A new strategic plan for Green care (2012) Initiated by The Ministry - PDF document

29.06.2012 Structure and research on Green care in Norway Dr. Bente Berget Norwegian University of Life Sciences NORWEGIAN UNIVERSITY OF LIFE SCIENCES A new strategic plan for Green care (2012)  Initiated by The Ministry of Agriculture and Food and the Ministry of Local Government and Regional Development  Goal: To develop quality-assured and socially beneficial welfare services on farms  The Ministries initiated the Green care promotion (2010-2012) NOK 18 mill was allocated to projects organised by the county councils  Totally 1100 Green care farms today (pedagogy, special needs education, occupational training, health and care services)  A quality assurance system is established from 2011  A approval system for Green care started in 2012  Green care farms must gain approval based on the Green care quality assurance system. The Norwegian Agricultural Quality System and Food Branding Foundation operates the system www.umb.no 2 1

29.06.2012 NORWEGIAN UNIVERSITY OF LIFE SCIENCES Therapeutic horticulture (TH) and clinical depression • PhD project Marianne Thorsen Gonzalez (2010) • Project owner: UMB • Additional project group members: • Prof. Terry Hartig, Uppsala University, Sweden • Prof. Marit Kirkevold, Oslo University • Prof. Egil Martinsen, Oslo University • Assoc. Prof. Grete Patil, UMB www.umb.no NORWEGIAN UNIVERSITY OF LIFE SCIENCES The intervention • Single group design with multiple measures • 46 people with clinical depression • Intervention: 12- weeks with outdoor garden activities, 3 hours 2 times a week. Four local farms in the Oslo area • The farmer facilitated the activities • The activities was adjusted to the groups and covered sowing, planting • and potting, weeding… • … and the possibility to • just be in the garden www.umb.no 2

29.06.2012 NORWEGIAN UNIVERSITY OF LIFE SCIENCES Key findings • Score on depression (BDI) decreased from before (T1, T2 ) to 4 (T3 ) , 8 (T4) and 12 (T5) weeks after start of the intervention • Self reported effectiveness in daily activities requiring cognitive recourses through directed attention (AFI) increased from before to after start of the intervention 82 30 80 28 78 Study 1 Study 1 Study 2 Study 2 76 26 74 24 72 BDI AFI 70 22 68 20 66 18 64 62 16 0 0 T1 T2 T3 T4 T5 T1 T2 T3 T4 T5 Measurement point Measurement point • The participants who experienced the most fascination with participating in the intervention also had the highest decrease in depression www.umb.no Animal-assisted therapy: effects on persons with psychiatric disorders working with farm animals Bente Berget (UMB), Øivind Ekeberg (UiO), Bjarne O. Braastad (UMB) 6 3

29.06.2012 NORWEGIAN UNIVERSITY OF LIFE SCIENCES Aim and method  Aim: document effects of animal-assisted therapy (AAT) with farm animals on humans with psychiatric disorders  Method: RCT-design with 90 adult psychiatric patients with different psychiatric diagnosis  60 patients to treatment and 30 to control, with 41 completers (68 %) in the treatment and 28 (93 %) in the control group  12-week intervention with ordinary work with cattle (dairy cows and beef cattle) or sheep three hours twice a week  All participants continued their initial treatment  Self-reported questionnaires to assess depression (BDI), anxiety (STAI), self-efficacy (GSE), coping ability (Coping Strategies Scale) and quality of life (QOLS-N) before, in the end, and at follow-up six months after the end of the intervention  Video registrations (treatment group) in the beginning and at the end of the intervention www.umb.no 7 NORWEGIAN UNIVERSITY OF LIFE SCIENCES Results  No significant effects of treatment during the intervention for any of the standardized instruments  Significant effects of treatment at follow-up for STAI, BDI, GSE and the Coping Strategies Scale  No change in quality of life (QOLS-N) for any of the groups  Totally most time on physical contact with the animals  Moderate health effects, however none being negative www.umb.no 8 4

