Integrating Horticulture into the Vocational Rehabilitation Process of Individuals with Fatigue,
Chronic Fatigue, and Burnout: A Theoretical Model

Patrick Millet, Ph.D.

Research findings show that persons suffering from fatigue, chronic fatigue, and burnout have great difficulty reintegrating into working life after medical treatment. This suggests that improvement is required in both the medical and the vocational rehabilitation processes if this situation is to be turned around. The introduction and assessment of new, non-traditional vocational programs and interventions is therefore suggested. This paper proposes horticultural therapy for this particular group (and possibly others as well) and considers the garden environment better than other environments for the development and pursuit of a vocational rehabilitation program.
A Four-Step Theoretical Model is presented, aimed at using horticultural therapy, that is, a cognitive restructuring process using gardening as the basis of activities with the aim of improving human well being, as the cornerstone for the vocational rehabilitation program. The model divides the rehabilitation process into the following four overlapping phases: 1) restoration; 2) evaluation and planning; 3) treatment – return to working capacity; and 4) job placement.

Fundamental to the model is the assumed immediate reduction of arousal levels of persons in a garden environment. This allows the early introduction of the rehabilitation program with ongoing evaluation of developing levels of physical and psychological functioning—utilizing the versatile work tasks performed in gardening activities—and leading to fulfilment of the rehabilitation process; a process that is argued to be more effective when pursed in a garden environment as compared with other, more traditional environments.
As work tempo increases, work performance gradually becomes more focused on quantity, quality, and efficiency. Work tasks also become less structured, giving opportunity for rehabilitees to take more initiatives and personal responsibility. In the final return-to-work phase, rehabilitees are gradually reintegrated into regular jobs parallel with being phased out of the vocational rehabilitation program. It is assumed that through the learning process involved in the vocational rehabilitation program, rehabilitees will be better able to cope with future daily strain.

Survey of Horticultural Therapy Programs in Tennessee
Jenny C. Pfeffer, Dennis E. Deyton and J. Mark Fly

A study was conducted to identify horticultural therapy programs in Tennessee and types of institutions, staff, activities, and clientele involved in the programs. An internet web-based survey was used in 2007 to survey representatives of member institutions in the Tennessee Hospital Association and the Tennessee Association of Homes and Services for the Aging; directors of botanical gardens; and members of the Tennessee Master Gardeners. The survey indicated that programs were individualized depending on the type of client served, funding, institution, and therefore, the resources available for the program. The survey found the most common purpose of horticultural therapy was to “improve mood” of clients, followed by “social interaction,” “stress reduction,” and “motor skill development.” Most respondents (91%) felt there was a need for more professional horticultural therapy training and a Tennessee Horticultural Therapy Association (86%).

It’s More Than Seeing Green: Exploring the Senses through Gardening
Amy Wagenfeld, PhD, OTR/L, MG, HTR, CAPS

Our senses provide the foundation to guide us through our lives, so what better way to nurture this foundation than through thoughtfully planned gardening activities for children? Just as we find joy in and rhapsodize all that is green, so too, can all children. Children with and without identified challenges find joy in the garden as they explore it through various sensory modes. Not only can children be the direct beneficiaries of a sensory based garden program, but also program facilitators, with guidance and instruction, can better appreciate the important role that multi-sensory gardening activities can provide to a child’s overall development.

A New Model for Horticultural Therapy Documentation in a Clinical Setting
Nancy Chambers, HTR

The horticultural therapy team at Rusk Institute, NYU Medical Center, created a new comprehensive patient reporting document that is integrated into the computerized system at the medical center. The staff observes and records each patient’s behavior and cognitive, physical, perceptual and sensory abilities, as well as social interaction skills. This new tool is posted on the patient’s secured chart and is available immediately to the entire team.

A Theoretical Perspective for Using Horticultural Therapy with Children
Charles E. Majuri, Ph.D.

(no abstract)