Which of the following three areas do care farm clients on a range of care farms find the most beneficial part of their experience, the social aspect, working in a farm environment or carrying out manual tasks with tangible outcomes?

by

Simon Robert King

being an Honours Research Project submitted in partial fulfilment of the requirements for the BSc (Honours) Degree in

Agriculture with Environmental Management

2011

Contents

List of Figures

List of Tables

List of Appendices

Acknowledgements

Executive Summary

Chapter 1. Introduction

Chapter 2. What is care farming?

2.1 Green care

Chapter 3. History of care farming

Chapter 4. What is the client base?

4.1 Mental health

4.2 Other groups

Chapter 5. Conventional therapies

5.1 Drug based

5.2 Therapy sessions

5.3 Other treatments

Chapter 6. Current status of care farming

6.1 UK

6.2 Europe

6.3 Future of care farming

6.4 Its importance for agriculture

Chapter 7. Indication of a research gap

Chapter 8. Research Methodology Design

8.1 Research question

8.2 Secondary research questions

8.3 Research approach

8.4 Research strategy

8.5 Interview design

8.6 Interview techniques

8.7 Limitations of the research

Chapter 9. Results

Chapter 10. Discussion

10.1 Question 1 – What is your favourite activity?

10.2 Question 2 – Do you prefer working with animals or other tasks?

10.3 Question 3 – What sort of things have you learnt since being here?

10.4 Question 4 – What new skills have you learnt and where would you use them?

10.5 Question 5 – Do you work as a team on the farm, and what do you do as a team?

10.6 Question 6 – Does having friends at the care farm make it a better experience?

10.7 Question 7 – Do you enjoy working in the countryside?

10.8 Question 8 - Have you ever done anything like this before?

10.9 Question 9 – In your own words what is the best aspect about coming to the care farm?

10.10 Question 10 - Has coming to the care farm helped you in any way?

Chapter 11. Conclusion and recommendations

11.1 Further research possibilities

Chapter 12. References

List of Figures

Figure 1 - Figure showing the umbrella nature of the term Green Care. Source - Green Exercise (Undated)

Figure 2 - Social benefits to care farm clients of attending a care farm

Figure 3 - Diversity in Care Farms - Source: Hine et al, 2008

Figure 4 - Characteristics of care farm with differing focus. Source: Hine et al, 2008

List of Tables

Table 1 - Table showing the clients favourite activity

Table 2 - Table showing if clients prefer working with animals or not

Table 3 - Table showing what areas clients have learnt skills in since being at the farm

Table 4 - Table showing what new skills clients have learnt

Table 5 - Table showing where clients would use their skills

Table 6 - Table showing if clients work as a team

Table 7 - Table showing what clients do as a team

Table 8 - Table showing whether clients enjoy working as a team

Table 9 - Table showing if clients have met new friends at the care farm and if they keep in touch

Table 10 - Table showing if clients feel having friends at the care farm makes it a better experience

Table 11 - Table showing if clients enjoy working in the countryside

Table 12 - Table showing if clients have done anything like CF before (in terms of working outside or with animals for example)

Table 13 - Table showing client’s favourite aspect of being at the care farm

Table 14 - Table showing how attending the care farm has helped the clients

List of Appendices

Appendix 1 - Information on the modes of action of anti-depressants……..……. 45

Appendix 2 - Copy of an interview sheet used during the research ……….……..47

Appendix 3 - Tables of interview results …..…………………………………...……49

Acknowledgements

I would like to take this opportunity to express my sincere gratitude to all those who have helped me with this dissertation, particularly my tutor Alison Monk for guiding me through the process. Also Gaynor Orton and Doeke Dobma for their support with contacting care farmers and promoting my work. And to all the care farms that I visited during the course of my study, thank you for the warm welcomes and help I received before, during and after my visits.

Finally thank you to the proof readers who corrected the mistakes throughout my work.

Executive Summary

Green care and more specifically care farming (CF) is becoming a more mainstream method of aiding vulnerable sections of society. It can be used to target a wide range of social groups, from those with mental health issues to disaffected young people and also those suffering from drug or alcohol addictions. A wide range of client groups means that the care farms are varied both in terms of client types and also in what services they offer, indeed these tasks change with the seasons. There is a substantial amount written in the literature on the benefits of working outdoors, working in a social environment and using tasks with tangible outcomes to provide mental or physical health benefits as well as education and social inclusion. However there is little research on what the clients find the most beneficial aspect of the experience.

Clients most enjoyed the social interaction, forming new friendships and working as a team. Being valued as part of a team was considered an important part of CF. However many of those interviewed enjoyed the whole experience, and it was recognised that this is what made attending the care farm useful.

The main findings indicated that the experience helped each client in an individual manner. This suggests that CF needs to reflect this, having a range of activities so that clients can choose what suits them best. However there were activities that the majority of people enjoyed to a certain extent, such as looking after the animals or just generally being outdoors.

