Digging for Victory: Horticultural Therapy with Veterans for Post-Traumatic Growth

by Joanna Wise

Overview

Horticultural Therapy is ideally suited to engage veterans alienated from traditional civilian healthcare routes who present with a range of complex and challenging healthcare needs. It presents, on the surface, as a deceptively simple and accessible activity. Carried out by trained professionals, it is an evidence-based, effective and cost-effective treatment. By targeting specific client-centred goals, it is able to integrate improved individual physical, emotional, cognitive and social outcomes with broader opportunities to transition successfully into civilian society through learning a valuable skill set and a meaningful occupation. This book provides a comprehensive introduction to the methods of Horticultural Therapy as applied to this unique client group. It describes the type of combat training and experiences veterans may have had, and sets out the common issues and pitfalls civilian therapists often face when working with the military. Looking to the future, it also identifies promising avenues in terms of how we may improve the treatment we offer to best serve the needs of these ex-service men and women who fight on our behalf.

Product Details

ISBN-13:	9781782200994
Publisher:	Taylor & Francis
Publication date:	03/16/2015
Pages:	336
Product dimensions:	6.00(w) x 8.90(h) x 0.90(d)

About the Author

Joanna Wise

Table of Contents

List of Figures xii

List of Tables xiii

List of Acronyms xv

Acknowledgements xvii

About the Author xxi

A Personal Perspective: Horticultural therapy and the military Anna Baker Cresswell xxiii

Foreword Jamie Hacker Hughes xxv

Preface: Growing history…the Victoria Cross Poppy xxvii

Introduction xxix

Chapter 1 Veterans with "invisible injuries" and their needs 1

Definition and numbers of veterans in the UK 1

Invisible injuries 3

Historical background of mental health problems in the Armed Forces 3

Symptoms of post-traumatic stress disorder 6

Vulnerability to mental health disorders 9

Barriers to conventional mental health services 11

Veterans' mental health needs 15

Veterans' needs at a group level 15

Veterans' needs at an individual level 17

Chapter 2 The trauma of killing 23

Our innate resistance to killing 23

Neurological and psychological mechanisms that overcome resistance to killing 25

Consequences of overcoming resistance to killing 32

Transition: from damage to development 37

Chapter 3 How horticultural therapy meets veterans' needs 41

Benefits of passive exposure to nature 42

Active benefits of horticultural therapy 45

Physical domain 52

Cognitive domain 53

Emotional domain 53

Social domain 53

Spiritual domain 54

The "ripple effect" on dependants 54

Vocational horticultural therapy 57

Evaluation of research evidence 59

Chapter 4 Structuring the horticultural therapy programme to ensure safe practice 63

Safety and stabilisation for veteran survivors of trauma 64

The physiology of trauma and its relevance to safe practice 65

Stages of recovery and implications for horticultural therapy groups 68

Stages of recovery from trauma 70

Stage one-safety and stabilisation 71

Stage two-remembrance and mourning 74

Stage three-recomrection 75

The weekly timetable 77

Ground rules 82

Numbers 84

Risk of veteran harm to self or others 88

Therapeutic timescale, efficacy, and effectiveness 90

Chapter 5 Staff support, supervision, and training 93

Recognition, feedback, support, and supervision 95

Communicating the military/civilian cultural divide 98

Military protocol 99

The power of language 102

Military structure and the significance of boundaries 103

"Need to know" 104

Judgement and societal attitudes 104

The "Drama Triangle" 107

Chapter 6 Referral and assessment 111

Referral 114

Referral pathways 115

Referral paperwork 122

Assessment 125

Assessment paperwork 126

The assessment interview 127

Chapter 7 Setting goals, defining outcomes 133

Matching evaluation to needs, goals, and outcomes 139

Standard instruments 141

Client-centred evaluation 146

Managing information using IT resources and equipment 151

Chapter 8 The horticultural programme 153

Developing horticultural skills and knowledge 153

Planning a twelve-month horticultural programme 154

Monthly plans 183

Task analysis 187

Characteristics of the "actor" 188

Activity analysis 188

Chapter 9 Site design features relating to veterans' needs 197

Size 198

Aspect 200

Soil and beds 202

Access 203

Site facilities 205

Equipment, tools, and adaptive designs 208

Plants 211

The aesthetics of good design 213

1 Genius loci 213

2 Harmony and contrast 214

3 Simplicity 214

4 Balance 214

5 Scale and proportion 215

6 Unity 215

Chapter 10 Recalibration: future directions for post-traumatic growth 217

Summary 217

Future directions: developing HT as a profession 219

Future directions: research 224

Future directions: developing HT as a treatment model 226

Recalibration for post-traumatic growth 226

Mindfulness in nature 231

Working with metaphor 235

Recalibration within the community 240

Conclusions 246

Appendix I Resources 249

Information and research on veterans with "invisible injuries" 249

Veterans' support organisations 250

Specialist horticultural therapy projects for veterans in the UK 252

Safe practice 253

Horticultural therapy: referral, assessment, and therapy resources 254

The horticultural programme 256

Site design features 257

Sustainability 259

Equipment, tools, and adaptive measures 260

Plants 261

Setting up a horticultural therapy project 262

Appendix II Social and therapeutic horticulture: more research required? An additional commentary Joe Semvik 264

References 269

Index 293