悠然＞第五期 - 園藝治療

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATH香 港 園 藝 治 療 協 會 園 藝 治 療 專 業 認 證 制 度協 會 於 三 年 前 開 始 推 行 園 藝 治 療 專 業 認 證 制 度 , 以 美 國 園 藝 治 療 協 會 認 證 制 度 為 藍 本 , 依 據 香港 獨 特 情 況 改 良 , 培 養 新 一 代 的 本 土 園 藝 治 療 師 。 園 藝 治 療 實 習 機 構 一 共 有 45 間 , 其 中 一 間 在澳 門 , 也 有 一 間 在 台 灣 。 經 過 三 年 , 到 目 前 為 止 , 註 冊 園 藝 治 療 師 9 位 、 助 理 園 藝 治 療 師 7 位 、園 藝 治 療 服 務 員 20 位 。 註 冊 園 藝 治 療 師 分 別 在 不 同 社 會 服 務 機 構 、 醫 院 及 學 校 帶 領 園 藝 治 療 小組 及 活 動 計 劃 。協 會 園 藝 治 療 專 業 註 冊 認 證 制 度 亦 與 亞 太 園 藝 治 療 協 會 (Asia Pacific Association of TherapeuticHorticulture, APATH) 連 繫 , 本 協 會 會 長 Connie 擔 任 亞 太 園 藝 治 療 協 會 秘 書 長 , 聯 同 該 會 會 長金 炯 得 先 生 及 各 會 員 國 , 一 起 在 亞 太 區 推 廣 園 藝 治 療 。園 藝 治 療 專 業 註 冊 的 級 別1. 園 藝 治 療 服 務 員 (HTF)園 藝 治 療 服 務 員 能 夠 在 註 冊 園 藝 治 療 師 (HKATH / AHTA) 督 導 下 , 在 園 藝 治 療 活 動 中 提 供 協 助 或 擔當 義 務 工 作 。 成 功 完 成 本 協 會 認 可 的 園 藝 治 療 基 礎 證 書 課 程 及 園 藝 治 療 活 動 實 務 操 作 證 書 課 程 ,並 實 習 60 小 時 。2. 助 理 園 藝 治 療 師 (AHT)這 級 別 是 讓 對 園 藝 治 療 有 興 趣 人 士 加 入 園 藝 治 療 的 專 業 行 列 。在 註 冊 園 藝 治 療 師 (HKATH / AHTA) 督 導 下 , 助 理 園 藝 治 療 師 可 策 劃 和 執 行 園 藝 治 療 活 動 / 計 劃 。 成功 完 成 本 協 會 認 可 的 園 藝 治 療 基 礎 、 中 級 及 高 級 證 書 課 程 。 並 實 習 200 小 時 。3. 註 冊 園 藝 治 療 師 (RHT)這 是 園 藝 治 療 師 註 冊 的 主 要 級 別 。 擁 有 認 可 學 士 學 位 或 具 同 等 學 歷 。 註 冊 園 藝 治 療 師 能 獨 立 地 策 劃及 執 行 園 藝 治 療 項 目 。 成 功 完 成 本 協 會 認 可 的 園 藝 治 療 基 礎 、 中 級 及 高 級 證 書 課 程 或 相 關 園 藝 治 療課 程 。 並 實 習 400 小 時 。園 藝 治 療 訓 練 課 程1. 園 藝 治 療 基 礎 、 中 級 、 高 級 證 書 課 程課 程 著 重 園 藝 治 療 的 知 識 和 技 巧 , 包 括 治 療 性 景 觀 。 讓 園 藝 治 療 師 掌 握 園 藝 治 療 軟 件 和 硬 件 上 的 知識 和 技 巧 。 所 有 認 證 級 別 必 需 修 讀 園 藝 治 療 基 礎 證 書 課 程 。 助 理 園 藝 治 療 師 及 註 冊 園 藝 治 療 師 必 需修 讀 園 藝 治 療 中 級 證 書 課 程 及 高 級 。2. 園 藝 治 療 證 書 課 程 – 小 組 技 巧 及 心 理 學 初 探讓 學 生 可 以 掌 握 小 組 工 作 和 輔 導 基 本 概 念 和 技 巧 , 並 認 識 人 類 成 長 和 行 為 。註 冊 園 藝 治 療 師 申 請 者 , 若 未 曾 於 專 上 學 院 或 大 學 修 讀 人 文 學 科 , 需 修 讀 此 課 程 。3. 園 藝 治 療 活 動 實 務 操 作 證 書 課 程課 程 的 特 點 是 園 藝 治 療 和 園 藝 的 整 合 。 學 習 園 藝 治 療 常 用 植 物 的 種 植 知 識 和 技 巧 。 註 冊 園 藝 治 療 師 申請 者 , 若 未 曾 於 專 上 學 院 或 大 學 修 讀 園 藝 學 科 ; 及 園 藝 治 療 服 務 員 申 請 者 , 需 修 讀 此 課 程 。

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATH園 藝 治 療 實 習1. 園 藝 治 療 服 務 員 (HTF)園 藝 治 療 實 習 時 數 共 60 小 時 。 其 中 園 藝 治 療 活 動 實 務 操 作 實 習 30 小 時 , 另 30 小 時 為 園 藝 治療 實 習 。2. 註 冊 園 藝 治 療 師 及 助 理 園 藝 治 療 師 (RHT & AHT)園 藝 治 療 實 習註 冊 園 藝 治 療 師 RHT:400 小 時助 理 園 藝 治 療 師 AHT:200 小 時專 業 督 導 園 藝 治 療 實 習園 藝 治 療 實 習- 註 冊 園 藝 治 療 師 :180 小 時 。- 助 理 園 藝 治 療 師 :120 小 時 。- 由 註 冊 園 藝 治 療 師 ( 由 HKATH 或 AHTA 認 證 ) 直 接 督 導- 在 本 協 會 認 可 的 實 習 機 構 , 協 助 或 推 行 園 藝 治療 小 組 或 計 劃 。- 參 與 本 協 會 認 可 之 「 園 藝 治 療 專 業 活 動 」。若 進 一 步 了 解 如 何 申 請 成 為 實 習 生 或 本 協 會 認 可 的 實 習 場 地 , 請 與 香 港 園 藝 治 療 協 會 聯 絡 。電 郵 :info@hkath.orgHong Kong Association of Therapeutic HorticultureHorticultural Therapy Professional RegistrationHKATH develop her HT registration system, with the America Horticultural Therapy Associationregistration system as blueprint, and based on unique situation of Hong Kong. It has smoothlylaunched for 3 years. So far, we have 9 Registered Horticultural Therapists, 7 Assistant HorticulturalTherapists and 20 Horticultural Therapy Facilitators. There are 45 HT internship sites, including onein Macau, and also one in Taiwan. Registered Horticultural Therapists are now leading HT groups andprojects in different social service agencies, hospitals and schools.HKATH HT professional registration system affiliate with the Asia Pacific Association of TherapeuticHorticulture (APATH). Our president, Connie, serves as Secretary of the APATH, working closelywith APATH President Mr. Kim Hyoung Deug and member countries to promote horticultural therapyin Asia Pacific region.Registration Levels1. Horticultural Therapy Facilitator (HTF)This level is intended for those persons helping or volunteering in the HT programs. They areexpected to have successfully completed HT Elementary Cert Course and HT Cert Course –Horticulture Practice, with 60 hours internship experience.2. Assistant Horticultural Therapist (AHT)This level is designed for those persons transitioning into the field of Horticultural Therapy. Theyhave successfully completed HT Elementary, Intermediate and Advanced Certificate Courses, toinclude 200 hours HT internship experience.