Chapter 1. Introduction

Care farming (CF) is defined by Hine et al. (2008) as a growing movement to provide health (both mental and physical), social or educational benefits through farming for a wide range of people. In general, care farms are targeted at disadvantaged people, whether this is mentally or physically (Di Iacovo and O’Connor, 2009). The growth of CF is due to multifunction agriculture becoming a cornerstone of the European Agricultural Policy, offering not just food, but preserving the character of the countryside and giving wider social benefits (Renting et al. 2008). CF is not just about care in the traditional sense but also teaching people how to maintain and promote both health and social rehabilitation (Haubenhofer et al, 2010). This corresponds with Di Iacovo and O’Connor (2009) who comment that the most important outputs of a care farm are health, education, therapy and potentially, employment. CF is a partnership between agriculture and the care sector (Hine et al 2008) (Dessein, 2008). Care farms are often less intensive than commercial production units, instead operators provide services that society needs, by increasing links between urban and rural areas (Hassink 2002). However farmers still have to generate an income and CF is a form of diversification, which allows a farm to stay in business (Hine et al, 2008).

The importance of green spaces for good mental health has long been theorised, however it has recently come to the fore again, the idea of humans having an attachment to nature was proposed by E. Wilson in 1984, with a theory called biophilia. This connection between humans and nature, a product of evolution in a ‘bio-centric world’, is ‘innate’ or hereditary (Kellert, 1993). Grahn and Stigsdotter (2003) report how the discovery of the importance of green spaces, is more of a ‘rediscovery’, reporting on their usefulness in helping with stress, obesity, cardiovascular disease and diabetes, by increasing people’s outdoor activity. There is increasing evidence to support the theory that the presence of natural areas contributes to quality of life, indicating the social and psychological benefits that enrich societies are of primary importance (Chiesura, 2002). Lewis and Booth (1994) proposed that there is a link between high levels of psychiatric morbidity and urban living; corresponding with the link between poor physical health and susceptibility for mental health problems (Halliwell et al, 2007). CF tries to fulfil both of the above requirements by providing physical tasks in a natural environment. It is the usefulness of the tasks carried out that gives the self-confidence and self-respect that makes CF successful (Nilsson et al, 2007). Nilsson et al. (2007) also report that the CF experience gives important positive social contact with the farmer and other clients, developing social skills.

Whitelaw et al (2008) state that mental health and well-being are made from three parts, social, emotional and psychological. Good mental health is the balance of all three, or ‘peace of mind’ (Douglas, 2007). Even though there is much literature on the benefits of physical activity for health and the importance of green spaces, the implications of these for mental health have not been well explored, due to the diverse and multifaceted nature of this area and its potential complexity in a trial situation (Whitelaw et al, 2008). Additionally a lack of clarity in definitions of mental health and environments, these are personal concepts, and mean different things to different people Douglas (2005).

However CF is not just for those with mental health issues, West Mercia Constabulary are investigating the use of CF to rehabilitate convicted people. By using the care farms to engage, teach skills and improve the quality of life of the offenders the force hopes to cut re-offending and provide after prison care much more cheaply (West Mercia Constabulary, 2008). Care farms are often used as centres for education, particularly for children. Teaching them how the countryside operates and where food comes from is an area that will increase in importance, multifunction agriculture will move the countryside closer to urban areas and it is vital that people understand how and why agriculture produces food.

CF comes under the wider umbrella of green care. Green care is the use of nature to provide health, social or educational benefits (Sempik et al, 2010). Green care does not have to take place solely in green environments, animal assisted intervention (AAT) for example is not limited in this respect, and the animal can be taken to any situation within reason to gain the valuable effect, (Haubenhofer et al, 2010).

Chapter 2. What is care farming?

2.1 Green care

There are many types of green care; the main areas will be covered in depth below, along with the evidence base for CF. Figure 1 below shows how it is the umbrella term for many different therapies. CF is one part of green care, encompassing many of the areas below.

Figure 1 - Figure showing the umbrella nature of the term Green Care. Source - Green Exercise (Undated)

2.1.1 Social Therapeutic Horticulture

Social therapeutic horticulture (STH) has developed from rehabilitation and occupational therapy with extensive use in vulnerable groups throughout the US and UK (Sempik and Aldridge, Not Dated). Nilsson et al (2007) comments how recent studies have shown nature can lower stress levels, restore powers of concentration, and alleviate irritability. There is a difference between horticultural therapy and therapeutic horticulture, typically horticultural therapy has clinical goals, whereas therapeutic horticulture gives for generalised benefits (Sempik and Aldridge, 2006). By creating a green space, clients can form a sense of belonging and identity, whilst integrating and interacting with the local community (Sempik et al, 2005). Starting and finishing a task with a tangible output gives increased self-efficacy and coping ability (Sempik et al, 2010). STH is a well proven therapy with the health benefits of participants well documented (Hine et al, 2008).

