beyondblue: the national depression initiative #FZPOE#MVFUP(SFFO5IFCFOFåUTPGDPOUBDUXJUIOBUVSFGPSNFOUBMIFBMUIBOEXFMMCFJOH
Beyond Blue
to Green:
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Mardie Townsend and
Rona Weerasuriya
Project conducted by
For more information
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© Copyright Beyond Blue Limited 2010. All rights reserved.
Associate Professor Mardie Townsend, PhD
Associate Dean (International and Development)
Faculty of Health, Medicine, Nursing and Behavioural Sciences
Deakin University
221 Burwood Highway
Burwood VIC Australia 3125
[email protected]
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of contact with nature for mental health and well-being. Beyond Blue Limited: Melbourne, Australia.
Edited by RaggAhmed www.raggahmed.com
This review was funded by beyondblue: the national depression initiative.
ISBN 978-0-9581971-6-8
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beyondblue: the national depression initiative
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1. Introduction
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1.2 Examining past and present trends in humans’ contact with nature
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2.1 Literature search strategy
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2.2 Selection of articles for the review
8
2.3 Analysis
8
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3.1 The biophilia hypothesis
9
3.2 Attention restoration theory
11
3.3 Stress reduction theory
12
3.4 Environmental self-regulation hypothesis
13
3.5 The bio-ecological model
13
3.6 The relaxation response
14
3.7 Maslow’s hierarchy of needs
14
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4.1 Introduction
17
4.2 Research linking nature contact with health and well-being
18
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5.1 Therapeutic landscapes
39
5.2 Local parks and green spaces as settings for therapeutic nature contact
41
5.3 Forests and woodlands as settings for therapeutic nature contact
43
5.4 Gardens as a setting for therapeutic nature contact
45
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5.6 Contact with animals
62
6. Dimensions of mental health positively affected by nature contact
ii
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83
6.1 Relaxation, restoration and stress reduction
85
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6.3 Acquired Brain Injury
90
6.4 Cognitive functioning: concentration and attention fatigue
91
6.5 Mood: depression, anxiety, aggression, anger and humour
92
6.6 Impact on physiological processes underpinning mental health
93
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7.1 Physical activity
95
7.2 Social connectedness and interactions
99
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8.1 Underlying impacts of climate change for mental health and well-being
104
8.2 Connections between contact with nature, environmentally sustainable
stewardship and mental health
106
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Appendix As-JTUPGCPPLTVTFEEVSJOHUIFMJUFSBUVSFTFBSDI
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Appendix C—Key assertions
118
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mental health concerns
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useful not only as fountains of timber and irrigating rivers, but as fountains of life.
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This report, commissioned by beyondblue: the national depression initiative (beyondblue),
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which have been broader in scope, the major focus of Beyond Blue to GreenJTPOUIFMJOLT
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and anxiety. While the review mainly concentrates on the most recent literature, where it
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literature from earlier reviews has been included.
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education, food, income, a stable ecosystem, sustainable resources, social justice and
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humans depend on nature not simply for material requirements such as water, food and
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Green aims to explore the evidence on the human–nature relationship and to understand
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this literature review.
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From birth to death, life enmeshes individuals within a dynamic culture consisting of the natural
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with life is a deep and complicated process in mental development. To an extent still undervalued
in philosophy and religion, our existence depends on this propensity, our spirit is woven from it,
hope rises on its current.
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maladaptation as they can promote holistic human health in modern urban environments
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Medline, Medline Pubmed, Medline With Full Text, Science Direct, Science Direct Freedom
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therapy, animal therapy, equine therapy, adventure therapy, contact with nature, mental health,
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animal interaction. These terms were used to identify relevant articles with any of the above
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articles could be located for certain sections of the review, the second search included
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The Latham Foundation, Australian Conservation Society, VicHealth, Victorian Department
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relevance of subject material to the review.
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8
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nature:
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awareness, harmony, balance, curiosity, exploration, creativity and an antidote to the
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way
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competence
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access the limitless opportunities offered by the process in the natural world to
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adaptability
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and material importance of the natural world on which we rely for survival.
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which contact with nature contributes to various facets of physical, emotional and intellectual
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of directed attention and active suppression of irrelevant information. When the capacity
to maintain directed attention becomes overloaded, performance declines, and people are
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contributes to recovery from this process in four ways. First, natural environments provide
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clouds, sunsets, snow patterns and the motion of leaves in the wind holds human attention
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desires, which allows attention to rest.
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have shown that contact with nature is the most common and most reliable source of
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An environment abundant with these four characteristics, or even just one of two, is
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11
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pressure and heart rate are some of the many emotions and indicators that are central to
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Because humans developed and evolved in natural environments as opposed to urban
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and endocrine responses that would adversely affect health. This is why such behaviour
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in intensity and less perceptually jumbled than many urban environments, they have
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12
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Results from studies indicate that positive emotional states can be achieved and enhanced
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emotional states and behaviours, as indicated in the numerous studies cited in section 6.2
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and symbols in its immediate environment. The effectiveness of this process is believed to
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13
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A number of the studies cited in section 4.2.1 describe how natural environments are
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The relaxation response is a subjective state unique to individual experiences, but similar
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induce a reverie in nature, have a similar quality in that they induce relaxation. However, they
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combination within natural objects of beauty, novelty, monotony, constancy and sudden beauty
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focused on nature or the natural environment, outlines the needs of humans in terms of a
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An analysis of the hierarchy indicates numerous ways in which nature and natural experiences
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Adapted 7 level
hierachy of
needs diagram
based on
Maslow’s theory
Self-actualisation
personal growth
and fulfilment
Aesthetic needs
beauty, balance, form etc
Cognitive needs
knowledge, meaning, self-awareness
Esteem needs
achievement, status, responsibility, reputation
Belongingness and love needs
family, affection, relationships, work group etc
Safety needs
protection, security, order, law, limits, stability etc
Biological and physiological needs
basic life needs - air, food, drink, shelter, warmth, sex, sleep etc
Figure 1: Adapted hierarchy of needs diagram based on Maslow’s theory (Chapman, 2001–2007).
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At the bottom level humans require basic essentials such as unpolluted air, clean water,
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activities, and prospects for recreation.
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A plethora of research has shown humans appreciate the diverse features offered by nature
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locations idealised in childhood memories of favourite holidays or iconic places in nature,
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XJUIPVUBOZGPSNBMåOBODJBMPSTZNCPMJDSFTUSJDUJPOTXIFSFTPDJBMUSBOTBDUJPOTTVDIBT
SFTQFDUJOHVOGBNJMJBSHFOEFSSPMFTPSEFWFMPQJOHGSJFOETIJQTXIJDIDSPTTFUIOJDBOEDVMUVSBM
CPVOEBSJFTDBOUBLFQMBDFJOBOFVUSBMSFTUPSBUJWFBOEBFTUIFUJDBMMZQMFBTJOHFOWJSPONFOU
%ZNFOUBOE#FMM4FFMBOEFUBM
)BWJOHBDLOPXMFEHFEUIFTFGBDUTJUJT
JNQPSUBOUUPSFJUFSBUFUIBUBDIJFWJOHUIFIFBMUIBOEXFMMCFJOHCFOFåUTPVUMJOFEBCPWFJT
MBSHFMZEFUFSNJOFECZUIFRVBMJUZRVBOUJUZBOEBDDFTTJCJMJUZPGUIFTFHSFFOTQBDFT0n#SJFO
C0n#SJFOB5ZSW¾JOFOFUBM
*OBMBSHFTDBMFVSCBOOBUVSFQSPKFDUJOUIF/FUIFSMBOETBOBUJPOXJEFTUVEZPOUIFCFOFåUT
UPIVNBOIFBMUIGSPNHSFFOTQBDFUJUMFEo7JUBNJO(pXBTDPOEVDUFEBUBIPVTFIPME
DPNNVOJUZBOESFHJPOBMMFWFM(SPFOFXFHHFOFUBM
&WJEFODFGSPNUIFQSPKFDU
TIPXFEUIBUSFTJEFOUTMJWJOHDMPTFUPHSFFOTQBDFTXJUIIPVTFIPMEHBSEFOTBOEBDDFTTUP
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An Estonian study, which evaluated the restorative effects of nature as well as its connections
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BDUJWJUJFTTVDIBTPCTFSWJOHOBUVSFUBLJOHXBMLTJOOBUVSBMTVSSPVOEJOHTIJLJOHBOEIVOUJOH
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#PUIUIFGBDUPGTQFOEJOHUJNFJOOBUVSFBOEUIFMFOHUI
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JODSFBTFTJOXFMMCFJOHSFQPSUFECZUIFQBSUJDJQBOUT
#BTFEPOUIFIZQPUIFTJTUIBUJODPNFSFMBUFEJOFRVBMJUZXPVMEIBWFMFTTPGBOJNQBDUPO
QPQVMBUJPOTJGUIFZIBEHSFBUFSFYQPTVSFUPHSFFOPQFOTQBDFTBTUVEZXBTDPOEVDUFE
JO&OHMBOEEJWJEJOHQFPQMFXIPXFSFZPVOHFSUIBOSFUJSFNFOUBHFJOUPGPVSJODPNF
EFQSJWBUJPOHSPVQTBOEåWFHSPVQTBDDPSEJOHUPUIFBDDFTTUIFZIBEUPHSFFOTQBDF5IF
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.PSUBMJUZEBUBGPS
äTIPXFEUIBUEFBUITGSPNBMMDBVTFTJOJODPNFEFQSJWFEDPNNVOJUJFTXBTMPXFS
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BOE1PQIBN
"'JOOJTIDBTFTUVEZFYBNJOFEUIFVTFBOEWBMVFPGHSFFOTQBDFTJOUIFDPOUFYUPGUIF
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and forests as well as remote natural areas which are accessed less often. While the more
21
FBTJMZBDDFTTJCMFBSFBTXFSFQFSDFJWFEBTQSPWJEJOHPQQPSUVOJUJFTUPFOKPZUIFOBUVSBM
scenes, peace, quiet, restoration and social interaction, the less accessible areas were also
appreciated for their aesthetic beauty, opportunities for adventure and contact with nature.