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATH3. Registered Horticultural Therapist (RHT)RHT is capable to plan and implement HT programs independently. They are expected to have abachelor degree at a university and successfully completed HT Elementary, Intermediate andAdvanced Certificate Courses, to include 400 hours HT internship experience.Horticultural Therapy Training & HT Certificate Courses1. Horticultural Therapy Elementary, Intermediate, Advanced Certificate CoursesThese courses focus on HT knowledge and skills, also including therapeutic landscape. It equipshorticultural therapist with the knowledge on software and hardware of HT.HT ElementaryCertificate Course is the basic requirements for all HT registration levels.HT Intermediate &Advanced Certificate Courses are the requirements for AHT & RHT registration.2. Horticultural Therapy Certificate Course -- Human ScienceStudents can acquire the basic group work and counselling skills, understanding on humangrowth and behaviour. For those RHT applicants who have not studied semester subjects onhuman science, they should have successfully completed this course.3. Horticultural Therapy Certificate Course – Horticulture PracticeThe characteristic of the course is integration of horticultural therapy and horticulture. Studentsfocus to acquire knowledge and skills in planting those plants commonly used in HT programs.The course is the requirements for HTF registration. Also, for those RHT applicants who havenot studied semester subjects on horticulture, they should have successfully completed thiscourse.Horticultural Therapy Internship1. Horticultural Therapist Facilitator (HTF)HT Internship of 60 hours should be under supervision of Registered Horticultural Therapists(AHTA or HKATH ). 30 hours are horticulture internship and the rest 30 hours will behorticultural therapy internship.2. Registered Horticultural Therapist & Assistant Horticultural Therapist (RHT & AHT)HT InternshipRegistered Horticultural Therapist:400 hrsAssistant Horticultural Therapist :200 hrsProfessional Supervised HT Internship-- RHT: 180 hrs-- AHT: 120 hrs-- should be supervised directly by HT InternshipSupervisor (HKATH) or HTR/ HTM (AHTA)HT Internship-- Help or lead HT groups or projects at HKATHaccredited internship sites.-- Participate at HKATH accredited “HT ProfessionalActivities”.Please contact HKATH for details of the applications as intern or as internship site.Email:info@hkath.org

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATHThe 1 st International Conference on Horticultural Therapyand Therapeutic Landscaping –“Horticultural Therapy and Therapeutic Landscaping for Health and Well-Being”Host Organisers:- Hong Kong Association of Therapeutic Horticulture- Centre for Gerontological Nursing, School of Nursing,The Hong Kong Polytechnic UniversityTentative Date : 20, 21 June 2014Theme areas:- Evidence-based HT & health- Therapeutic landscaping & health- New trends in application of HT & therapeutic landscaping- HT with special populations- Sustainable HT programs- Policy development of therapeutic landscaping in metropolitan cityOversea speakers are invited from US, Korea and Taiwan including:Professor Paula Diane Relf- Professor Emeritus of Horticulture- Virginia Polytechnic Institute and State University (Virginia Tech)- Co-Founder and Past President of American Horticultural Therapy Association- Founder and Past Chair of People Plant CouncilCandice Shoemaker, Ph.D.- Professor, Horticulture and Human Health- Director, Graduate Studies in Horticultural Therapy and Urban Food Systems,Kansas State University

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATH海 外 園 藝 治 療 實 習 - 行 政 院 衛 生 署 八 里 療 養 院 ( 台 灣 )香 港 園 藝 治 療 協 會 安 排 了 第 一 次 海 外 園 藝 治 療 實 習 小 組 -- 香 港 、 澳 門 、 台 灣 的crossover。 實 習 機 構 是 台 灣 行 政 院 衛 生 署 八 里 療 養 院 , 服 務 對 象 是 精 神 病 患 者 。實 習 生實 習 助 理實 習 督 導實 習 機 構 聯 絡 人: 黃 達 洋 , 澳 門 扶 康 會 怡 樂 軒 職 能 治 療 師 , 助 理 經 理: 喬 建 欣 及 司 徒 素 琼 , 助 理 園 藝 治 療 師 (HKATH): 馮 婉 儀 , 註 冊 園 藝 治 療 師 (AHTA), 香 港 園 藝 治 療 協 會 會 長: 張 建 隆 , 職 能 治 療 師實 習 日 期 由 2013 年 5 月 22 至 29 日 , 上 、 下 午 舉 辦 園 藝 治 療 實 習 小 組 , 每 組 6 次 聚 會 。實 習 督 導 Connie 於 5 月 23 及 24 日 進 行 現 塲 督 導 。這 次 種 籽 成 功 的 撒 播 , 希 望 日 後 也 能 在 不 同 的 地 方 開 花 結 果 , 而 中 國 亦 在 萌 芽 中 , 園 藝治 療 實 習 小 組 將 會 展 開 。Overseas HT Internship – Bali Psychiatric Center, DOH (Taiwan)HKATH arranged the 1 st Overseas Horticultural Therapy Internship – crossover among HongKong, Macau and Taiwan. Internship site is the Bali Psychiatric Center, DOH (Taiwan). Theservice target is mentally ill patients.Intern : Vong Tat Leong, Occupational therapist, assistant manager,Yee Lok Centre of Fuhong Society of MacauInternship Assistants : Kiu Kin Yan, Judy & Szeto Soo Kheng ,assistant horticultural therapist (HKATH)Internship Supervisor : Fung Yuen Yee, Connie,registered horticultural therapist (AHTA), President, HKATHInternship Site Contact Person : Chang Chien Lung , occupational therapistInternship started from 22 to 29 May 2013. There were HT groups in the morning andafternoon respectively with 6 sessions. Connie conducted internship live supervision on 23and 24 May.HT seeds were sowed. It is hoped to flourish someday in future. Internship in China is inprogress and plan to start in coming autumn.

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATH一 次 難 忘 的 實 習 之 旅喬 建 欣 Kiu Kin Yan, Judy, AHT (HKATH)某 一 天 , 收 到 CONNIE 老 師 來 電 , 問 我 有 沒 有 興 趣 到 台 灣 當 園 藝 治 療 輔 助 員 ; 當 時 心 情 十 分 興奮 , 因 為 這 是 另 一 種 的 學 習 , 於 是 馬 上 在 第 二 天 向 公 司 請 假 。出 發 前 , 與 來 自 澳 門 的 實 習 生 阿 達 和 香 港 的 阿 SOO 一 起 開 會 討 論 , 原 來 預 備 工 夫 也 不 少 , 絕對 不 能 看 輕 , 感 覺 自 己 代 表 香 港 的 園 藝 治 療 協 會 ,絕 不 能 「 失 禮 街 坊 」, 還 得 要 了 解 文 化 〔 例 如 台 灣規 定 某 溫 度 以 下 是 不 能 開 冷 氣 〕 與 詞 彙 的 差 異 〔 例如 我 們 常 用 的 膠 袋 , 普 通 話 是 塑 料 袋 〕, 才 能 至 臻完 美 。 幸 而 阿 達 在 台 灣 唸 大 學 , 住 了 好 幾 年 , 才 沒有 笑 話 連 篇 出 現 。 還 有 就 是 得 到 八 里 療 養 院 職 能 治療 師 張 建 隆 的 滿 分 協 助 , 令 整 個 實 習 過 程 順 利 進行 , 事 半 功 倍 。到 了 台 灣 第 一 天 , 到 了 八 里 療 養 院 , 建 隆 首 先 帶 我 們 到 疾 病 防 控 部 學 習 如 何 正 確 洗 手 , 並 需 要在 接 觸 病 人 前 後 要 洗 手 , 以 免 感 染 細 菌 或 將 細 菌 傳 染 他 人 , 每 人 還 獲 發 酒 精 洗 手 液 一 支 。 之 後便 與 他 商 討 開 小 組 的 物 資 安 排 , 晚 上 還 要 到 附 近 的 店 舖 買 東 西 。第 二 天 , 大 清 早 便 準 備 了 。 小 組 正 式 開 始 , 我 的 心 情 真 是 戰 戰 競 競 , 這 是 由 於 我 是 第 一 次面 對 精 神 病 的 對 象 , 怕 自 己 不 懂 面 對 突 發 事 情 , 又 恐 怕 文 化 差 異 或 語 言 不 通 ; 後 來 見 到 上午 的 八 人 男 子 組 , 他 們 有 說 有 笑 , 十 分 友 善 , 心 想 必 定 是 建 隆 精 心 挑 選 的 參 加 者 , 致 不 令我 們 有 額 外 的 壓 力 。 下 午 女 子 組 也 顯 得 積 極 參 與 , 有 問 有 答 , 加 上 帶 組 的 阿 達 也 能 帶 起 活動 的 氣 氛 ; 整 體 來 說 , 無 論 是 室 內 手 工 藝 活 動 或 簡 單 種 植 , 還 是 戶 外 的 耕 種 活 動 , 參 加 者都 表 現 我 很 投 入 。總 括 來 說 , 雖 然 我 只 參 與 了 四 天 的 活 動 , 但 也 覺 得 十 分 有 意 義 和 值 得學 習 。 海 外 實 習 , 真 的 需 要 裡 應 外 合 , 先 有 香 港 園 藝 治 療 協 會 的CONNIE 穿 針 引 線 , 再 有 台 灣 八 里 宗 療 養 院 的 支 持 , 提 供 場 地 實 習 ;建 隆 無 私 的 協 助 , 甚 至 他 從 家 中 帶 來 不 少 小 組 用 的 物 資 , 還 有 對 台 灣有 所 認 識 的 阿 達 , 最 後 輔 助 員 阿 SOO 的 盡 心 盡 力 , 令 整 個 實 習 順 利進 行 。

