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Burnout in popular language, and in mainstream media is as a synonym for extreme states whether exhaustion or a lack of patience and a high degrese of intolerance.
The problem is that the most prominent authors in this field, Herbert Freudenberger and Christina Maslach, differ in characterization and in the way of describing the clinical presentation of the Burnout phenomenon.
Herbert J. Freudenberger (1926-1999) was a German Jew who escaped, when he was still a child with his family from Nazi to the United States, and became the psychologist considered the “founding father” of the Burnout Syndrome concept.
Freudenberger played a vital role in the free clinic movement around the end of 1960 who encouraged the opening of several clinics in the United States providing free services to indigent and marginalized people especially heroin users.
According to drug addicts, after repeated punctures, some veins became “useless” for new drug applications: in other words, they were “burned out”.
Over time, Burnout has become a popular slang associated with extreme states of exhaustion. Freudenberger would work 10 to 12 hours daily in his private office and then stay up until midnight or later, work at St. Mark Free Clinic.
In 1974, he wrote the article Staff Burnout, in which he describes the clinical presentation of those affected by the Burnout Syndrome that he himself experienced twice because of the crazy pace of his job.
He defined : “a state of fatigue or frustration caused by devotion to a certain cause, way of life, or a relationship that did not correspond to expectations”.
Depending on the individual vulnerability once the brain's adaptive mechanisms has to face a stressor agent continuously becames exhausted. Therefore, chronic stress, also as a rule, is considered non-adaptive.
On the opposite adaptive stress, as a rule, is acute stress with a non-lasting effect. Even if, acute stress of great intensity may cause the so-called acute stress disorder (ASD).
The neuroscientific thesis stating that chronic, long-lasting stress, regardless of its cause (whether work, stormy marriage, socioeconomic problems, etc.), is a potential cause of the disease is increasingly consolidated.
Besides its significant negative impact on the central nervous system, countless studies have demonstrated that chronic stress may harm the immune, cardiovascular, and neuroendocrine systems (Anderson, 1998). Among its consequences, we mention the weakening of the immune
system arterial hypertension diffuse muscle pain heart diseases and mental disorders or illnesses, such as depressive and anxiety disorder (BAUM; POLSUSNZY, 1999).
Due to different reasons, which often intertwine (e.g., genetics, personality, psychological structure, affective sensitivity, among others), it has already been shown that some people are more resilient to chronic stress, while others are more vulnerable.
The Burnout Syndrome proposed by Freudenberger is vast and confusing, with many symptom and different severity from person to person as:
It is impossible not to recall the words Freudenberger spoke in 1989: “We need to be careful not to attribute so many concepts to Burnout that it becomes meaningless”.
For Freudenberger, denial is also a cause of Burnout including denial of failure, age, fear, death, and feelings. This is because denial is a defense mechanism, as it is used to maintain a false image, the dichotomy between desire and reality, at a very high energy cost and this energy deficit is closely related to the genesis of Burnout and related to chronical stress, whether it comes from work, marriages, relationships etc.
For Freudenberger, the Burnout Syndrome is curable. In Burnout: How to Beat The High Cost of Success (1981), the psychologist states: “Burnout is reversible, no matter what stage it is in” he suggested some ways to minimize the main causes of burnout.
Burnout began to be related to work, with Christina Maslach, professor and researcher at the University of California, Berkeley (USA). In the first half of the 1970s, when Burnout became Maslach’s main object of study, the researcher prioritized in her work professionals who worked directly with the public.
Maslach chooses to focus her object of study on labor relations, not expanding the concept of Burnout to other areas of life as Freudenberger did. Maslach’s option fundamentally contributes to the history of Burnout Syndrome as an occupational syndrome, which is still widespread.
Based on psychometric psychology and statistical tools Maslach created her own characterization of Burnout Syndrome throughout her years of study. In 1977, she defined Burnout as a syndrome characterized by physical and emotional exhaustion caused by a crisis in the relationship between the worker and work, which can affect all professional (regardless of profession and activity).
And has three dimensions:
In 1981, Maslach and collaborators published the MBI (Maslach Burnout Inventory), a test used to assess quantitatively Burnout Syndrome until the present day being used ten times more than other measures in articles and dissertations on the subject. And published the Inventory Manual, a document that is equivalent to a “user guide” for using MBI (Maslach Burnout Inventory), in any of its versions. This document explains the correct handling of the instrument, its applications, and interpretations. The use of MBI and inventory manual are protected by copyright, MBI is a test aimed exclusively at measuring the Burnout Syndrome proposed by Maslach and her collegues. It is an instrument similar to a questionnaire, developed inductively from items about the three dimensions of Burnout Syndrome.
Currently, there are five versions of MBI
There is no cut-off point in MBI which can separate who has or does not have Burnout.