2.1.2 Animal Assisted Therapy

There has been much research into the use of animals as therapy for people with mental illness. They provide an ‘uncritical ear’ and ‘attentive eye’ stimulating a response in patients who would otherwise not respond to people (Beck and Katcher, 1996). This is because clients, typically those suffering from depression, have been hurt by words in the past, animals do not use words, and the client can befriend the animal when they cannot befriend humans (Beck and Katcher, 1996). Animals also have no hidden agenda and provide the challenge that some clients need to tempt them from being withdrawn (Hassink, 2002). Beck and Katcher (1996) agree stating how animals draw attention outwards, leading to relaxation. Social support from pets maybe a replacement for lacking human support (McNicholas and Collis 2006). In terms of wider benefits, research by Serpel (1991) suggests that owning a pet may improve physical health as well as mental, although this can be more longer term. Animals do not having the linguistic capacity to hurt the clients, they do not pre-judge or talk down to them, this links with how the farmer should treat the clients, the farmer uses enthusiasm and knowledge to interest the clients and in return is often seen as a figure-head (Hassink 2002). However, Berget et al (2007), suggest that only some persons with mental disorders would find occupational therapy with animals beneficial. AAT is also used as a therapeutic aid for children; it was found that children interacted with the animals in much the same way as they would with a therapist (Mallon, 1994). The success of AAT can be explained as being due to three distinct reasons; learning new tasks through the intervention led to more self-confidence, the intervention was a catalyst, improving the response of the conventional psychiatric treatment, and finally that the patient experienced a pleasurable social interaction that reduced fear of new situations, apparent in follow-up work (Berget et al, 2008). This study however only had a short period before the follow-up work, and therefore other effects may have been seen after this time. Another study into the effects of contact with a pet, found that conversational and social skills improved over a 12 month period (Barak et al, 2001). Sempik et al, (2010) also suggest that contacts with animals are a catalyst to social exchanges, as they give common ground or a subject of discussion.

However when using animals as part of therapy it is important to consider the welfare of the animal as it may not adjust to having a large amount of human attention, therefore animals with the correct temperament and behaviour must be selected and these animals should have intense human contact during their early life and into adult hood (Hassink, 2002). The farmer should have a positive attitude towards the animal; this gives less negative interactions and higher production (Hemsworth et al, 1993). However bringing patients into contact with animals does increase risks particularly in terms of zoonotic diseases and animal bites (Beck and Katcher, 2003). An example of AAT is the Greatwood charity, which takes in retired or rescued racehorses, retrains them, with the aim of rehoming them. However the charity also provides an opportunity for children with special needs to interact with the horses, learning life skills and emotional literacy in the process (Greatwood, not dated).

2.1.3 Ecotherapy

Mind (2007) describes ecotherapy as a free, natural, accessible treatment for improving mental health. Ecotherapy is the exploration of relationships between oneself, nature and others; this may be carried out by meditation, directional walking or spending time alone in a natural setting. This puts the participants in a mutual healing connection with nature (Jordan, 2009). Ecotherapy.org (undated), a company that carries out ecotherapy, describes potential activities; directional walking, for example walking south to remember childhood experiences, can help to relive and share situations that have caused stress in the past. Evidence indicates that the better quality one’s relationship with nature, the better one’s mental health will be (Burns, 2007). Intervening with nature can be part of ecotherapy; for example the Offenders and Nature schemes in which offenders voluntarily take part in outdoor work experience (Forest Research Group 2007). These are hard physical tasks undertaken in small teams, and the results can be seen and appreciated by both the offenders and the public (Forest Research Group, 2007), this scheme allows the offenders to develop skills and qualifications, reducing the dependency on crime when released. The client’s health is improved, they are more socially included, and the environment benefits (Haubenhofer et al, 2010).

2.1.4 Facilitated Green Exercise and wilderness or nature therapy

The association between physical inactivity and poor mental health has increasing evidence, as does the relationship between poor mental health and limited access to nature (Whitelaw et al, 2008) (Pretty et al 2005). Therefore therapies that address poor mental health would be expected to include physical activity and exposure to nature. Hine et al (2011) comments that social contact and interaction with the environment are the attractions to outdoor exercise, and better physical health leads to a more positive mental health state. With nature and wilderness therapy the aim is to incorporate a third party into the therapy situation creating a client, therapist and nature relationship (Berger, 2009). The focus on nature and the client’s relationship with their peers provides the therapeutic environment, however the client has to be removed from distractions and their previous destructive environment (Russell et al, 1999). Nature is unpredictable and uncontrollable, taking part in nature therapy allows clients to develop the ability to cope with unexpected situations and show flexibility (Berger, 2006). Clients have to engage with an unknown environment, with unfamiliar people, learning basic skills and undertaking tasks, encouraging responsibility and emotional development (Russell et al, 1999). Wilderness therapy is generally considered to be a specific intervention, removing clients from their previous destructive environment rather than being just about experiencing the wilderness (Haubenhofer et al, 2010).