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATHPalliative Care Patients’ Experience on Horticultural TherapyKan Wai YinRegistered Nurse, Graduate of the Hong Kong Polytechnic UniversityHorticultural therapy was conducted for palliative care patients in 2011 summer. It was a researchproject co-organized by the Hong Kong Polytechnic University, Hong Kong Association ofTherapeutic Horticulture and Haven of Hope Hospital. The aim of the study was to explore theexperience of horticultural therapy on palliative care patients. A total of 29 patients participated in thestudy. Observations and interviews were conducted during the period. Participants showed positiveresponses towards horticultural therapy. It brought them with happiness, new planting experience anddistraction from illness.Most of the participants reflected that they were happy and actively participated in the horticulturaltherapy. The process of having the horticultural activities gave them enjoyment and happiness.“I enjoyed in the activity process very much! I was very happy. There was a delightfulfeeling, coming from my deep heart... I was smiling all along.”Some participants expressed that they liked looking at the flowers and the greenery. The flowers grewsplendidly, as though they were smiling. They were simply happy whenever they looked at the plants,or enjoyed the odour of the plants.“I like growing flowers. I am very happy whenever I think about it. It is because I will beespecially happy when I look at the flowers. It’s my feeling. There were lots of flowersgrowing here. It’s worthwhile for me to look at and appreciate the flowers.”“It is delightful to have the horticultural activities. I feel happy when looking at the greenplants. The smell of grass makes me feel fresh and comfortable, as though I have been tothe countryside… I am delighted, with a fresh feeling. I will be happy whenever I look atthe green colour.”Horticultural therapy brought new planting experiences. Some patients mentioned that it was theirfirst time having different horticultural activities like growing and flower arranging. The differentplanting methods in horticultural therapy provided the participants with a fresh feeling.“It’s my first time to arrange flowers. My first time to grow the Dracaena sanderiana ( 富 貴竹 ) with the use of plastic beads… I had never tried before. It’s my first time. And it’s myfirst time to grow wheatgrass ( 小 麥 草 ) too.”

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATHPalliative care patients had a first-hand and different experience of planting. They could have directcontact with the soil and plants which they had never had previously.“I have never had such a feeling before. It seems different. It’s another feeling. Thoseplants you see in the park are different from these that were arranged by me! You can’ttouch the plants in the park… not even for a while! But now I have a first-hand experience.It’s me who grew the plants myself. I arranged the plants myself… paved the soil andpressed on it.”Horticultural therapy helped distracted patients away from negative thoughts of their disease. Instead,they could focus their attention on the plants. Their comfort, vigor and mood improved as a result ofthe horticultural activities.“My attention might be on looking at the plant and providing care to it. I got diverted, andwas not thinking those bad things.”“The activities provided distraction and relieved my physical discomfort. I love flowers. Itis good to concentrate on doing what I like… I will be in full vigor when I smell the flowersand see the natural colors.”Palliative care patients had positive experience towards horticultural therapy. They enjoyed thehorticultural activities and provided care to the plants. They were happy, had new planting experienceand got distracted from their disease. Further studies on the impact of horticultural therapy onpalliative care patients had been undergoing. It is hoped that horticultural therapy improved theirclinical outcomes and quality of life.

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATHGardens in health care: An introduction to the design and application ofhealing gardens, therapeutic gardens, and horticultural therapy gardensPaula Diane Relf, Prof. Emeritus, Virginia Tech University.ABSTRACTPeople intrinsically recognize that being around plants, being in a garden is good for you. Throughouthistory people have used the garden as a place of mediation, sanctuary and healing. However for along period of time medical philosophy and practice took us away from natural elements to syntheticmedications and surgery. In recent times, a shift in attitudes back toward a holistic approach towardhealth and well-being has resulted in a significant increase in interest of researchers in documenting,quantifying and understanding the health effects of plants. Thus research has now documented that thebenefits are not just a placebo effect. Health benefits, which range from stress reduction to improvedoutcomes for specific ailments, accrue from working with plants, merely being in the presence ofplants and viewing them, and consuming healthful fruits, vegetables, and herbs. Healing landscapesand horticultural therapy have become increasingly viable fields of research. As the use of plants inhealth care is experiencing a resurgence that involves both the general public and professionals fromseveral fields there is not yet a consensus on the terminology, theoretical foundation or researchmethodology used to document and insure the efficacy of this interaction. This paper addressessome of the most widely held concepts.INTRODUCTIONMost researchers involved in studying the relationship of nature to human health and well-beingrecognize the Biophilia hypothesis of E. O. Wilson (1984) as one of the major supporting theories fortheir work. The Harvard University entomologist coined the term to refer to humans' love of livingthings, an "innate tendency to focus on life and lifelike processes.". Wilson maintains that humans arenaturally attracted to other living organisms - flora and fauna and related environment (i.e. the greenhues of plants and blues of water as opposed to the grays of concrete and other unnatural materials) -because of our evolutionary development in the natural world.According to Gerlach-Spriggs, et. al., (1998)“Restorative or healing gardens for the sick have beenpart of the landscape of healing since medieval times. Such gardens have been parts of hospitals,hospices, rehabilitation centers, and more recently nursing homes for the infirm and elderly.”However by the 1950’s economic considerations began to reduce the farm, the garden and the openground around various types of healthcare facilities. The combination of new medical technology andinsurance company pressure to reduce the length of stay further contributed to the loss ofoutdoor-nature experiences in health care. Other factors took precedence over the idea that there couldbe healing quality to nature. Not long after this transition to a technology-based world beganchanging health care, a few individuals began to doubt the wisdom of the shift. By 1972 thepredecessor to American Horticultural Therapy Association had been formed and the Kaplans at

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATHMichigan State University were beginning their groundbreaking research in environmentalpsychology. Throughout the 1970’s and 1980’s increasing numbers of researchers and healthcarefacilities began to explore the healing and therapeutic impact of nature.The rising interest in alternative or complementary medicine and a holistic lifestyle through the1990’s appears to have encouraged the application of the research documenting positive benefits ofnear-by nature to health. However the most influential researchers in the field, including RogerUlrich, Rachel and Steven Kaplan, Clare Cooper Marcus, and Marni Barnes, agree that the value ofthe garden in health is very difficult to prove and new methods of assessing the impact must becontinually tested.An extensive overview of the role of plants in human health is available from a referred journal articlethat is on-line at no cost. It was prepared as part of the American Society for Horticultural Science’shistorical review for the 100th anniversary of the society and published in HortSciences. Clicking onthe following site will download a free PDF file of all of the papers in the historic review, from the listof articles, click on the one entitled Human Issues in Horticulture by Relf and Lohr:http://www.electronicipc.com/data/journalez/pdf/0420/002/HistoricalReview2003.pdf.LANDSCAPNG FOR PUBLIC HEALTHFrom the broadest view, the environment in which we live directly impacts our mental and physicalhealth. Of course most of us recognize that plants and the landscape play a major role in establishingand maintaining a healthy environment. However, only in recent years has the need to conductresearch that helps better design our environment to be healthy been recognized and pursued.Research on both indoor and out plants is documenting that plants help solve many of our urbanenvironmental remediation and clean-up problems and reduce the potential for future problems. Theconclusion from the research available to date is that the landscape, properly designed andmaintained, may play a critical role in the health of the environment and impacts the quality of lifeand economics of individuals, businesses and communities. (Relf and Lohr, 2004)Likewise, the community in which we live greatly impacts our physical and mental health. Again, theconcept that we need to understand how plants impact community health and how to better design tobring about that benefit is relatively new. Plants and gardening enhance health of communities inmany ways beyond environmental health and aesthetics; ranging from a greater sense of communityto reduced crime and from reduced stress to obesity management. There is strong indication that urbangreening is highly successful in building communities and reducing the public health hazardsassociated with isolation, loneliness, poor exercise, and lack of community ties. Frumkin (2001) atEmory University School of Public Health has called for more collaborative, clinical, and

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATHepidemiological research documenting the benefits of interactions with natural landscape, plants, andanimals, so that prescriptive interventions for specific illnesses could be offered by the medicalcommunity and supported by health insurance companies. He points out that such research wouldalso foster zoning and planning decisions that would promote greater community health.The research and theories related to these two broader areas of landscape and health shed importantlight on the area of our focus: gardens in health care.GARDENS IN HEALTH AND WELL-BEINGHealthcare can be viewed as being a continuum with prevention being the primary goal of mostindividuals (we don’t want to get sick); medical treatment being the domain of the doctors andhospital; restoration and maintenance of life quality being the role of a variety of therapist andrehabilitation facilities; and long term or terminal professional care in nursing care centers andhospice being needed by a few individuals. There is an increasing need for an international consensusclarifying the meaning of terms used within the over-all subject area of the therapeutic role of gardensand gardening in health care. Among the terms in common usage, there are many terms describing thevarious levels of interactions between plants and gardens, the patient, and other individuals within thehealth care community.Prevention. The research of Rachel and Steven Kaplan and many of their former graduate studentsand collaborators focuses on the restorative value of nature to maintain the health and well-being ofall individuals. They have assessed people’s perception of their environment and addressed whatpeople value most in their surroundings. They and others researchers, such as Francis Kuo, havelooked at the impact that nearby nature can have on physical and mental health, mental functioning,and social relationships. One of their important conclusions is that while the nature experience musthave “extent” that is not a reflection of size, but rather that it is extensive enough to meet one’sexpectation and needs. Thus a restorative natural setting can be small, quite large, or anywhere inbetween.Restoration Gardens, Meditation Gardens, and Sanctuary Gardens are terms often applied to publicand private gardens that are not affiliate with healthcare but designed with the idea that the userswould experience an exceptional level of mental and/or physical enhancement due to experiencing aperiod of time as a visitor in the garden. The Kaplans’ research and theories of the restorative valuenature to individuals in communities and public parks underlie much of the knowledge of restorativegardens. In addition, many other types of gardens (including Sensory Gardens, Medicinal Gardens,Commemorative Gardens, Memorial Gardens, and Sculpture Gardens) are seen by some as beingrestorative or healing gardens. In fact, the terms healing and restorative are often usedinterchangeably. There does seem to be an agreement that while almost any landscape mayultimately be considered to be restorative the key to achieving restoration goes beyond aesthetics. InHealing Gardens, (Barnes and Cooper Marcus, 1999): “Gardens can be healing and restorative via a