"TUVEZJOUIF6,BOE*UBMZJOWFTUJHBUJOHUIFVTFPGHSFFOTQBDFTBOEQFSDFQUJPOTPGJUT
CFOFåUTGPDVTFEPOTJYHSFFOTQBDFT"UPUBMPGTVCKFDUTGSPN*UBMZBOEGSPNUIF6,
UPPLQBSU-BGPSUF[[BFUBM
5IFTQBDFTXFSFWJTJUFEPOEBZTXIJDIXFSFIPUBOETVOOZ
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QPTJUJWFBTTPDJBUJPOCFUXFFOUIFGSFRVFODZPGWJTJUTBOEUJNFTQFOUJOHSFFOTQBDFTBOEUIF
CFOFåUTBOEXFMMCFJOHSFQPSUTQSPWJEFECZQBSUJDJQBOUTEVSJOHUIFTVSWFZ4UBUJTUJDBMBOBMZTJT
PGUIFEBUBTVQQPSUFEUIFTUVEZIZQPUIFTJTUIBUGSFRVFODZPGVTFPGHSFFOTQBDFTDPVME
HFOFSBUFCFOFåUTBOEXFMMCFJOHGPSQFPQMF5IJTDBOCFQBSUMZFYQMBJOFECZUIFDBQBDJUZ
HSFFOTQBDFTQPTTFTTUPQSPWJEFCFUUFSUIFSNBMDPNGPSUEVSJOHQFSJPETPGJOUFOTFIFBU
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*OUFSNTPGXPSLQMBDFIFBMUINVMUJQMFTUVEJFTIBWFJEFOUJåFEUIFCFOFåUTPGWJFXTPGOBUVSF
UISPVHIBXJOEPXGPSFNQMPZFFT'PSFYBNQMFBTVSWFZXBTVOEFSUBLFOCZ,BQMBOBOE
DPMMFBHVFT
XJUIFNQMPZFFTPGXIPNIBEOPWJFXTUPUIFPVUTJEFPSOPWJFX
PGOBUVSBMFMFNFOUTDPVMETFFOBUVSBMFMFNFOUTGSPNUIFJSXPSLQMBDFBOEXIPTF
XPSLUPPLQMBDFNPTUMZJOOBUVSBMTFUUJOHTTVDIBTQBSLT5IFSFTFBSDIJODMVEFERVFTUJPOT
about perceived job stress and effectiveness of various restorative opportunities, life
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UIFQBSUJDJQBOUTXIPDPOEVDUFEXPSLNPTUMZPVUEPPSTSFQPSUFEUIFNPTUQPTJUJWFGFFMJOHT
JOSFMBUJPOUPUIFRVFTUJPOTPOUIFTVSWFZUIFSFTFBSDIFSTTVHHFTUUIBUUIJTDPVMEIBWFCFFO
BUUSJCVUBCMFUPUIFUZQFPGXPSLCFJOHEPOFBOEUIFSFGPSFDBOOPUCFBTTVNFEUPCFUIFSFTVMU
only of time spent in natural environments. However, the comparison between those who
could and could not view nature or any natural elements showed that individuals with natural
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"TVCTFRVFOUTUVEZVTFEBTVSWFZXJUIRVFTUJPOTPOIFBMUIQTZDIPMPHJDBMGVODUJPOJOHMJGF
TBUJTGBDUJPOBOEXPSLFOWJSPONFOUTUPJOWFTUJHBUFUIFBTTPDJBUJPOCFUXFFODPOUBDUXJUI
OBUVSFBOEFNQMPZFFTBUJTGBDUJPOBOEIFBMUI,BQMBO
*UJOWPMWFEQBSUJDJQBOUTXIP
XFSFJOSFMBUJWFMZTFEFOUBSZKPCT&NQMPZFFTXIPDPVMEMPPLPVUPOUPUIFOBUVSBMXPSME
SFQPSUFEGFFMJOHMFTTGSVTUSBUFETIPXFEJNQSPWFEMFWFMTPGQBUJFODFGPVOEUIFJSKPCNPSF
DIBMMFOHJOHBOEFYQSFTTFEHSFBUFSFOUIVTJBTNGPSJUBOESFQPSUFEIJHIFSMJGFTBUJTGBDUJPOBOE
PWFSBMMIFBMUI"GVSUIFSTUVEZCZUIFTBNFSFTFBSDIHSPVQJOWFTUJHBUFEUIFFGGFDUPGWJFXTPO
QTZDIPMPHJDBMSFTUPSBUJPOJOBOPGåDFFOWJSPONFOU'JOEJOHTTIPXFEBWJFXEJTQMBZJOHHSFBUFS
BWBJMBCJMJUZPGOBUVSFIBEBTUSPOHFGGFDUPOTBUJTGBDUJPOBOESFTUPSBUJWFSBUJOHT4VCKFDUT
EJTQMBZFEMFTTGSVTUSBUJPOBOENPSFQBUJFODFBHSFBUFSFOUIVTJBTNBOEMJGFTBUJTGBDUJPOBOE
JNQSPWFNFOUTUPPWFSBMMIFBMUISBUJOHT#ZDPOUSBTUWJFXTXJUIPVUOBUVSBMFMFNFOUTIBEUIF
PQQPTJUFFGGFDUJOUFSNTPGTBUJTGBDUJPOBOESFTUPSBUJPO,BQMBO
22
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TVDIBTUSFFTWFHFUBUJPOQMBOUTBOEGPMJBHFJOBHJWFOWJFXCVGGFSFEUIFOFHBUJWFJNQBDUTPG
KPCTUSFTTGPSTVCKFDUT5IFJSJOUFOUJPOUPRVJUSFEVDFEBOEBNBSHJOBMCVUQPTJUJWFFGGFDUXBT
TFFOJOUIFJSHFOFSBMXFMMCFJOH-FBUIFSFUBM
8IFSFUIFSFXFSFMPXFSQFSDFOUBHFT
#FZPOE#MVFUP(SFFO5IFCFOFåUTPGDPOUBDUXJUIOBUVSFGPSNFOUBMIFBMUIBOEXFMMCFJOH
PGUIFTBNFFMFNFOUTPSXIFOUIFZXFSFDPNQMFUFMZBCTFOUTVCKFDUTTIPXFEIJHIFSTUSFTT
SFQPSUFEMPXFSKPCTBUJTGBDUJPOBOEBOJODSFBTFEJOUFOUJPOUPRVJU-FBUIFSFUBM
1SFUUZ
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XPSLFSTBTTPDJBUFEXJUIMPPLJOHPVUJOUPHSFFOFSPVUEPPSFOWJSPONFOUT
For people with chronic and terminal illnesses, contact with nature has also been shown to
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4BDLTEFTQJUFOVNFSPVTBOEWBSZJOHEJTBCJMJUJFTJUJTSBSFUIBUIVNBOTXPVMETUBZJOEPPST
when an opportunity to be outdoors is provided.
In people with terminal and chronic illness, studies have shown increased communication
EVSJOHJOUFSBDUJPOTXJUIOBUVSF3FDBMMJOHNFNPSJFTQMBOOJOHBOETFUUJOHHPBMTBOEMFBSOJOH
new ideas are commonly seen evidence of mental stimulation associated with nature contact.
#FMPXBSFFYBNQMFTGSPN3FZOPMET
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4DFOBSJP#JMMJTBOZFBSPMENBOBOEBTIFJTEJHHJOHJOUIFEJSUIFCFHJOTUPUBML
BCPVUIJTMJGFCFGPSFUIFJOTUJUVUJPOo*PODFIBEBGBSN*CVJMUBMMUIFTUPOFXBMMTPONZ
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Scenario 2: An extract from a story from Bring Me the Ocean3FZOPMETQ
"
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4BDLT
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1BSLJOTPOnTEJTFBTFXIPBMUIPVHIPGUFOVOBCMFUPJOJUJBUFNPWFNFOUDMJNCFEVQBOEEPXO
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EJTFBTFQBUJFOUTXIPIBWFWFSZMJUUMFTFOTFPGPSJFOUBUJPOUPUIFJSTVSSPVOEJOHTLOPXFYBDUMZ
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UIPTFFYQFSJFODJOHDPHOJUJWFEJGåDVMUJFTBOESFEVDFEQIZTJDBMEFYUFSJUZEVFUPBHFPSJMMOFTT
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6OJUFE4UBUFT#SBXMFZ
.BOZTUVEJFTJOWFTUJHBUJOHUIFCFOFåUTPGDPOUBDUXJUIOBUVSFUISPVHIIVNBOäBOJNBM
interactions for people with chronic or terminal illnesses have also found positive results
.D$VMMPDI'SJU[FUBM"SOPME,PWBDTFUBM"MMFOFUBM#BSBL
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described in detail in section 5.6.2.
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23
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)FFSXBHFO1SFUUZ
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3FTFBSDIMJOLJOHOBUVSFDPOUBDUXJUIDIJMESFOnTEFWFMPQNFOU
It is commonly believed that children have a predilection for natural environments and that
environments preferred by children are primarily comprised of natural elements (Seeland et
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awareness and sensitivity to the natural elements present in the environments, such as
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24
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#VSEFUUFFUBM
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"OFOSJDIFE
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CFOFåUTJOMFBSOJOHBOENFNPSZQSPWJEFTPQQPSUVOJUJFTUPBDDSVFBOEEJTQMBZEFDJTJPO
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B
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"SFTFBSDIQSPHSBNJO4XFEFODPNQBSFEDIJMESFOGSPNTJNJMBSTPDJPFDPOPNJDCBDLHSPVOET
XIPVOEFSUPPLNFBTVSFTPGNPUPSDPPSEJOBUJPOBOEBUUFOUJPODBQBDJUZ1BSUJDJQBOUTXFSF
selected from two daycare centres set in urban environments: one was surrounded by
CVJMEJOHTBCSJDLQBUIBOEMPXQMBOUTXIJMFUIFPUIFSXBTBOPVUEPPSBMMXFBUIFSDFOUSF
TVSSPVOEFECZPSDIBSETPOUXPTJEFTBTXFMMBTBOVOUBNFEHBSEFOBOEBXPPEMBOE(SBIO
FUBM
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*OUIF64BTUVEZPCTFSWFEUIFCFIBWJPVSPGQVCMJDIPVTJOHSFTJEFOUTJOUXPEJGGFSFOU
outdoor spaces: one with many trees and the other with a relatively barren environment with
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'JOEJOHTJOEJDBUFEUIBUTQBDFTXJUIUSFFTXFSF
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PVUEPPSTQBDFTUIBOJOUIFMBSHFMZCBSSFOTFUUJOH5IFBVUIPSTCFMJFWFUIBUUIFTFGBDUPST
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25
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who continued to experience a lesser amount of nature nearby.
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26
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a history of success in outdoor environmental education. Schools also carry out projects
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vary from their usual school routine.
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people
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the value of place for people, which enhances their sense of ownership of a place with which
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Everybody needs beauty as well as bread, places to pray in and play in where nature may heal
and cheer and give strength to the body and soul.
