Date Presented 04/01/2022

People with mental illness and limited resources tend to experience depression and decreased motivation to socialize with others. As a therapeutic intervention, gardening can affect a person’s mental health, well-being, social participation, and life satisfaction. This case series monitored four residents at a transitional housing facility to assess the preliminary and conclusive effects of a 5-week gardening group therapy on hope and well-being.

Primary Author and Speaker: Jessica Dawn Tsotsoros

Additional Authors and Speakers: Reagan Collins, Amberlee Middleton, Juanita Hinckley, Breanna Boyer, Alexandra Speer

Contributing Authors: Hope Beach, Piper Rinehart, Alexandra Hamilton, Elizabeth Wallace, Amber Estes, Kaci Cunningham

BACKGROUND: Gardening activities provide positive health outcomes such as reducing depression and anxiety, improving quality of life, and an increased sense of community (Soga et al., 2016). This case series followed four residents living in a supported housing facility, consisting of veterans and previously unhoused individuals, many of whom have mental illnesses and comorbidities. This facility aims to prevent homelessness by offering activities to increase community engagement and job participation. Previously, no occupation-based activities, like gardening, were offered. The participants contributed to a preliminary needs assessment to understand the context and current occupations. The results suggested that COVID-19 increased the prevalence of grief, depression, and loneliness, contributing to decreased community participation. While living in transitional housing, a person can easily lose their sense of self-worth and purpose, contributing to withdrawal from their community. Forming connections to help individuals thrive in social situations while developing purpose, is beneficial for decreasing feelings of despair (Terry et al., 2019). To close this gap we established a five-week group intervention.

PURPOSE: To establish a community garden addressing the needs of participation and sense of belonging, facilitating empowerment and encouraging purposefulness. Ultimately, uncovering the participants’ potential to overcome obstacles hindering them from meeting their goals and choosing healthy pathways.

METHOD: This case series used pre- and post-measures to evaluate an occupation-based group therapy intervention. Fifteen residents at the facility signed up for the group intervention, and five consented to the research study. Four participants attended 80% or more of the two-hour sessions. At the end of the five weeks, semi-structured interviews were held to discuss personal growth and overall thoughts about the program. Audio recordings were utilized to document the responses and stored on a secured, encrypted file to be transcribed and de-identified. Pre and post measures included the Flourishing Scale (FS) and the Trait Hope Scale (THS) for Adults. The FS is an eight-item scale administered to measure features of social-psychological functioning associated with subjective experiences of living life while striving to better oneself. (Schotanus-Dijkstra et al., 2016). The THS was designed to examine the natural inclination of hope in people 15 years and older. The format of the scale uses four questions related to agency, four associated with pathway, and the remainder are distractor questions (Coduti & Schoen, 2014).

RESULTS: Two participants improved on the THS. One participant displayed growth on all scales. Two participants improved on the FS, all four participants demonstrated positive change in their agency scores, and one participant improved on their pathway score. Preliminary data from the interviews revealed themes of “hope” and “finding a path.”

CONCLUSION: Based on our findings, a community garden can provide an avenue for hope and self-fulfillment for adults with mental illness in a supported living environment. Occupational therapy practitioners may consider community gardening as a group intervention for this population for the benefit of increasing hope and finding a meaningful path for participants.


Coduti, W. A., & Schoen, B. (2014). Hope model: A method of goal attainment with rehabilitation services clients. Journal of Rehabilitation, 80(2), 30-40.

Schotanus-Dijkstra, M., Ten Klooster, P. M., Drossaert, C. H. C., Pieterse, M. E., Bolier, L., Walburg, J. A., & Bohlmeijer, E. T.. (2016). Validation of the Flourishing Scale in a sample of people with suboptimal levels of mental well-being. BMC Psychology, 4(1).

Soga, M., Gaston, K. J., & Yamaura, Y. (2016). Gardening is beneficial for health: A meta-analysis. Preventive medicine reports, 5, 92–99.

Terry, R., Townley, G., Brusilovskiy, E., & Salzer, M. S.. (2019). The influence of sense of community on the relationship between community participation and mental health for individuals with serious mental illnesses. Journal of Community Psychology, 47(1), 163–175.