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATHnumber of mechanisms. The most obvious is the aesthetics of nature, that is, creating a beautifulverdant place that will be a powerful enticement to go outdoors.” However, this concept is takenfurther by these authors and clarified by Gerlach-Spriggs (1998), “A restorative garden is intended byits planners to evoke rhythms that energize the body, inform the spirit, and ultimately enhance therecuperative powers inherent in an infirm body or mind.”In specializing in design of restorative landscapes the firm of Roy-Fisher Associates, Inc (2006).identified several common garden features with restorative qualities: Clarity. Healing Garden design should be clear and inspiring, notambiguous or unintelligibly abstract. Access. The garden should be easily accessible. Codes and locks are obstaclesand need to be reconsidered. A successful garden has simple and directwayfinding in place. Gathering Spaces. The garden must have open space for events and activities.Open space creates opportunity and encourages interaction and socializationwith others. Private/Intimate Spaces. Alongside gathering spaces, we need intimate spacesto escape, to mourn, to relax, to hold private conversations, and just to think. Inspiration. Healing gardens engender a variety of responses from its users.Besides stress relief, users need inspiration and encouragement to accomplishgoals and restore oneself. Sculpture, painting, and music can revitalize thespirit and make it stronger. Connection to Nature. Modern society is awakening to the notion thatimmersion in the organic can put us in places no built environment can. Thescent of a rose, the bright orange of a Hibiscus, the sound of an oak’s boughsin the wind, and the soothing rumble of a waterfall are natural stimulants andcan be alternatives to pain medication and other methods that don’t give thebody a chance to heal itself first.Cooper Marcus (2001) identified seven essential components to creating gardens that heal. They are:visibility, sense of security, physiological comfort, opportunities to make choices—seeking privacy orgathering for social support, engagement with nature, familiarity, unambiguously positive designfeatures. According to her, the garden can possess one or many of the above characteristics thus thedefinition is broad and inclusive.Based on the current work and writings of researchers and landscape architects, it can be interpretedthat a restorative garden can be anything from an herb in the window or a pot of grass to clip for aHospice patient to public spaces such as the Vietnam Memorial. It may be very private and individualor intended for group sharing. It may be targeted to children or elderly or for any age. It may be foremployees to recover from the morning stress during lunch or travelers to avoid road rage during adriving break.

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATHConclusion: Ultimately the concept of Restorative Gardens is refocusing the design of the landscapefrom the aesthetic and functional needs of the site to the psychological, social, and physical needs ofthe users. This trend could lead to healthier individuals, communities and environments.GARDENS IN HEALTHCARE SETTINGSIn healthcares setting in which treatment is being provided by teams of professionals, there have beena number of studies that document the healing quality of near-by-nature. One of the most recognizedand cited studies conducted by Ulrich took advantage of ten years of clinical data on cholecystectomypatients who were randomly assigned to rooms facing either a stand of deciduous trees or a brick wallbased on room availability. He restricted his study to matched pairs of males who were in the hospitalonly when the trees were in foliage and was able to determine statistically significantly positiveeffects of the view of trees. These results included patients spending less time in the hospital andusing fewer doses of strong pain relievers if they had a room with a view of trees rather than a view ofa brick wall (Ulrich, 1984). Other studies using nature scenes and sounds as an intervention in arandomized control design and restorative activities such as walking in a garden both had similarpositive results.Although space is at a premium in urban/suburban locations, most healthcare facilities have areas thatare suitable for landscaping for healing or restorative purposes. Often the plantings in these areas (ifexistent at all) are mandated by local codes to meet minimum aesthetic standards that are far belowthe architectural standards of the building and often serve to detract or demean the facility. Likewisemaintenance is sub-par and unhealthy plants add to the feeling of disrespect. In their book, HealingGardens, Clare Cooper Marcus and Marni Barnes analyzed and categorized the different types ofoutdoor/planted spaces in the hospital settings they were studying. The spaces they defined in theirstudy are: Landscaped Grounds, Landscaped Setback, The Front Porch, Entry Garden, Courtyard,Plaza, Roof Garden, Roof Terrace, Healing Garden, Meditation Garden, Viewing Garden, TheViewing/Walk-in Garden, A Tucked-Away Garden, Borrowed Landscape, Nature Trails and NaturePreserves, and Atrium Garden. The attributes of each are discussed thoroughly in the book and theirpotential to contribute to the overall health characteristics of the facility are considered. Needless tosay, while many of the facilities have comparable architecture locations as those given above, mostare not using them most effectively for their healing qualities.Healing Gardens As a result of the earlier studies of Ulrich and the Kaplans, the concept of designinglandscapes at hospitals, hospices, and similar sites for their healing qualities rather than merely tocover the grounds is gaining favor. According to their study a healing garden is defined as “a categorythat includes outdoor or indoor garden spaces in hospitals that are specifically designated as healinggardens by the administration and the designer” (Cooper Marcus and Barnes, 1999), which means thatdirected thought has been given to creating a therapeutic environment. This concept is further

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATHemphasized by Gerlach-Spriggs and Wiesen (2002), “When landscape architects enter the realm ofhealth care, they do so to assist the medical profession as it strives to meets its goals. When designingtherapeutic gardens, landscape architects assume the standards of the medical profession as well astheir own.Research sponsored by the Center for Health Design on the use and therapeutic benefits of hospitalgardens finds an overwhelmingly positive response from employees, patients, and their families andfriends for these types of gardens (Marcus and Barnes, 1999). They are gardens designed to be places ofretreat, respite, tranquility, etc. In general the healing gardens are designed by professionals andinstalled and maintained by a grounds maintenance staff and intended for use by staff, visitors, andclients at their discretion, rather than as a part of a treatment plan. Though usually designed and caredfor by professionals, research has indicated that these types of gardens may be more effective increating a restoration effect if the various users are directly involved in all aspects of the design,installation, and maintenance of the garden.According to Ulrich and others focused primarily on the environment in the treatment setting, healinggardens should contain prominent amounts of real nature content such as green vegetation, flowers,and water and should have therapeutic or beneficial effects on the great majority of its users. As anexample Cooper-Marcus and Barnes (1995) quotes a healthcare employee regarding their use of hegarden "It’s like time has stopped, like a vacuum, a quiet space. I’m really glad it’s here; it gives mean out’. I close my eyes and listen to the water like I'm hearing a stream or a brook . . .. I can get awayfrom the downstairs hustle and bustle. It’s the best thing about this hospital."Therapeutic Gardens. The term “therapeutic garden” is used to describe a garden designed specificallyfor use as part of a medical treatment program. It can be considered as a subcategory or specific typeof Healing Gardens. It may be a physical extension of a Physical Therapy or Occupational TherapyDepartment on a rooftop or patio that is for exclusive use by the therapist and patients of that area. Itmay be a specific portion of a larger garden clearly designed to facilitate many of the exercises andexperiences in an OT or PT Unit. It could include walkways, steps, wooden or grassed raised beds touse as outdoor exercise mats, flat area for ball, rope, and other exercises, etc. In either situation,patients should be involved in the design to discuss both physical and psychological factors related tothe design and location that might not be anticipated by the professional (for example, unacceptablelevels of public exposure). In addition, the therapeutic garden may be integrated into a larger healinggarden as a somewhat private and sheltered location for the client to begin practicing the skillsacquired in the rehab unit in a quasi-public setting. A therapeutic garden may be designed for a talktherapist to work individually or with small groups in a setting conducive to relaxation andcommunication. Privacy will be of utmost concern.Therapeutic gardens may be part of a treatment plan in which the client is under direct supervision ofthe therapist or may give the client the opportunity for free use of the area within the context of its