In 1998, Maslach and Goldberg proposed a “Burnout-engagement” continuum. Just as there are the antitheses (black and white) for these researchers, there are also the opposite poles “ Burnout and engagement”.
To pass from burnout to engagement the path is to resolve the six possible areas of disagreement between person and work:
Nowaday the method for diagnosing Burnout, predominantly accepted by experts for having the importance and worldwide recognition of the World Health Organization (WHO) is the one in the ICD-11 (International Classification of Diseases, 11th Review) under the code QD85.
On ICD 11 Burnout remains synonymous with exhaustion and is left outside the group of mental disorders or illnesses. (So based on these documents, the term “cure” for Burnout is inappropriate because it is not a disease). Because the description of burnout in ICD 11 is based the one previously made by Christina Maslach, it refers explicitly the occupational context and should not be applied to describe experiences in other areas of life.
„Burn-out is a syndrome conceptualized as a result of chronic stress in the workplace that has not been successfully managed which can affect all professionals (regardless of profession and activity).
Burnout has three dimensions that in the diagnosis must be considered simultaneously and are:
The most significant difference between Maslach and ICD11 is how the burn-out is diagnosed. In the first one, everything is based on a self-performing test, MBI (Maslach Burnout Inventory), which is highly objectionable from a technical-semiologic point of view instead of having the need of a professional, also because based on ICD-11, we observed that the diagnosis of burnout is a diagnosis of exclusion (also called a residual diagnosis), in other words, it can only be confirmed after discarding other diagnostic hypotheses.
Source: Lecture on this topic given by Ania Balducci University of Bologna, Italy, April 2024.
THE USE OF HORTICULTURE THERAPY IN THE PREVENTION OF BURNOUT SYNDROME
Being in a garden is in itself therapeutic. The natural environment promotes overall relaxation and relaxation through the parasympathetic nervous system, and also promotes physical, mental recovery in the event of injury or stress. Regular contact with nature, or even structured activities associated with the natural environment, are of great benefit in the prevention of burnout syndrome. People working in the helping professions are more at risk of burnout than other professions.
People suffering from burnout need not only the healing influence of nature, but also the therapeutic accompaniment of a suitably educated professional, a horticulture therapist. It is not enough to just leave the workplace. People affected need to restore a healthy work-life balance and develop more resilience to properly address relational issues with their superior colleagues.
Contact with nature and teamwork strengthen and amplify our relational skills, encouraging us to take responsibility for taking care of ourselves as we take care of plants, because only in this way can they produce good fruits.
People in the condition of burnout must become aware of how the correct management of relationships is a fundamental element and that this vision should also be applied to the needs of others. Nature teaches us that every plant in the garden has different needs and that even at each stage of its life the same plant to grow and produce requires different conditions of space, water, light, soil, and support on a trellis.
The horticultural activities that can be effectively inserted in a program of prevention and cure of this condition, should therefore focus on metaphors related to “healthy borders” as a living space and the care of a plant as a similitude of the care of ourselves. The activities should serve to promote reflection on one’s own needs by encouraging recognition and expression of one’s own needs in the workplace (e.g., sowing, thinning, watering, repotting, harvesting, all these activities allow use of metaphors). We can also discuss the interaction between the different cultivated plants nearby.
We must work on the belief that natural biodiversity is proof that accepting differences improves every environment, also at work. Much importance can be given to the time of harvest, because often in a work environment we are only a part of the process and this satisfaction is not allowed. Cultivating for others to harvest can be an important lesson and to elaborate this step, we can introduce the rotation of groups in collective activities.
These examples of practical and focused activities with plants can produce remarkable results, encouraging people to spend time outdoors and connect with others. The work with the body is the natural tool to access our mind and spirit, restoring its balance.
In recent decades, more than ever before, there has been talk of accelerated times, which place many demands on contemporary people in their personal and professional lives. Today, 55% of the world's population lives in cities and this figure is growing. https://www.un.org/uk/desa/68-world-population-projected-live-urban-areas-2050-says-un
Moreover, people spend 80-90% of their time indoors. The term "indoor generation" is emerging. https://www.researchgate.net/figure/Time-spent-in-various-indoor-locations-among-people-reporting-time-habitue-shabitue-s_tbl1_7062081
"Nature Deficit Disorder" is a term first used by Richard Louv, he claims that the increase in childhood obesity, attention deficit disorder, learning disabilities, depression, anxiety and many other problems in children are caused by children's lack of contact with nature. https://richardlouv.com/blog/what-is-nature-deficit-disorder
Louv stressed that this is not a new medical diagnosis, but rather suggests that children's lack of contact with nature is an alarming recent trend. Although his theory is not accepted by all, it has helped to "name" the current state of situation. His theory was complemented by Elisabeth Dickinson, who stresses the importance of adult! society assessing and possibly reassessing its own social, political and economic goals, as this is the only way to bring about change. It is clear that the lack of contact with nature affects not only children but a large part of the world's society. https://fernainymat2017.wordpress.com/wp-content/uploads/2017/07/the-misdiagnosis-rethinking-nature-deficit-disorder.pdf
At the same time, a new trend is developing that seeks to reconnect humans with nature. The healing influence of nature is supported by much research. People need nature to live healthy lives. Nature is becoming part of urban planning, not only parks but also community gardens are the new modern neighbourhoods, green and blue zones are becoming the norm. The term "Nature Based Interventions" has emerged as a catch-all term for a variety of not only therapeutic approaches and activities that harness the healing influence of nature.
