Mental health problems are leading causes for early and prolonged withdrawal from the workforce. Green work on care farms represents a prevocational training program intended to stimulate return to work for people with mental health problems. Research suggests that care farms may improve mental health, but there is still little knowledge of the subjective perspective of clients in green work programs.
OBJECTIVE:
To gain a deeper and broader understanding of the individual experiences of people with mental health problems participating in green work on care farms in Norway.
METHODS:
A hermeneutic phenomenological research design was applied. Ten semi-structured interviews were conducted. The self-determination theory (SDT) was adapted to gain a deeper understanding of the themes that emerged in the analysis process of the interviews.
RESULTS:
Five main themes materialize describing participants’ experiences within the green work program. The main themes consist of (1) structure and flexibility, (2) understanding and acknowledgement, (3) guidance and positive feedback, (4) nature and animals, and (5) reflections on personal functioning and the future.
CONCLUSION:
The main themes identified indicate a high degree of autonomy support and need satisfaction within the care farm context, which according to SDT can facilitate good human functioning, and well-being.
BrageS, IhlebækC, NatvigB, Bruusgaard D. Muskel- og skjelettlidelser som årsak til sykefravær og uføreytelser. Tidsskrift for Norsk Legeforening2010;130(23):2369–2370.
3.
KringlenE, TorgersenS, CramerVA. Norwegian psychiatric epidemiological study. The American Journal of Psychiatry2001;158(7):1091–108.
4.
KesslerRC, Aguilar-GaxiolaS, AlonsoJ, ChatterjiS, LeeS, OrmelJ, ÜstünTB, WangPS. The global burden of mental disorders: An update from the WHO World Mental Health (WMH) Surveys. Epidemiologia e Psichiatria Sociale2009;18:23–33.
5.
DunnEC, WewiorskiNJ, RogersES. The meaning and importance of employment to people in recovery from serious mental illness: results of a qualitative study. Psychiatric Rehabilitation Journal2008;32(1):59–62.
6.
Shepherd G. The value of work in the s. Psychiatric Bulletin1989;13:231–233.
7.
van NiekerkL. Participation in work: A source of wellness for people with psychiatric disability. Work2009;32(4):455–465.
8.
ProvencherHL, GreggR, MeadS, MueserKT. The role of work in the recovery of persons with psychiatric disabilities. Psychiatric Rehabilitation Journal2002;26(2):132–144.
9.
BlusteinDL. The role of work in psychological health and well-being: A conceptual, historical, and public policy perspective. American Psychologist2008;63(4):228–240.
BartleyM. Unemployment and ill health: Understanding the relationship. Journal of Epidemiology and Community Health1994;48(4):333–337.
12.
McKee-RyanF, SongZ, WanbergCR, KinickiAJ. Psychological and physical well-being during unemployment: A meta-analytic study. Journal of Applied Psychology2005;90(1):53–76.
13.
DooleyD, CatalanoR, WilsonG. Depression and unemployment: Panel findings from the epidemiologic catchment area study. Am J Commun Psychol1994;22(6):745–765.
14.
Green Care: A conceptual framework, a report of the working group on the health benefits of green care. COST 866, Green care in Agriculture. 2010.
15.
HassinkJ, van DijkM, Farming for health: Green-care farming across Europe and the United States of America. HassinkJ, van DijkM, editors. New York:Springer; 2006.
16.
HineR, PeacockJ, PrettyJ. Care farming in the UK: Contexts, benefits and links with therapeutic communities. Therapeutic Communities2008;29(3):245–260.
17.
PedersenI, DalskauLH, PatilG, IhlebaekC, Care farming programs in pre-vocational rehabilitation for people with mental health problems. Work. In review.
18.
PedersenI, Ihlebæk C, KirkevoldM. Important elements in farm animal-assisted interventions for persons with clinical depression: A qualitative interview study. Disability and Rehabilitation2012;34(18):1526–1534.
19.
ElingsM, HassinkJ. Green care farms, a safe community between illness or addiction and the wider society. Therapeutic Communities2008;29(3):310–322.
20.
HassinkJ, ElingsM, ZweekhorstM, van den NieuwenhuizenN, SmitA. Care farms in the Netherlands: Attractive empowerment-oriented and strengths-based practices in the community. Health & Place2010;16(3):423–430.
21.
CohenS, UnderwoodLG, GottliebBH, editors. Social support measurements and interventions, A guide for helath and social scientists. New York:Oxford university press; 2000.
22.
CohenS. Social relationships and health. American Psychologist2004;59(8):676–684.
23.
CohenS. Psychosocial models of the role of social support in the etiology of physical disease. Health Psychology1988;7(3):269–297.
24.
BaumeisterRF, LearyMR. The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psychological Bulletin1995;117(3):497–529.
25.
BartonJ, PrettyJ. What is the Best dose of nature and green exercise for improving mental health? A multi-study analysis. Environmental Science & Technology2010;44(10):3947–3955.
26.
BergetB, EkebergI, BraastadB. Animal-assisted therapy with farm animals for persons with psychiatric disorders: Effects on self-efficacy, coping ability and quality of life, a randomized controlled trial. Clinical Practice and Epidemiology in Mental Health2008;4(9).
27.
de BruinS, OostingS, van der ZijppA, Enders-SlegersM-J, ScholsJ. The concept of green care farms for older people with dementia. Dementia2010;9(1):79–128.
28.
VadnalK. Farming for health in Slovenia. Farming for Health Green-Care Farming Across Europe and the United States of America Wageningen UR Frontis Series2006;13:249–269.
29.