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATHidentified therapeutic benefit to the patient. For example, wandering gardens are designed forAlzheimer patients to help reduce symptoms associated with the disease such as violent outbursts.Therapeutic gardens are typically designed and maintained by professionals for the use of thetherapist and client. Gerlach-Spriggs and Wiesen (202states that, “a ‘therapeutic garden’ is an attemptto improve the medical environment, not from a purely aesthetic standpoint, but rather in pursuit ofthe treatment of disease.” Further, if the garden is used appropriately and successfully it will assistrecovery from disease and can be evaluated by using clinical data to obtain measurable outcomes.Horticultural Therapy Gardens. Horticultural therapy gardens are designed specifically for the use ofpatients in the care and cultivation of plants as part of a treatment program thus are a subcategory oftherapeutic gardens with unique characteristics. Horticultural therapy is a treatment modality used bymany different professionals as a part of their over-all treatment regime. To be considered as trulyhorticultural therapy, a program must have three elements: a client in treatment for a defined problem,a goal the client is trying to achieve, and the responsibility by the client for the care of living plants.The goals of the program vary from one facility to another and address physical, emotional, social,intellectual and spiritual needs of the patient. Horticulture as therapy for individuals with a variety ofdiagnoses has a long history. It has been used effectively in psychiatric hospitals since the late 1800s; itlikewise has a long history of use with individuals with intellectual impairment particularly invocational and educational centers. Programs are also found in rehabilitation hospitals and VeteransAdministration hospitals. More recently there have been reports of positive responses to horticultureactivities from seniors with Alzheimer’s disease in an adult day services program. In addition,arboreta and botanic gardens are employing registered horticultural therapists to conduct educationaloutreach programs for professionals and clients in treatment facilities in their communities.Gardens designed for conducting horticultural therapy programs differ from a healing garden of thegeneral healthcare facility or even a therapeutic garden in several ways; most importantly, they mustbe designed for the client to assume full, or at least partial, responsibility for the care and life of theplant. It is the sense of ownership and responsibility – the knowledge that the plant is dependent forcare - that contributes much of the therapeutic value of HT. It is a key in motivating the client to manyof the actions in the garden. If the clients feel that staff will maintain the plants if they choose not to,then the dynamics of the therapy session can change significantly. For this reason the HT gardenneeds to be small enough for the client to indeed care for it appropriately. It needs to be composed ofplants both of interest to the client and within their skill and knowledge level to care for successfully.The garden needs to be designed and plants selected such that the area will look reasonably attractiveeven with minimal maintenance. It should be in a location such that it will be acceptable to allow it todeteriorate to the level of competency of the clients as they achieve success through personresponsibility. Depending on the needs and diagnosis of the clients in HT, the garden may requiremore privacy than some of the other types of gardens.

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATHIt is important to note that the same garden might serve all four functions, but would need to bedesigned with special consideration. The garden may be open to the general public for restoration butthis use should not interfere with the use by staff or family members at the healthcare facility whomay need privacy for grieving or for intimate talks with loved ones who are using the garden as atruly healing space. Patients who are participating in treatment with therapists may not be comfortablehaving the public watch them utilize the therapeutic elements of the garden; for example, as theylearn to walk again. Similarly, if the horticultural therapy garden is public in nature there may be astrong temptation on the part of the staff to assume responsibility for the life of the plant from thepatient in order to keep the gardening “looking nice” for the public. This, of course, eliminates thetherapeutic benefit to the patient of the nurturing of the garden. In effect, it turns the horticulturaltherapy garden back into a healing landscape with very different goals and effects. The design of agarden for multiple uses will require the though understanding of goals and needs of all of theintended clients. This may be facilitated by segmenting the garden with privacy plantings and walls.DESIGN GUIDELINESA few basic guidelines apply for the design of any type of healing garden. These include: The client (including administrators, staff and patients) should be involved throughout thedesign process. The garden should be easy to access, comprehend, and navigate. The garden should provide a sense of security, safety, and familiarity. The garden should encourage wildlife (birds, butterflies, small animals, etc.) in the garden andsome domestic animals if appropriate. The garden should stimulate an understanding of self through understanding of the cycle oflife through plants.SUGGESTED BOOKS1. Appleton, Jay. 1996. The Experience of Landscape. John Wiley & Sons. England.2. Carpman, Janet Reizenstein; Grant, Myron A. and Deborah A. Simmons. 1986. Design ThatCares. American Hospital Publishing, Inc.3. Carstens Diane Y., 1993 Site Planning and Design for the Elderly: Issues, Guidelines, andAlternatives. Wiley; New Ed edition.4. Crisp, Barbara. 1998. Human Spaces: Life-Enhancing Designs for Healing Working, andLiving. Rockport Publishers, Inc. Massachusetts.5. Francis, Mark; Lindsey, Patricia, and Jay Stone Rice. 1994. The Healing Dimensionsof)People Plant Relations: Proceedings of a Research Symposium. Center for DesignResearch. UC Davis, California.6. Francis, Mark and Randolph T. Hester, Jr. 1990. The Meaning of Gardens. The MIT Press.Cambridge, Massachusetts and London, England. 81

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATH7. Gerlach-Spriggs, Nancy; Kaufman, Richard Enoch and Sam Bass Warner, Jr. 1998.Restorative Gardens: the healing landscape. Yale University Press. New Haven and London.8. Kaplan, Rachel and Stephen Kaplan. 1989. The Experience of Nature. Cambridge UniversityPress.9. Kaplan, Rachel; Kaplan, Stephen and Robert L. Ryan. 1998. With People in Mind. IslandPress.10. Kellert, Stephen R. and Edward O. Wilson. 1993. The Biophilia Hypothesis. Island Press.11. Lewis, Charles A. 1996. Green Nature/Human Nature: The Meaning of Plants in our Lives.University of Illinois Press. Urbana and Chicago.12. Marberry Sara O., editor. 1995.Innovations in Healthcare Design: Selected Presentations fromthe First Five Symposia on Healthcare Design. Wiley Publishers.13. Cooper Marcus, Clare and Marni Barnes. 1995. Gardens in Healthcare Facilities: Uses,Therapeutic Benefits, and Design Recommendations. The Center for Health Design, Inc. .14. Messervy, Julie Moir. 1995. The Inward Garden. Little, Brown & Company. Canada.15. Rawlings, Romy. 1998. Healing Gardens. Willow Creek Press. WI.16. Relf D, ed. 2004. Expanding Roles for Horticulture in Improving Human Well-Being and LifeQuality, Brussels, Belgium: International Society for Horticultural Sciences, ActaHorticulturae 639. http://www.actahort.org/books/639/index.htm17. Matsuo, E. and P.D. Relf, eds. 1995. Horticulture in Human life, Culture and EnvironmentISHS Acta Horticulturae 391 http://www.actahort.org/books/391/index.htm18. Relf, Diane. 1992. The Role of Horticulture in Human Well-Being and Social Development: ANational Symposium. Timber Press, Inc. Portland, Oregon.19. Sempik J, Aldridge J, Becker S. 2003.Social and therapeutic horticulture: evidence andmessages from research. Leicestershire, UK: THRIVE,.20. Tyson Martha M., 1998 The Healing Landscape: Therapeutic Outdoor Environments NewYork: McGraw-Hill.21. Wilson, Edward O. 1984. Biophilia. Harvard University Press.22. Wilson, Edward O. 2002. The Future of Life. Alfred A. Knopf, a division of Random House,Inc. United States.Internet Websites:1. American Horticulture Therapy Association http://www.ahta.org2. Canadian Horticultural Therapy Association http://www.chta.ca/3. Center for Health Design http://www.healthdesign.org/4. Dirtworks PC Landscape Architecture http://www.dirtworks.us/healthcare/5. HortScience ASHS Historical Review select Human issues in Horticulture by Relf and Lohrhttp://www.electronicipc.com/data/journalez/pdf/0420/002/HistoricalReview2003.pdf6. Plants for People http://www.plants-for-people.org7. Plants at work http://plantsatwork.org/8. Therapeutic Garden Design http://host.asla.org/groups/tgdpigroup/

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATH9. Therapeutic Landscapes Database http://www.healinglandscapes.org10. Thesis Master of Architecture Annalisa Gartman Vapa:http://scholar.lib.vt.edu/theses/available/etd-05132002-115528/CITATIONS1. Cooper Marcus, C. 2001. "Hospital Oasis." Landscape Architecture, Vol. 91, No. 10, pp. 36-99.2. Cooper Marcus, Clare and M. Barnes.1995. Gardens in Healthcare Facilities: Uses,Therapeutic Benefits, and Design Recommendations. Martinez, CA: The Center for HealthDesign.3. Frumkin H. 2004. White coats, green plants: clinical epidemiology meets horticulture. In:Relf D, ed. Expanding Roles for Horticulture in Improving Human Well-Being and LifeQuality, Brussels, Belgium: International Society for Horticultural Sciences, Acta Horticulturae639:15-27.4. Frumkin, H. 2001.American Journal or Preventive Medicine 20(3). “Beyond Toxicity: HumanHealth and the Natural Environment.” Elsevier Science Inc.5. Gerlach-Spriggs, Nancy; Kaufman, Richard Enoch and Sam Bass Warner, Jr. 1998. RestorativeGardens: the healing landscape. Yale University Press. New Haven and London.6. Gerlach-Spriggs, N. and A. Wiesen 2002. The Therapeutic Garden: A Collaboration OfProfessions. Therapeutic Garden Design 3 (1): 5 . Viewed 05 June 2006on-line athttp://host.asla.org/groups/tgdpigroup/TGD_2002_newsletter.pdf.7. Relf, P.D. and V.I. Lohr. 2003. Human issues in horticulture. HortScience. 38(5):984-993.8. Roy-Fisher Associates, Inc, Landscape Architecture Environmental & Land Planning 381Tequesta Drive Tequesta, Florida 33469 http://www.roy-fisher.com/Healing%20Garden.pdfviewed 9 June 2006.9. Ulrich, R. S. 1984. View Through A Window May Influence Recovery From Surgery. Science,Vol. 224, pp 420-421.10. Wilson, E. O. Biophilia, 1984, Harvard University Press