The term Nature-Based Interventions can be understood as an umbrella term for many approaches, methods, measures and activities that offer contact with nature or use it in a structured way.
Nature-based interventions can be divided into two basic groups:
Nature-based therapies and nature-based activities have in common that they somehow harness the healing influence of the natural environment or its elements and have a positive effect on a person's mental and physical health and overall sense of well-being.
The main difference between these two groups is in the education of the accompanying person and the evaluation of the activity.
Nature-based therapies
Education: Those providing nature-based therapies must have a therapeutic background (doctor, psychologist, psychiatrist, art therapist, etc.), plus additional training in nature-based therapies.
Evaluation: Various measurable scales can be used for evaluation, but also questionnaires of a more subjective nature, depending on the type of assignment and the client's problem.
Several examples of nature-based therapy:
1. Garden therapy/therapeutic gardening - use activities or being in a garden, in a natural environment or contact with nature to make the client feel better mentally and physically. It can take many forms and in the Czech Republic it is mainly associated with social services, health care and education. In German-speaking countries, the term Garten Therapy and Therapeutic Gartening is more commonly used, whereas in English-speaking countries and in the USA the term Horticultural Therapy is more established.
FINDINGS FROM ITALY AND SWEDEN?
2. Forest therapy - the effect of the natural environment, originated in Japan, now adapted in many European countries. In Sweden forest therapy is used in the treatment of depression and burnout syndrome too. The therapist cares for the client in a natural environment through structured activities, working with the doctor who determines the client's diagnosis.
3. Psychotherapy in the natural environment - the specialist takes the client and his order out into nature, in the Czech Republic there are many private subjects that move their therapies out into the natural environment, e.g. the psychological-psychotherapeutic group Therapy among the trees or movement of ecotherapy (eco - nature; therapy – treatment, it is a supportive treatment or healing in the environment of nature), e.g. www.ekoterapeut.cz .
4. Animal-assisted therapy and farm therapy
Many species of animals can assist in therapy or healing activities - traditionally dogs, cats, horses, but also small animals (rabbits, guinea pigs, exotic birds, fish) or farm animals (donkeys, llamas, etc.)
Horticulture therapy trainings in the Czech Republic
JABOK https://www.jabok.cz/en
Higher vocational school offering education in social work, social and special education and intercultural work. The founder is a church association, but the school is open to all without the need for church affiliation. It has more than 30 years of tradition and cooperates with other foreign institutions. The school has agreements for practice with more than 70 other organizations (schools, public institutions, social service providers, etc.). It is a member of the Association of Social Work Educators and other professional associations and professional groups.
Jabok has been offering garden therapy courses since 2015 to the professionals, lay public and school students. Courses are accredited by the Ministry of Labour and Social Affairs.
CHALOUPKY https://www.chaloupky.cz/en/
Non-profit non-governmental educational institution with a long tradition. It has been operating in the Vysočina Region since 1992, it deals mainly with environmental education and education for nature protection and sustainable living. Every year, it conducts hundreds of one-day and multi-day educational programmes for children and teachers. It runs the social rehabilitation service Klub Lebeda and offers social-therapeutic programmes for people with special social needs. It works with the garden therapy method in ownnatural gardens.
It provides courses accredited by the Ministry of Labour and Social Affairs for social service workers and other interested parties or public, and helps to introduce garden therapy into social service facilities.
MARKÉTA JINDŘICHOVSKÁ
https://irel.knihovny.cz/Record/auth.AUT10-001143240?sid=388809
Occupational therapist, lecturer in occupational therapist certification training, lecturer in vocational subjects at university, has many years of experience with people with psychological disorders offers course accredited by the Ministry of Labour and Social Affairs - Fundamentals of therapeutic gardening in rehabilitation (occupational therapy) - 8 h
The course covers two areas - rehabilitation (occupational therapy) and garden therapy, which have historically developed in parallel. These two topics are linked so that the participants of the course get an idea and guidelines for the implementation of therapeutic gardening with a specific target group or in a specific facility.
Professional training in Garden Therapy, Sweden
There are some recent initiatives in Sweden about training within nature based interventions, including animals. But, the longest work and knowledge has been carried out at the Swedish University of Agricultural Sciences, campus Alnarp. They provide courses at University level.
