Process and Outcomes of Horticultural Therapy for People With Disabilities

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

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.

Study Overview

• Status: Completed
• Conditions: Intellectual Disability; Mental Disorders, Severe
• Intervention / Treatment: Behavioral: Horticultural therapy; Other: Comparison

Detailed Description

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.

• Study Type: Interventional
• Enrollment (Actual): 50
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Hong Kong
  • Wong Chuk Hang, Hong Kong
    • Tung Wah Group of Hospitals Wong Chuk Hang Complex

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Treatment; Participants joined a 8-session horticultural therapy group program (60 minutes per session) over 8 weeks.	Behavioral: Horticultural therapy; 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).
Other: Comparison; Participants joined 4 sessions of individual, parallel, and table-top activities of their own interest, e.g. reading, drawing, coloring.	Other: Comparison; 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.

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: The Hong Kong Polytechnic University
• Investigators: Principal Investigator: Andrew MH Siu, PhD, The Hong Kong Polytechnic University

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2019
• Primary Completion (Actual): September 30, 2020
• Study Completion (Actual): January 29, 2021

Study Registration Dates

• First Submitted: April 1, 2021
• First Submitted That Met QC Criteria: June 1, 2021
• First Posted (Actual): June 8, 2021

Study Record Updates

• Last Update Posted (Actual): June 8, 2021
• Last Update Submitted That Met QC Criteria: June 1, 2021
• Last Verified: March 1, 2021

More Information

Terms related to this study

• Keywords: severe mental illness; horticultural therapy; care home residents
• Additional Relevant MeSH Terms: Nervous System Diseases; Neurologic Manifestations; Neurobehavioral Manifestations; Neurodevelopmental Disorders; Mental Disorders; Intellectual Disability
• Other Study ID Numbers: HSEARS20191030004

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No