Overview CoP FfH 2004,2005,2006

Yvon D. Schuler ORGYD process advice

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Community of Practice Farming for Health (FfH)

By; Yvon D. Schuler ORGYD procesadvies Wagnerlaan 67 6815 AD Arnhem info@orgyd.nl +31651231903

Overview of the Annual meetings in 2004-2005-2006

Introduction In this short paper I try to give an overview of the topics and actions that we discussed during our three CoP meetings. I hope it will be helpful to prepare for our coming meeting in Ghent. All participants of the three meetings received a copy of the reports made after the sessions. This information can also be found on the website www.farmingforhealth.org. This November 2007 the new website will be available again.

1. Meeting 2004 March 23-26th also called preparatory conference Therapeutic Farm de Vijfsprong Vorden The Netherlands This invitational meeting focussed on the exchange of first impressions on the State of Art of Farming for Health. People from the Netherlands invited people from abroad to get together and learn from each other. 42 participants in total excepted the invitation. They all made posters to present their projects. It started with an introduction of Derk Klein Bramel about the therapeutic Farm, Jan Hassink about the perspective on actions to be taken coming years and Bas Pedroli on the aims of the conference programme. After that Yvon D. Schuler (process leader of the meeting) introduced the working method of warming up and cooling down during the work days. Yvon also explained the notion on Communities of practice. After that we started the presentations and made a mindmap on eye-catching ideas, striking similarities, inspiring examples, reflections and options.

Overview CoP FfH 2004,2005,2006

Yvon D. Schuler ORGYD process advice

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Themes discussed 2004 - The goal was to start an international network of people involved in Farming for Health practice, governance and research and talk about the Community of Practice as a work form. The exchange of ideas and experience between these groups was found to be most important. - It was clear that the practice was very different between the participating countries, but there were also many varieties of Care Farms to discover. - Also the term Farming for Health was under discussion. What do we mean by Farming for Health (FfH). It was finally found to be a broad term that could cover al the different examples and programmes in the world. The term Green Care also was discussed. It is mostly about Care and not about farming, effect on the quality of life and the care for the surroundings. Al this should be taken in account when talking about FfH. - What is an implicit or explicit Care Farm? What kind of Care Farms are there and for what kind of groups (elderly, youth etc.) - What about the organization/ approach of the farms: producing Food/Products (Farmer stay Farmer), being a therapeutic farm or both? - Is social inclusion of Patients needed?

Looking for best practices around the world could help to set standards of working and international guidelines. Funding of all kinds of research (not only evidence based) should be promoted. Training and education for farmers is needed. Also information for the policy makers is important. Quality of the work and the Farms should be discussed more. Funding (sources) of and legislation on FfH is still a problem in most countries.

Outcomes 2004 (Conference report available see website Archive folder 2004)

A list of Actions was made. We still use this and elaborate on that. A questionnaire on the developments in the different countries. We started a dictionary on terms used in this context in different countries. Common terminology and categorization is important. One of the biggest tasks to coordinate was the making of a book on the State of Art on Farming for Health. We made a contribution list and agreed on the working plan. We need to get more information on all the forms of FfH included Horticultural Therapy and Animal Assisted Therapy. Storytelling was found to be a forceful instrument to exchange experiences. We started brainstorming on the next meeting in 2005 and agreed on the topics, the workshop subjects for the conference in 2005. We made a working plan. It is important to have enough time for excursions and talking to each other. We all will work on improving the network, especially in our own countries by involving other people.

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Building a Community of Practice. This network will become a global International Network. We committed to actions after the meeting in 2004

2. Meeting 2005 March 16-19th Hotel Wageningse Berg Wageningen The Netherlands Jan Hassink opend the meeting with his presentation Farming for Health across Europe comparison between countries. He referred to the book in progress in which contributions of members of the CoP FfH were published. The printed version of this book is still available , but an online version can be downloaded. The soft cover copy is available through jan.hassink@wur.nl. We were proud this book to be a cooperative action of the CoP FfH. Rabbinge (University of Wageningen) opened the meeting by saying that Agriculture can take good care of people and that studies should be done to search for evidence on the positive impulse of this branch. Look for the things you have in common, but also for all kind of differences. Why do they exist? Out of all the identified themes in 2004, the programme comity selected five main topics. All topics were introduced. 1. Inclusion keynote speaker Joe Sempik talked about: Integration and quality of life: a question of integrity and identity. www.growingtogether.org.uk 2. Farm life keynote speaker Thomas von Elsen spook about: Sustainable rural development and social health: landscapes of the future. 3. Society keynote speaker Piet Driest introduced: Public responsibility and individual involvement: crossing borders 4. Research keynote speaker Diane Relf on: Farming for Health: Research lessons from the United States 5. Practice keynote speaker Hannelore Speelman about Care Farm the Noorderhoeve in the Netherlands We had different workshops within the topics: - The position of green care in a changing society and the effects on clients. - Economics and social entrepreneurschip Policies in health care, agriculture, urban areas and countryside We had group discussions on: - The position of green care in a changing society, and its effects on clients. Bjarne Braastad from Norway presented his research project, which is about the effects of farm animals on the well-being of clients with psychiatric problems. His team has chosen to set up a Randomised Clinical Trial (RCT), which is the first randomised research in this field. Clients sign a form, stating that they will either be part of the control group (without intervention), or take part in farm activities. Bjarne and his team used various questionnaires in this