Today they offer the courses:
Therapeutic Horticulture: possibilities of education in Italy
University of Bologna - 1st Level Master in Therapeutic Horticulture
360 hours of lectures; 375 hours of internship and project work
CFU 60
3800
Therapeutic Horticulture basic module
Professional course
IU Rusconi Ghigi Foundation, Bologna
70 lecture hours, recognised certificate, until 2022 CME credits
520 euro
Course for Expert in Wellbeing Gardens and Vegetable Gardens
Professional course
Monza Park Agricultural School, Monza (MB)
200 hours, recognised certificate and professional figure recognised in the Lombardy region (professional figure of garden technician, but not of horticulturist)
2000 euro
Horticultural therapy training course
Professional course
Orme Association, Turin
52 hours, certificate
250 euro
Hortus Medicus - Education Tool in Action
Therapeutic horticulture training curriculum
University of Milan
120 hours
Horticultural Therapy Course - Expert in Wellbeing Gardens and Horticulture
Professional course
Futura Formazione SRL, Brescia
80 hours, recognised certificate
1002 euro
Vegetable and vegetable gardens in care contexts
Course for adults
ABFeu Azienda Bergamasca Formazione
60 hours, recognised certificate
600 euro
Short courses of a few hours on therapeutic horticulture
Course cod. F1 Healing Gardens & Horticultural Therapy: design and implementation of therapeutic green areas in health care facilities
Course for adults
Teachers Senes, Fumagalli, Neonato
IM-Servizi Tecnici Milan
8 hours, recognised certificate
320 euro + VAT
THERAPEUTIC GARDENS: DESIGN GUIDELINES
Professional refresher course
Italian Garden Academy _ Mati Group Pistoia
Online course with in-presence part 18/24 hours
180 euro
Legambiente Rho (MI)
One-day course on regenerative horticulture
Orto Foresta, regenerative farm, Florence
Training courses 0-6
Horticultural therapy and inclusive education
Online course on request
Vegetable gardens, educational horticulture, education, well-being
Various courses and projects in Italy, particularly in north-central Italy
Course on Kitchen Gardens and Educational Gardens
Professional course accredited by the Ministry of Education
Training courses 0-6
Online course 10 hours, recognised certificate
89 euro
Related topics
Wellness phytotherapist
Professional course
The garden of Pimpinella, Metropolitan City of Bologna
280 hours in 2023, now new courses with in-depth modules on the use of plants and wellness
Outdoor education
University of Bologna - 1st Level Master in Outdoor Education
Level I Inter-University Master's Degree Academic EDUCATION AND NATURE
COMPETENCES FOR ECOLOGICAL EDUCATION AND SUSTAINABILITY
The Master's Course is jointly realised by lecturers from the Department of Human Sciences for Education ‘Riccardo Massa’ of the University of Milan Bicocca, the Department of Human and Social Sciences of the University of Valle d'Aosta, the Department of Humanities, Social Sciences and Cultural Enterprises of the University of Parma and the Department of Educational Sciences ‘Giovanni Maria Bertin’ of the University of Bologna, together with lecturers from other universities and other experts.
Gardens have been with man for ages. Although healing in nature is an ancient and proven practice, it is now finding its place as a new profession of horticultural therapy. Horticultural therapy and therapeutic horticulture are terms that are sometimes confused even by professionals. The overall situation is further complicated by inconsistent terminology, differing opportunities and requirements for professional education and the requirements of a horticulture therapy programme, both within individual countries and within Europe or internationally.
Currently, the profession of horticultural therapy exists in the USA, but is not yet recognised in Europe. The American Horticultural Therapy Association (AHTA/American Horticultural Therapy Association) defines professional standards and qualifications for the practice. In Europe, the term 'therapeutic horticulture' or 'social and therapeutic horticulture' is used instead of 'horticultural therapy'. Trellis' definition of horticulture therapy shows that the terms 'horticultural therapy' and 'therapeutic horticulture' are used synonymously, whereas in the USA they are strictly separated.
In German-speaking countries the term Gartentherapie is used for horticultural therapy and therapeutisches Gärtnern for horticultural activities, whereas in English-speaking countries and in the USA the terms Horticulture Therapy and Therapeutic horticulture are more established, or the term Social and Therapeutic horticulture is used. (is used in England)
Horticultural therapy is not working in the garden. It is a therapeutic method, offering a range of options and activities that are suitable for different target groups, for children, adults and even the elderly. Horticultural therapy can also be used indoors or with a bedridden client, thus providing contact with nature for people who cannot get into the garden. The healing effects of horticultural therapy are felt not only in the treatment and recovery from injuries, but also when people are overworked or stressed. (or for prevention - therapy, prevention and rehabilitation)
The AHTA (American Horticultural Therapy Association) definition of horticultural therapy: 'Horticultural therapy is participation in horticultural activities facilitated by a registered horticultural therapist to achieve specific goals within a defined treatment, rehabilitation or vocational plan. Horticultural therapy is an active process that takes place in the context of a set treatment plan, with the process itself being considered a therapeutic activity, not an end product."