PedersenI, NordaunetT, MartinsenEW, BergetB, BraastadBO. Farm animal-assisted intervention: relationship between work and contact with farm animals and change in depression, anxiety, and self-efficacy among persons with clinical depression. Issues in Mental HealthNursing2011;32(8):493–500.
30.
MalterudK. Qualitative research: Standards, challenges, and guidelines. The Lancet2001;358:483–488.
31.
DeciEL, RyanRM. The “What” and “why” of goal pursuits: Human needs and the self determination of behavior. Psychological Inquiry2000;11(4):227–268.
32.
KvaleS, BrinkmannS. Interviews: Learning the craft of qualitative research interviewing. 2nd ed. Los Angeles:Sage; 2009.
33.
SilvermanD. Doing qualitative research; A practical handbook. Second edition ed. London:Sage publications; 2005.
34.
CoyneIT. Sampling in qualitative research. Purposeful and theoretical sampling; merging or clear boundaries? Journal of Advanced Nursing1997;26(3):623–630.
35.
GiorgiA. Phenomenology and psychological research. Pittsburg:Duquesne University Press; 1985.
36.
MalterudK. Kvalitative metoder i medisinsk forskning – en innføring. Oslo, Norway:Universitetsforlaget; 2003.
37.
MalterudK. Systematic text condensation: A strategy for qualitative analysis. Scandinavian Journal of Public Health2012;40(8):795–805.
38.
ReeveJ, NixG, HammD. Testing models of the experience of self-determination in intrinsic motivation and the conundrum of choice. Journal of Educational Psychology2003;95(2):375–392.
39.
DeciEL, RyanRM. Facilitating optimal motivation and psychological well-being across life’s domains. Canadian Psychology/Psychologie Canadienne2008;49(1):14–23.
40.
RyanRM, DeciEL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist2000;55(1):68–78.
41.
GagnéM, DeciEL. Self-determination theory and work motivation. Journal of Organizational Behavior2005;26:331–362.
42.
DeciEL, EghrariH, PatrickBC, LeoneDR. Facilitating Internalization: The Self-Determination Theory Perspective. Journal of Personality1994;62(1):119–142.
43.
DeciEL, VansteenkisteM. Self-determination theory and basic need satisfaction: Understanding human development in positive psychology. Ricerche di Psicologia2004;27(1):23–40.
44.
MorrowSL. Quality and trustworthiness in qualitative research in counseling psychology. Journal of Counseling Psychology2005;52(2):250–260.
45.
DeciEL, RyanRM. Self-determination theory: A macrotheory of human motivation, development, and health. Canadian Psychology/Psychologie Canadienne2008;49(3):182–185.
46.
La GuardiaJG. Developing Who I Am: A self-determination theory approach to the establishment of healthy identities. Educational Psychologist2009;44(2):90–104.
47.
RyanRM, DeciEL. Self-regulation and the problem of human autonomy: Does psychology need choice, self-determination, and will?. Journal of Personality2006;74(6):1557–1586.
48.
DeciEL, La GuardiaJG, MollerAC, ScheinerMJ, RyanRM. On the benefits of giving as well as receiving autonomy support: Mutuality in close friendships. Personality and Social Psychology Bulletin2006;32(3):313–327.
49.
StoneDN, DeciEL, RyanRM. Beyond talk: Creating autonomous motivation through self determination theory. Journal of General Management2009;34:75–91.
50.
RyanRM, DeciEL. The darker and brighter sides of human existence: Basic psychological needs as a unifying concept. Psychological Inquiry2000;11(4):319–338.
51.
PatrickH, KneeCR, CanevelloA, LonsbaryC. The role of need fulfillment in relationship functioning and well-being: A self-determination theory perspective. Journal of Personality and Social Psychology2007;92(3):434–457.
52.
SheldonKM, BettencourtBA. Psychological need-satisfaction and subjective well-being within social groups. British Journal of Social Psychology2002;41(1):25–38.
53.
La GuardiaJG, RyanRM, CouchmanCE, DeciEL. Within-person variation in security of attachment: A self-determination theory perspective on attachment, need fulfill-ment, and well being. Journal of Personality and Social Psychology2000;79(3):367–384.
54.
RyanRM, La GuardiaJG, Solky-ButzelJ, ChirkovV, KimY. On the interpersonal regulation of emotions: Emotional reliance across gender, relationships, and cultures. Personal Relationships2005;12(1):145–163.
55.
RyanRM, WeinsteinN, BernsteinJH, BrownKW, MistrettaL, GagnéM. Vitalizing effects of being outdoors and in nature. Journal of Environmental Psychology2010;30:159–168.
56.
WeinsteinN, PrzybylskiAK, RyanRM. Can nature make us more caring? Effects of immersion in nature on intrinsic aspirations and generosity. Personality and Social Psychology Bulletin2009;35(10):1315–1329.
57.
KowalJ, FortierMS. Motivational determinants of flow: Contributions from self-determination theory. The Journal of Social Psychology1999;139(3):355–368.
58.
SheldonKM, RyanRM, ReisHT. What makes for a good day? competence and autonomy in the day and in the person. Personality and Social Psychology Bulletin1996;22:1270–1279.
59.
RyanRM, BernsteinJH, BrownKW. Weekends, work, and well-being: Psychological need satisfactions and day of the week effects on mood, vitality, and physical symptoms. Journal of Social and Clinical Psychology2010;29(1):95–122.
60.
RyanRM, FrederickC. On energy, personality, and health: Subjective vitality as a dynamic reflection of well-being. Journal of Personality1997;65(3):529–565.
61.
NixGA, RyanRM, ManlyJB, DeciEL. Revitalization through self-regulation: The effects of autonomous and controlled motivation on happiness and vitality Journal of Experimental Social Psychology1999;35:266–284.
