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Walter KH, Otis NP, Miggantz EL, Ray TN, Glassman LH, Beltran JL, Kobayashi Elliott KT, Michalewicz-Kragh B. Psychological and functional outcomes following a randomized controlled trial of surf and hike therapy for U.S. service members. Front Psychol 2023; 14:1185774. [PMID: 37359884 PMCID: PMC10286579 DOI: 10.3389/fpsyg.2023.1185774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/21/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Exercise-based interventions have established benefits for the treatment of depression and other psychological outcomes; however, limited data exist evaluating psychological, social, and functional outcomes for exercise outdoors. Methods The current study sought to expand knowledge about the breadth of effects following outdoor exercise interventions by using data from a randomized control trial comparing Surf and Hike Therapy among 96 U.S. active duty service members with major depressive disorder (MDD). Assessments examining psychological symptoms and functioning were completed before and after the 6-week programs, and 3 months following program completion. Participants also completed assessments before and after each exercise session. Multilevel modeling was used to determine whether psychological and functional outcomes (anxiety, positive and negative affect, resilience, pain, and physical and social functioning) improved for service members receiving Surf or Hike Therapy, and whether improvements differed by intervention. Results Study findings showed improved anxiety (p < 0.001), negative affect (p < 0.001), psychological resilience (p = 0.013), and social functioning (p < 0.001) following program participation, with no differences by intervention. Positive affect, pain, and physical functioning did not significantly improve after the program. Within sessions, positive affect (p < 0.001) and pain (p = 0.036) changed, and to a greater extent for those in the Surf Therapy condition. Conclusion Study results suggest that both Surf Therapy and Hike Therapy can improve psychological symptoms and social functioning impairments that commonly co-occur among service members with MDD, but Surf Therapy may provide enhanced immediate effects on positive affect and pain. Clinical trial registration ClinicalTrials.gov, NCT03302611.
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Affiliation(s)
- Kristen H. Walter
- Health and Behavioral Sciences, Naval Health Research Center, San Diego, CA, United States
| | - Nicholas P. Otis
- Health and Behavioral Sciences, Naval Health Research Center, San Diego, CA, United States
- Leidos, Inc., San Diego, CA, United States
| | - Erin L. Miggantz
- Health and Behavioral Sciences, Naval Health Research Center, San Diego, CA, United States
- Leidos, Inc., San Diego, CA, United States
| | - Travis N. Ray
- Health and Behavioral Sciences, Naval Health Research Center, San Diego, CA, United States
- Leidos, Inc., San Diego, CA, United States
| | - Lisa H. Glassman
- Health and Behavioral Sciences, Naval Health Research Center, San Diego, CA, United States
- Leidos, Inc., San Diego, CA, United States
| | - Jessica L. Beltran
- Health and Behavioral Sciences, Naval Health Research Center, San Diego, CA, United States
- Leidos, Inc., San Diego, CA, United States
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King L, Campbell D, Finkbeiner M, Gallimore J, Kennedy J, McCarthy E, Ketcheson F. The mySELF group: Recreation- and art-based group therapy as adjunct treatment for posttraumatic stress disorder. JOURNAL OF MILITARY, VETERAN AND FAMILY HEALTH 2023. [DOI: 10.3138/jmvfh-2022-0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
LAY SUMMARY Military personnel and Veterans receiving psychotherapy for mental health diagnoses such as posttraumatic stress disorder (PTSD) often have only modest symptom improvement. The authors wondered whether participating in a therapeutic recreation and creative arts group along with psychotherapy would aid recovery. A 12-week program called the my Social life, Expression, Leisure and Food (mySELF) group was created that offered therapeutic recreation, art, and music therapy. A total of 36 clients, most with PTSD, who had been receiving psychotherapy for an average of three years completed the program and submitted pre- and post-group questionnaires. The authors examined leisure attitudes, quality of life, and mental health symptoms before, immediately after, and four months after the group. Results showed significant improvements in leisure attitudes, environmental quality of life and depression, anxiety, stress, and PTSD symptoms. These preliminary results suggest that therapeutic recreation, art, and music therapy are beneficial for military personnel, Veterans, and Royal Canadian Mounted Police receiving psychotherapy.