AHTA's definition of a horticultural therapist: "Garden therapists have a foundation of knowledge in plant science, human science, and garden therapy principles and experience in the application of garden therapy.
The American Horticultural Therapy Association supports the definition that a garden therapist is a person who:
AHTA, American Horticultural Therapy Association. Online. Available from: https://www.ahta.org/ahta-definitions-and-positions [cited 2025-1-15].
Definition of therapeutic horticulture by Trellis (UK-based Therapeutic Horticulture Association):
"Therapeutic gardening (sometimes referred to as 'Social and Therapeutic Gardening') is a process where trained professionals work with people using plants, gardening and connecting with nature to help them improve their physical and mental health and wellbeing, skills and abilities."
"Therapeutic gardening is a unique professional field with its own set of specialist skills and knowledge, which primarily incorporates health/care skills, gardening and therapeutic/adaptive gardening (gardening skills/tools adapted to health and support needs). Therapeutic horticulture can be imagined as a combination of horticultural and health/care professions.
Garden therapy and therapeutic gardening are interchangeable terms for the purposeful use of plants and gardens to improve health and well-being. The use of plants as a therapeutic method is grounded in the professional practice of garden therapy."
"Trained garden therapists work by setting specific therapeutic goals to improve the physical, mental, or cognitive health of diverse groups of people who are recovering from illness or injury or living with long-term physical disabilities or mental disorders."
Trellis. Online. Available from: https://www.trellisscotland.org.uk/social-therapeutic-horticulture [cited 2025-1-15].
The essentials for therapy to be therapy and not just gardening:
If the activity does not meet the above requirements, it is not horticultural therapy or therapeutic horticulture but GARDENING. (it is just gardening because also in therapeutic horticulture you have to set goals even if they can be group goals) In some countries these names are used interchangeably (as is evident from the Trellis definition).
Types of horticultural therapy programmes in the USA
Horticultural therapy programs/activities can have different focuses - depending on what the client/patient's area of therapy goal is. In the USA, they are divided into three basic groups:
ACTIVE VERSUS PASSIVE
Therapy and garden activities can be more or less active. Sometimes a distinction is made between active and passive garden therapy. Active means that the client/patient engages in various activities. Passive/receptive means that the client stays in the garden environment, which has a positive effect on him/her (documented by many studies). (The difference is considered if the client is interacting and changing the natural environment like during cultivation activities and when is not interacting so we have no modification of the environment).
PERSONAL STORY
Prevention of burnout syndrome in the helping professions through green care (garden therapy)
Ingineer Soňa Staňková, DiS., certified specialist
I have been working with other people for 22 years. Most often I am in the role of facilitator, lecturer and coach of workshops of personal development. For 12 years I have been supporting other professionals - coaches and personal development consultants in their work with clients. I knew quite a lot about burnout syndrome from a theoretical point of view and I never thought that I would know it fully on my own. I have always felt quite energetic and strong for overcoming challenges and new and often difficult situations.
That is why, as I approached the age of 40, I accepted the challenge of managing the Czech branch of a non-profit organization. At that time I was running my own business, which itself brings challenges and stress. At the same time other stressors entered my life that I couldn´t have planned - marital discord, moving from the home and more challenging family situations to deal with.
Me and burnout syndrome
Heavy workload. The pressure of carrying the responsibilities of being a leader of two organizations. Family changes where I began to feel that I didn't have the support of those closest to me. So it was probably just a matter of time before exhaustion started knocking on the door. But before it knocked, it crept in quite subtly and slowly. Looking back on this period now, I notice that the gradual creep may have been observable in my communication with other people. I was tired of responding to questions or requests of other people and I answered them quite irritably. I felt a great deal of pressure and tension building up inside of me because I was overstepping my boundaries and not respecting my needs for peace and rest. Still work took priority, where I was dealing with challenging situations regarding reorganization and relationship conflicts.
During this creeping time, I also enrolled in ecotherapy training with the hope to finally take some time for myself and something just for me. But within the first year of training, burnout syndrome had already made it to the door. The training was very mentally demanding and drained my last drops of energy, I had left. The constant pressure for deep self-reflection and the training director's expectation for high performance began to trigger physiological changes in my body. I began to notice more frequent tremors in my body and a feeling that I was about to pass out from exhaustion. I was not getting quality sleep at night. The demands of the job, the pressure of it, and family, with pressure for self-development and self-reflection, was more and more increasing in my perception.
