Abstract
This paper presents findings from real life situations, a longitudinal single case study on the role of natural environments in nature-based rehabilitation (NBR) for individuals with stress-related mental disorders, at the Alnarp Rehabilitation Garden in Sweden. A sample of 43 former clients voluntarily participated in semi-structured interview, and the data were analyzed according to interpretative phenomenological analysis (IPA). Three main superordinate themes were identified as the three phases of NBR—Prelude, Recuperating and Empowerment—explaining and illuminating the role of the natural environments in each phase. An explanatory model of NBR in this context is presented including the three phases of NBR, IRP supportive occupations and a pyramid of supporting environments. A new component of supportive environments was identified and herby named, Social quietness, an important component facilitating personal and intimate engagement with the natural environments.
Highlights
Mental health problems are estimated to be among the major global contributors to work disabilities [1,2]
This study was designed as longitudinal single case study [43,44] using semi-structured interviews [44,45] and interpretative phenomenological analysis (IPA) [46,47]
The nature-based rehabilitation (NBR) at the Alnarp Rehabilitation Garden is defined as a supportive environment consisting of the multimodal and transdisciplinary rehabilitation team, the group of eight participants, the individual him/herself, occupations, and the specially designed garden
Summary
Mental health problems are estimated to be among the major global contributors to work disabilities [1,2]. In Sweden, sick leave due to mental health problems has increased in recent years [3,4,5], and according to a Swedish Social Insurance Agency report, the most common cause of sickness absence from work is stress-related mental disorders [3]. It is well known that chronic stress exposure, mostly studied as work-related stress, can result in clinical symptoms and mental complaints, often referred to as stress-related mental disorders [6,7]. The burnout concept, which has been widely used in stress research, is commonly defined as a mental condition that has developed as a result of continuous stress exposure related to psychosocial factors at work [8]. Burnout is mostly used to study working populations and is commonly not used in clinical practice
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