FLORAL ARRANGEMENT PROGRAMME IN SCHIZOPHRENIA 627 affected positively by using such an arrangement procedure. The purpose of this study is to demonstrate the potential of the SFA programme for develop- ing working memory, as well as visuospatial manipulation. The SFA pro- gramme involves complex analysis of visuospatial information, and requires participants to store and use the information correctly to create ﬂoral arrangements. We predicted that the SFA programme would stimulate positively an individual’s visuospatial manipulation and memory process. Additionally, the use of natural materials may reduce tension and anxiety and increase motivation among schizophrenic patients during their rehabilita- tion programme (Sullivan, 1979). A previous study involving horticultural therapy reported an increase of activity through ﬂower arrangement work in a patient with schizophrenia, who usually displayed severe difﬁculty in socialising (Pereira & Pereira, 2009). Recently, other studies have reported that natural ﬂowers and leaves decrease anxiety and fatigue, and increase positive feelings in hospitalised patients and healthy employees (Dravigne, Waliczek, Lineberger, & Zajicek, 2008; Park and Mattson, 2009). Our pre- vious study with schizophrenic patients also found that a horticultural pro- gramme (vegetable cultivation) had comparatively higher attendance (mean, 45.3%) than other daily programmes such as cooking, exercise and so on (30 – 40 %) (Yamakawa et al., 2008). The SFA programme may have a positive impact on motivation, and induce improvement in visuospatial ability. We believe that the ﬁndings of the present study may contribute to the improvement of cognitive rehabilitation in schizophrenic patients. METHODS Participants We recruited 20 patients from two psychiatric day-care facilities who were diagnosed with schizophrenia or schizoaffective disorder, according to the criteria described in the DSM-IV-TR (American Psychiatric Association, 2004). The criteria for participation included having no history of cognitive deﬁcits of organic origin or due to mental retardation, no major physical han- dicap, and no current substance abuse. Both facilities were the same size and connected to general hospitals. In these facilities, users were usually engaged in one or two different activities, such as singing, cooking, and light exercise as psychological therapy in a day programme. All the participants provided their written informed consent before participating in the study. This study was approved by the Ethics Committees of the hospitals in which it was con- ducted. The SFA group comprised 10 patients (6 men and 4 women). We selected the 10 experimental participants from one facility to compare the attendance rate for the SFA programme to that of a previous study conducted