It was also a period when I achieved several significant professional awards. Among other things, in that eco-therapeutic training. The completion of the projects, the handover ceremony to the new head of the organisation, and yet I felt a deep emptiness inside me. The good feeling of accomplishment was not forthcoming, on the contrary. It began a 9-month journey where burnout syndrome not only knocked on the door of my life, but took over my life. There came a deep fatigue, a loss of motivation to do the activities I loved.
Any contact with people was extremely challenging and exhausting for me. I didn't last long attention. I stopped taking care of my body. I stopped caring about what I eat and how I look. It's like my speed and fullness of life suddenly shifted from speed 5 not only to speed 1, but to driving through life with the handbrake on. The final stop was in a moment of losing faith in the meaning of what used to be the meaning of life for me. The deep restart, the syndrome burnout, or dark night of the soul are names that have been attributed to this process.
I left group therapy training and moved to individual support. The only thing I was craving at the time was PEACE! And I could only find it in one place – in nature. The natural environment of the parks, woods and gardens offered me its arms. A place where no one judged me for something I was doing or not doing, or whether I was reacting to something correctly. In nature, I felt absolute acceptance of who I am. No pressure to perform. Just nature and me. I remember walking for six months to the park and just lay down on the grass under a tree, by the roots, and just lie or sit on a bench under a lime tree. It wasn't minutes, it was hours that I spent that way. It was summer, and it helped me to be in nature almost all day long. Touching the flowers and leaves of the trees was like a balm for my soul. Touching them gently I enjoyed the smell of nature. The heat of summer's excitement on my skin awakened my mindfulness so that my body began to calm, and the trembling I had felt in my body in the winter and the beginning of spring, was no longer there. My body began to bring itself into balance through stillness and being in nature. Even though I spent most of my time in a public park where people were moving around, I was able to find my piece, an island in nature all to myself. To sit on a bench or right on the ground. Dig my hands into the soil, into the water. I would go to the park and garden even in the rain. One time it was raining really hard, and I decided to help the park workers remove the mud from the paths so that the water could drain away. What a great feeling that was. To be able to be active again, and in a place - nature - that I already had feelings for, the place I had a loving relationship with.
As the summer came and I began to have a little more energy, I noticed that I was regularly encountering the same people. They were also spending quite a few hours every day there. With the onset of the fall season, I already started to feel much better and had a renewed desire to talk to people again. I got to know some of the people in the park and actually, it wasn't a surprise to me that they shared with me their stories of why they came to the park so often and for such a long time. Their stories were in some ways similar to mine. The nature in the park offered all of us a natural therapeutic practice. A place of peace, balance, time to just be in the full presence without any evaluation.
Current journey and plans
Today this experience is behind me and I feel much stronger and more balanced than before. I have rebuilt my life from the ground upon different values than the ones I lived before. One of those core values is Balance. I realize now that preventing burnout is about listening to my body, emotions and soul before even the subtle signs of imbalance. I am much better at managing my time. I choose carefully the work and projects I want to work on. As well as the people I want to be surrounded with. Every day I spend at least 1 hour outdoors in nature, whatever the weather.
I plan to continue to invite the power of nature not only for myself, but also for my clients through ecotherapy and the natural environment - forests, parks, gardens. I have been running programs for 5 years where we are guided on our journey of self-care and growth. I participate in the implementation of a project that aims to build a nature retreat center where people can find support for their life balance in the form of ecotherapy and other methods of self-care. I would like to use this project to inspire others to do the same, to find ways to maintain balance in their professional and personal lives. I encourage everyone to find his own way to connect with nature, whether it's through gardening, walking or other activities.
Not only does it help recovery, but it's a way to prevent burnout in the future.
Five good examples in Sweden
The rehabilitation is called a variety of names, as Nature assisted rehabilitation (NUR), Green rehabilitation, Garden therapy, Green care and more. But all of them aim for the same goal – using nature and gardening to promote health for people.
Example 1: Green rehab in Gothenburg´s Botanical garden is for people with stress related illnesses.
It is for employees within the health care region of Western Götaland. The work focuses on bringing people back to work with the help of gardening and the ability of the natural world to promote human health. They combine their knowledge with established methods in work related therapy, psychotherapy and physiotherapy.
https://www.vgregion.se/ov/grona-rehab/
Example 2: Nature assisted rehabilitation in the countryside (NUR).
Patients with burnout syndrome, depression (not deep depression) or anxiety can have their rehabilitation at a farm in the countryside. All health centers and psychiatric care reception in the Region of Skåne can offer patients the opportunity to take part in NUR. The Region has agreements with eight farms. The farms have different themes. Some of them has focus on gardening and some of them work with animalshttps://vardgivare.skane.se/vardriktlinjer/forsakringsmedicin/naturunderstodd-rehabilitering/
Example 3: (we will probably change this example later) Nature assisted rehabilitation, Västra Götalandsregionen.