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research, measuring e.g. quality of life, depression, coping abilities, anxiety, selfesteem and social and working abilities. The first results indicate that farmers and clients do not always agree on the degree of development and that clients scores can vary considerably from day to day, depending on their mood. - Developing a conceptual framework of Farming for Health. We surged for a shared conceptual framework about what happens within Farming for Health. We also looked for suitable research methods for registering potential effects on clients from working on green care farms. - How can the various policy domains in health care, agriculture, urban / rural spatial planning, mutually strengthen or counteract with reference to Inclusion. - How to raise public awareness (action plan) by : alliances, umbrellaassociations of people with disabilities, elderly, youth, nature-protection organisations, slow food o ways: direct media: good practices, research results, stories articles in professional magazines inviting stakeholders on farms European open day at the care farm green care reality soap national and European price for the best entrepreneur indirect translation of articles for shared information CoP and CoP-website We also had excursions to several Care Farms: De groote Fliert, Klein Essen and De Hooge Kamp.

Themes discussed 2005 - Theoretical Models for Research and Program Development in Agriculture and Health Care: Avoiding Random Acts of Research. (D. Relf). The urge for researchers to provide clearer operationalizations of process and outcome variables, baseline and long-term follow-up data, and control and comparison treatment groups. - People-plant interaction: the physiological, psychological and sociological effects of plants on people. (M. Elings) - Monitoring of Practice is necessary. We do need to have guidelines ( a professional body) - Effects for clients a) Health promoting aspects of plant, animals, green care farms and green environment (mechanisms); how does it work b) Effects of green care, plants, animals and landscape on the well being/health of clients c) Research methodology to measure the effects of green care farms for clients

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d) The views and hypotheses related to green care in the agricultural and health care sector e) Design of healing landscapes and healing farms - Economics a) The costs effectiveness of green care at micro and macro level b) The contribution of green care to financial prospects of agriculture and countryside c) The financing of garden projects as therapeutic action research. - Looking for success criteria for Green Care: like involving the hole family in the therapeutic setting, agreements on treatment and monitoring the treatment. - Policies in health care, agriculture, urban areas and countryside a) How can Farming for Health fit into current and future health systems, preventive and curative b) Needs and possibilities of collaboration between different target groups c) Needs and possibilities of collaboration between different examples of Farming for Health : green care, Animal Assisted Therapy, Horticultural Therapy, City Farms, Healing Gardens, Healing Landscapes. - The position of green care in a changing society a) Consciousness and change of paradigm in health care and agriculture b) Quality of life and salutogeneses in relation to green care - Education Education programmes and needs for workers and clients in the green care sector. What qualifications do farmers or therapists need to work on a care farm? Standards should be made. Outcomes 2005 (a report was made >>see folder 2005 in website Archives) - CoP FfH still doesnt work like we want. Most of the people dont get in contact with each other after the yearly meeting. Some of the research actions are successfully implemented. There is still action to be taken to promote interaction between the annual meetings > Website construction started. - Exchange of education and training systems will be started. - On the theme of Quality the Dutch will exchange their Handbook on Quality for Care Farms. - The list of Actions was set up on policy issues, social economy (social return on investment), CoP household and Knowledge based activities: o 1. survey and translate quality and competence systems (either sophisticated or implicit) o 2. develop guidelines to enhance the process of developing and demonstrating quality o 3. promotion of European day of Farming for Health o 4. European prize for social entrepreneurship in Farming for Health o 5. develop video on care farms o 6. collect data on (socio-) economic performance of green care initiatives: parameters

Overview CoP FfH 2004,2005,2006

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o 7. social return on investment initiative o 8-12 put articles, research concepts and results in the web-site and set
up discussion groups; develop and maintain web-site; set up mailing list: develop e-Newsletter. 13. enlarge CoP south- and eastward 14. exchange education and training programmes 15. survey on care farms across Europe 16. pushing research proposals 17. develop web-based dictionary-glossary on care farming (also connected to action 8-12) 18. special issue of Horticultural Technology: theoretical frameworks We also planned further meetings in Norway (2006) and Belgium (2007)