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contact with nature, many studies address both the mental and physical health outcomes
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28
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wilderness or decisions to move to rural environments are related to the desire both to
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those mentioned here afford experiences which have a restorative quality and result in a
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mailed a questionnaire and 63 per cent responded. The questions focused on: activities
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the perceptions of health, environment and the relationship between them (Pinder et al.
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the forest projects, users of the forest and participants in THERAPI projects. Interviews
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A recent article in The Boston Globe newspaper stated scientists have found that merely
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in Adelaide, Australia, used a mailed survey to examine the association of perceived
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associated with mental health than with physical health. Earlier, a major study in the city of
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Helping others to grow.
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#VSMTC
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to and from school has reduced drastically, while the quantity of time spent by children in front
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GPS
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any restrictions. These same convictions have been voiced by participants in numerous
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capacity of natural elements to reduce the impact of stressful life events (Wells and Evans
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favourite places and reasons for these choices, collected data from 1436 respondents in
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32
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IBWF
been summarised in Appendix F.
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were born in Australia had at least one parent who was born overseas. This shows the
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to those directly subjected to it ... [but] can create a climate of apprehension and fear that
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34
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Data on hospitalisations and mortality due to serious mental disorders and illnesses indicate
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Every part of the earth is sacred to my people. Every shining pine needle, every sandy shore,
every mist in the dark woods, every meadow, every humming insect. All are holy in the memory
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know: the earth does not belong to man, man belongs to the earth. All things are connected
like the blood that unites us all. Man did not weave the web of life, he is merely a strand in it.
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#BTFEPOUIJTJOUFSEFQFOEFOUSFMBUJPOTIJQXJUIOBUVSF*OEJHFOPVTQFPQMFCFMJFWFUIFJS
spiritual, physical, mental and social health is reliant on the ability to live in harmony with
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belief that if an individual does not maintain physical, spiritual, social and mental health, they
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36
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to provide an employee with a brief respite from the demand for directed attention which
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environments.
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4.3.8 People with disabilities
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38
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would enter … after the Mesozoic, the age of reptiles, and the one we’re in, the Cenozoic, the
age of mammals, the Arimozoic, which means the age of loneliness. And we’d never get it
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humanity—that is, our relationship with the rest of life, in all its diversity.
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nature affects the human mind.
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"TQIBMUESZXBMMBOEçVPSFTDFOUMJHIUTBSFBGBSDSZGSPNNFBEPXTUSFFTBOETUBST"XBMLJO
the woods, planting a garden, visiting a wilderness and catching a glimpse of wild creatures
EPFTTPNFUIJOHRVJUFJOEFTDSJCBCMFGPSUIFTPVM5IFQFBDFJOTQJSBUJPOBOEQMFBTVSFCSPVHIUCZ
contact with nature is downright therapeutic. The further we get from it, the less whole we feel.
8ZTPOHQ
(SFFOTQBDFTTVDIBTQBSLTCPUBOJDBMHBSEFOTDPNNVOJUZHBSEFOTBMMPUNFOUTGBSNT
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4BDLT
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A recent study conducted in Toronto, Canada showed that participants reported that the
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0n$BNQPFUBM
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41
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"DPOTJEFSBCMFOVNCFSPGTUVEJFTDPOåSN
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JMMOFTTFT'SVNLJO,BQMBO1BSTPOTFUBM6MSJDI6MSJDI
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found positive results. Participants with stress symptoms, psychosocial problems such as
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emotional health:
Growing up, I lived in a house that had a fairly big backyard and a creek across the street. It was
when I was by myself that the environment meant the most to me. Nature was the one place
where, when everything in my life was going bad, I could go and not have to deal with anyone
else. My dad died of brain cancer when I was nine. Going out into nature was one outlet that
I had, which truly allowed me to calm down and not think or worry. I really believe that there is
something about nature, that when you are in it, it makes you realise that there are far larger
things at work than yourself. This helps to put problems in perspective. Being in nature can be a
way to escape without fully leaving the world.
-PVWQQå
42
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for people who were expected to spend more of their time closer to their homes, such as
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IZQPUIFTJTUIFSFMBUJPOTIJQXBTTUSPOHFSGPSQFPQMFCFUXFFOUIFBHFTPGBOESBUIFS
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EJTPSEFSBOEEFQSFTTJPO.BBTFUBM
'PSFTUTBOEXPPEMBOETBTTFUUJOHTGPSUIFSBQFVUJDOBUVSF
DPOUBDU
)VNBOTJUIBTCFFOTIPXOPSJHJOBMMZMJWFEJOGPSFTUFOWJSPONFOUTCVUPVSBODFTUPSTBSF
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BM
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people is evidenced by the deliberate location of numerous sanatoria on forested plateaus.
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UIFQPPSIFBMUIUSFOETTFFOJONPTUJOEVTUSJBMJTFEBOEVSCBOJTFETPDJFUJFT-FFFUBM
8PPEMBOETPGGFSPQQPSUVOJUJFTGPSQIZTJDBMBDUJWJUJFTUIBUBSFCFOFåDJBMGPSIFBMUIQSPWJEF
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DPOTFSWBUJPOBOEGVSUIFSQMBOUJOHPGUSFFTXIJDIDMFBOTFUIFBUNPTQIFSF$FOUSBM4DPUMBOE
$PVOUSZTJEF5SVTU
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IBWFTIPXOUIBUQFPQMFFOKPZUIFDBMNJOHTFOTBUJPOCSPVHIUPOCZMJTUFOJOHUPUIFTPVOEPG
XBUFSJOBXPPEMBOETFUUJOHBOEUIFBMNPTUTZNCPMJDTFOTFPGTUBCJMJUZBOEDPOUJOVJUZHJWFO
UPMJGFJOUIFQSFTFODFPGUSFFT.JMMJHBOBOE#JOHMFZ
4PNFTUVEJFTIBWFTIPXOUIBU
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SFTQPOEFOUTJUXBTFYQFSJFODJOHUIFEJWFSTJUZPGBXPPEMBOEFOWJSPONFOUJOBNVMUJTFOTPSZ
way that made it therapeutic.
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JOUIFGPSFTUBJSBOEXBMLJOHXFSFFYBNJOFEJOBTUVEZCZ:BNBHVDIJFUBM
5IFTF
SFDSFBUJPOBMBDUJWJUJFTBSFCFMJFWFEUPQSPNPUFQIZTJDBMBDUJWJUZBOEQTZDIPMPHJDBMSFMBYBUJPO
"OPOJOWBTJWFTUSFTTGSFFNFUIPEVTJOHTBMJWBTBNQMJOHUPNFBTVSFUIFDJSDBEJBOSIZUIN
of salivary amylase activity was employed in the study, since increased sympathetic nervous
system activity is a major stimulator of salivary amylase. First, the salivary amylase activity
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DPOTUBOUUISPVHIPVUUIFEBZ*OUIFBDUJWFQIBTFPGUIFTUVEZNFBTVSFTPGTBMJWBSZBNZMBTF
BDUJWJUZQSJPSUPBOEGPMMPXJOHBXBMLJOBOVSCBOBOEGPSFTUFOWJSPONFOUJOEJWJEVBMMZTIPXFE
that salivary amylase activity of the subjects was reduced in the forest environment, relative
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JTMFTTBDUJWFXIFOJOGPSFTUFOWJSPONFOUT5IFBVUIPSTTVHHFTUUIBUGPSFTUFOWJSPONFOUTIBWF
BQPTJUJWFBTTPDJBUJPOXJUISFEVDFEFOWJSPONFOUEFSJWFETUSFTTJOIFBMUIZQFPQMF
43
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"MM
the studies utilised 12 male participants and experimental procedures were similar to the
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forests, and blood was sampled on the second and third days to measure immune system
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C
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44
"OPUIFSSFDFOUTUVEZFYBNJOFEUIFQIZTJPMPHJDBMBOEQTZDIPMPHJDBMSFTQPOTFTUPSFBMGPSFTU
landscapes as well as the therapeutic uses of forests relative to urban environments (Lee et
BM
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&BDI
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concentration to assess the stress response of subjects to different environments, and
systolic and diastolic blood pressure and pulse rate were used to study the activity of the
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pulse rate, which are associated with the activation of the parasympathetic nervous system,
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scene relative to an urban one.
(BSEFOTBTBTFUUJOHGPSUIFSBQFVUJDOBUVSFDPOUBDU
The world for humans is richer for the presence of an environment formed by other species.
The carefully tended gardens around a Japanese Buddhist temple are tributes to this human need.
#JSDIQ
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45
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BOESFOFXBMWJTJCMFJOUIFOBUVSBMMBOETDBQFT1BTTJWFFOHBHFNFOUTVDIBTMPPLJOHBUPS
TJUUJOHPSXBMLJOHJOUIFHBSEFOXBTBQQSFDJBUFECZUIFTVCKFDUTXIJMFBDUJWFFOHBHFNFOU
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UPPUIFSTXBTTIPXOUPJNQSPWFTPDJBMJOUFSBDUJPOQSPNPUFOFJHICPVSIPPESFOFXBMJOTUJM
a sense of achievement and satisfaction, and provide aesthetic pleasure from contact with
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people to combat social exclusion and isolation. The authors believed that these positive
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"TUVEZCZ6MSJDI
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"SFDFOUBOBMZTJTPGEBUBHBUIFSFEGSPNB4DPUUJTI)FBMUI4VSWFZIBTGPVOEUIBUoEPNFTUJD
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/FXTQBQFSDPMVNOJTU
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46
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development of healthy communities:
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community
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open the door to friendly association and lead to further cooperation, which has the
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DIBOHFTJOUIFDPNNVOJUZ
q CZQSPWJEJOHBTVSSPVOEJOHUIBUJTNPSFDPNGPSUBCMFQIZTJDBMMZJOXIJDIUPMJWFBOEXPSL
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GPSDIJMESFOUPUBLFQSJEFJOUIFJSXPSLBTXFMMBTJNQSPWFUIFJSTFOTFPGSFTQPOTJCJMJUZBOE
TFMGDPOåEFODFXIJMFQSPWJEJOHBDPOTUSVDUJWFDIBOOFMGPSFOFSHZ.BMMFS3FMG
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BOEUIF64"
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JOTJEFBOEPVUPGUIFJOTUJUVUJPO*UJTIPXFWFSJNQPSUBOUUPLFFQJONJOEUIBUUIFEFHSFFPG
positive impact that can be attained depends, at least to some extent, on the richness and
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as participation in the process of consumption, production, social interaction and political
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social life, developed a sense of peace and relaxation, and promoted happiness and
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Depression Scale indicated improved scores as well as improved function.