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Affiliation(s)
- Lisa King
- St. Joseph’s Health Care Parkwood Institute, Operational Stress Injury Clinic, London, Ontario, Canada
| | - Doreen Campbell
- St. Joseph’s Health Care Parkwood Institute, Veterans Care, London, Ontario, Canada
| | - Marie Finkbeiner
- St. Joseph’s Health Care Parkwood Institute, Veterans Care, London, Ontario, Canada
| | - Jane Gallimore
- St. Joseph’s Health Care Parkwood Institute, Operational Stress Injury Clinic, London, Ontario, Canada
| | - Jill Kennedy
- St. Joseph’s Health Care Parkwood Institute, Veterans Care, London, Ontario, Canada
| | - Emily McCarthy
- St. Joseph’s Health Care Parkwood Institute, Veterans Care, London, Ontario, Canada
| | - Felicia Ketcheson
- St. Joseph’s Health Care Parkwood Institute, Operational Stress Injury Clinic, London, Ontario, Canada
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Serfioti D, Hunt N. Extreme sport as an intervention for physically injured military veterans: the example of competitive motorsport. Disabil Rehabil 2022; 44:7566-7574. [PMID: 34641751 DOI: 10.1080/09638288.2021.1985630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE Physically or psychologically injured military veterans are motivated and benefited by physical activity or sport that may involve high levels of achievement. The aim of this study was to provide an in-depth insight into the impact of Competitive Motorsport (CM) on physically injured/disabled veterans' subjective well-being and in turn determine if it improves the quality of their lives. METHODS This is a qualitative study. Two sets of semi-structured interviews were conducted with 14 male British military veterans including a 6-month follow-up. All participants were subjected to a permanent, moderate or severe, physical injury/disability. Data were analysed in accordance with the principles of Thematic Analysis. RESULTS/CONCLUSIONS Five key elements (familiar environment, team spirit, adrenaline rush, competition and equality) made CM a unique experience for physically injured/disabled veterans. Various psychological and physical benefits were found, including an increased sense of accomplishment, opportunity to socialise in a non-clinical environment, embracement of body image and adoption of a healthier lifestyle. Since physical activity and sport are among growing research on alternative interventions for military veterans, they deserve serious consideration as part of the treatment regimens and rehabilitation programmes to improve physically inured/disabled veterans' physical and mental health.Implications for RehabilitationCompetitive Motorsport is an effective means of improving physical health and subjective well-being of physically injured/disabled military veterans.Multiple perceived psychological and physical benefits were identified over time, including motivation for living, embracement of body image and adoption of a healthier lifestyle.Competitive Motorsport deserves consideration as part of the treatment regimens and rehabilitation programmes to improve physically injured/disabled veterans' physical and mental health while facilitating transition to civilian life.
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Affiliation(s)
- Danai Serfioti
- The University of Nottingham, Faculty of Medicine & Health Sciences, School of Medicine, Nottingham, UK
| | - Nigel Hunt
- The University of Nottingham, Faculty of Medicine & Health Sciences, School of Medicine, Nottingham, UK
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Mixing Job Training with Nature-Based Therapy Shows Promise for Increasing Labor Market Affiliation among Newly Arrived Refugees: Results from a Danish Case Series Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084850. [PMID: 35457716 PMCID: PMC9031245 DOI: 10.3390/ijerph19084850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/01/2022] [Accepted: 04/13/2022] [Indexed: 01/27/2023]
Abstract
The unemployment rate among newly arrived refugees in European countries is high and many experience mental health problems. This has negative consequences on integration and mental well-being. In this case series study we investigated the effect of a 30-week program that included horticulture activities, nature-based therapy, and traditional job training on job market affiliation and mental well-being. Fifty-two refugees met initial screening criteria and twenty-eight met all inclusion criteria and were enrolled. The program took place in a small community and consisted of informal therapeutic conversations, exercises aimed at reducing psychological stress, increasing mental awareness and physical wellbeing. At the end of the program traditional job market activities were led by social workers. Provisionary psychiatric interviews showed that at baseline 79% met criteria for either an anxiety, depression, or PTSD diagnosis. After the program, statistical analyses revealed an increase in the one-year incidence of job market affiliation (n = 28) and an increase in mental health according to two of four questionnaire measures (nrange = 15–16). The results strengthen the hypothesis that horticulture and nature-based therapy can help refugees enter the job market. However, the small sample size emphasizes the need for methodologically stronger studies to corroborate these preliminary findings.