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATHHORTICULTURAL THERAPY IN NURSING HOMESCandice A. Shoemaker, Ph.D.Professor, Horticulture and Human HealthDepartment of Horticulture, Forestry, and Recreation ResourcesKansas State UniversityHorticultural therapy is the engagement of a client in garden-related activities, facilitated by a trainedtherapist, to achieve specific treatment goals. Therapeutic benefits occur when people are exposed toplants, and when they are involved in planning, planting, growing, and caring for plants. Horticulturaltherapy is an adaptable treatment tool for clients of all ages and abilities. Given that gardening is apopular leisure-time activity for older adults it is particularly well-received with older adultpopulations.Horticultural therapy is practiced in healthcare, rehabilitation and vocational facilities, as well as incommunity programs such as senior centers and community gardens. Several universities andinstitutions offer certificate, associate, and bachelor degree programs in horticultural therapy. TheAmerican Horticultural Therapy Association is a national association serving the profession and offersa voluntary registration system for horticultural therapists.What research tells us:Physical, psychological, and cognitive abilities as well as social roles are impacted as a person ages.Gardening can be used in a therapeutic way to address these issues and improve the elder’s physicaland emotional conditions, cognitive ability and social interactions. Reported outcomes from passivecontact and active participation in gardening experiences at geriatric care facilities include: Maintenance of life satisfaction Reduced stress Providing sensory stimulation Improved memory and concentration Improved social interaction Reduced agitation in residents with Alzheimer’sWhat horticultural therapy practitioners say:Due to the nature of gardening, a horticultural therapy program in a long-term care facility canaddress some of the needs that arise from simply living in an institution. A horticultural therapyprogram can provide opportunity for: Self-expression: horticulture activities offer excellent outlets for creative expression, forexample, designing a flower bed or patio container, flower arranging, or caring for bonsai Variety: horticulture activities are guided by the seasons, i.e. planting seeds in spring,harvesting produce through the summer, etc.

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATHChange: gardens and plants are always changing, overtime a seed becomes a mature,flowering plantControl and independence: care for indoor plants, patio plants, and providing resident’s theirown garden spaceSocial interaction: horticulture and gardening tend to bring people with a common interest andpast experiences together in an enjoyable wayService: horticulture activities offer many opportunities for service from making anddelivering flower arrangements to bed-ridden people or to the dining area to growing andselling plants to raise funds for special projects for the institutionMental stimulation: for the novice gardener as well as the experienced, horticulture is astimulating field of studyPhysical activity: many of the activities of gardening are moderate-intensity activityGetting started:A horticultural therapy program in a long-term care facility can add much to the lives of the residents.In establishing and maintaining a program consider the following: Conduct an informal (or formal) feasibility study of the residents to determine their interestand degree to which they feel they would be involved If an outside garden is to be implementedo The site should receive at least 6 hours of direct sun for vegetables and most floweringplantso A source of running water should be nearbyo Assess the soil and amend if neededo The site should be easily accessible by the residentso The site should be in view of a high traffic area to remind the residents to visit thegardeno Shade and seating should be near the garden for passive enjoyment of the garden If a patio garden is to be implementedo Stained concrete reduces the amount of glare and provides a level surfaceo Shade and seating should be nearby to offer rest, provide a break from the sun, andprovide an area for seated activities such as transplanting or just socializingo Consider the view from the inside, design the patio garden in such a way to lure peopleto the outdoorso Provide choice by using movable seatingo The patio can be designed with raised beds of varying heights, table-like raisedcontainers, vertical-frame beds, hanging baskets on pulleys, and containers to providegardening opportunities for residents of varying abilities

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATHFor indoor gardeningo Consider tropical plants, many are well suited for the reduced light levels of indoorenvironmentso Most plants can be grown under fluorescent bulbs, in a sunny room provide 8 hours oflighting, in a windowless room provide 14 hours of lightingPlant selection is important, consider plants for their fragrance, texture, taste, sound,familiarityLook to your community for supporto Contact your local county extension agent for gardening adviceo Look to your local Master Gardeners, educated through the state extension service, forgardening advice and serviceo Contact your local gardening clubs, most have service as part of their mission, as wellas providing gardening adviceo Contact your local nurseries, garden stores, hardware stores for donation of materialsand supplies, including the large chain storesResourcesAmerican Horticultural Therapy Association, http://www.ahta.org, 3570 E. 12th Ave. Suite 206,Denver, CO 80206, 1-800-634-1603Gardening for Good, http://www.gardening4good.org/Thrive, http://www.thrive.org.uk/Selected Books:Accessible Gardening: Tool and Techniques for Seniors and the Disabled. Joann Woy, 1997,Stackpole Books, ISBM 0-8117-2652-5Gardening is for Everyone. Audrey Cloet and Chris Underhill, 1990, B.T. Batsford Ltd, 4 FitzhardingStreet, London, ISBN 0-285-64954-XGardens in Healthcare Facilities: Uses, Therapeutic Benefits, and Design Recommendations. ClareCooper Marcus, MA, MCP and Marni Barnes, MLA, LCSW, 1995, University of California atBerkeley. The Center for Health Design, Inc. ISBN 0-9638938-2-3Growing with Care: Using Greenery, Gardens and Nature with Aging and Special Populations. BetsyKreidler, 2002, Venture Publishing, ISBN 1-892132-34-6Horticultural Therapy and the Older Adult Population. Suzanne E. Wells, MS; Ed. with AmericanHorticultural Therapy Association and Friends Organization. 1997, Haworth Press, Inc. ISBN0-7890-0045-8. [Also published as: Activities, Adaptation & Aging, Vol. 22, Numbers (1/2)(3) 1997.]Horticulture as Therapy: Principles and Practice. Sharon P Simson and Martha C. Straus, editors,1998, Haworth Press, Inc. ISBN 1-56022-859-8

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATHA Note from Taiwan: Healthy Landscape, Healthy PeopleProfessor Chang Chun-YenDepartment of Horticulture and Landscape ArchitectureNational Taiwan UniversityThe number of people seeking nature-based recreation opportunities and green-related lifestyles isincreasing in Taiwan, as it is throughout the world. Evidence from various experiments, surveys, andliterature shows that natural environments are important not just for wild life but also for human healthand wellbeing. After more than 15 years of studying how natural landscape provides ecological services interms of its configuration and composition, my group and I have worked together on ways of realizingbeneficial encounters with natural landscapes and now have an interest in proposing a Healthy LandscapeHealthy People conceptual framework. A healthy landscape plays a vital role in terms of preserving nativewildlife, promoting human health, and as in our case recently, providing a better Qi setting and perception.The following are brief introductions of our working patches within the framework.In terms of preserving native wildlife, studies of landscape ecology define a healthy landscapefrom the aspect of the level of naturalness, which is measured by landscape ecological metrics. Landscapeecological metrics provide an objective way to define physical environment and allow attributes of alandscape to be analyzed. So, the relationship between a physical environment and the level of the healthof its wildlife can be found. Besides, our group has not just emphasized this relationship but alsodemonstrated various landscape scales that sensitively reflect different native species, particularly but notonly in the context of rural Taiwan.More than being essential for preserving wildlife, a healthy landscape also has a profoundlypositive effect on the public’s health and wellbeing. Although still in its relatively early stages, there isalready a large body of research demonstrating that access to a healthy landscape, such as well-configuredgreen space, is a fundamental resource in terms of enhancing psychological wellbeing, reducing stress,promoting healing outcomes, improving cognitive capacity, and building place identity. We have beentrying to pull together related theories, such as stress reduction theory and Attention Restoration Theory, tosupport related studies, which were operated particularly in nature-based recreation areas, leisure ruralareas, or work places. With both qualitative and quantitative analysis, we have tried to identify theeffective factors of the natural landscape on health experience. Along with psychological measurements,we also emphasized psychophysiological indices. Using biofeedback instrument, we collected multiplepsycholphysiological reactions while exposing participants to landscape stimuli. The results showed asimilar direction as in the literature. Furthermore, we compared the positive effect of activities, thecomposition of plants in an office, and restorative experience in rural leisure areas. All of these workswere pulled together to provide support for the beneficial effects of green or natural environment onpublic health, particularly for those who face daily pressure in an urban context.

