FLORAL ARRANGEMENT PROGRAMME IN SCHIZOPHRENIA 629 In each session, the participants had to make ﬂoral arrangements twice. Thus, the present programme involved making eight ﬂoral arrangements. We prepared three ﬂoral arrangement patterns with differing levels of difﬁculty. The patients were instructed to execute the easiest pattern on the ﬁrst two sessions of the programme, and the more complex designs were used for the latter two sessions in order of increasing difﬁculty. The SFA programme was conducted in a group setting. All the natural materials, the absorbent sponge and the instruction sheet were placed in front of each participant. The instruction sheet was available to the partici- pants throughout the SFA work, however, they could not concentrate on the sheet and the other materials simultaneously, since they were beyond their central eye ﬁeld. Participants needed to shift their attention from the materials to the instruction sheet and absorbent sponge to create the ﬂoral arrangement. Each session was divided into two phases with a short rest period of about 10 minutes in the middle. During the ﬁrst half of the session, participants followed the step-by-step instructions provided by a staff member. The steps were based on the stages of the instruction sheet. The instruction sheet and impressions on the sponge showed which material should be used and where, and how to put it on the sponge. Three staff members (a nurse, occupational therapist, and clinical psychologist/neuro- psychologist) assisted participants who completed the task more slowly than others. None of the assistants was an expert in ﬂoral arrangement. One of the three had practised creating the ﬂoral arrangement according to the SFA method and instructed the other two assistants on the treatment pro- cedure. In the second half of the session, the participants completed the ﬂower arrangement without the assistance of the staff by referring to the instruction sheet. Cognitive outcome measurements As a measure of the cognitive outcome, we used block-tapping, digit span tests according to the Wechsler Memory Scale – Revised (Wechsler, 1987), and Rey-Osterrieth Complex Figure Test (copy and immediate recall version) (Osterrieth, 1944; Rey, 1941). These assessments were made twice, immediately before and after the four sessions of the SFA programme. A pre-test of the Rey-Osterrieth complex ﬁgure was executed about two months before the SFA programme in the SFA group. Control participants were also assessed twice using the same assessments at an interval of two weeks. A neuropsychologist, clinical psychologist, and voluntary worker assessed cognitive outcomes. One of three testers conducted one of three cognitive tests for each participant both in the pre- and post-test phases. The participants’ attendance was recorded and this was used as a variable representing their motivation towards completing the SFA programme.