Anna María Pálsdóttir
The Alnarp Rehabilitation Garden, established in 2002, offers nature-based rehabilitation (NBR) for individuals with stress-related mental illnesses such as exhaustion disorder (ED) (ICD-10 F43.8). ED occurs after many years of prolonged stress and the lack of sufficient recovery. The symptoms are severe tiredness and exhaustion, with low executive function and mental, physical and social impairments. The rehabilitation process has been described as vulnerable, and recovery can take months or even years. It is recognized that individuals with ED are in great need of rest and mental recovery, especially before they actively participate in a rehabilitation program. Therefore, to support rest and mental recovery, a specially designed garden, a select treatment team, and a specially designed activity program were developed at the Alnarp Rehabilitation Garden.
The garden and horticultural occupations were the base for the whole intervention. The two-hectare rehabilitation garden was designed according to theories on nature’s restorative effects and the theory of supportive environments and contains places for work, rest, and contemplation. It is divided into two major areas: the Nature Area (informal and non-cultivated) and the Cultivation and Gardening Area (formal and cultivated). It is further sub-divided into different smaller garden rooms, each with restorative properties that can enhance mental recovery.
The garden contains evergreen and deciduous trees and shrubs, as well as a vast variety of perennials and annuals; there is always something to look at or work with throughout the year. The color scheme is dominated by soft hues; strong hues are limited to certain areas in the garden where the clients can partake of them when they have developed the strength to handle strong colors. The size, height, form, texture, and fragrance of the plants vary in order to stimulate and awaken the senses, with an emphasis on seasonal variation. The connection to the seasons is important as nature has a rhythm of its own that cannot be sped up or forced as it switches between active and dormant phases. Many rehabilitation participants have lived stressful lives without regular rest. By working at the same pace as nature and the plants, the participants note the shift between the phases.
There are also specially designed garden rooms and greenhouses that facilitate meaningful horticultural and gardening occupations. Horticultural occupations capture the participants’ attention and help them be in the moment “right here, right now”, a somewhat diminished capacity for most participants. By working with their hands, they relax their focused attention. Their cognitive function rests and they switch from thinking to feeling – their hands in the earth, feeling and smelling it incorporates feeling in their bodies and their minds can rest, gaining mental recovery. The team works through the garden and the horticultural occupations to reach the rehabilitation goals. Nature is rich in opportunities for this purpose and it seems easy for everyone to find something to engage in as an active or passive (resting) occupation.
For further reading, please see:
Pálsdóttir, A. M., Grahn, P., & Persson, D. 2014. Changes in experienced value of everyday occupations after nature-based vocational rehabilitation. Scandinavian Journal of Occupational Therapy. Early Online, 1-11. DOI: 10.3109/11038128.2013.832794.
Pálsdóttir, A.M., Stigsdotter, U.K. and Grahn. P. 2011. Preferred qualities in a therapy garden that promote stress restoration. Conference proceedings, 27-29 June. Research into inclusive outdoor environments for all. Open Space/People Space, Edinburgh.
Grahn, P., Tenngart Ivarsson, C., Stigsdotter, U., & Bengtsson, I-L. (2010). Using affordances as a health promoting tool in a therapeutic garden. In C. Ward Thompson, P., Aspinall & S. Bell (Eds.), Innovative approaches to researching landscape and health. Open Space: People Space 2. New York: Routledge; pp 116–54.
Adevi, A., & Mårtensson, F. 2013. Stress rehabilitation through garden therapy: the garden as a place for recovery from stress. Urban Forestry and Urban Greening, 12; 230-237.