628 MOCHIZUKI-KAWAI ET AL. Age Years of education Age of onset MMSE score Medication∗ PANSS PANSS total PANSS positive PANSS negative TABLE 1 Characteristics of SFA and Control Groups SFA (n ¼ 10) Control (n ¼ 10) M 32.4 13.0 19.7 27.8 498.5 39.7 15.5 20.9 (SD) (10.0) (1.3) (3.1) (2.3) (275) (7.5) (3.6) (6.9) M 36.0 12.2 20.3 26.2 662.7 41.3 17.4 24.7 (SD) (10.3) (1.3) (4.7) (2.3) (528) (11.0) (5.7) (5.0) MMSE: Mini-Mental State Examination (Folstein et al., 1975). ∗ medication in milligrams per day, total chlorpromazine-equivalent neuroleptic dose. in the same facility (Yamakawa et al., 2008). The control group also com- prised 10 patients (4 men and 6 women), 4 of whom were from one facility and the remaining 6 from another facility. No signiﬁcant differences were observed between the patients in the SFA and control groups in terms of their characteristics (Table 1). Materials We provided cut ﬂowers, small branches with leaves (Figure 1b), and poly- gonal shaped absorbent sponges marked with impressions of various shapes (Figure 1c) for the SFA programme. Participants were asked to put each natural material in the correct impression in the sponge based on an instruc- tion sheet which indicated the procedure for creating a particular ﬂower arrangement; the procedure was divided into four or ﬁve stages, each of which involved the arrangement of a different ﬂower or leaf (Figure 1d). A neuropsychologist decided the arrangement design (round type), and funda- mental treatment procedure based on the advice of a ﬂoral arrangement teacher. Programme tools, including the marked sponge and the instruction sheets, were developed by the staff, including a psychiatrist and occupational therapist belonging to the day-care facility. Procedure The SFA programme involved four sessions (each of which was scheduled as a half-day programme and lasted for about one hour) that were spaced out over a period of two weeks. We asked participants to attend all four sessions.