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Q
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the types of characteristics required for community development and health promotion in the
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As a consequence, there was:
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social connection reduces anxiety.
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PGXFMMCFJOHUISPVHIBDUJWJUJFTTVDIBTPCTFSWBUJPOMJTUFOJOHTUSPMMJOHTJUUJOHBOEFYQMPSJOH
UIFOBUVSBMTQBDF$PPQFS.BSDVTBOE#BSOFT
'PSFYBNQMFBHSPVQPGUISFFIFBMJOH
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UISFFHBSEFOTBSFBCVOEBOUXJUIQMBOUTBOEæPXFSTCVUBMTPXJUIWBSJPVTVOJRVFGFBUVSFT
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BOE/JDFMM
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with improved mood and satisfaction with the facility, and the majority of respondents felt a
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/FX:PSL$JUZIBTBQMBZHBSEFOXIFSFDIJMESFOXJUICSBJOJOKVSJFTDBOSFHBJOUIFJSTLJMMTJOBO
outdoor environment as opposed to a formal indoor exercise room.
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DPODFOUSBUJPOUIBUJODSFBTFTUIFBCJMJUZUPSFTUpoHBSEFOJOHSFEVDFTQFPQMFnTXPSSJFTBCPVU
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%BWJT
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DPOåSNFEUISPVHIUIFSFTVMUTGSPNBO"VTUSBMJBOTUVEZDPOEVDUFEJO%VCCP/FX4PVUI
8BMFT4JNPOTFUBM
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JOUFSBDUJPOBTJUCSJOHTQFPQMFPVUPGUIFJSSPPNTpoXPSLJOHJOUIFHBSEFOJODSFBTFTQBUJFOUTn
NPCJMJUZBOEEFYUFSJUZBTXFMMBTPGGFSJOHHFOUMFFYFSDJTFBOENPWFNFOUp%BWJTQ
0UIFSCFOFåUTGPSNFOUBMXFMMCFJOHTVDIBTJNQSPWFENPPEJODSFBTFETFMGFTUFFNBOE
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4QFDJæDUIFSBQFVUJDBQQSPBDIFTVTJOHOBUVSFDPOUBDU
5IFGPMMPXJOHTFDUJPOIJHIMJHIUTBSBOHFPGEJGGFSFOUBQQSPBDIFTUPUIFUIFSBQFVUJDVTFPG
DPOUBDUXJUIOBUVSF8IJMFUIFNBJOGPDVTPGUIJTEPDVNFOUJTPOHSFFOTQBDFTsUIBUJTUIF
JOæVFODFPGOBUVSFCBTFETFUUJOHTGPSNFOUBMIFBMUIBOEXFMMCFJOHsJUJTBMTPWBMVBCMFUP
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5.5.1 Ecotherapy
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#FZPOE#MVFUP(SFFO5IFCFOFåUTPGDPOUBDUXJUIOBUVSFGPSNFOUBMIFBMUIBOEXFMMCFJOH
q TUSFTTSFEVDUJPOBOEJODSFBTFEDPNGPSUGPSJOEJWJEVBMTEFBMJOHXJUIFNPUJPOBMBOEPS
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51
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the dysfunctional behaviours and emotions within them and understand how these can
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$MJOFCFMMDJUFEJO#VSMTBQ
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and to participate in actions that will help save their ecosystem and biosphere.
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special needs
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research and repopulation projects
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#VSMTB
52
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in therapy needs to form a therapeutic relationship with nature, just as they would with
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part in adventure, wilderness and horticulture therapy.
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activities at Meanwhile Gardens in London:
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q BTFOTFPGTZOFSHZXJUIOBUVSF
q a sense of freedom in the outdoors
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VOEFSTUBOEJOHPGNFUBQIPSTHJWFOCZOBUVSF
q a sense of expectation and surprise
q BMBDLPGOFHBUJWFKVEHNFOUT
q USVTUJOPOFTFMGQSJEFBOEJNQSPWFETFMGFTUFFN
q TLJMMTEFWFMPQNFOUBOEFNQMPZBCJMJUZ
q a sense of place.
53
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.JOE
5.5.2 Adventure therapy and wilderness therapy
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while cares will drop off like autumn leaves.
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Q
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from the usual urban base and the distance the wilderness provides is what has created the
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54
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5IFGPSNFS
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a control condition in which participants continued with their daily routines. The latter had
urban environment, natural environment, and passive relaxation conditions. Assessments
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Q
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q BDMFBOTJOHQIBTFBEESFTTJOHDMJFOUTnDIFNJDBMEFQFOEFODJFTCZSFNPWJOHUIFNGSPN
the destructive environments that perpetuated their addictions
q a personal and social responsibility phase: natural consequences and peer interaction
helps clients to learn and accept personal and social responsibility. Self care and
personal responsibility are facilitated by natural consequences in the wilderness and
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q a transition and aftercare phase: clients prepare to return to the environment from
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*ODSFBTFE
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constructive use of leisure opportunities, and reduced rates of reoffence are also seen as
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5IFSBQFVUJDHBSEFOJOH
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5IF
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55
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discussed in section 4.3.4.
5.5.4 Horticulture therapy
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them to employment. This type of horticulture therapy is rooted within a rehabilitation model
4BOEFMQ
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are commonly seen. This is described in detail in the next section. The third type is a social
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56
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A study to assess the effectiveness of horticulture therapy activities was conducted at an
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activities.
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involvement in therapeutic horticulture had improved their relationships with their family (54
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normally socially excluded, vulnerable adults who were commonly otherwise subjected to
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5.5.5 Green exercise
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health related measures.
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fact that none of these improvements were affected by the type, intensity or duration of the
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improvements in mental health scores, a reduction in depression, and a trend towards
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58
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climb trees and enjoy nature.
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From a mental health perspective this method of contact with nature is believed to be
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Green schoolyards provide opportunities to relax, exercise and restore attention for all
children. They also improve teacher motivation, social behaviours and relationships while
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outdoor environment, has also been shown to improve physical activity levels for children
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standardised achievement test scores, improved attitude towards school, and improvements
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q overall there were improvements in school social environments.
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#Z
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activities are believed to favour a resistance to disease as well as to assist in the path to
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health or social problems for a short while.
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61
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combined within a treatment intervention to protect and enhance the health of individuals
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$POUBDUXJUIBOJNBMT
I have always enjoyed animals and marvelled at their effect on people. They seem to possess
several of the characteristics that Carl Rogers described as being so important to the therapeutic
relationship: ‘unconditional positive regard and warmth’.
1BSTIBMMQ
62
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historical perspectives on human and animal relationships, and the development of research
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sources, they are noted.
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in treatment plans for handicapped people.
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"SCPS.JDIJHBOBOEQTZDIJBUSJTU.JDIBFM.D$VMMPDIQSFTDSJCFEQFUTGPSQBUJFOUT"SPVOEUIF
same time, veterinarian Leo Bustad started Bustad Buddies at Pullman Memorial Hospital and
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conducted early research on the effects pets have on blood pressure and human mortality
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Children with pervasive developmental disorders have shown both behavioural and social
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63
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centres, hospitals, schools, rehabilitation facilities, acute and critical care units and prisons
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been seen to externalise and communicate aspects about themselves and their experiences
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64
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Documented evidence shows that people who feel any connection for companion animals
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5.6.1 Pet ownership
There seems to have been a universal need and affection for pets, which took different forms in
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with nature and with the elemental forces of nature which may be symbolised by God. It appears
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human needs.
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65
Our need for love, closeness and touching, and connection with nature, is what draws us to pets
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and abilities that still makes them suited for survival in nature. Our close relationship with them
keeps nature ever near, and in a very convenient, safe, cuddly and loving form.
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companionship, humour, play, exercise, a sense of power, outlets for displacement, projection
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older adult Medicare patients, those who owned pets appeared to experience less distress and
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reported that pets provided them with added opportunities for relationships, fun, play,
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66
Any type of relationship in which an individual feels cared for, loved or valued can be
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has a positive effect on the competency of individuals to cope with the everyday stressors
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such as enhanced immune function and the reduction of either perceived stress or the
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visits as a result of stressful life events compared to pet owners, and the authors have
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problem, many respondents noted the importance of pets for their mental health in terms of
companionship, friendship and love as well as positive impacts on their physical health (Kidd
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68
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that, for people with physical disabilities, contact with animals leads to fewer depressive
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4DIMPUFQ
Animal-assisted interventions (AAI)
May be co-facilitated by dogs, cats, horses, rabbits,
farm animals, rodents and other small animals,
birds, aquatic animals and wild animals.
Animal-assisted therapy
(AAT)
As practised in the helping
professions, such as
counselling, psychotherapy,
social work etc. With horses,
it is known as equinefacilitated mental health,
equine-assisted psychotherapy, equine-facilitated
counselling etc.
As practised in
physiotherapy/kinesiology.
With horses, it is known
as hippotherapy
As practised in other
para/medical professions,
such as recreational therapy,
speech therapy, nursing,
occupational therapy etc.
Animal-assisted education
(AAE)
Animal-assisted activities
(AAA)
Reading assistance animals
Pets or certified "therapy"
animals in the classroom
Informal pet visitation (e.g.
family member brings pet to
visit grandparent in hospital)
Dog-bite prevention
programs
Certified "therapy" animal
visitation programs (e.g. in
the context of recreational
programs in nursing homes)
Humane education programs
Therapeutic riding
Companionable zoos and
therapeutic farms (may also
provide AAT and AAA)
Equine-facilitated learning,
in the context of personal
and professional development
and experiential learning
(may overlap significantly
with equine AAT in the
helping professions)
Prison/juvenile detention
centre-based dog/horse
training programs
Figure 2: Types of animal-assisted interventions (Schlote 2009, p. 4)
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discussed in any detail.
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Q
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Pets can bring out the best in us. They help us empathise, focus outward, nurture, develop
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non-judgmental acceptance and teach loving touch. Pets put us in touch with that good and kind
inner being we so sparingly let out.
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5IF
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"MMFUBMQ
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q GPTUFSJOHTPDJBMJTBUJPO
q JODSFBTJOHBXJUIESBXOQFSTPOnTSFTQPOTJWFOFTTBOEBOJNBUJPO
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q IFMQJOHUPLFFQJOEJWJEVBMTJOUPVDIXJUISFBMJUZCZQSPWJEJOHGPSNTPGTFOTPSZ
stimulation.
Patients who have symptoms of withdrawal and show little response towards attempts by
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therapeutic introduction of animals.
