Process and Outcomes of Horticultural Therapy for People With Disabilities

Study Overview
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Brief Summary
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Horticultural therapy (HT) is the engagement of a client in horticulture activities facilitated by a trained therapist to achieve specific and documented treatment goals (American Horticultural Therapy Association, 2012). People's interactions with plants, through goal-orientated horticultural activities in the form of active gardening, as well as the passive appreciation of nature, could be therapeutic to people with mental or intellectual disabilities in many ways (Eling, 2006; Parkinson, Lowe, & Vecsey, 2011). This study aims to conduct evaluation studies of HT group programmes for care home residents with severe mental illness.

Detailed Description
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This is a randomized, single-blind, controlled study in which the outcomes of the horticultural therapy program is compared with a comparison group. Outcome measures were compared at Pre-intervention and post-intervention.

Official Title
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Examining the Process and Outcomes of Horticultural Therapy for People With Severe Mental Illness, Intellectual, and Multiple Disabilities

Conditions
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Mental Disorders, Severe, Intellectual Disability

Intervention / Treatment
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* Behavioral: Horticultural therapy
* Other: Comparison


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnosis of severe mental disorder, e.g. schizophrenia, schizoaffective disorder, bipolar disorder. age 18 - 65. care home resident Exclusion Criteria: organic brain disorder difficulties in communication for joining horticultural activity.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Treatment<br>Participants joined a 8-session horticultural therapy group program (60 minutes per session) over 8 weeks. | Behavioral: Horticultural therapy<br>* A structured 8-session group therapy program, in which participants learn about plants, green spaces, plant-human interactions. During the program, the participants are guided by therapist to grow or take care of both indoor and outdoor plants, do small horticulture projects (like cooking, making drinks, herb projects).<br>|
| Other: Comparison<br>Participants joined 4 sessions of individual, parallel, and table-top activities of their own interest, e.g. reading, drawing, coloring. | Other: Comparison<br>* 4 session of semi-structured and free engagement in activities of their choice. The activities that they could choose are mostly table-top activities which are solitary in nature, and does not require social interaction.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Mental Well-being | Chinese Short Warwick-Edinburgh Mental Well-being Scale (C-SWEMWBS). The C-SWEMWBS uses a five-point Likert scale. The average scores for the scale ranges between 1 and 5, and a higher score indicates better mental well-being. | Pre-test, Postest (8 weeks from pre-test), Change from Pretest to Posttest is assessed | 
| Change in Engagement in Meaningful Activity Scale (EMAS) | Engagement in Meaningful Activity Scale (EMAS). The EMAS has 12 items measured on a four-point Likert scale. The average score for the scale is 1- 4 and a higher score indicates higher engagement. | Pre-test, Postest (8 weeks from pre-test), Change from Pretest to Posttest is assessed | 
| Change in Perceived Benefits of Horticultural Therapy | This is a opinion survey developed by the clinical setting to collect participants' attitude toward horticultural therapy. It has 7 items and participants are asked to respond using a five-point scale ranging from strongly disagree to strongly agree. The average score ranges from 1 to 5, and a higher score indicates that the participant perceived the benefits of horticulture therapy as higher. | Pre-test, Postest (8 weeks from pre-test), Change from Pretest to Posttest is assessed | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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horticultural therapy, severe mental illness, care home residents