With the same system as in Skåne, the Region of Västra Götaland is offering patients NUR on two farms.https://grevegarden.se/manniskor/rehabilitering-och-kurser/naturunderstodd-rehabilitering/
Example 4: The Rehabilitation garden, at Campus Alnarp, SLU, Swedish University of Agriculture.
The garden is situated north of the city of Malmö in southern Sweden. It is a part of the research infrastructure at the university and aims to develop the knowledge about nature based interventions for treatment and rehabilitation focusing on factors that promote and maintain health holistically. https://www.slu.se/institutioner/institutionen-for-manniska-och-samhalle/miljopsykologi/alnarps-rehabiliteringstradgard/
Example 5: Grön Arena, Green Arena – farms
The activities carried out on a Green Arena-farm are customized according to every person's special needs to achieve development and improved quality of life. The activities are based on farm work with animals, gardening and nature. Green Arena works for everyone regardless of age and background so that they will have a richer life throughout the activities on the farm. There are Green Arena-farms all over Sweden from Skåne in the South up to Norrbotten in the north (distance over 1 500 km).
https://hushallningssallskapet.se/tjanster/landsbygd/gron-arena/
Rehabiliteringen benämns med flera olika namn, det rör sig om Naturunderstödd rehabilitering (NUR), Grön rehabilitering, Trädgårdsterapi och Grön omsorg med mera. Samtliga syftar till samma sak - att med hjälp av naturen och trädgårdar främja människors hälsa.
Exempel 1: Gröna Rehab i Göteborgs Botaniska trädgård vänder sig till personer som har en stressrelaterad ohälsa. För att kunna ta del av verksamheten behöver man ha Västra Götalandsregionen som arbetsgivare.
Verksamheten är arbetslivsinriktad och bygger på den forskningsbaserade kunskapen om trädgårdens och naturens goda förmåga att ge återhämtning och stressreduktion.
Vi kombinerar denna kunskap med etablerade metoder inom arbetsterapi, psykoterapi och fysioterapi.
https://www.vgregion.se/ov/grona-rehab/
Exempel 2: Naturunderstödd rehabilitering på landsbygd (NUR) Vuxna patienter med utmattningssyndrom, lätt till medelsvår depression eller ångest kan få rehabilitering på en gård i landsbygdsmiljö. Alla vårdcentraler och psykiatriska öppenvårdsmottagningar i region Skåne som uppfyller förutsättningarna kan erbjuda patienter naturunderstödd rehabilitering på landsbygd (NUR)
Region Skåne har avtal med åtta gårdar. Gårdarna har olika inriktning. En del gårdar har fokus på odling och växtlighet och en del på produktionsdjur och djurhållning.
https://vardgivare.skane.se/vardriktlinjer/forsakringsmedicin/naturunderstodd-rehabilitering/
Exempel 3: Naturunderstödd Rehabilitering NUR i Västra Götalands regionen.
Med hjälp av natur, trädgård och djur, legitimerad vårdpersonal och processinriktade aktiviteter erbjuds rehabilitering för personer som är hel- eller deltidssjukskrivna för stressrelaterad psykisk ohälsa, utmattningssyndrom samt lätt till medelsvår depression. VGR har avtal med två gårdar.
https://grevegarden.se/manniskor/rehabilitering-och-kurser/naturunderstodd-rehabilitering/
Exempel 4: Alnarps rehabiliteringsträdgård
Alnarps Rehabiliteringsträdgård ligger i södra Sverige strax norr om Malmö. Den tillhör Sveriges lantbruksuniversitet, och är anlagd i den östra delen av campusområdet i Alnarp. ART är en del av universitetets forskningsinfrastruktur. Syftet med trädgården är att utveckla kunskapen om naturbaserade insatser för behandling och rehabilitering, relaterat till ett salutogent förhållningssätt, som fokuserar på faktorer som främjar och bibehåller hälsan ur ett holistiskt perspektiv. Det har utförts en mängd olika studier i rehabiliteringsträdgården där man sett positiva resultat på rehabiliteringen för personer med utmattningsrelaterad ohälsa.
Exempel 5: Grön Arena Gårdar
Verksamheten på Grön arena gårdar anpassas efter den enskilde individen för att nå personlig utveckling och en förbättrad livskvalité. Aktiviteterna utgår från gårdens arbete med djur, natur och trädgård.
Grön Arena jobbar för att alla oavsett ålder och ursprung ska få ett rikare liv genom olika aktiviteter på en Grön Arenagård. Grunden i arbetet är djur och natur och dess läkande kraft för människan. Det finns Grön Arenagårdar över hela Sverige – från Skåne i söder till Norrbotten i norr.
https://hushallningssallskapet.se/tjanster/landsbygd/gron-arena/
Five good examples in Italy
rehabilita)on through hor)culture and landscaping, appren)ceships, work placements for disadvantaged people.
Personnel specialized on the subject of social agriculture, professional agronomists and educators.