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In the case of children and adolescents with severe emotional disorders, who often display an
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which included rapport and physical contact with the animals, resulted in reduced stress and
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Reported data from numerous hospitals claim that patients and staff are happier, less sad,
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""5IBTCFFOTIPXOUP
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need for medications, enhance quality of life, improve physical function, decrease stress and
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of distraction away from the illness and provide relaxation to the children. These expectations
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place and the ward a happier one with the presence of the pets.
A classic study on the use of animals therapeutically to assist inpatients to handle stress
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patients.
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for patients with psychotic disorders, mood disorders and other disorders after AAT,
and for patients with mood disorders after therapeutic recreation sessions. The authors
concluded that AAT was associated with reduced anxiety levels for inpatients with a variety
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reduced anxiety levels for those with mood disorders.
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stay clients, beyond those accounted for by the presence of a human visitor such as a
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who developed a chronically depressed mood. The presence of a terrier, adopted by the
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A case study of an assault victim who had treatment resistant depression, shows evidence
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at the time he presented himself to the hospital, did not display any psychotic symptoms
or meet the criteria for mania. What he did present were symptoms of atypical depression
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characterised by low mood, hopelessness, persistent tearfulness, rejection sensitivity,
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others for approval and reassurance.
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responsible behaviour, a request was made to the staff and upon evaluation, a suitable
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""5XJUISFTJEFOUTPGBHFEDBSFGBDJMJUJFT
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for patients with dementia to increase levels of socialisation, activity and a sense of mastery.
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5.6.2b Therapeutic use of dolphins
A recent study has examined the effects of dolphins on mildly to moderately clinically
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5.6.2c Therapeutic use of horses
There is something about the outside of a horse that is good for the inside of a man.
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writers such as Galen and others are also believed to have commented with optimism on the
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Horses are believed to be unique in the manner in which they respond to humans and, due
to the sensitivity they show the environment, they are believed to have the ability to read
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Research has shown that the majority of adolescents and children with severe emotional
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EFP is a form of psychotherapy which includes a horse in the therapy session and at times
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of all three terms is combined.
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friendships and have successful social interaction with people.
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clinical maladjustment composite, atypical scale, sense of inadequacy scale, and relationship
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scale, conduct problems scale, anxiety scale, depression scale, somatisation scale, attention
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on seven scales.
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of Australia Limited provides information on similar services offered to people with diverse
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for people who are often socially isolated to interact and communicate with others who have
similar interests, while the horse has also been shown to serve as a therapeutic outlet for
communication and stress.
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Apart from the types of animals discussed above, other animals such as rabbits, birds,
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12 months examined the effects animals had on patients and found that, compared to the
wards without animals, the wards with animals used half the quantity of medication, had
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in normal social situations, the interaction and socialisation with the parrots rebuilds this
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the community as healthy individuals.
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disorders, and anxiety and personality disorders completed questionnaires which measured
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meditation in nature activates a deeper connection that is larger than us.
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Scientists also believe that the behaviours of people in modern human societies have created
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be affordable, accessible and equitable choices to consider within both preventative and
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expressed the desire to participate in occupations which facilitate social interactions and the
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ecotherapeutic approaches described in sections 5.1 to 5.5.
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cities and the demands of jobs are effectively reduced and restoration and recovery from
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It has been well established that natural environments offer a more effective way of
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urban environments, requested volunteers to rate the restorative quality of views of natural
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selected by participants who complained of headaches, chest or stomach pains and faintness
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spent in favourite natural places compared to those without health problems.
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four predictor variables additionally included in the study were the four common features of a
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for fascination in the study questionnaire as well as the fact that the questions were oriented to
focus on fascination instead of soft fascination, which is supposed to have special restorative
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relaxation, opportunity to contemplate in privacy and the calmness of the environment that
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as a whole.
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many similar views. Study participants believed that:
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stress reduction technique in future interventions.
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The sense of rejuvenation and relaxation that has been documented in many of these studies
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88
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not provide alternative explanations for the study results. The results from this study show
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The most recent study by these authors examined the effects of exposure to various physical
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facility, the children completed concentration and impulse control tests, administered by a
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#VSMTB
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A fact sheet published by what was then the NSW Department of Tourism, Sport and
Recreation states that participation in sports and recreational activities is a powerful way to
improve the quality of life for people with ABI (Department of Tourism, Sport and Recreation
/48
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many philosophers, writers and laypeople, and recent studies have proven the validity of
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While social incivility, irritability and deterioration of interpersonal relations have been noted
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evidence in the literature shows that directed attention plays a crucial role in successful
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Controlled perception, which can also be described as directed attention, is utilised to a very
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students to natural environments, urban environments and passive relaxation conditions
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hypotheses were supported by the results. Participants felt that recovery from attention
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affected the outdoor experience. The results showed there was no difference in the manner
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nature experience alone that had an impact on their ability to concentrate.
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can be established that nature in all its diversity can provide a number of the variables required
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the newly formed nerve cells move to the injured area in attempts to repair the area (Komitova
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Researchers have proposed that this process may be relevant to people who suffer severe
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Certainly, in other related studies, natural environments have been shown to function as a
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that the rehabilitative effect of nature is tied to its function as an enriched environment, which
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interaction, achievement and relaxation, which contribute to quality of life for people with
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Adults who exercise have been shown to have lower anxiety levels, both chronic and acute
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and based on their achievements, were not competent at sports. Results also showed
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the possibilities it offers for aesthetic appreciation and also the active interest it instils in
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recreational and transport requirements.
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sportsmen showed consistently lower stress levels, as measured by heart rate and cortisol
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Given that human mental health is a state of being that is both affected by and affects the world
in which we live, the link between mental health and climate change is critical if we are to achieve
positive change. Currently western ways of thinking and doing perpetuate the illusion that we are
not an integral part of a planetary system, but rather above and in control of it. Human
well-being—indeed survival—is likely to be very limited if this world view does not change.
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symptoms seen at the start of autumn and winter and the appearance of mania or hypomania
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be a result of the economic incapacity to actively participate in society created by those
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Already, the quality of life for many European residents is believed to have been lowered due to
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this condition can itself present with neuropsychiatric symptoms such as confusion, delirium
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rates already out of proportion to the population distribution, such factors may compound the
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result in stress for the affected populations and, potentially, mental health conditions.
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The environmental crisis is an outward manifestation of a crisis of mind and spirit. There could
be no greater misconception of its meaning than to believe it is concerned only with endangered
wildlife, human-made ugliness, and pollution. These are part of it, but more importantly, the crisis
is concerned with the kind of creatures we are and what we must be in order to survive.
1SPGFTTPS-ZOUPO,$BMEXFMMDJUFEJO5PXOTFOEBQ
It is good to realise that if love and peace can prevail on earth, and if we can teach our children to
honour nature’s gifts, the joys and beauties of the outdoors will be here forever.
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IVNBOIFBMUI8)0
While environmental protection and sustainability are closely connected to human health
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community can play to ensure a healthy and sustainable future for both the planet and its
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towards the environment affect their behaviour and actions, but also that these values are
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q IFMQUPSFJOGPSDFUIFOFFEUPJNQSPWFHSFFOTQBDFTBTBSFTPVSDFGPSIFBMUI
q FNQPXFSDPNNVOJUJFTUPDPMMFDUJWFMZDSFBUFTPMVUJPOTBOEXPSLUPXBSETDPNNPOHPBMT
q create a sense of ownership and foster a sense of community cohesion and social
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5IFQSPKFDUTEJTDVTTFEJOUIFCPPLRestorative Commons: Creating Health and Well-Being
Through Urban Landscapes$BNQCFMMBOE8JFTFO
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relaxation derived from the serenity of the bushland environment, reduced social isolation and
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for all participants.
"SFDFOUSFQPSUJOWFTUJHBUJOHUIFQPUFOUJBMNPUJWBUPSTCBSSJFSTBOECFOFåUTPGFOWJSPONFOUBM
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q &7JTCPUIMJOLFEUPBOEQSPNPUFTTPDJBMJODMVTJPO
q EV is seen as a potential tool to overcome social exclusion and isolation1
q EV promotes social capital, which is commonly used to refer to social structures
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q &7JNQSPWFTTFMGFTUFFNBOEQSJEF2
q &7FOIBODFTTFMGFGåDBDZBOEIBTFNQPXFSJOHQPUFOUJBM
q &7QSPNPUFTPQQPSUVOJUJFTGPSCFJOHPVUEPPSTFOKPZJOHOBUVSFBOEJUTFMFNFOUT
Participants in this study commented:
“I can sit in the hillside for ten minutes and it can be as effective as a Prozac. I can sit there and I just
get a high, I suppose from looking at the beauty.”
0n#SJFOFUBMQ
“I mean, we come out bird watching, it doesn’t cost us a penny, but at the end of the day, I’ll go
home after I’ve had a good day out somewhere, hit the pillow on the night and there’s no rubbish
in your head; you hit the pillow and you’re gone. You wake up the next day and you’re refreshed
and you feel better within yourself and you feel like you’ve achieved something and you just feel that
you’re a better human being and you haven’t got any time for the dross that’s going on around you.”
0n#SJFOFUBMQ
1
A US study showed that people experiencing social isolation were “6.59 times less likely to survive a
stroke, 3.22 times more likely to commit suicide and 1.59 times less likely to survive coronary heart
disease” (Kawachi et al. 1996; cited in O’Brien et al. 2008, p. 30).
-PXTFMGFTUFFNIBTCFFOJEFOUJåFEBTBTTPDJBUFEXJUISJTLGBDUPSTTVDIBTBMDPIPMBCVTF1SJUDIBSE
et al.; cited in O’Brien et al. 2008). Additionally “self-esteem can buffer the impact of stress on
psychological distress (Marcussen 2006, p. 6).
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with nature itself, the study results showed participants had minimal environmental and
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populations. As numerous researchers, scientists, philosophers and political leaders have
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a relevant factor to be considered in this equation, as the study showed that the most
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112
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113
"QQFOEJY"r-JTUPGCPPLTVTFEEVSJOHUIFMJUFSBUVSFTFBSDI
"MUNBO*BOE8PIMXJMM+FET
Behaviour and the Natural Environment, Plenum Press,
/FX:PSL/:
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Advances in environmental psychology, Lawrence
&SMCBVN"TTPDJBUFT)JMMTEBMF/+
#FDL"BOE,BUDIFS"Between Pets and People: The Importance of Animal
Companionship1VUNBO/FX:PSL/:
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Australia/FX4PVUI8BMFT6OJWFSTJUZ1SFTT-UE4ZEOFZ/48
$IBOEMFS$Animal Assisted Therapy in Counselling, 3PVUMFEHF/FX:PSL/:
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Hospitals, NAI Publishers, Rotterdam.
