAnalysis

Verbatim transcriptionSignificant statementsThemesExplain experiences

ResultsThree themes were identified amongst responses regarding participant experiences in their garden

SocializationPurpose Mental and Physical Wellness

SocializationParticipants reported feeling isolated prior to becoming involved in a gardenThe garden has been a way to connect and socialize with others

“before gardening at home I was aggravated and made me angry at little things, but here when we socialize it helps to relax, keeps me happy with talking with other people it helps my mind. ”“It’s good that I know that there is people out there who are like me...”“I left all my families back in Laos, I come here just myself. The garden help me to everyday life and just with the garden see friends. ”

PurposeThe need to care for the gardenProvide food for themselves and families

“It contributes back to me that I’m getting something to contribute to my family”“It’s a self-help process for me, in the morning I wake up, I have purpose, what I need to do today if I plant something it looks like they’re calling me, the plant is calling me to come today, I have to go”“so garden it motivates me, made me working hard, keeps me moving ”

Mental & Physical WellnessParticipants stated they believe the garden has enhanced their mental and physical healthOpportunity for exercise

“I have gained physical strength...also helping my mobility, which is my arm and body, and working in the garden”

Stress relief“I used to cry and also cry a lot, but when I tend in the garden my distress and everything that I have is release, to see the garden and working at it, it just disappears”“I feel like my emotional is stable now. My immune system has changed, I feel more normal than living in the chronic illness (depression)”“It keeps me fresh and it keeps me healthy”

Additional FindingsParticipants demonstrated with multiple statements the importance of having access to the gardenConcerned with the growth and the continuation of their gardenBelief that gardening is better than medicine and traditional Western treatmentHalf of the participants became very emotional during the interviews

LimitationsTranslationData collection

Implications For PracticeAdvocacy for limited culturally appropriate programs Development of gardens in other settings of carePrescribing nature

Future ResearchSimilar structured studiesExamination of best practicesDevelopment of outcome measurement tools

“I only went out for a walk and finally concluded to stay out till sundown, for going out, I found, was really going in.”

- John Muir