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HTI Student Profile – Cynthia Conk, HTR

Linking People and Plants

HorticulturalTherapy at the Wyoming State Hospital

My name is Cynthia Conk and I am a Certified Therapeutic Recreation Specialist
(CTRS) and have worked at the Wyoming State Hospital for 18 years. I
am currently assigned to the forensic unit and have been the Program
Manager of the greenhouse for five years. Prior to my participation
in the certification program at the Horticultural Therapy Institute
(HTI), the main focus of activities at the greenhouse was “to keep
the plants alive.” When I started classes at the HTI I learned
how fortunate I was to have a greenhouse. Even though the heating and
cooling system needs some work and the fiberglass is deteriorating I
don’t complain anymore. I’m grateful to have a greenhouse that provides
us with the plant material we need for our program. The hospital is
in Evanston, Wyoming and at 6500 feet we are able to lengthen our growing
session and have a year-round program. WSH provides mental health services
for the citizens of Wyoming. We have a combination of short-term acute
care, long-term SPMI (severe persistent mental illness) and forensic
clients. Our campus is spread over 20 acres and includes group homes
within the community. The needs and considerations vary considerably
when providing programming for the clients.

Our HT program is a combination therapeutic/social program. The HT activities
take place primarily in the greenhouse and in the attached activity
room. We also have designated areas around the hospital grounds where
we have developed garden areas near living units that provide accessible
“outdoor classrooms” in the summer. We strive to create environments
that promote and allow for growth. An assessment developed specifically
for HT is given to each client prior to participating in the HT program.
It assesses cognitive, social, physical and leisure needs/limitations
and provides background information to help staff work more effectively
with each individual. Activities are provided that focus on client’s
needs/limitations and participation is documented towards client goals/objectives.

During the summer of 2006, I provide 8 contact hours a week for clients. Two
hours of HT groups are part of the forensic day treatment program for
the NGMI (not guilty due to a mental illness.) This group of clients
is my main workers and they help take care of the needs of the plants
at the greenhouse. The focus of the HT groups is leisure skill development
and improved quality of life. Activities focus around watering, pruning,
propagation, weeding, seeding, soil prep, planting, de-heading and all
the tasks associated with the greenhouse. They also help prepare for
our semi-annual plants sales. Two of the clients entered potted plants
into the Uinta County Fair in the fall and took home the grand champion
and reserve champion ribbons in floral/horticulture division. This was
a highlight for all the hard work they did during the summer.

Two hours
a week are dedicated to the short-term acute care clients. One group
was held at the greenhouse for those clients who could leave the unit.
The other group was on the unit for the clients who were less stable.
The size of group for these clients is limited due to the need for more
assistance during the activities. The unit staff accompanied and assisted
the clients during the activities. The focus of the HT activities is
more functional skills development such as focusing on tasks, following
directions, positive interaction with others, self-expression and improved
endurance/strength. Activities are completed within the time frame of
the group. I utilize activities ideas from the year-round HT activities
session I took from the HTI in 2004 and resources found in books, magazines
and on various web sites.

The final and largest group of clients is from the outpatient programs. Four hours
a week were dedicated to this program. Two hours spent in structured
activities and two hours were “open” for any interested clients
to drop in and assist in daily tasks being done. These clients are stable
in their illness and require less overall supervision but still benefit
from staff assistance during HT activities. The main focus for these
clients is leisure skills development, improved quality of life and
self-expression. Because the outpatient program has long term clients
were are able to do activities that continue from week to week. Early
in the spring we propagate and plant seeds. The clients tend to the
needs of their plants and learn to thin and transplant. They plant the
large containers that are placed in the common use areas and water and
nurture them throughout the summer. Flower collecting and preserving
are activities they enjoy and the material from these activities are
used in craft activities during the winter months.

When I
began as the Program Manager of the Greenhouse, I had experience as
a therapist in developing recreational programs for the clients and
was comfortable with assessing client needs, analyzing data and creating
care plans related to leisure activities. The Horticultural Therapy
Program was an avenue that had so much potential but lacked the structure
needed to make it a viable therapy at our facility. I put together a
proposal to attend the Horticultural Therapy Institute so I might become
certified as a Horticultural Therapist and provide an alternative therapeutic
modality. I began classes in January 2005 and was able to go straight
through the five sessions and finished February 2006. Each class provided
me with the knowledge needed to make the most of my program. The guest
speakers who shared with us how they utilized HT with their populations
inspired me. I learned characteristics of various populations and the
benefits HT could be in improving their quality of life. We studied
the history of HT with special populations and the human-plant relationship.
We shared our ideas with our classmates and developed a wide variety
of possible goals for participation in HT programs. We learned about
HT treatment models and processes and explored our own personal journey
with the benefits of HT. We developed programs and assessments for specific
populations that we were interested in or were currently working with
at the time. My favorite activity was developing indoor and outdoor
sites for HT settings. I was able to take specific areas at the hospital
and develop ideas for these areas. When I returned to WSH, I presented
the plans to the Facilities Director and he and I are currently working
together to put raised beds near the Visitors Center based on the assignment
I did in class. It is an area that has high traffic use with the clients
and visitors to the hospital. Besides providing a beautiful visual effect
to those who visit the hospital, it will also provide another “outdoor
classroom” for the HT clients. The final class was learning to
manage an HT program and putting it all together. This covered needs,
population, purpose, facilities and equipment, integrating with other
services, personnel, and resources. I have the support of the hospital
administration and a greenhouse/activity room. The professional disciplines
are also supportive of the program and the benefits they see with individual
clients.

The biggest
challenge my program faces is the lack of a designated operating budget.
When developing a budget during the HT Management class, I determined
that I needed a minimum of $1000.00 a year to operate an HT program.
This did not include any large expenses related to the greenhouse needs.
I have a wish list for those. We are able to raise approximately $600.00
from our semi-annual plant sales. Recently, I was given an area in our
hospital canteen and have set up a boutique to sell plants to the clients
and employees. We have been able to generate about $60 a month from
these sales. Once a year, I send a proposal to the Consumer Benefit
Counsel for specific projects that will benefit clients. They have donated
money to the program to purchase material for planting containers that
are located in courtyards around the hospital grounds. The supervisor
of the Therapeutic Services Department also has given the program money
in the spring to help purchase supplies needed to begin the growing
season. Just this past year, I have sought money from each of the specific
program managers to help defray costs of material for the groups their
clients attend. I have learned to utilized resources within the community
both businesses and volunteers. A local nursery donated over $800.00
in plants. When the local grocery store remodeled their produce section,
they donated all their old tables — perfect for raised work areas.
The Master Gardener’s Club designed the landscape in front of our new
45-bed acute care facility and has provided volunteer hours to the HT
program.

I am enjoying
my experiences in horticultural therapy and give credit to the staff
at the HTI as well as my classmates throughout the USA for helping me
put it all together. Building a network of professionals is essential
and has provided support and good friendships. Please feel free to contact
me if you have questions, need ideas or want to share experiences.

Cynthia
Conk, CTRS, HTR
Evanston, WY
cconk@state.wy.us

 



 


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