‘Horticulture as a Medical Treatment’ – The Report

So, after a 14 month journey, commencing with first reading about the Winston Churchill Memorial Trust in October 2012, the report of my travelling fellowship to the USA and Canada has been published on the WCMT website.

The report is approximately 10,000 words long and contains information relating to the design and accessibility of therapy gardens, horticultural based therapeutic activities, outcome measures and documentation, the education and professional registration of therapists and Horticultural Therapists as professionals.

It has been a real privilege to be involved with the Winston Churchill Memorial Trust and I wanted to the report to meet the high standards that the Trust and it’s previous Fellows have set. I can only hope it has.

The main aim of the project was to learn from professionals in North America and bring the information back in order to help support and inspire other therapists whilst raising the profile of horticultural therapy as an effective and professional therapy.

The report can be viewed and downloaded free from: http://www.wcmt.org.uk/users/richardbrown2013

John Hancock Tower, Chicago

‘Therapeutic Horticulture’ A Video Montage

Here is ‘Therapeutic Horticulture’ – A Winston Churchill Memorial Trust video montage. It is a short video I have put together with some of the footage I took from my Fellowship travels. I do not aim for it to be the definitive video on the project, hopefully wet the appetite for some longer and more detailed examinations of the gardens and projects I visited.

Chicago Botanic Garden

 

First of all, let me apologise for the delay in writing this one up. Since returning home and to work and to renovating our house (with some fruit wine making thrown in!) it had dropped off the end of that list somewhat.

Chicago Botanic Garden is world renowned as a garden alone. This can also be said for its accessible garden and horticultural therapy service.

Opened in 1972 (relatively young for a botanical garden), the “living plant museum” is situated north of Chicago in Glencoe and covers 385 acres of previous wetland which was excavated to create 9 islands housing 26 display gardens (including the world’s first and largest enabling garden) that are surrounded by 4 wildlife areas.

The horticultural therapy service is made up by three members of staff; Barb Kreski (Director of Horticultural Therapy Services), Alicia Green (Coordinator, Buehler Enabling Garden) and Clare Johnson (Off-site Coordinator and Design Consultant). They offer therapy programs in the Buehler Enabling Garden, off-site programming, accessible and healing garden design consultation and run horticultural therapy and healthcare garden design teaching courses.

I was fortunate enough to be given the opportunity by Barb Kreski to see the original enabling garden that Gene Rothert created. Since the creation of the BuehlerGarden it has now fallen into disrepair and is soon to be built on, but it was an absolute privilege to see where the ideas that have later become the world’s most famous accessible garden were sown. The garden was made at low cost to demonstrate how accessibility could be achieved by everyone. The raised beds being made from cinder blocks (breeze blocks to us in the UK) and wood. Planters made from chimney pots and hard standing suitable for wheelchair access throughout.

Old Enabling Garden

 

The Buehler Enabling Garden was built in and is the pinnacle of accessible gardens. All of the ideas and concepts that Gene Rothert started and worked on in the old garden were incorporated in the Buehler.

I hope to cover all the ideas in my final report, which you will be able to download for free, but I will highlight some here. The hanging baskets are on a pulley system so they can be higher and lowered quickly and easily so that people can work on and appreciate them at any level.

 

There is a grid garden for people with sight difficulties. Each plant is planted in the middle of the square of the grid, with the plant being chosen for their sensory benefits. A person can then count out which grid they are working in, know the plant they are growing in the middle and everything around it can be weeded out.

‘Pan beds’ are designed to slope slightly away from the person who is working on them so that they do not get wet, particularly if there legs are underneath the bed.

The garden also has a raised lawn area. The idea behind this is for people who are in wheelchairs it can often be difficult to transfer in and out of the chair to lay on the grass. With the grass being brought up to seating level, transferring is much easier and, for some, can be done without the help of anyone else.

 

A demonstration potting shed displays adapted tools for people to try and feel the weight of before committing to buy them.

 

Alicia’s job is to maintain the garden to the Botanical Garden standards, including following themes on planting whilst balancing this with running therapy programs in the garden and coordinating volunteers.

Whilst I was in the Buehler Garden the overall feeling was that it was just another garden, along with the other 25. Only when you looked closely and read the signage was it evident that you were in an accessible garden. Surely that is what we are all aiming for, people being able to just garden, in a garden that everyone can access, no fuss.

As mentioned above, the Horticultural Therapy Team also run programs off-site and I accompanied Barb Kreski on a visit to a local school for children with autism where Barb runs sessions on linking caring for plants with self-care, discussing what plants need to stay alive and pointing out that each one might need different amounts of things (e.g. sunlight and water). The children were clearly engaged, offering ideas and suggestions throughout.