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Littman AJ, Bratman GN, Lehavot K, Engel CC, Fortney JC, Peterson A, Jones A, Klassen C, Brandon J, Frumkin H. Nature versus urban hiking for Veterans with post-traumatic stress disorder: a pilot randomised trial conducted in the Pacific Northwest USA. BMJ Open 2021; 11:e051885. [PMID: 34556516 PMCID: PMC8461737 DOI: 10.1136/bmjopen-2021-051885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To evaluate feasibility and acceptability of a group-based nature recreation intervention (nature hiking) and control condition (urban hiking) for military Veterans with post-traumatic stress disorder (PTSD). DESIGN AND SETTING A pilot randomised controlled trial conducted in the US Pacific Northwest. PARTICIPANTS Veterans with PTSD due to any cause. INTERVENTIONS Twenty-six participants were randomised to a 12-week intervention involving either six nature hikes (n=13) or six urban hikes (n=13). PRIMARY AND SECONDARY OUTCOME MEASURES Feasibility was assessed based on recruitment, retention and attendance. Questionnaires and postintervention qualitative interviews were conducted to explore intervention acceptability. Questionnaires assessing acceptability and outcomes planned for the future trial (eg, PTSD symptoms) were collected at baseline, 6 weeks, 12 weeks (immediately after the final hike) and 24 weeks follow-up. RESULTS Of 415 people assessed for eligibility/interest, 97 were interested and passed preliminary eligibility screening, and 26 were randomised. Mean completion of all questionnaires was 91% among those in the nature hiking group and 68% in those in the urban hiking group. Over the course of the intervention, participants in the nature and urban groups attended an average of 56% and 58%, respectively, of scheduled hikes. Acceptability of both urban and nature hikes was high; over 70% reported a positive rating (ie, good/excellent) for the study communication, as well as hike locations, distance and pace. Median PTSD symptom scores (PTSD Checklist-5) improved more at 12 weeks and 24 weeks among those in the nature versus urban hiking group. CONCLUSIONS This pilot study largely confirmed the feasibility and acceptability of nature hiking as a potential treatment for Veterans with PTSD. Adaptations will be needed to improve recruitment and increase hike attendance for a future randomised controlled trial to effectively test and isolate the ways in which nature contact, physical activity and social support conferred by the group impact outcomes. TRIAL REGISTRATION NUMBER NCT03997344.
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Affiliation(s)
- Alyson J Littman
- Seattle-Denver Center of Innovation, VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington, USA
| | - Gregory N Bratman
- School of Environmental and Forest Sciences, University of Washington, Seattle, Washington, USA
| | - Keren Lehavot
- Seattle-Denver Center of Innovation, VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
- Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, USA
| | - Charles C Engel
- Seattle-Denver Center of Innovation, VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - John C Fortney
- Seattle-Denver Center of Innovation, VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Alexander Peterson
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Alex Jones
- Outdoors for All, Seattle, Washington, USA
| | - Carolyn Klassen
- Seattle-Denver Center of Innovation, VA Puget Sound Health Care System, Seattle, WA, USA
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA
| | | | - Howard Frumkin
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
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Herring TE, Knowles LM, Alschuler KN. Outdoor Adventure Programs for Persons with Multiple Sclerosis: A Review and Agenda for Future Research. Int J MS Care 2021; 23:186-192. [PMID: 34483758 DOI: 10.7224/1537-2073.2020-066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Persons with multiple sclerosis (MS) often experience myriad symptoms that affect functioning and quality of life (QOL). Although there are a growing number of nonpharmacologic interventions designed to improve symptom severity and interference and maximize QOL, these particular treatments are limited by barriers to accessibility and, at times, a poor patient-intervention fit. Thus, it is important to consider alternative or supplemental nonpharmacologic treatments for people with MS. Outdoor adventure programs-group-based outdoor adventures aimed at enhancing QOL and fostering personal growth-could be one such alternative or supplemental approach. This topical review provides an overview of outdoor adventure programs; explores the current literature on these types of programs for the general population and medical populations; examines how outdoor adventure programs could enhance mood, functioning, and QOL for individuals with MS; and suggests future directions for research on outdoor adventure programs tailored to persons with MS.
