Green Care: A Conceptual Framework - Frisk i naturen

model is that people develop self-identity and derive a sense of fulfilment
through daily occupations. Meaningful and successful experiences
develop confidence and feelings of mastery which motivate them to
meet new challenges. Occupational therapy interventions may include
building personal capabilities, modifying environments, or reconsidering
occupational processes and goals (Christiansen et al, 2005). These too are
outcomes which green care programmes aim to achieve.
5.2 Therapeutic communities as green care
communities
Therapeutic communities for adults, in specific mental health settings,
came about as a result of two British war time experiments, at Northfield
Military Hospital in Birmingham and Mill Hill in London (Kennard, 1998).
Both were innovative group based programmes for aiding the recovery of
battle shocked soldiers, based on psychoanalysis and social learning theory;
they included little horticultural or agricultural activity. From these, the
modern therapeutic communities in the British National Health Service
have evolved. However, although they are often identified as the origin of
therapeutic communities, their work was predated by important movements
in mental health generally called ‘moral treatment’, more than a century
beforehand. For example, Samuel Tuke founded the Retreat Hospital in
1796, as a reaction by the Quakers against the poor conditions then existing
for the treatment of mental illness. In these more humane settings of care,
hospital farms were an important part of the therapy and ideas of selfsufficiency
were included.
Since the middle of the twentieth century, specialised therapeutic
communities have also developed in British prisons, using a democratically
structured programme of group therapy. These have limited but variable
access to therapeutic horticultural activities.
Illich (1976) strongly criticised the way in which people’s bodily condition
was made pathological and often worse by over-zealous medicalisation
and “expropriation of their health”. Therapeutic communities, although
often residing in old-fashioned institutional settings, espoused a very
different view to the traditional medical one: rather than health and its care
being expropriated by irresistible and powerful external forces, healing
is substantially the responsibility of the individuals concerned and their
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