The team, through Clare Johnson, offer advice on creating accessible and healing gardens. She also designs programs for services which she helps to set up and run before leaving the staff to continue to run the programs.

AHTA 40th Anniversary Conference in Minneapolis

The American Horticultural Therapy Association (AHTA) conference takes place over three days (1 day of optional pre-tours and two days of conference) in a different location each year. Previous years have included Chicago, Washington State, New York and North Carolina.

Pre-tour visits were given of the Ebenezer Care Center, Allina Health Care and the Minnesota Landscape Arboretum. Please see the previous blog entries (below) for more detailed information about those visits.

Due to the amount of presenters and subjects covered the conference is split into a range of 3 concurrent sessions and you are required to submit which ones you wish to attend prior to starting the conference. The difficultly for me personally was obtaining a balance between the sessions that interested me and the sessions that would benefit the whole project.

I finally chose and attended the following, I wont dissect them all here, as it would be too long, but the information gained will go into the full report.

• Thirty Years of Programming in Tennessee: Then, Now and Future. (Douglas Airhart, Ellen Wolfe and Sherry Winnett)
• Collaboration: Enhancing Patient Centered Care (Kate George)
• Publishing Your Research in HT (Jane Saiers)
• Developing Core Competencies in HT in Rehabilitation Medicine (Teresia Hazen)
• Healing Gardens: From Concept to Eye Sparkling Detail (Virginia Burt)
• HT and Disability – Starting a Program from the Ground Up
• Career Exploration of Horticultural Therapy Professionals (Candice Shoemaker)
• Forest Amenities and Human Health Promotion in Japan (Iwao Uehara)
• HT Plus Art Therapy: An Intervention (Miho Kataoka) 

I also had chance to meet some wonderful people working within horticultural therapy within Minnesota and across the United States.

For more information on the AHTA please visit: http://ahta.org/ (They also have a very active LinkedIn group).

Minnesota Landscape Arboretum

 

The final visit of the AHTA conference pre-tours was to the University of Minnesota Landscape Arboretum in Minneapolis.

The horticultural therapy program is run from the Center for Spirituality and Healing and is part of Nature Based Therapeutics (NBT), which also includes animal-assisted interactions, facilitated green exercise, therapeutic landscapes and care farming. The Center offers courses in ‘Therapeutic Landscapes: Therapeutic Benefits of Plants, Landscapes and Natural Environments’, ‘Therapeutic Horticulture: Improving Wellbeing Through Plant Environments’ and ‘Applications in Therapeutic Horticulture’.

The horticultural therapy program commenced in 1992 and states it’s goal as “maximising individual quality of life, developing skills and attributes necessary for self determination, and promoting community integration through the simple pleasures of the garden”. It estimates that each year over 4,000 people have benefited from the program’s horticultural and nature based therapeutic activities.

As well as offering on site sessions the Center delivers off-site specifically designed sessions and consultation as well as support and professional advice on creating a therapeutic landscape.

It was also chance for me to experience some Minnesota late summer weather. Extremely heavy downpour of rain for about an hour followed by a sunny and very humid afternoon where all signs of rain had vanished within two hours.

The arboretum is vast and well worth visiting whether you are exploring the nature based therapeutics or not. I particularly enjoyed the board walk across the wetland marsh.

 

The Arboretum and University of Minnesota are clearly at the cutting edge of work, teaching and research in horticultural and nature based therapies. Long may it continue.

For more information about the Arboretum’s horticultural and nature based therapy programs please visit: http://www.arboretum.umn.edu/ht_engage.aspx

Allina Health Care

The second of the AHTA conference pre-tours in Minneapolis was to the Allina Health Care Hospital.

The visit was split into two, the rooftop rehabilitation garden and the garden and therapy room used by the mental health service.

The mental health service works with people who are acutely ill and admitted for a short period.

The use the garden and therapy room to help people introduce coping mechanisms into their life. Due to the severe winters in Minnesota they rely on the indoor space and try to do as many different activities as possible, including making herbal teas and extending to arts and crafts.

A gentle approach to patients being involved in the activities is taken with some people only able or wish to be present in the area, with participation coming as time progresses.

The second part of this visit, in the same hospital, was to the rooftop rehabilitation garden.

The rooftop garden has been actively delivering horticultural therapy for 25 years and aims to use the activities to meet rehabilitation patients’ physical, emotional and cognitive goals.

Run by the recreational therapy team patients are referred to the horticulture facility based upon their initial assessment. The hospital also employs art, music and drama therapists as part of the recreational team.

The garden planting is mainly concentrated on containers and raised beds, which are made to ADA (Americans with Disabilities Act) standards for accessibility. They find that tools designed for children work well as they are usually lightweight and easy to grip.