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Hanks M, Wright AE, McKinnon J. Wounded Veterans in Parks and the Joint Recovery Team: American Veterans in Underwater Archaeology. JOURNAL OF VETERANS STUDIES 2021. [DOI: 10.21061/jvs.v7i1.243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Bettmann JE, Prince KC, Ganesh K, Rugo KF, Bryan AO, Bryan CJ, Rozek DC, Leifker FR. The effect of time outdoors on veterans receiving treatment for PTSD. J Clin Psychol 2021; 77:2041-2056. [PMID: 33899932 DOI: 10.1002/jclp.23139] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/08/2021] [Accepted: 03/25/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Duration, frequency, and intensity of nature exposure link to different physical and psychological benefits. The present study aimed to determine how time outdoors affected military veterans' posttraumatic stress disorder (PTSD) symptomology during PTSD treatment. METHOD Hypotheses regarding time outdoors and the effect of program duration on PTSD symptoms were examined using multilevel models. The authors hypothesized that hours outdoors, both within- and between-persons, would predict reduced PTSD symptomology, program duration would predict reduced PTSD symptomology, and that hours outdoors and program duration would be significant when accounting for the other. RESULTS The present study found that time outdoors correlated with participants' decreased PTSD symptomology: the more time participants spent outdoors, the greater the reduction in their PTSD symptoms. CONCLUSION The effect of time outdoors was significant within-person, not between persons, suggesting that nature exposure may be used as an adjunct to traditional mental health treatment where exposure or dosage should be person-specific.
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Affiliation(s)
| | | | | | - Kelsi F Rugo
- The University of Utah, Salt Lake City, Utah, USA
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9
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Barakat C, Yousufzai S. Green space and mental health for vulnerable populations: A conceptual review of the evidence. JOURNAL OF MILITARY, VETERAN AND FAMILY HEALTH 2020. [DOI: 10.3138/jmvfh-2019-0040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: Mental health is an essential component of overall health that is affected by various environmental factors. Research suggests the inclusion of green space and nature settings in built environments is beneficial for mental health, particularly for vulnerable populations such as military Veterans. Inequities exist for certain populations in relation to accessing a high quality and quantity of green space. Methods: This conceptual review offers a broad assessment of peer-reviewed literature examining links between green space and mental health. Results: Many studies have highlighted associations between exposure to green space and the mental health of vulnerable populations, such as Veterans and individuals of relatively low socio-economic status (SES). Evidence points to the importance of contextual features of green space, such as quality and quantity of green space, in relation to mental health benefits. Engagement in nature-based outdoor activities in green space, or other nature settings, appears to offer restorative effects linked to cognitive function and mental health benefits. Discussion: There is an emerging body of evidence on the relationship between mental well-being and accessibility to green space and nature settings, particularly for vulnerable populations. More research should focus on accessibility to green space and nature settings for the Veteran population.