&NPSZ%Effects of Therapeutic Horsemanship on the Self Concept and Behaviour of
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114
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116
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nature .BMMFSFUBM
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A = Anecdotal
T = Theoretical
E = Empirical
What the research demonstrates with certainty
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physiological effects that occur when
humans encounter, observe or otherwise
positively interact with animals, plants,
landscapes or wilderness
Natural environments, such as parks,
foster recovery from mental fatigue and
are restorative
There are established methods of naturebased therapy (including wilderness,
horticultural and animal-assisted therapy
among others) that have success
healing patients who previously had not
responded to treatment
When given a choice people prefer natural
environments (particularly those with water
features, large old trees, intact vegetation
PSNJOJNBMIVNBOJOæVFODF
UPVSCBO
ones, regardless of nationality or culture
The majority of places that people
consider favourite or restorative are
natural places, and being in these places
is recuperative
People have a more positive outlook on
life and higher life satisfaction when in
proximity to nature (particularly in urban
areas)
The majority of health problems society
will face, now and in the future, are likely
to be stress-related illnesses, mental
health problems and cardiovascular
health problems
118
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&
D D D
D D D
D D D
D D
D D D
D D D
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Frumkin 2001, Beck and Katcher
1996, Rohde and Kendle 1994, Ulrich
et al. 1991, Parsons 1991, Friedmann
et al. 1983a, Friedman et al. 1983b
Kaplan 1995, Hartig et al. 1991,
Kaplan and Kaplan 1990, Kaplan and
Kaplan 1989, Furnass 1979
Fawcett and Gullone 2001, Crisp and
O'Donnell 1998, Lewis 1996, Russell
et al 1996, Beck et al. 1986, Katcher
and Beck 1983, Levinson 1969
Herzog et al. 2000, Newell 1997,
Parsons 1991
Herzog et al. 2000, Hertzog et al.
1997, Newell 1997, Korpela and
Hartig 1996, Rohde and Kendle 1994,
Kaplan and Kaplan 1989
Kuo 2001, Kuo and Sullivan 2001,
Kaplan 1992a, Leather et al. 1998,
Lewis 1996, Kaplan and Kaplan 1989
Commonwealth Dept of Health and
Aged Care and Australian Institute of
Health and Welfare 1999, Australian
Institute of Health and Welfare 1998
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Social capital is decreasing and is likely to
continue to decline
T
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D D D
Exposure to natural environments, such
as parks, enhances the ability to cope
with and recover from stress, cope with
subsequent stress, and recover from
illness and injury
D D D
Observing nature can restore
concentration and improve productivity
D D D
Having nature in close proximity (e.g.
urban or national parks), or just knowing
it exists, is important to people regardless
of whether they are regular "users" of it
,FZSFGFSFODFT
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Putnam 1995
Parsons 1991, Ulrich et al. 1991,
Ulrich 1984
Taylor et al. 2001, Leather et al. 1998,
Tennessen and Cimprich 1995
Cordell et al. 1998, Kaplan and Kaplan
1989
What the research demonstrates with promise
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nature that enhances health, and
humans rely on nature intellectually,
emotionally, physically and spiritually
D D
Fawcett and Gullone 2001, Frumkin
2001, Roszak et al. 1995, Kellert and
Wilson 1993, Katcher and Beck 1987,
Wilson 1984
There may be a genetic basis to human
BGåMJBUJPOXJUIBOEBUUSBDUJPOGPSOBUVSF
D D
Kellert 1997, Newell 1997, Kellert and
Wilson 1993
Separation from nature via modern
living is detrimental to human
development, health and well-being
Regular contact with nature, such
as provided by parks, is required for
mental health
There are psychological and
QIZTJPMPHJDBMCFOFåUTUPIFBMUIGSPNUIF
act of nurturing living things (including
plants, animals, and humans)
Nurturing is an essential part of human
development, and lack of opportunities
to nurture may be detrimental to health
and well-being
5PPNVDIBSUJåDJBMTUJNVMBUJPOBOEMBDL
of exposure to natural environments,
such as parks, can cause exhaustion
and reduce vitality
T
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D D
D
D D
D D
D
Frumkin 2001, Scull 2001, Stilgoe 2001,
Kellert 1997, Katcher and Beck 1987
Kellert 1997, Bustad 1996, Wilson 1993,
Lewis 1992, Katcher and Beck 1987
Kellert 1997, Bustad 1996, Wilson 1993,
Lewis 1992, Katcher and Beck 1987
Kellert 1997, Bustad 1996, Wilson 1993,
Lewis 1992, Katcher and Beck 1987
Stilgoe 2001, Parsons 1991, Katcher
and Beck 1987, Furnass 1979,
Stainbrook 1973 in Lewis 1996
#FZPOE#MVFUP(SFFO5IFCFOFåUTPGDPOUBDUXJUIOBUVSFGPSNFOUBMIFBMUIBOEXFMMCFJOH
What research is required
"TTFSUJPO
&WJEFODF
"
Theoretical and/or empirical evidence
on whether human health is affected
by lack of opportunities to experience
nature
Theoretical and/or empirical evidence
on whether the destruction of the
nature environment directly affects
human health and well-being and is
linked to the prevalence of mental
disorders in modern society
T
Frumkin 2001, Stilgoe 2001, Kellert
1997, Katcher and Beck 1987
Roszak et al. 1995
D
Kickbusch 1989
D
Frumkin 2001, Putnam 1995
Theoretical and/or empirical evidence
on the role that natural environments
(natural capital) play in facilitating social
and human capital, and the outcome/s
in terms of health
D
Empirical evidence on the role of nature
in wilderness and adventure therapy
D D
Evidence on the extent, nature and
process of the impact of nature and
parks in maintaining psychological
health
Evidence on the extent, nature and
process of the impact of nature and
parks on quality of life (and happiness)
Evidence on whether exercise carried
out in natural settings (parks) has
HSFBUFSIFBMUICFOFåUTUIBOJOEPPS
exercise
&
D
Anecdotal and/or empirical evidence
on the importance of parks to the
community in terms of health and the
BDUVBMIFBMUICFOFåUTQFPQMFEFSJWF
from parks
Evidence on whether the health and
life satisfaction of some population
groups (e.g. Friends of Parks groups,
park volunteers, wildlife feeders and
carers, or birdwatchers) is greater
than others, where those groups have
regular contact with nature/wilderness
via parks
,FZSFGFSFODFT
Crisp and O'Donnell 1998, Crisp and
Aunger 1998
Townsend and Maller 2003, Townsend
2006, Moore et al. 2007
D
Krenichyn 2005, Wood et al. 2008
D
D D
Wood et al. 2008, Ho et al. 2005, Louv
2005
Pretty et al. 2007
D D D
121
"QQFOEJY%s&YBNQMFTPGHPBMTBOETUSBUFHJFTUPBEESFTT
NFOUBMIFBMUIDPODFSOT
5SFBUNFOUHPBMT
""5TUSBUFHZ
"OYJFUZ
Decrease symptoms of anxiety or agitation
Hold or stroke the companion animals while
interacting with the therapist or the therapy group.
Talk to the animal.
Receive affection from the animal.
Improve ability to relax using diaphragmatic
breathing and relaxation techniques
Observe how a relaxed animal rests and breathes.
Identify and reduce irrational thoughts which
trigger or exacerbate anxiety
Discuss possible origin and symptoms of the
animal’s irrational fears (e.g. thunder) and relate to
client’s fears when possible.
Practise imitating the animal while imagining
stressful situations in anxiety hierarchy
(desensitisation).
Have client consider the origins of their own anxiety
or phobia and identify the thoughts and sensations
that trigger anxiety.
Have client explain why the animal need not be
afraid. Help client develop coping self-statements
for client’s situation.
If client is a child, then ask child to help animal
confront fears with rational and more positive
beliefs. A card game that matches irrational
thoughts with the best counter ideas could be
developed.
Reduce avoidance of anxiety provoking
situations, place, groups etc
While client pets the animal, use guided imagery
to desensitise fears (e.g. confrontations,
using elevators, giving a speech, taking a test
successfully, sleeping alone in the dark).
The animal may be able to accompany the client
while they face some fears.
Increase assertiveness
%JTDVTTåHIUPSæJHIUSFBDUJPOTJOBOJNBMTDPXFSJOH
vs aggression) and apply to people.
Practise role-playing with the animal taking various
roles.
Practise process of gradually getting the animal to
approach something it initially fears.
Identify and modify lifestyle variables that
increase stress
122
Discuss stressors on animals and people (e.g.
excessive noise, not eating or sleeping well,
arguments, losses) and how these situations could
be improved.
#FZPOE#MVFUP(SFFO5IFCFOFåUTPGDPOUBDUXJUIOBUVSFGPSNFOUBMIFBMUIBOEXFMMCFJOH
5SFBUNFOUHPBMT
""5TUSBUFHZ
Reduce frequency of worrying, apprehension
and avoidance tactics
Write/tell stories (related to client’s own anxiety
and worries) about a dog or other animal that
overcomes its fears by facing them and discovering
they are not real.
If client is a child, then ask them to illustrate the
story.
Reduce secondary symptoms of anxiety
(e.g. restlessness, fatigue, irritability, stomach
aches, and sleep disturbances)
Include client’s symptoms in above stories with
ways to reduce them.
If client is a child, then exercise/play hard with
animal, then practise relaxing while petting animal
and imagining relaxing scenes together.
%FQSFTTJPO
Brighten affect and mood
Hold or stroke the companion animal while
interacting with the therapist or the therapy group.
Teach the animal to do a trick or engage in play
with the animal.
Decrease learned helplessness behaviours.
Increase sense of control over self and
environment
Work with the human–animal team to effectively
command the animal and to problem-solve when it
does not respond correctly.
Directly confront this issue, using the animal as an
example, and transfer it to other situations.
Reduce isolation, boredom, loneliness
Engage in play with the animal.
Learn about and then assist in the care/grooming/
feeding of the animal.
Reminisce about the past.
Remember and repeat information about the
animal.
Learn about the animal, then introduce the animal
to peers.
Take the animal for a walk.
Receive apparent acceptance from the animal.
Give appropriate affection to the animal.
Decrease feelings of worthlessness
Provide pleasure for, or give affection to, the animal.
Spend time caring for/grooming the animal.
Take the animal for a walk, play its favourite game
(e.g. fetch).
Address grieving/loss issues
Talk about animals the person has known.