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATHTo narrow the gap between a physically healthy landscape and human health, we have recentlybeen working on Qi-related theories and experiments. In traditional Chinese culture, Qi is an activeelement that exists as part of any living being. Qi is frequently described as the flow of energy thatsurrounds a creature or element of the environment. Traditional Chinese philosophy states that humanscan absorb Qi energy from their surroundings and, in doing so, they get “in tune” with the environment.Allowing Qi to permeate one’s body is seen as essential to health and well-being. Recently, therelationship between Qi and human health has received considerable attention. Many studies haveexamined the outcomes of Qi exercise, but relatively few have paid attention to physical environmentalconditions or how environmental precursors affect positive Qi. For the millions of practitioners of Qi, thisis an important gap in the literature that limits the capacity of practitioners to boost positive energy of Qiin their surroundings and thereby increasing the health impacts of their Qi practice. By developing areliable measurement to describe environmental Qi, our group conducted studies to explore anenvironment’s Qi field and Qi experience. For now, the result demonstrates that landscape structure andvisual quality matter to Qi perception and, furthermore, settings with good a Qi field also tend to possessmore natural elements and consider artificial constructions as disturbances.To the conclusion, it is clear from the brief description above that a healthy landscape is not justessential for wildlife but also for human health. Being isolated form nature has become a commonlifestyle in modern society, and people suffer from stress-related chronic disease more seriously eachdecade. To draw an overview of this problem, we tried to construct a Healthy Landscape Healthy Peopleconceptual framework. While structuring this framework, we realized that many scientific gaps still needto be filled. From our perspective, a Qi-related study is one of many novel ways that is worth trying,though it is obviously not the only way. For example, to identify more specifically the effects of alandscape on perception, fMRI experiments have shed some light on brain mechanisms in recent years.fMRI experiments could be a powerful way to demonstrate relationships between healthy landscape andpeople, and an increasingly amount of researchers have adopted this new technique of inquiry. Thegrowing body of related studies has now revealed the great value of natural/green environment inimproving and facilitating a holistic and a sustainable life; however, there is still much more creative andpracticable effort needed in this inter-disciplinary area to provide more substantial and solid scientificevidence. In our view, our conceptual framework might be helpful to pull these efforts together.

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATH青 少 年 園 藝 活 動 ( 課 程 ) 園 藝 治 療 效 益 的 探 討Effects of horticultural therapy of horticultural activity (curriculum)in adolescent:A descriptive research衛 生 署 八 里 療 養 院張 建 隆1 、 羅 雪2 、 張 宇 甄12新 北 市 立 淡 水 高 級 商 工 職 業 學 校2摘 要青 少 年 從 少 年 進 入 青 春 期 , 身 、 心 發 育 已 產 生 一 些 微 妙 的 變 化 , 以 因 應 未 來 成 年 人 所 需 的 功能 。 青 澀 時 期 面 對 不 同 負 向 的 壓 力 , 如 課 業 壓 力 、 同 儕 競 爭 壓 力 、 家 庭 經 濟 支 持 上 壓 力 、 適 應 新環 境 心 理 壓 力 等 ; 生 理 方 面 , 如 食 欲 不 振 、 頭 痛 、 全 身 無 力 等 ; 心 理 方 面 , 如 心 情 低 落 、 注 意 力不 集 中 、 偏 向 負 向 思 考 等 。 如 果 因 此 無 法 承 受 成 績 和 入 學 帶 來 的 負 擔 和 壓 力 , 有 可 能 憂 鬱 、 逃 學 、蹺 家 、 暴 力 行 為 、 藥 物 濫 用 、 自 殺 。 預 防 勝 於 治 療 (Prevention is better than cure); 園 藝 療 法 , 在 高 職新 生 應 用 其 課 程 ( 活 動 ) 二 個 月 , 從 心 理 層 面 、 生 理 層 面 、 社 交 層 面 和 認 知 層 面 瞭 解 ; 在 問 卷 調 查 經過 SPSS18.0 統 計 分 析 結 果 顯 示 : 園 藝 活 動 , 帶 動 手 部 操 作 , 肢 體 協 調 變 得 靈 巧 ; 青 春 期 思 考 與 行為 的 叛 逆 性 , 其 情 緒 維 持 平 靜 ; 在 園 藝 知 識 和 技 能 上 獲 得 新 知 , 在 應 用 實 習 課 程 , 懂 得 團 隊 合 作及 和 他 人 友 善 連 結 ; 在 日 常 生 活 中 有 著 踏 實 感 。關 鍵 詞 : 青 少 年 、 園 藝 療 法 、 信 度前 言 :華 人 社 會 文 化 , 青 少 年 日 常 生 活 重 心 , 以 課 業 為 主 , 忽 略 其 它 生 活 事 項 重 要 性 , 衍 生 壓 力 而不 自 知 ; 如 課 業 壓 力 、 同 儕 競 爭 壓 力 、 家 庭 經 濟 支 持 上 壓 力、 適 應 新 環 境 心 理 壓 力 等 ; 生 理 方 面 , 如 食 欲 不 振 、 頭 痛 、 全 身 無 力 等 ; 心 理 方 面 , 如 心 情 低 落 、注 意 力 不 集 中 、 偏 向 負 向 思 考 等 。人 為 主 動 的 個 體 , 受 有 目 的 之 活 動 ( 提 供 各 類 刺 激 ) 影 響 ; 經 由 其 內 在 意 志 與 動 機 , 發 揮 自 己 的能 力 ( 黃 曼 聰 、 陳 威 勝 、 陳 芝 萍 ,2011)。 園 藝 活 動 經 由 身 、 心 、 手 、 腦 一 致 性 應 用 , 生 理 神 經 肌 肉達 到 活 絡 效 果 、 啟 動 頭 腦 功 能 , 可 以 讓 心 情 穩 定 、 消 除 緊 張 、 舒 解 壓 力 。利 用 植 物 的 園 藝 療 法 , 讓 青 少 年 體 會 到 自 己 與 同 儕 一 樣 地 共 同 栽 培 植 物 的 共 同 經 驗 , 且 賦 予 責任 感 與 合 作 觀 念 ; 把 自 己 收 穫 的 成 果 送 給 師 長 、 家 人 、 朋 友 , 增 進 社 會 交 往 能 力 ( 孫 基 哲 ,2006)。文 獻 報 告 指 出 其 衍 生 壓 力 、 憂 鬱 問 題 , 尤 以 高 中 生 較 明 顯 ; 忽 略 青 少 年 身 心 平 衡 的 發 展 。 反觀 , 高 職 生 著 眼 技 職 教 育 , 除 了 學 識 課 程 外 , 並 重 技 藝 實 習 ,達 到 學 以 致 用 ; 此 過 程 潛 移 默 化 , 身 心 是 否 有 正 向 發 展 ? 本 文 探 討 高 職 生 園 藝 課 程 ( 活 動 ) 園 藝 治 療效 益 。

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATH方 法1. 北 部 某 高 職 園 藝 科 一 年 級 新 生 42 人 , 園 藝 課 程 活 動 實 施 二 個 月 後 , 職 能 效 益 問 卷 調 查 。2. 人 口 學 調 查 : 女 生 21 人 , 男 生 21 人 。 年 齡 為 15 歲 。 教 育 程 度 為 國 中 畢 業 進 入 高 職 學 校 的 新 生 。3. 園 藝 課 程 活 動 每 週 實 施 11 小 時 。4. 此 園 藝 活 動 ( 課 程 ) 園 藝 治 療 效 益 問 卷 十 五 題 選 項 中 , 有 二 個 題 項 為 反 向 題 , 量 表 填 答 採 用 李 克 特五 點 量 表 (Likert-type scale) 格 式 。 最 後 計 分 時 , 反 向 題 反 向 計 分 。5. 共 計 九 週 後 的 問 卷 , 有 效 問 卷 41 份 、 無 效 問 卷 1 份 。6. 統 計 分 析 :SPSS 18.0 統 計 套 裝 軟 體 。結 果1. 整 體 問 卷 題 問 項 均 表 正 向 反 應 , 如 表 一 , 高 職 生 對 園 藝 活 動 ( 課 程 ), 此 問 卷 最 低 分 為 40 分 、 最 高分 為 70 分 ,( 滿 分 75 分 ), 平 均 54.63 分 。2. 園 藝 活 動 ( 課 程 ) 效 益 問 卷 十 五 題 選 項 中 , 有 二 個 題 項 設 計 反 向 題 , 分 別 為 [ 園 藝 類 科 對 上 學 是 有 負擔 ]、[ 園 藝 類 科 會 帶 來 憂 鬱 的 心 情 ]。 反 向 題 反 向 計 分 。3. 有 四 項 題 問 [ 園 藝 類 科 對 自 己 的 情 緒 可 以 維 持 平 靜 心 情 ]、[ 園 藝 類 科 對 自 己 的 自 信 心 有 提 昇 ]、[ 園藝 類 科 對 自 己 日 常 生 活 事 物 , 負 向 思 考 轉 變 正 向 思 考 ]、[ 園 藝 類 科 對 自 己 上 課 會 集 中 注 意 力 ],50% 以 上 學 生 表 示 “ 沒 意 見 ”, 推 測 高 職 新 生 剛 離 開 熟 悉 國 中 環 境 與 學 習 文 化 , 進 入 技 職 學 校 教育 新 環 境 , 對 自 己 面 對 自 身 心 理 層 面 問 題 , 當 下 採 取 保 留 態 度 。4. 問 卷 中 自 認 為 手 部 功 能 靈 巧 ( 表 二 ,phy1) 和 肢 體 協 調 靈 活 ( 表 二 ,phy2); 在 獨 立 樣 本 t 檢 定 ,「 變異 數 相 等 的 Levene 檢 定 」 之 F 值 未 達 到 顯 著 差 異 (F=1.291,p=.263>.05 及 F=.243,p=.625>.05),表 示 二 問 項 樣 本 變 異 數 同 質 , 查 看 「 假 設 變 異 數 相 等 」 列 之 數 據 ,t 值 =2.941、df=39、p=.005