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Affiliation(s)
- Caroline Barakat
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
| | - Susan Yousufzai
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
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10
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Bettmann JE, Anstadt G, Kolaski AZ. Therapeutic Adventure for Military Veterans with Mental Illness: A Conceptual Argument. ECOPSYCHOLOGY 2020. [DOI: 10.1089/eco.2019.0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Gretchen Anstadt
- College of Social Work, University of Utah, Salt Lake City, Utah, USA
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11
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Wheeler M, Cooper NR, Andrews L, Hacker Hughes J, Juanchich M, Rakow T, Orbell S. Outdoor recreational activity experiences improve psychological wellbeing of military veterans with post-traumatic stress disorder: Positive findings from a pilot study and a randomised controlled trial. PLoS One 2020; 15:e0241763. [PMID: 33237906 PMCID: PMC7688151 DOI: 10.1371/journal.pone.0241763] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 10/15/2020] [Indexed: 11/19/2022] Open
Abstract
Exposure to the natural environment is increasingly considered to benefit psychological health. Recent reports in the literature also suggest that outdoor exposure that includes recreational pursuits such as surfing or fishing coupled with opportunities for social interaction with peers may be beneficial to Armed Forces Veterans experiencing Post-Traumatic Stress Disorder (PTSD). Two studies were conducted to evaluate this possibility. In particular, these studies aimed to test the hypothesis that a brief group outdoor activity would decrease participants’ symptoms as assessed by established measures of PTSD, depression, anxiety and perceived stress, and increase participants’ sense of general social functioning and psychological growth. Experiment one employed a repeated measures design in which UK men and women military veterans with PTSD (N = 30) participated in a group outdoor activity (angling, equine care, or archery and falconry combined). Psychological measures were taken at 2 weeks prior, 2 weeks post, and at 4 month follow up. We obtained a significant within participant main effect indicating significant reduction in PTSD symptoms. Experiment two was a waitlist controlled randomised experiment employing an angling experience (N = 18) and 2 week follow up. In experiment 2 the predicted interaction of Group (Experimental vs. Waitlist Control) X Time (2 weeks pre vs. 2 weeks post) was obtained indicating that the experience resulted in significant reduction in PTSD symptoms relative to waitlist controls. The effect size was large. Additional analyses confirmed that the observed effects might also be considered clinically significant and reliable. In sum, peer outdoor experiences are beneficial and offer potential to complement existing provision for military veterans with Post Traumatic Stress Disorder.
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Affiliation(s)
- Mark Wheeler
- Department of Psychology, University of Essex, Colchester, Essex, United Kingdom
| | - Nicholas R. Cooper
- Department of Psychology, University of Essex, Colchester, Essex, United Kingdom
- * E-mail:
| | - Leanne Andrews
- Department of Health and Social Care, University of Essex, Colchester, Essex, United Kingdom
| | - Jamie Hacker Hughes
- Northern Hub for Veterans and Families Research, University of Northumbria, Newcastle upon Tyne, United Kingdom
| | - Marie Juanchich
- Department of Psychology, University of Essex, Colchester, Essex, United Kingdom
| | - Tim Rakow
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience; King’s College, London, United Kingdom
| | - Sheina Orbell
- Department of Psychology, University of Essex, Colchester, Essex, United Kingdom
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Havlick DG, Cerveny LK, Derrien MM. Therapeutic landscapes, outdoor programs for veterans, and public lands. Soc Sci Med 2020; 268:113540. [PMID: 33298384 DOI: 10.1016/j.socscimed.2020.113540] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/30/2020] [Accepted: 11/16/2020] [Indexed: 11/29/2022]
Abstract
In recent decades, scholars have developed ideas about therapeutic landscapes that explore how social processes, symbolism, and physical features generate diverse meanings. We examine here how therapeutic landscapes are produced and utilized for outdoor programs for military veterans, particularly veterans experiencing post-traumatic stress. Outdoor programs for veterans (OPVs) provide restorative opportunities through nature immersion and outdoor recreation. OPVs involve diverse social settings, activity types, durations, geographic and land management contexts, and degrees of therapeutic intervention. In many combinations they can generate therapeutic landscapes conducive to some degree of recovery. Our analysis relies on qualitative data gathered through semi-structured interviews with OPV providers and participants, mental health specialists, and public land officials. Arguing against a reductionistic approach, we suggest that the diversity of OPVs and disparate character of activities, locations, and dosages may contribute in important ways to the efficacy of these programs. Ironically, the very qualities that present challenges for measuring and evaluating the benefits of OPVs may prove to be advantageous with respect to therapeutic outcomes. We highlight how public lands present a distinctive set of attributes that make them particularly well-suited to provide therapeutic opportunities, and that agency policies can shape the development of therapeutic landscapes.