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3. Meeting 2006 June 21-24th Hotel Alstor Stavanger Norway The programme comity chose three main topics: Research, Benefits of Green Care Farming and Practices. They asked some special keynote speakers to elaborate on these issues. After the warm Welcome by Tora Aasland Into the courtyard a Norwegian concept, many presentations followed. The meeting was reported in three newsletters. Jan Hassink Farming for Health across Europe Reider Almas An aspect of the multifunctional agriculture Rachel Hine Application of recent research findings for the development of National Care --Thomas von Elsen Benefits of Care Farms for Nature and Landscape development Gunnar Tellnes Green Care as seen from the medical view Simon Oosting Development of green care from the farmers perspective --Bente Berger Farm-animals assisted therapy for people with mental disorders Diane Relf Gardens in Health Care Erling Krogh The farm as a pedagogical resource In the evening programme we had an introduction by City gardener Torgeir Srensen about the design of Parks in the city. The following days we focused on the action list. All participants are involved in actions and now was the time to tell what they had done or to give a workshop to get input from other members. These Action Reports gave an inside in the development of the promised actions during the year. There were workshops on: - Special Pedagogies on farms by Erling Krogh, Robert Milne and Yvon D. Schuler - Participatory photo and video by Gerard Assouline and Paolo Pieroni

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- Social return on investment by Gert Rebergen - Quality systems by Jaap Meijer - European day and Prize for Green Care by Yvon D. Schuler and Katrien Goris. And in the evening a workshop on Story-telling as a therapy by Yvon D. Schuler. Also some special topics were part of the programme like the presentations about: - Education on Nature, health and quality of life in Norway by Grete Patil - Blended values as means of communication by Gert Rebergen - Organisational networks and international cooperation by Massimo Testa - Healing through working by Truida de Raaf - Researching the Benefits- advances and difficulties by Joe Sampik We also had a midway evaluation by Yvon D. Schuler in which the benefits of the CoP Farming for Health were listed, the main goals and design of a CoP were explained again. We had a central session on Health Effects. Three presentations bij Marjolein Elings, Simone de Bruin and Konrad Neuberger. We discussed the way we should organize our Community of Practice by Yvon D. Schuler Furthermore we had excursions to Care farms: Soma grd in Sandnes, Care Farm in Steindal, museum in H with a Barn Opera as a treat. And also joined the midsummer celebration by the coast. Themes discussed 2006 the quality of the care on farms isnt linked to the size of the Farms. Quality rules can be implemented and evaluated in every farm. The translation of the Dutch Quality Handbook in English is a start. Also the Norwegian Guidelines for Development of GC Farms is translated. Do Farmers need special educational programmes? Or can we state that Farmers are natural counsellors? The challenges of Green Care within our societies to meet the care needs of so many people as Green services. To help the practice we have to increase the research basis. So look for research methods that can help the fieldworkers. Effective intervention have to work in every paradigms. Evidence based working is necessary but not the only way. Make room for experiments. Therapeutic Causality Report Methodology (RCT) will look systematically at the work methods (relation between patient and therapist (Farmer?) Green designing for patients (healing Gardens) and the benefit of these gardens for the wellbeing of the landscape. Designing healthy environments for Care Farms! Farms as healthy environments.

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The farm as a pedagogical resource and environment for health and well-being for pupils. Children need the natural environment to develop the skills. Education and training programmes for Farmers to become Social Farmers are developed in the Netherlands and in Norway (Living School programme of Erligh Krogh and Linda Jolly Social return on Investment is a method to measure blended value in terms of cash flow. So ecological and social values count. This can be important for Farming for Health.

Outcomes 2006 (during the meeting three newspapers were made> see web archive folder 2006) The CoP FfH must become a active group of people from government, research and practice. The group presenting the practice of Green Care should be expanded. New views from the side of the medical profession and the farmers. New groups have to be included in discussions and presentations. We discussed the range of the CoP Farming for Health. Is animal assisted Therapy and horticultural Therapy included? Yes but the focus should be on the functional Farm as the context. The dictionary of new FfH related words will be filled constantly. There will be a video project based on visual methods in research. Working with photocameras (see information on SOFAR project) We have to plan new research actions and participate in the COST action and SOFAR research programmes

Midway evaluation CoP What purpose does this CoP FfH has? We made a list of the Benefits of the Cop. (look for this list in the web folder Archive 2006). Also look for papers on CoP organization Learning as a social system and What do we want to achieve and how do we want to organize? All the action groups will report on their progress. We will discuss at what frequents we will continue with the meetings. The next annual meeting (2007) is in Belgium and the after that the Italians will take over. We also want to have different workgroups for Research and Practice

In 2007 the Farming for Health meeting will be in Ghent Belgium. There will be a special information website!!!