Works with users in charge of Mental Health, disabled adults, youths in charge of Child Neuropsychiatry, people with addic)ons.
hCps://coopagriverde.it/
The BeeBo project by beekeeper Zeid Nabulsi, on the other hand, starts from the rela)onship with bees to re-establish a deep connec)on with nature. To protect bees from intensive farming and pes)cides, the beekeeper moves them to protected and healthy places. His approach is based on listening: staying close to the insects without interfering, trying to tune into their frequency, with respect. He offers courses to bring children and adults closer to the world of bees. He works with many companies to encourage contact between workers and nature through the world of bees, a rela)onship that is mainly based on sensory s)mula)on involving all five senses. With the BeeBo project, he has also developed an environmental biomonitoring system using beehives located at various points around the city. The bees collect invisible but valuable samples, which are analysed twice a year to contribute to a shared understanding of the state of the urban environment.
therapeu)c hor)culture, nature educa)on and environmental educa)on
Specialized staff on the subject of therapeu)c hor)culture, professional agronomists.
Works with users in charge of Mental Health, disabled adults, minors in charge of Child Neuropsychiatry. The Founda)on carries out experimental ac)vi)es to promote socialisa)on and exchange between workers in large companies. These ac)vi)es are designed and guided to increase opportuni)es for well-being through contact with nature, but also to raise awareness of high-quality green areas where people can reconnect with nature. www.fondazioneiu.it
An agency that focuses on human capital and its development, providing services with passion and exper)se in a labour market that requires flexibility. An agency that believes that the future of human resources lies in the ability of companies to establish posi)ve connec)ons with people, reconciling business objec)ves with innova)on, engagement, transparency, compliance with rules and coopera)on on the most pressing social and environmental issues. We invest in people and in crea)ng open and s)mula)ng work environments, recognising that personal and professional growth is essen)al for the long-term success of the company. We promote diversity, inclusion and equal opportuni)es in the workplace, while also commiSng to reducing our environmental impact. We encourage community empowerment through the languages of sport, culture and solidarity. hCps://www.lavoropiu.it Several loca)ons in Italy.
Or0 del Mediterraneo Social Farm, Catania theme park, social and therapeu)c hor)culture, environmental educa)on.
Personnel specialized on the subject of social agriculture and therapeu)c hor)culture, professional agronomists and educators.
Training paths and business internships aimed at the social inclusion of drop-out, disabled and unemployed youth. Social agriculture is the most effec)ve approach to promo)ng job placement programs for disadvantaged individuals. hCps://www.or)delmediterraneo.eu/il-progeCo h:ps://maps.app.goo.gl/LPa4ryNfZWE3U5No6
References (Czechia): https://drive.google.com/drive/folders/1Y6vkEA22-j4QDMd7QITkeSRUSDOfI3rr?usp=sharing
References (Sweden): https://drive.google.com/drive/folders/1wm2e4IZzEn3aM6S_KisHC293a2PouSza?usp=sharing
References (Italy): https://drive.google.com/drive/folders/1mqRnYsg30b_ROqwDo-zSGtHr-Tv3g2gA?usp=sharing
Organizace GreenArena si klade za cíl práci dle principů Green Care. Využívají zemědělská zvířata, přírodu a zahradničení. Nabízí své služby pro dospělé všech věkových kategorií a v současnosti se velmi chtějí kromě jiného věnovat prevenci duševních onemocnění včetně syndromu vyhoření. Organizace také spolupracuje s výzkumníky z vybraných švédských univerzit.
Webové stránky organizace nalezente zde.
Asociace zahradní terapie, z. s. vznikla 1. 3. 2019 po letech příprav a setkávání příznivců této metody práce s klienty. Společně tak spřízněné organizace i jednotlivci dali vzniknout spolku, který se snaží podporovat tuto metodu a rozšiřovat povědomí o širokých možnostech jejího využití. Sdružujeme zástupce ze všech oblastí - socálních, zdravotních a pečovatelských služeb, zahradníky, zahradní architekty, vzdělavatele, organizace pro environmentální vzdělávání aj.
Odkaz na webové stránky naleznete zde.
Fondazione Pietro Giacomo Rusconi, Villa Ghigi, l’Innovazione Urbana. Nadace funguje jako „otevřená a rozšířená laboratoř“, která systematicky zajišťuje přístup obyvatel ke spoluvytváření proměny města Bologna v obyvatelnější a odolnější organismus. Je centrem pro environmentální vzdělávání/vzdělávání udržitelnosti v rámci regionu, spolupracuje s magistrátem Bologna a dalšími institucemi v oblasti vzdělávání a podílí se na řízení a zlepšování přírodních a krajinně-environmentálních aspektů území
Nadace rozvíjí, podporuje a pracuje na inovačních projektech ve třech hlavních makrosférách:
Webové stránky organizace naleznete zde.