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Affiliation(s)
- David G Havlick
- Department of Geography and Environmental Studies, University of Colorado Colorado Springs, 1420 Austin Bluffs Pkwy, Colorado Springs, CO, 80918, USA.
| | - Lee K Cerveny
- Pacific Northwest Research Station, USDA-Forest Service, 400 N. 34th St., Suite 201, Seattle, WA, 98103, USA.
| | - Monika M Derrien
- Pacific Northwest Research Station, USDA-Forest Service, 400 N. 34th St., Suite 201, Seattle, WA, 98103, USA.
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Theal R, Kerin JL, Romaniuk M. Psychosocial Outcomes of Australian Male and Female Veterans Following Participation in Peer-Led Adventure-Based Therapy. JOURNAL OF VETERANS STUDIES 2020. [DOI: 10.21061/jvs.v6i2.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Milton AC, La Monica H, Dowling M, Yee H, Davenport T, Braunstein K, Flego A, Burns JM, Hickie IB. Gambling and the Role of Resilience in an International Online Sample of Current and Ex-serving Military Personnel as Compared to the General Population. J Gambl Stud 2019; 36:477-498. [PMID: 31620927 DOI: 10.1007/s10899-019-09900-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Compared to the general population, military personnel are particularly vulnerable to developing gambling problems. The present study examined the presentation of gambling-including gambling frequency, personal thoughts on reducing gambling and recommendations from others to reduce gambling-across these populations. Additionally, the study measured the association between gambling and various psychosocial risk and protective factors-including psychological distress, suicidal ideation, external encouragement to reduce substance use, days out of role, personal wellbeing, resilience, social support and intimate bonds. Data was extracted from the Global Health & Wellbeing Survey, an online self-report survey conducted in Australia, Canada, New Zealand, the United Kingdom and the United States. Of the 10,765 eligible respondents, 394 were military veterans and 337 were active military personnel. Consistent with previous research, a higher proportion of gambling behaviours were observed in both current and ex-serving military samples, compared to the general population. To varying degrees, significant associations were found between the different gambling items and all psychosocial risk and protective factors in the general population sample. However, the military sample yielded only one significant association between gambling frequency and the protective factor 'resilience'. A post hoc stepwise linear regression analysis demonstrated the possible mediating role resilience plays between gambling frequency and other psychosocial risk (psychological distress, and suicidal thoughts and behaviour) and protective factors (personal wellbeing) for the military sample. Given the findings, it is recommended that routine screening tools identifying problem gambling are used within the military, and subsequent resilience focused interventions are offered to at risk personnel.
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Affiliation(s)
- A C Milton
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, 2006, Australia. .,Project Synergy, InnoWell Pty Ltd, Sydney, NSW, Australia.