Reminisce about past animal loss/es.
Discuss how animals might feel when their animal
companion dies, when baby animals leave their
mothers etc.
Transfer this to the human situation.
123
5SFBUNFOUHPBMT
""5TUSBUFHZ
Reduce suicidal ideation/behaviour
Ask: “If the animal were to die suddenly what
impact would his death have on those who love
him? What impact would YOUR suicide have on
your family and friends?”
3FæFDUPOUIFBOJNBMnTUPUBMTFMGBDDFQUBODF
without shame, without judging or comparing
himself to others.
If the client is a child, then talk about how the
animal has suffered a loss similar to the child’s.
Discuss how the animal might feel sad, hopeless or
guilty, and what could be done to help the animal
feel better.
Then discuss how the animal could let you know
that he was feeling better. Apply to the child.
Increase positive mood, attitudes for a period of
__ consecutive weeks
Consider the simple things that make animals/
people happy.
Engage in some of those activities.
Have client keep a Pleasure Journal of small,
enjoyable events.
Ask clients about their future and what will make
them happy. If client is a child, then ask them to
draw a picture of themself in the future.
Improve reality-testing and orientation (reduce
dissociation, self-mutilation etc.)
Have client touch or stroke animal to help ground
them in the present.
Have client describe the animal objectively in terms
of their appearance, needs, activities; where the
animal is now, what month it is etc.
Increase energy, initiative and activity level
Play actively with the animal, take animal on regular
walks (either client’s own animal or yours).
Have client plan and teach the animal a new trick.
Increase assertion
Have client obedience train their own animal or
yours.
Compare the ways animals and people react to
an assertive tone of voice, to “no”, to positive
reinforcement etc.
Improve decision-making and concentration
Ask client what to do about a problematic
behaviour of the animal’s (parallel to client’s
behaviour when possible).
Plan short-term goals and steps toward reaching
goals.
Apply process to client’s situation.
If client is a child, then allow the child to decide
what food treat to give the animal, or which game
to play, or to decide when the animal needs to go
out.
124
#FZPOE#MVFUP(SFFO5IFCFOFåUTPGDPOUBDUXJUIOBUVSFGPSNFOUBMIFBMUIBOEXFMMCFJOH
5SFBUNFOUHPBMT
""5TUSBUFHZ
Reduce irrational thoughts that increase or
maintain depression
Discuss the client’s (or animal’s) negative selfbeliefs.
Practise contradicting with rational statements.
As evidence to refute client’s irrational thoughts,
point out the animals affection and loyalty to client,
despite past mistakes, imperfections etc.
Increase social interaction
Have client interpret the animal’s feelings based on
the animal’s behaviour.
Ask the client to talk about their own feelings and
behaviours in similar circumstances.
In groups, take turns to throw a ball for the animal
or demonstrate tricks the animal has learned to do.
Discuss amazing animal tales or feats.
Get an adequate amount of restorative sleep
most nights for a period of ___
Client observes how relaxed the animal is and
how it breathes deeply. Practise similar breathing
techniques while visualising relaxing dream images
for the client (or animal).
Try the same technique at night.
Increase interest and participation in daily
activities
Monitor attendance and interaction at AAT
sessions.
Talk about the client’s daily activities and determine
what may make them more fun.
Note how frequently the client smiles at or pets the
animal.
Improve appetite most days for a period of ___
consecutive weeks
1PJOUPVUDIBSBDUFSæBXTPSæBXTJOQIZTJDBM
appearance of the animal and how they do not
affect the animal’s self image. Work on translating
this to clients who have problems with their own
self image.
If client is a child, then have a tea party where the
child feeds the animal and him or herself.
Play “red light green light” when eating meals.
"UUFOUJPO%FæDJU)ZQFSBDUJWJUZ
Improve attention/concentration
Teach the animal a trick or an obedience
command.
Transfer success in activities with the companion
animal to treatment activities and daily living
activities.
125
5SFBUNFOUHPBMT
""5TUSBUFHZ
Decrease distractibility
Work with the human–animal team to help maintain
concentration on the work with the animal when
giving commands or teaching a trick.
Directly confront this issue, using the animal as an
example, and transfer it to other situations.
Improve memory (short-term or long-term) or
recall.
Recall information about the animal (name, age,
colour, etc.).
Reminisce about animals the person knew or had
in the past.
Remember details about the animal and the
animal’s care.
Describe the animal when it is not present.
Follow a sequence of instructions with the animal.
Improve reality orientation
Take the animal around and introduce it to others.
Interact with (pat, play with, talk to, groom, etc.) the
animal.
Reminisce about the past.
Remember and repeat information about the
animal.
Describe the animal.
Decrease self-talk relating to fantasy world
Work with the human–animal team to emphasise
the importance of staying focused on the “here and
now” with the animal when giving commands.
Directly confront this issue, using the animal as an
example, and transfer it to other situations.
(Information extracted from The Therapy Dog Training Institute, 1999, ‘Utilising therapy dogs in
mental health settings’; The Delta Society, 1996, ‘The Human Health Connection: Standards of
practice for animal-assisted activities and therapy’; and The Delta Society, 1997, ‘Therapeutic
Interventions’; cited in Urichuk and Anderson, 2003, pp. 94–105).
126
#FZPOE#MVFUP(SFFO5IFCFOFåUTPGDPOUBDUXJUIOBUVSFGPSNFOUBMIFBMUIBOEXFMMCFJOH
"QQFOEJY&s&OHMJTIUFSNJOPMPHZJOUIFMJUFSBUVSFBOEJO
QSBDUJDF
"OJNBMTJOHFOFSBM
)PSTFT
Pet therapy
1FUBTTJTUFEUIFSBQZ
1FUGBDJMJUBUFEQTZDIPUIFSBQZ
1FUPSJFOUFEDIJMEQTZDIPUIFSBQZ
1FUPSJFOUFEQTZDIPUIFSBQZ
Pet psychotherapy
1FUNFEJBUFEUIFSBQZ
Pet visitation
)VNBODPNQBOJPOBOJNBMUIFSBQZ
"OJNBMGBDJMJUBUFEUIFSBQZ
"OJNBMBTTJTUFEUIFSBQZ
"OJNBMBTTJTUFEQTZDIPUIFSBQZ
"OJNBMBTTJTUFEDPVOTFMMJOH
"OJNBMBTTJTUFETPDJBMXPSL
"OJNBMBTTJTUFEFEVDBUJPO
"OJNBMBTTJTUFEMFBSOJOH
"OJNBMBTTJTUFEOVSTJOH
"OJNBMGBDJMJUBUFEDPVOTFMMJOH
"OJNBMBTTJTUFEBDUJWJUJFT
"OJNBMBTTJTUFEJOUFSWFOUJPOT
"OJNBMBTTJTUFETVQQPSUTFSWJDFT
"OJNBMBTTJTUFETVQQPSUNFBTVSFT
"OJNBMBTTJTUFEDSJTJTSFTQPOTF
$PUIFSBQZXJUIBOBOJNBM
'PVSGPPUFEUIFSBQZ
&RVJOFGBDJMJUBUFEQTZDIPUIFSBQZ
&RVJOFBTTJTUFEQTZDIPUIFSBQZ
&RVJOFGBDJMJUBUFEDPVOTFMMJOH
&RVJOFGBDJMJUBUFEQFSTPOBMEFWFMPQNFOU
&RVJOFGBDJMJUBUFEFYQFSJNFOUBMMFBSOJOH
&RVJOFBTTJTUFEFYQFSJNFOUBMMFBSOJOH
&RVJOFGBDJMJUBUFENFOUBMIFBMUI
&RVJOFGBDJMJUBUFEXFMMOFTT
&RVJOFGBDJMJUBUFEMJGFDPBDIJOH
&RVJOFBTTJTUFEDPBDIJOH
&RVJOFBTTJTUFEHSPXUIBOEMFBSOJOH
&RVJOFBTTJTUFEMFBSOJOHBOEDPBDIJOH
&RVJOFHVJEFEFEVDBUJPO
&RVJOFHVJEFEDPBDIJOH
&RVJOFBTTJTUFETFMGJNQSPWFNFOUT
&RVJOFBTTJTUFEUIFSBQZ
&RVJOFBTTJTUFEMFBSOJOH
&RVJOFGBDJMJUBUFEMFBSOJOH
&RVJOFHVJEFEMFBSOJOH
Hippotherapy
5IFSBQFVUJDSJEJOH
3JEJOHUIFSBQZ
)PSTFBTTJTUFEUIFSBQZ
)PSTFBTTJTUFEMFBSOJOH
)PSTFBTTJTUFEDPBDIJOH
)PSTFHVJEFEMFBSOJOH
&RVJOFFYQFSJNFOUBMMFBSOJOH
&RVJOFFYQFSJNFOUBMMFBSOJOHBOEDPBDIJOH
0UIFSTQFDJFT
$BOJOFBTTJTUFEUIFSBQZ
%PHBTTJTUFEUIFSBQZ
$BUBTTJTUFEUIFSBQZ
#JSEBTTJTUFEUIFSBQZ
-MBNBBTTJTUFEUIFSBQZ
#PWJOFBTTJTUFEUIFSBQZ
'BSNBOJNBMBTTJTUFEUIFSBQZ
%PMQIJOBTTJTUFEUIFSBQZ
&MFQIBOUBTTJTUFEUIFSBQZ
Table extracted from Schlote 2009, p. 9.
