painting and later holiday decorating with nature-based items (e.g., planting amaryl- lis bulbs, decorating with evergreens). One activity that can be done at any time is brew- ing tea with mint and other herbs that have been harvested and stored from the summer. At the end of winter (usually sometime in February), the grow rack for plants becomes a constantly rotating incubator for new seeds to germinate. These seedlings are then ready for transplanting when the summer garden- ing cycle resumes. While it is ideal to have patients work with live plants year-round, there are times when dierent activities can attract more individuals to participate who might not otherwise have an interest. This approach also ensures that the focus is not constantly on the basic care and upkeep of plants, which can become repeti- tive and dull. Building on previous research that has shown that exposure to images or fac- similes of natural elements can provide simi- lar benefits to actually being in nature (Beu- keboom et al., 2012; Mostajeran et al., 2021), other activities were developed and tried that still brought a focus to nature. These activi- ties could include painting pots that would be used for new plants in subsequent weeks, decorating artificial trees and wreaths with winter-appropriate floral and nature-based accessories, or selecting plants for a home gar- den out of a seed catalog. In all these activities, the emphasis was placed on patient enjoyment instead of clinical treatment goals. When requested by a physical or occu- pational therapist, however, we would col- laborate to blend the clinical goals with the activity planned for that day. In one instance, a patient was given the choice to lift weights in the gym for 30 min or work with us mov- ing soil for an equivalent time. Instructions were given by the physical therapist and the patient performed the gardening activity under supervision. With this program flexi- bility, activities can be adjusted to ensure that almost every patient can participate, and the responsibility of overcoming barriers to par- ticipation was placed on university program management and recreational therapy sta rather than on the individual patient. Encouraging patients to assist with most of the work in the therapeutic horticulture spaces was routinely the most challenging part of the program. Students were instructed to always check to see if there was a patient
to either do the task with them or at least enjoy spending time near the plants—even if the student had to do the actual work. This directive meant that routine tasks such as the trimming of spent flowers, weeding, or other nonessential care and maintenance often was delayed until either a patient was willing to help or until it became necessary to complete the task for the health of the plants. This problem lessened, however, as a number of patients, particularly those with stays greater than 2–3 weeks, became deeply involved in the garden. These patients would learn directly from the students about the required maintenance and care of the plants and then would assist on days when stu- dents were not present in the garden. This involvement led to patients having a greater sense of ownership over the garden spaces; some patients even referred to specific plants as “theirs.” These more involved patients respected the communal nature of the garden spaces and were helpful conduits to engage more people in the activities oered as part of the program. The program was implemented by two uni- versity program managers (a faculty member and a graduate student, who are authors of this article) and dedicated recreational thera- pists from SVAMC. The program would not have been possible, however, without the involvement of a large number of undergradu- ate student volunteers and interns. Over the 10 years of the program thus far, approximately 30 students have been involved with the ther- apeutic horticulture program for at least one semester of their academic career. It was core to the program that these students be given flexibility in their involvement, have oppor- tunities to develop new or existing skills, and that the experience would serve them well in their career paths after graduation.
Three ideas guided the work that was done through this collaboration between SUNY ESF and SVAMC. First was a focus on the human–nature connection, meaning that most activities had to provide hands-on experiences with plants or natural elements. Second was a priority placed on fun and edu- cation to make the experiences enjoyable and to help patients explore new hobbies that they could potentially do after they were dis- charged from the hospital. Finally—although this idea was often the most dicult—was the idea that this garden was patient-centered, and patients were encouraged to do as much of the care and maintenance of the garden as was feasible. University program manage- ment, recreational therapy sta, or students would complete tasks only when necessary. Having the patients do most of the garden- ing was done to help provide the therapeutic benefits of the garden to the patients, but also to instill a greater sense of pride and owner- ship in the patients. Each of these principles will be explored further, specifically focusing on how this program was implemented. Starting in the late spring to early summer, the outdoor garden on the SVAMC roof begins to fill with new seedlings that will eventu- ally stretch across the length of the terrace. Replenishing soil, adding new plants, and controlling the weeds or undesired growth extend well through the middle of the sum- mer, with early-season plants being replaced by ones that will last into the fall. During the middle of summer, the focus generally starts to shift to harvesting edible plants that are in the garden. Examples include picking toma- toes to make fresh salsa, harvesting eggplant to cook on the grill, or using a wide variety of herbs in dishes. As the season begins to turn cold, the garden will be shut down around October, because the plants go dormant or begin to die. Further- more, the patient population often is unable to go outside in temperatures below 70 °F. Space indoors has been set up, though, to allow for the therapeutic horticulture program to con- tinue year-round. The indoor space includes two areas with window ledges for plants (one on the patient floor and one looking out at the rooftop garden), and a grow rack for plants in the dining/recreation room. To help manage the perception of time pas- sage during the fall and winter, activities are chosen to be more seasonal, such as pumpkin
Student Involvement
Recruitment Students were recruited primarily in one of three ways. The first, and generally most preferable option, was by word-of-mouth from other students. Once a student had worked with the program for a semester, university program management would encourage the student to invite classmates who they thought would be a good fit for the program. Additionally, the program would
25
January/February 2024 • Journal of Environmental Health
Powered by FlippingBook