| | - H La Monica
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, 2006, Australia.,Project Synergy, InnoWell Pty Ltd, Sydney, NSW, Australia
| | - M Dowling
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, 2006, Australia.,Project Synergy, InnoWell Pty Ltd, Sydney, NSW, Australia
| | - H Yee
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, 2006, Australia.,Project Synergy, InnoWell Pty Ltd, Sydney, NSW, Australia
| | - T Davenport
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, 2006, Australia.,Project Synergy, InnoWell Pty Ltd, Sydney, NSW, Australia
| | - K Braunstein
- Project Synergy, InnoWell Pty Ltd, Sydney, NSW, Australia
| | - A Flego
- The Movember Foundation, Melbourne, VIC, Australia
| | - J M Burns
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, 2006, Australia
| | - I B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, 2006, Australia
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Shirazipour CH, Tennant EM, Aiken AB, Latimer-Cheung AE. Psychosocial Aspects of Physical Activity Participation for Military Personnel with Illness and Injury: A Scoping Review. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/21635781.2019.1611508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Emily M. Tennant
- School of Kinesiology & Health Studies, Queen’s University, Kingston, Ontario, Canada
| | - Alice B. Aiken
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Amy E. Latimer-Cheung
- School of Kinesiology & Health Studies, Queen’s University, Kingston, Ontario, Canada
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Psycho-Physiological Stress Recovery in Outdoor Nature-Based Interventions: A Systematic Review of the Past Eight Years of Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101711. [PMID: 31100773 PMCID: PMC6572302 DOI: 10.3390/ijerph16101711] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 05/02/2019] [Accepted: 05/11/2019] [Indexed: 01/08/2023]
Abstract
Background: In modern, urban daily life, natural environments are increasingly recognized as an important resource for stress recovery and general well-being. Aim: the present review aims to provide an overview and synthesis of the past eight years’ research into the psycho-physiological effects of outdoor nature-based interventions, related to stress recovery. Method: a structured search was performed in seven databases, returning 5618 articles. Removal of duplicates and initial screening gave a total of 95 studies. After full text reading, 36 studies were included in the assessment. Results: most of the psychological outcomes were related to different emotional measures. The synthesis of the results points towards outdoor, nature-based exposure having a positive effect on different emotional parameters, related to stress relief. The studies into physiological measures showed more equivocal results. Conclusion: the research, conducted over the past eight years, into outdoor, nature-based exposure has now attained a sound evidence base for psychological and especially emotional effects, but the evidence base for physiological effects within this timeframe shows a great degree of heterogeneity. Limitations: interpretation of the results is limited by the review only covering the past eight years’ research on the subject.
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Shirazipour CH, Latimer-Cheung AE, Aiken AB. Quality physical activity experiences for military Veterans with a physical disability: Exploring the relationship among program conditions, elements, and outcomes. JOURNAL OF MILITARY VETERAN AND FAMILY HEALTH 2019. [DOI: 10.3138/jmvfh.2018-0017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: In this study, we evaluate the physical activity (PA) participation of Veterans with a physical disability, particularly the role of experiential elements of quality participation in facilitating desired program outcomes. We hypothesized that quality elements would mediate the relationship between quality program conditions and participation outcomes. Methods: Forty-nine Veterans with a physical disability (mean age = 43.61 [SD 8.81] y) completed questionnaires before and after PA event participation, as well as at a 3-month follow-up. Results: Results demonstrated that an indicator of the quality element belongingness mediated the relationship between coach interpersonal skills and two PA indicators (i.e., planning and intentions) after event participation. The same quality indicator also mediated the relationship between coach interpersonal skills and family integration after event participation and at the 3-month follow-up. Discussion: These findings provide preliminary evidence linking quality PA program conditions and elements to PA participation outcomes.
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Affiliation(s)
- Celina H. Shirazipour
- Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, California, USA
- School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada
| | - Amy E. Latimer-Cheung
- School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada
| | - Alice B. Aiken
- Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
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Greer M, Vin-Raviv N. Outdoor-Based Therapeutic Recreation Programs Among Military Veterans with Posttraumatic Stress Disorder: Assessing the Evidence. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/21635781.2018.1543063] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Michael Greer
- School of Social Work, College of Health and Human Sciences, Colorado State University, Fort Collins, Colorado
| | - Neomi Vin-Raviv
- School of Social Work, College of Health and Human Sciences, Colorado State University, Fort Collins, Colorado