I also discovered an interesting fact whilst in Minneapolis: Minnesota has the most gardeners per population ratio in the USA.

For more information about Allina Health Care please visit: http://www.allinahealth.org/

Fore more information about the ADA accessible standards please visit: http://www.ada.gov/2010ADAstandards_index.htm

 

Ebenezer Care Centre

Located in the heart of Minneapolis, Minnesota the Ebenezer Care Centre offers senior living services, including independent and assisted living as well as having an award winning healing garden with horticultural therapy program (awarded ‘Innovation of the Year’ by the Minnesota Health and Housing Alliance – MHHA in 2001).

As part of the American Horticultural Therapy Association (AHTA) conference they organise pre-conference tours of programs in the local area. This is an extremely valuable activity and learning experience and is certainly worth the amount of organisation that I am sure takes place. The Ebenezer care centre was first of these visits.

The garden was brought to life by the ‘Friends of Ebenezer’ group and has gone onto employ two registered Horticultural Therapists (one working full time and the other spending approximately 30% of her time carrying out HT) and offer internships for training Horticultural Therapists.

Approximately 20 of us were welcomed with a well set up and organised tour of the garden where we were split into small groups and moved around the garden speaking to staff, service users and volunteers about different aspects of the garden. It also included freshly made scones. To a Yorkshireman who had been away from home for over three weeks, this was a very welcome surprise. I had two.

For more information on the horticultural therapy program please visit: http://www.fairviewebenezer.org/Programs/S_017606

 

Trinity Services, Joliet

I visited the garden project attached to the day program at Trinity Services, in Joliet, just south of Chicago.

Trinity Services are the largest residential home operators for people with disabilities in the Illinois area. The horticultural therapy program is attended by approximately 40 people each day and is just one of the many learning opportunities offered by Trinity services, including vocational programs for people aiming to enter competitive employment.

The building was previously a school and the outdoor grassed ‘playground’ has been slowly converted into a working therapy garden since a greenhouse was installed in the early 1990’s. Led by trained horticultural therapist Laura Donnelly the garden now contains two large greenhouses, various sitting areas, a turtle pond, different sized raised beds, including one that rotates so people in wheelchairs do not have to keep moving when working the whole bed. The also have a large variety of bought adapted tools to meet everyone’s working needs.

As well as the traditional gardening activities they offer a large range of alternative activities for service users to be involved in, such as making seasonal wreaths, drying flowers and making potpourri, all of which are sold along with plants at regular sales. All money raised goes back into the program.

Drying Flowers

Trinity Services and the garden program are well known in the local community and this has led to specific projects in the garden being supported and carried out by the Boy Scouts (they got a badge for their work) and Caterpillar, the American construction equipment manufacturer, amongst others.

Rotating Bed

Frederick Meijer Garden

Located in Grand Rapids, Michigan, the garden is built on land formally owned by Frederick Meijer who operated the large supermarket chain Meijer’s.

Opened in 1995 its centre piece is a large glasshouse containing tropical and Mediterranean gardens, with the outside being split into a sculpture park, gardens and a wetland wildlife habitat.

Frederick Meijer’s wish was for the site to be used by children so he included a large children’s garden. They also run specific child-focussed events, such as a ‘grandparents evening’ where the garden is only open to grandparents with their grandchildren.

The garden’s real draw is the ‘American Horse’ sculpture. Originally a creation by Leonardo Da Vinci in 1482, it was never fully completed and only a clay model was made, but this was destroyed in Milan by invading French soldiers in 1499. After much discussion and negotiation sculptor Nina Akamu created the ‘American Horse’ and installed it at the Meijer Garden and another at the Hippodrome de San Siro in Milan.

American Horse

However, being born in Yorkshire and living in Wakefield, home of The Hepworth Gallery, I was delighted to find the Barbara Hepworth sculpture ‘Summer Dance’ on display.

Summer Dance by Barbara Hepworth

For more information on the Frederick Meijer Garden please visit: http://www.meijergardens.org/

Fore more information about The Hepworth Gallery in Wakefield please visit: http://www.hepworthwakefield.org/

Amish Quilt Gardens

 

After leaving my new friends in Michigan the route passed through Northern Indiana so I thought I would take the opportunity to stay in the heart of “Amish Country” – Shipshewana.

Handmade quilts are traditional and synonymous with the Amish lifestyle and they are represented all across this area of Indiana with by large bedding schemes following the historical Amish quilt patterns. The Quilt Gardens have become a tourist activity in their own right with a Quilt Gardens map showing the location and driving route to each scheme. 

In the garden at Essenhaus, Middlebury over a thousand begonias were planted just to create the outside edge of the planting scheme.

For more information on the Amish Quilt Gardens please visit: http://www.amishcountry.org/things-to-do/quilt-gardens