A prospective study of group cohesiveness in therapeutic horticulture for clinical depression

Abstract

This study aimed to assess changes in psychological distress and social participation in adults diagnosed with clinical depression during and after participating in a therapeutic horticulture programme, and to investigate if the changes covaried with levels of group cohesiveness during the intervention. An intervention with a single-group design was repeated with different samples in successive years (pooled n = 46). In each year, five groups of 3-7 participants went through the intervention. Data were collected before, twice during, and immediately after a 12-week therapeutic horticulture programme, as well as at 3-months' follow up. Mental health assessments included the Beck Depression Inventory, the State Subscale of Spielberger State-Trait Anxiety Inventory, the Positive Affect Scale from the Positive and Negative Affect Scale, the Perceived Stress Scale, and the Therapeutic Factors Inventory-Cohesiveness Scale. The analysis of the pooled data confirmed significant beneficial change in all mental health variables during the intervention. Change from baseline in depression severity persisted at 3-months' follow up. Increased social activity after the intervention was reported for 38% of the participants. The groups quickly established strong cohesiveness, and this continued to increase during the intervention. The average level of group cohesiveness correlated positively, but not significantly, with change in all mental health outcome variables.

Mental health rehabilitation in a care farm context: A descriptive review of Norwegian intervention studies

“…In the study by Gonzalez et al [39], levels of group cohesiveness correlated positively with improvements in mental health and perceived stress. A majority of participants rated the social component of the intervention as important and reported a higher rate of social activity after the intervention.…”

“…The participants reported high levels of group cohesiveness, and the levels of group cohesiveness correlated positively, although not statistically significantly, with improvements in depression severity, anxiety levels, positive affect, and perceived stress levels. The participants positively evaluated the social aspects of the therapeutic horticulture intervention, and more than a third of the participants reported increased social activity after having participated in the intervention [39].…”

“…Gonzalez et al [37][38][39][40] have carried out two singlegroup design studies of the possible benefits to people with clinical depression of participating in a horticultural activities on four urban farms. Both aimed to examine changes in depression and perceived attentional capacity.…”

The influence of therapeutic horticulture on social integration

“…There is a developing evidence base about the effectiveness of TH and a number of studies have suggested that contact with nature is essential in helping people reestablish a sense of overall well-being (Fieldhouse 2003). It is believed that exposure to nature can have a positive effect on a person's mental well-being moreover, Gonzalez et al's (2010) prospective study of cohesiveness for people in a TH programme, found that it can be a beneficial supplementary intervention in clinical depression. Equally, it was reported by Van den Berg, (2010) and Mayer et al (2008) that exposure to nature can have a positive effect on a person's mental well-being; moreover, Gonzalez et al's (2010) Burls (2007) argued that there remains ambiguity as to the effectiveness of some models of ecotherapy, such as therapeutic horticulture.…”

“…It is believed that exposure to nature can have a positive effect on a person's mental well-being moreover, Gonzalez et al's (2010) prospective study of cohesiveness for people in a TH programme, found that it can be a beneficial supplementary intervention in clinical depression. Equally, it was reported by Van den Berg, (2010) and Mayer et al (2008) that exposure to nature can have a positive effect on a person's mental well-being; moreover, Gonzalez et al's (2010) Burls (2007) argued that there remains ambiguity as to the effectiveness of some models of ecotherapy, such as therapeutic horticulture. Moreover, Burls & Caan (2005) note that working outdoors can help individuals to connect which subsequently can alleviate social isolation, but further research is needed to understand how this occurs in relation to the types of exposure to nature (Burls 2007).…”