- University of Northern Colorado Cancer Rehabilitation Institute, School of Sport and Exercise Science, University of Northern Colorado, Greeley, Colorado
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Houlden V, Weich S, Porto de Albuquerque J, Jarvis S, Rees K. The relationship between greenspace and the mental wellbeing of adults: A systematic review. PLoS One 2018; 13:e0203000. [PMID: 30208073 PMCID: PMC6135392 DOI: 10.1371/journal.pone.0203000] [Citation(s) in RCA: 133] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/12/2018] [Indexed: 01/17/2023] Open
Abstract
Introduction The view that interacting with nature enhances mental wellbeing is commonplace, despite a dearth of evidence or even agreed definitions of ‘nature’. The aim of this review was to systematically appraise the evidence for associations between greenspace and mental wellbeing, stratified by the different ways in which greenspace has been conceptualised in quantitative research. Methods We undertook a comprehensive database search and thorough screening of articles which included a measure of greenspace and validated mental wellbeing tool, to capture aspects of hedonic and/or eudaimonic wellbeing. Quality and risk of bias in research were assessed to create grades of evidence. We undertook detailed narrative synthesis of the 50 studies which met the review inclusion criteria, as methodological heterogeneity precluded meta-analysis. Results Results of a quality assessment and narrative synthesis suggest associations between different greenspace characteristics and mental wellbeing. We identified six ways in which greenspace was conceptualised and measured: (i) amount of local-area greenspace; (ii) greenspace type; (iii) visits to greenspace; (iv) views of greenspace; (v) greenspace accessibility; and (vi) self-reported connection to nature. There was adequate evidence for associations between the amount of local-area greenspace and life satisfaction (hedonic wellbeing), but not personal flourishing (eudaimonic wellbeing). Evidence for associations between mental wellbeing and visits to greenspace, accessibility, and types of greenspace was limited. There was inadequate evidence for associations with views of greenspace and connectedness to nature. Several studies reported variation in associations between greenspace and wellbeing by life course stage, gender, levels of physically activity or attitudes to nature. Conclusions Greenspace has positive associations with mental wellbeing (particularly hedonic wellbeing), but the evidence is not currently sufficient or specific enough to guide planning decisions. Further studies are needed, based on dynamic measures of greenspace, reflecting access and uses of greenspace, and measures of both eudaimonic and hedonic mental wellbeing.
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Affiliation(s)
- Victoria Houlden
- Warwick Institute for Science of Cities, University of Warwick, Coventry, West Midlands, United Kingdom
- * E-mail:
| | - Scott Weich
- ScHARR, University of Sheffield, Sheffield, South Yorkshire, United Kingdom
| | - João Porto de Albuquerque
- Centre for Interdisciplinary Methodologies, University of Warwick, Coventry, West Midlands, United Kingdom
| | - Stephen Jarvis
- Department of Computer Science, University of Warwick, Coventry, West Midlands, United Kingdom
| | - Karen Rees
- Warwick Medical School, University of Warwick, Coventry, West Midlands, United Kingdom
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Poulsen DV, Stigsdotter UK, Davidsen AS. "That Guy, Is He Really Sick at All?" An Analysis of How Veterans with PTSD Experience Nature-Based Therapy. Healthcare (Basel) 2018; 6:E64. [PMID: 29904038 PMCID: PMC6023361 DOI: 10.3390/healthcare6020064] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 06/02/2018] [Accepted: 06/08/2018] [Indexed: 11/17/2022] Open
Abstract
Serving in the military leads to mental diseases, such as post-traumatic stress disorder (PTSD), for a percentage of soldiers globally. The number of veterans with PTSD is increasing and, although medication and psychological treatments are offered, treatment results could be improved. Historically, different forms of nature-based therapy have been used for this target group. However, in spite of anecdotally good results, studies measuring the effect of this form of therapy are still lacking. The aim of this study is to explore how veterans with PTSD manage their everyday lives during and after a ten-week nature-based intervention in a therapy garden. METHODS Eight veterans participated in qualitative interviews, which were conducted during a one-year period and were analyzed using interpretative phenomenological analysis (IPA). RESULTS Five themes emerged from the IPA analysis: Bodily symptoms; relationships; building new identities; the future; and lessons learned. All the participating veterans gained a greater insight into and mastering of their condition, achieved better control of their lives, and developed tools to handle life situations more appropriately and to build a new identity. This improved their ability to participate in social activities and employment. CONCLUSION The results should be considered in the future treatment of veterans with PTSD.
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Affiliation(s)
- Dorthe Varning Poulsen
- Department of Geosciences and Natural Resource Management, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark.
| | - Ulrika K Stigsdotter
- Department of Geosciences and Natural Resource Management, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark.
| | - Annette Sofie Davidsen
- The Research Unit for General Practice, University of Copenhagen, Øster Farimagsgade 5, 1014 København K, Denmark.
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