"QQFOEJY's*NQBDUTBOECFOFæUTPGoPGGFOEFSTBOEOBUVSFp
TDIFNFT
128
/BUVSF
QSPWJEFS
PSHBOJTBUJPOT
1SJTPOBOE
PGGFOEFS
NBOBHFNFOU
Ability to carry
out work that is
desirable but not
done due to lack
of resources (staff
time unavailable
or contractor
costs high)
Prison delivering
effective
rehabilitation
and reintegration
opportunities to
prisoners
Opportunity to
test structured
approach to
working
Areas made
lighter and
brighter
(improved feeling
of security)
More diverse
woodlands and
habitats
Work completed
to a high
standard due
to enthusiasm
and hands-on
approach; more
åOJTIFEBOE
SFåOFEMPPLCZ
using hand tools
Large step
forwards for
prisoners nearing
end of their
sentences in
being granted
release on
temporary license
to work outside
prison
Opportunity to
improve mental
health and wellbeing and selfesteem through
regular physical
outdoor activities;
also affects
emotional stability
and ability to
adjust to life’s
demands
Improved
aesthetics of
woodland nature
conservation
areas (areas
looking tidier and
appreciated by
most, although
not all)
Increased
populations of
common and
rare fauna and
æPSBEVFUPBDUJWF
conservation
management
practices
Ecosystems
improved
through targeted
management of
habitats to favour
diversity
Offenders carry
out reparative
work—repaying
debt they owe to
society
Chance to
experience
restorative effects
of woodlands and
green spaces
Improved
accessibility,
better-maintained
paths
Restoration
of neglected
habitats
“Investing
in People”;
providing an
opportunity for
disadvantaged
people to gain
work experience
and training in
the land-based
employment
sector
Offenders have
the opportunity to
gain experience
in a commercial
but supportive
environment,
improving their
employability after
release
Opportunity
to improve
QIZTJDBMåUOFTT
and experience;
PUIFSCFOFåUT
of outdoor work
(fresh air, pleasant
surroundings)
Increased
sightings of
CJSETCVUUFSæJFT
æPSBBOEGBVOB
due to active
conservationmanagement
practices
0GGFOEFS
WPMVOUFFST
$PNNVOJUZ
&OWJSPONFOU
#FZPOE#MVFUP(SFFO5IFCFOFåUTPGDPOUBDUXJUIOBUVSFGPSNFOUBMIFBMUIBOEXFMMCFJOH
/BUVSF
QSPWJEFS
PSHBOJTBUJPOT
1SJTPOBOE
PGGFOEFS
NBOBHFNFOU
Nurturing a future
workforce and
volunteer base
Enabling offender
to develop
personal skills
(communication,
decision making,
endurance/
stamina, team
-working)
Chance to
develop personal
and interpersonal
skills in a
non-prison
environment (with
supervisor, fellow
workers and site
visitors)
Experiencing
positive
outcomes of
“punishment
systems”; form
of reparation and
reconciliation
Increasing public
awareness of
investment
in social
forestry, nature
conservation and
public access to
green space
Duty of care to
prisoners in terms
of providing
a healthy
environment and
staying in good
health
Develop teamworking skills,
awareness of
health and safety
issues, and a
safe approach
to working in
a potentially
hazardous
environment
Experiencing
offenders
as “working
people” and
“fellow human
beings” (part
of a restorative
process)
Positive thinking
and experiences
of prisoners can
send a message
of hope and
opportunity to
other inmates
0GGFOEFS
WPMVOUFFST
$PNNVOJUZ
&OWJSPONFOU
Movement
towards more
environmentally,
socially
economically
sustainable
outcomes
Carter and Hanna 2007
3FGFSFODFT
"CCPU$IBQNBO+m5JNFPVUJOmHSFFOSFUSFBUTnBOEBEPMPTDFOUXFMMCFJOHnAustralian Youth Studies, vol.
OPQQr
"CSBIBN-m(BSEFOJOHUVSOTPVUUPCFHFOUMFUIFSBQZGPSEFQSFTTJPOnAkron Beacon Journal+VOF
"EMBSE11FSSFBV71PQ7BOE$PUNBO$m7PMVOUBSZFYFSDJTFEFDSFBTFTBNZMPJEMPBEJOBUSBOTHFOJD
NPEFMPG"M[IFJNFSnTEJTFBTFnJournal of NeuroscienceWPMOPQQr
"MESJEHF+4FNQJL+BOE#FDLFS4m4PDJBMBOEUIFSBQFVUJDIPSUJDVMUVSF&WJEFODFBOENFTTBHFTGSPN
SFTFBSDInCenter for Child and Family Research: Evidence Issue, vol. 6.
"MM"-PWJOH(BOE$SBOF-m"OJNBMT)PSTFCBDL3JEJOHBOE*NQMJDBUJPOTGPS3FIBCJMJUBUJPO5IFSBQZn
The Journal of RehabilitationWPMOPQQr
"MMEFSJEHF1m"DBUTVSQBTTJOHJOCFBVUZBOEPUIFSUIFSBQFVUJDBOJNBMTnPsychiatric Bulletin, vol. 15, pp.
r
"MMFO+,FMMJHSFX%BOE+BGGF%m5IFFYQFSJFODFPGQFUPXOFSTIJQBTBNFBOJOHGVMPDDVQBUJPOn
Canadian Journal of Occupational TherapyWPMOPQQr
"NFSJDBO"DBEFNZPG1FEJBUSJDTm$MJOJDBMQSBDUJDFHVJEFMJOFEJBHOPTJTBOEFWBMVBUJPOPGUIFDIJMEXJUI
BUUFOUJPOEFåDJUIZQFSBDUJWJUZEJTPSEFSnPediatricsWPMQQr
"OEFSTPO*BOE1BSU1EEA report 10/2005: Environment and Health&VSPQFBO&OWJSPONFOU"HFODZ
$PQFOIBHFO
"OEFSTPO83FJE$BOE+FOOJOHT(m1FUPXOFSTIJQBOESJTLGBDUPSTGPSDBSEJPWBTDVMBSEJTFBTFnThe
Medical Journal of AustraliaWPMQQr
"OESFX,m5IFXJMEFSOFTTFYQFEJUJPOBTBSJHIUPGQBTTBHFnJournal of Experiential Education, vol. 22, no.
1, pp. 3543.
"OUPOJPMP$BOE3FWFMFZ.m3BOEPNJTFEDPOUSPMMFEUSJBMPGBOJNBMGBDJMJUBUFEUIFSBQZXJUIEPMQIJOTJOUIF
USFBUNFOUPGEFQSFTTJPOnBritish Medical Journal, vol. 331, pp. 1231–1234.
"SNTUSPOH%Bm"DPNNVOJUZEJBCFUFTFEVDBUJPOBOEHBSEFOJOHQSPKFDUUPJNQSPWFEJBCFUFTDBSFJOB
OPSUIXFTU"NFSJDBO*OEJBOUSJCFnDiabetes EducatorWPMOPQQ
ssCm"TVSWFZPGDPNNVOJUZHBSEFOTJOVQTUBUF/FX:PSL*NQMJDBUJPOTGPSIFBMUIQSPNPUJPOBOE
DPNNVOJUZEFWFMPQNFOUnHealth and PlaceWPMOPQQr
"SOPME+m5IFSBQZEPHTBOEUIFEJTTPDJBUJWFQBUJFOUQSFMJNJOBSZPCTFSWBUJPOTnDissociation, vol. 8, pp.
r
"VTUJO&+PIOTUPO:BOE.PSHBO-m$PNNVOJUZ(BSEFOJOHJOB4FOJPS$FOUFS"UIFSBQVFUJD
JOUFSWFOUJPOUPJNQSPWFUIFIFBMUIPGPMEFSBEVMUTnTherapeutic Recreation JournalWPMOPQQr
"VTUSBMJBO#VSFBVPG4UBUJTUJDT.FBTVSJOH8FMMCFJOH'SBNFXPSLTGPS"VTUSBMJBOTPDJBMTUBUJTUJDT$BOCFSSB
ACT: Commonwealth of Australia.
"VTUSBMJBO#VSFBVPG4UBUJTUJDTPopulation Distribution, Indigenous Australians, 2001"#4$BU/P
Australian Bureau of Statistics, Australian Government, Canberra, ACT.
ssThe Health and Welfare of Australia’s Aboriginal and Torres Straight Islander Peoples 2003, ABS Cat.No.
"VTUSBMJBO#VSFBVPG4UBUJTUJDT"VTUSBMJBO(PWFSONFOU$BOCFSSB"$5
ssNational Aboriginal and Torres Straight Islander Social Survey 2002"#4$BU/P"VTUSBMJBO
Bureau of Statistics, Australian Government, Canberra, ACT.
ssThe Health of Older People in Australia: A snapshot 2004-05"#4$BU/P"VTUSBMJBO
Bureau of Statistics, Australian Government, Canberra, ACT.
ssBPrisoners in Australia 2008"#4$BU/P"VTUSBMJBO#VSFBVPG4UBUJTUJDT"VTUSBMJBO
Government, Canberra, ACT.
ssCAustralian Social Trends"#4$BU/P"VTUSBMJBO#VSFBVPG4UBUJTUJDT"VTUSBMJBO(PWFSONFOU
Canberra, ACT.
ssBAustralian Social Trends, March 2009"#4$BU/P"VTUSBMJBO#VSFBVPG4UBUJTUJDT"VTUSBMJBO
Government, Canberra, ACT.
ssCPopulations by Age and Sex: Regions of Australia, 2008"#4$BU/P"VTUSBMJBO#VSFBVPG
Statistics, Australian Government, Canberra, ACT.
Australian Conservation Foundation [ACF], Australian Council of Social Service, and CHOICEEnergy Equity:
1SFQBSJOHIPVTFIPMETGPSDMJNBUFDIBOHFFGæDJFODZFRVJUZBOEJNNFEJBDZSFUSJFWFE4FQUFNCFShttp://
acoss.org.au/papers/energy_equity>.
#FZPOE#MVFUP(SFFO5IFCFOFåUTPGDPOUBDUXJUIOBUVSFGPSNFOUBMIFBMUIBOEXFMMCFJOH
"VTUSBMJBO)FBMUI.JOJTUFSTNational Mental Health Plan 2003–2008, Australian Government, Canberra, ACT.
"VTUSBMJBO*OTUJUVUFPG)FBMUIBOE8FMGBSFThe Health and Welfare of Australia’s Aboriginal and Torres Strait
Islander Peoples 2003, AIHW Cat.No. IHW11, Australian Institute of Health and Welfare, Canberra, ACT.
"VTUSBMJBO*OTUJUVUFPG)FBMUIBOE8FMGBSFAustralia’s Health 2008. The eleventh biennial report of the
Australian Institute of Health and Welfare, AIHW, Canberra
ssJuvenile detention numbers on the riseSFUSJFWFE/PWFNCFShttp://www.aihw.gov.au/
mediacentre/2009/mr20091104.cfm>.
"VTUSBMJBO*OTUJUVUFPG6SCBO4UVEJFTBOE$JUZPG.FMCPVSOFm$IBQUFS0QFO4QBDFnEnvironmental
Indicators for Metropolitan MelbourneOPQQr
ssEnvironmental Indicators for Metropolitan Melbourne, no. 5,
#BHPU,m5IF*NQPSUBODFPG(SFFO1MBZ4QBDFTGPSDIJMESFO"FTUIFUJDBUIMFUJDBOEBDBEFNJDn The
Journal of the Victorian Association for Environmental Education, vol. 28, no. 3, pp. 12–16.
#BJOFT$m$IBJSNBOnTJOUSPEVDUJPOnGreenspace and Healthy Living National Conference.BZ
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