title: Therapeutic horticulture in clinical depression: a prospective study of active components.
abstract: OBJECTIVE
  This paper is a report of a study conducted to assess change in depression severity, perceived attentional capacity and rumination (brooding) in individuals with clinical depression during a therapeutic horticulture programme and to investigate if the changes were mediated by experiences of being away and fascination.
  
  
  BACKGROUND
  Individuals with clinical depression suffer from distortion of attention and rumination. Interventions can help to disrupt maladaptive rumination and promote restoration of depleted attentional capacity.
  
  
  METHODS
  A single-group study was conducted with a convenience sample of 28 people with clinical depression in 2009. Data were collected before, twice during, and immediately after a 12-week therapeutic horticulture programme, and at 3-month follow-up. Assessment instruments were the Beck Depression Inventory, Attentional Function Index, Brooding Scale, and Being Away and Fascination subscales from the Perceived Restorativeness Scale.
  
  
  RESULTS
  Mean Beck Depression Inventory scores declined by 4.5 points during the intervention (F = 5.49, P = 0.002). The decline was clinically relevant for 50% of participants. Attentional Function Index scores increased (F = 4.14, P = 0.009), while Brooding scores decreased (F = 4.51, P = 0.015). The changes in Beck Depression Inventory and Attentional Function Index scores were mediated by increases in Being Away and Fascination, and decline in Beck Depression Inventory scores was also mediated by decline in Brooding. Participants maintained their improvements in Beck Depression Inventory scores at 3-month follow-up.
  
  
  CONCLUSIONS
  Being away and fascination appear to work as active components in a therapeutic horticulture intervention for clinical depression.
authors.affiliation: Department of Plant and Environmental Sciences, Norwegian University of Life Sciences, As, Norway. marianne.gonzalez@umb.no
authors.forename: Marianne Thorsen
authors.initials: MT
authors.lastname: Gonzalez
authors.forename: Terry
authors.initials: T
authors.lastname: Hartig
authors.forename: Grete Grindal
authors.initials: GG
authors.lastname: Patil
authors.forename: Egil W
authors.initials: EW
authors.lastname: Martinsen
authors.forename: Marit
authors.initials: M
authors.lastname: Kirkevold
mesh_terms: D000328:Adult; D001288:Attention; D003627:Data Interpretation, Statistical; D003866:Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D005260:Female; D051639:Gardening; D006801:Humans; D008297:Male; D008875:Middle Aged; D015399:Nursing Research; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013850:Thinking; D016896:Treatment Outcome