29.06.2012 Farm animal-assisted interventions in clinical depression Ingeborg Pedersen (UMB), Egil W. Martinsen (Oslo University Hospital), Bente Berget (UMB), Camilla Ihlebæk (UMB), Marit Kirkevold (UiO), Trine Nordaunet (UMB), Bjarne O. Braastad (UMB) 9 NORWEGIAN UNIVERSITY OF LIFE SCIENCES Aim and method Main aim: Investigate changes in mental health of persons with clinical depression participating in a farm animal-assisted intervention (work and contact with dairy cattle twice a week for 12 weeks)  29 participants: 6 men and 23 women, mean age: 37.8  Randomly assigned to intervention (n=16) or control (n=13)  All participants continued their initial treatment  Assessments:  Mental health (Beck Depression Inventory, Generalized Self- Efficacy Scale, State-Trait Anxiety Inventory) at recruitment, start, 4 and 8 weeks, at the end of intervention, at follow-up three months after end of intervention  Video recordings: twice (early and late, 1.5 – 3.0 hours)  Qualitative interview of eight participants of their experience (work tasks, animal interaction and contact with the farmer) www.umb.no 10 5

29.06.2012 NORWEGIAN UNIVERSITY OF LIFE SCIENCES Results  The randomized controlled trial: – A statistical significant decline in depression and increase in self- efficacy in the intervention group at the farm, this was not seen in the control group. No significant differences between the intervention and control group  The video study: – Favorable correlations between work tasks that could be descried as complex and challenging like moving animals and milking procedures, and decline in depression and state-anxiety  The interview study: – A realistic working community is important and the farmer’s attitude and commitment is essential – Central elements: the interventions’ flexibility and experience of coping www.umb.no 11 Animal-assisted interventions and psychiatric disorders – knowledge and attitudes among practitioners Bente Berget and Bjarne O. Braastad (UMB), Sverre Grepperud (UiO), Olaf Aasland, UiO and The Research Institute of the Norwegian Medical Association 6

29.06.2012 NORWEGIAN UNIVERSITY OF LIFE SCIENCES Aim, method and results  Aim: Examine knowledge, attitudes and belief in treatment effects of AAI’s for psychiatric patients among GP’s, psychiatrists and psychologists in Norway  Method: A postal questionnaire made for the purpose sent to a representative sample of 4 00 GP’s, 400 psychiatrists and 300 psychologists  Results  Response rate 42,9 %  2/3 had some or significant knowledge of AAI’s  2/3 was motivated to learn more about AAI and use it in own clinical practice, psychiatrists and psychologists more motivated than GP’s, and young practitioners more motivated than the older practitioners  Women more than men believed in treatment effects  Beliefs in treatment effects highest for improved physically capacity  9 out of 10 expressed that AAI’s should be used in psychiatric treatment www.umb.no 13 The effect of the horse on adolescents’ self-efficacy, self-esteem and social skills - a four-year project with a cross-over design and control group Hilde Hauge, PhD student Bjarne O. Braastad and Bente Berget (UMB), Ingela Lundin Kvalem, (UiO), Marie Jose Enders-Slegers, (Univ. of Utrecht) 7

29.06.2012 NORWEGIAN UNIVERSITY OF LIFE SCIENCES Aim and method  Main aim: to examine what teenagers can learn from being on a farm with horses, and how this can enhance their self-esteem and feeling of mastery  Method:  80 adolescents aged 12-15 years are given an intervention with horses on a small farm two hours a week for four months  Registrations: - inventories (self-efficacy, resilience, social competence, relation to horses) - video recording: “ Adolescent’s mastery of tasks and interaction with the horse through horse assisted activities” (study 1)  29 adolescents (13-15 years old),25 girls and 4 boys  7 participants had been riding before  Registration of positive attitude towards the horses www.umb.no 15 NORWEGIAN UNIVERSITY OF LIFE SCIENCES Results  Adolescents given the opportunity to work with horses and ride once a week for four months showed active behaviour and had positive contact with the horse both early and late in the intervention period. There were only positive or neutral responses from the horse  The adolescents persisted in retrying tasks after failure more frequently late in the intervention than in the beginning. The intervention might serve to enhance self- efficacy among the adolescents in relation to tasks with the horses (Hauge, Braastad, Kvalem and Pedersen) www.umb.no 16 8