A recent study, published in the journal Health & Place, investigates the use of care farming, the combination of therapeutic practices in agricultural spaces, as an intervention for individuals who have experienced traumatic grief. The mixed-method study, led by Joanne Cacciatore at Arizona State University, found promising signs of improvement in individuals who received therapeutic interventions at a “carefarm” following the experience of a traumatic loss.
“The framework draws attention to the very geography of therapeutic interventions and communities, focusing on place as active and constitutive of health, while recognizing that it is not possible to separate experiences of health and wellbeing from the places in which they are experienced,” Cacciatore and her co-authors, Richard Gorman and Kara Thieleman, writes.
“Interventions that promote health must also attend to the confluence of environmental, interpersonal, and individual influences in therapeutic landscapes where the ‘social and spatial are intimately intertwined.’”
The loss of a loved one can create a complex set of emotional experiences that is markedly difficult for an individual to process. When this loss is under traumatic circumstances, that is, when the individual’s death is a result of homicide, suicide, or other violent means, or when the one is highly dependent on the individual, one may experience traumatic grief.
“Traumatic grief is a complex experiential condition, having biological, psychological, social, and cultural facets. It can incite a long-term and intense form of distress, putting individuals at risk of a variety of emotional, mental, and physical health impairments and adverse health behaviors, alongside wider impacts affecting income, employment status, and relationships,” Cacciatore, Gorman, and Thieleman explain.
Treatment for traumatic grief has become increasingly medicalized, in part due to the addition of Persistent Complex Bereavement Disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.
“This move has been celebrated for capturing grief-related problems unrelated to depressive or posttraumatic stress symptoms, but critiqued for introducing the risk of pathologizing normal responses to loss and advocating normative symptoms and arbitrary timelines on grief that may invalidate and silence the wide range of normal experiences related to traumatic bereavement,” the authors write.
A response to the increased medicalization of the grief process is therapeutic environments where one can receive therapeutic treatment in multiple ways. One such environment is a carefarm, defined as “the use of commercial farms and agricultural landscapes as a base for promoting mental and physical health through normal farming activity.”
In a recent attempt to understanding the impact of carefarms on individuals’ traumatic grief experiences, researchers recruited 22 adults in the southwest region of the United States. Most participants had experienced the death of a child (77.3%) and the remainder had experienced the death of a sibling (22.7%). Most reported that the death had been sudden and unexpected (86.4%), while others reported that it was the result of long-term illness (4.5%) or marked “other” and indicated that the death was from a terminal illness within a year of diagnosis.
Volunteer participants spent two separate days, a total of 10 hours, on a carefarm located in Northern Arizona. A key part of the carefarm is the animals that live there. All animals on the carefarm have been rescued and, “exist in an egalitarian model; that is, the farm aims to provide a level of autonomy to the animals, with their willingness to interact with humans, or not, being respected and foregrounded.”
As part of the study, each participant received 4-6 hours of traumatic grief-focused therapy while at the farm, interacted with the animals, and were free to use various restorative spaces on the farm.
The researchers utilized a mixed-method design with a standardized measure, the Therapeutic Grief Inventory-Self Report (TGI-SR), as well as a qualitative interview in an attempt to “understand the effects of a care farm intervention on [participants’] subjective experience of trauma and grief.”
When the TGI-SR was administered before the intervention, all participants’ scores suggested a high level of bereavement related stress. After participating in the two-day treatment, individuals were re-administered the TGI-SR and structured interviews were conducted.
Qualitatively, three themes emerged as important to the participants:
1. The restorative space of the carefarm.
“The ‘affective atmosphere’ of safety that participants associated with the space of the carefarm shaped how they interacted with the formal counseling. Participants felt enabled to explore their emotions and perspectives surrounding trauma and loss.”
2. The community aspect of the carefarm.
“Participants frequently reported that being part of a community of people affected by grief was a beneficial facet of their carefarm experience, countering the loneliness and social isolation common in bereavement.”
3. Connection to animals at the carefarm.
Benefits were demonstrated quantitatively as well. The researchers found a significant reduction in grief intensity on the TGI-SR following the carefarm intervention, with a mean improvement of 14 points. At posttest the mean score had fallen below the clinical cutoff, meaning that, on average, participants no longer met criteria for clinically significant grief.
Carefarms highlight the importance of the environment for the healing process. This study is only one example of a carefarm that provides restorative spaces and community settings for addressing traumatic grief. The authors conclude:
“The results from this evaluation reflect the benefits of creating specific communities and spaces for those affected by grief to find solidarity, support, and resilience. It also suggests the value that a ‘therapeutic landscapes’ approach might bring to thinking about bereavement support.”
Cacciatore, J., Gorman, R., & Thieleman, K. (2020). Evaluating care farming as a means to care for those in trauma and grief. Health & Place, 102281. (Link)