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATH表 二表 三表 四

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATH討 論 與 結 論1. 無 對 照 組 。 本 文 研 究 參 考 他 學 者 論 述 青 少 年 日 常 生 活 問 題 的 現 狀 與 改 善 措 施 。2. 高 職 新 生 應 用 於 園 藝 課 程 ( 活 動 ), 從 問 卷 中 的 心 理 層 面 、 生 理 層 面 、 社 交 層 面 和 認 知 層 面 皆 有 正向 的 效 益 ( 如 表 一 )。 生 理 方 面 , 男 生 比 女 生 的 園 藝 活 動 帶 來 體 驗 有 顯 著 效 益 。 心 理 方 面 , 園 藝 類科 高 職 新 生 , 在 問 卷 調 查 未 發 現 , 顯 著 壓 力 存 在 。 原 因 : 除 了 一 般 教 室 的 學 識 教 育 , 還 有 園 藝操 作 活 動 ( 實 習 課 程 ); 與 植 物 環 境 接 觸 , 為 其 特 點 。 在 問 卷 中 課 業 壓 力 選 項 有 58% 學 生 肯 定 園 藝活 動 減 緩 課 業 壓 力 、32% 學 生 未 表 示 意 見 。 臺 灣 文 獻 ( 弘 光 學 報 ) 調 查 有 30.5% 青 少 年 存 在 著 憂 鬱傾 向 ; 在 問 卷 中 園 藝 課 程 ( 活 動 ) 未 發 現 有 顯 著 憂 鬱 的 心 情 。3. 在 應 用 實 習 課 程 , 懂 得 團 隊 合 作 及 和 他 人 友 善 連 結 ; 在 日 常 生 活 中 , 內 心 有 著 踏 實 感 ( 表 二 ,psy1)。參 考 文 獻1. 曾 慈 慧 、 毛 慧 芬 、 凌 德 麟 ( 民 93)。 園 藝 治 療 在 職 能 治 療 中 的 應 用 , 科 學 農 業 ,52(7,8),198-211。2. 孫 基 哲 ( 民 95) 。 種 植 有 益 健 康 的 室 內 植 物 。 台 中 : 晨 星 。3. 張 彩 秀 ( 民 97)。 青 少 年 健 康 行 為 與 憂 鬱 情 緒 之 差 異 分 析 , 弘 光 學 報 , 52,55-65。4. 劉 曉 玫 ( 民 97) 。 高 中 生 憂 鬱 情 緒 之 研 究 ( 未 出 版 碩 士 論 文 ) 。 慈 濟 大 學 , 花 蓮 。5. 陳 惠 美 ( 民 98)。 園 藝 活 動 對 人 與 環 境 之 效 益 , 自 然 生 態 環 境 與 健 康 效 益 國 際 研 討 會 論 文 集 ,50-65。6. 劉 真 伶 ( 民 98)。 健 康 焦 慮 、 健 康 促 進 生 活 型 態 與 輔 助 / 替 代 醫 療 行 為 之 研 究 ( 未 出 版 碩 士 論 文 ) 。南 台 科 技 大 學 , 台 南 。7. 洪 瑜 筑 ( 民 99)。 治 療 性 園 藝 活 動 應 用 於 觀 護 少 年 之 行 動 研 究 ( 未 出 版 碩 士 論 文 ) 。 國 立 台 灣 大學 , 台 北 。8. 張 元 毓 、 蘇 瑋 佳 、 張 俊 彥 ( 民 99)。 學 生 從 事 園 藝 操 作 之 表 現 與 其 提 升 注 意 力 及 獲 得 成 就 感 多 少之 關 係 。 臺 灣 園 藝 ,56(1),57-65。9. 黃 曼 聰 、 陳 威 勝 、 陳 芝 萍 ( 民 100)。 精 神 健 康 職 能 治 療 - 理 論 與 實 務 。 臺 北 市 : 五 南 。10. 廖 曼 利 、 紀 芬 蓮 、 歐 聖 榮 ( 民 101)。 園 藝 治 療 活 動 對 高 中 生 減 輕 憂 鬱 效 益 之 研 究 , 人 與 植 物 學術 研 討 會 論 文 集 ,78-89。11. 吳 明 隆 ( 民 101)。SPSS 操 作 與 應 用 : 問 卷 統 計 分 析 實 務 ( 二 版 七 刷 ) 。 臺 北 市 : 五 南 。12. Butterfield, B., & Relf, D. 1992. In: Relf, D.(ed). The role of horticulture in human Well-being and socialdevelopment (pp211-212).Timber Press, portland, Oregon, US.13. Clopton, H. 1998. Horticultural therapy in a therapeutic farm community. J. Therap. Hort. 9:9-14.14. Christine, L., & Rebecca, L. 2006. Horticultural therapy methods—making connections in health care,human service, and community programs. CRC Press,Boca Raton London New York.

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATH

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATH「 園 藝 治 療 實 習 簡 介 、 個 案 實 習 及 研 討 」 分 享 會 2-1-2013有 志 在 園 藝 治 療 專 業 發 展 的 實 習 生 , 這 晚 齊 集 在 聖 雅 各 福 群 會 聽 取 如 何 成 為 一位 專 業 的 園 藝 治 療 師 , 認 證 制 度 的 專 業 資 格 。 會 後 , 由 註 冊 園 藝 治 療 師 分 享 在實 習 期 間 要 注 意 的 事 情 。「 園 藝 治 療 實 務 體 驗 – 葉 脈 書 籤 DIY」 工 作 坊 26-6-2013原 來 做 葉 脈 書 籤 的 事 前 工 夫 , 真 的 不 少 。 導 師 Ronald 清 楚 教 導 如 何 做 得 好 葉 脈 書 籤 。 當 天 ,會 員 都 小 心 翼 翼 地 把 葉 肉 擦 走 , 塗 上 顏 色 , 過 膠 , 就 成 為 他 們 的 葉 脈 書 籤 。

悠 然 .2013.6 月 號 . 第 5 期 . 香 港 園 藝 治 療 協 會 HKATH2013 年 9 月 社 區 畫 廊本 協 會 之 展 板 將 於 九 月 份 在 荃 灣 港 鐵 站 之 社 區 畫 廊 展 出 。2013 下 半 年 專 業 增 值 講 座< 會 員 費 用 全 免 . 備 茶 點 享 用 >8/2013:「 園 藝 治 療 用 於 婦 女 濫 藥 」 專 題 講 座9/2013: 第 三 屆 會 員 大 會 暨 「 園 藝 治 療 實 習 小 組 於 台 灣 」 分 享12/2013:「 園 藝 治 療 實 習 簡 介 、 個 案 實 習 及 研 討 」 分 享 會地 點 : 聖 雅 各 福 群 會 . 灣 仔 石 水 渠 街 85 號備 註 : 名 額 有 限 , 先 報 先 得 ;舉 行 日 期 、 時 間 、 材 料 費 、 報 名 手 續 等 詳 情 , 將 於 活 動 舉 行 前 約 3 周 , 經 電 郵 通 知 各 會 員* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *如 有 意 就 園 藝 治 療 資 訊 投 稿 或 提 供 意 見 , 歡 迎 電 郵 至 info@hkath.org 與 吳 小 姐 聯 絡( 投 稿 人 交 來 圖 文 必 須 持 有 版 權 , 不 可 轉 載 , 並 註 明 投 稿 人 真 實 姓 名 、 電 話 及 電 郵 地 址 )