The model identifies the different relationships within STH, with the Practitioner managing and guiding all of them; although these relationships exist in all the models, the way in which the role operates differs across them.
The relationships include:
- The building of rapport between the practitioner and each person attending the programme.
- The guidance or management of the person in relation to the garden (understanding their nature connectedness or affinity for nature to engage them in areas of gardening familiar, aspirational, or comfortable to them).
- The guidance or management of the person in relation to the gardening activities ensuring that they are accessible (access issues in STH are physical, sensorial, cognitive, and also emotional) and achievable.
- The guidance or management of the person’s relationship with the other members of the social environment (the group they are gardening with but also potentially other people, volunteers, other team members, members of the public, etc.)
- The support, guidance, and potential management of the person in relation to their individual outcomes.
- The guidance and management of the whole programme in relation to the community (this can be because of other reciprocal agendas or work areas and also critically to ensure the benefits and outcomes achieved in the garden have value and significance for each person in their life within the community).
With an understanding of the needs of the group and the individual within it, the practitioner can balance the active processes accordingly. For example, for a person with severe or complex mental ill health, time in nature is likely to be significantly more valuable, offering attention restoration and improving mood. With acute symptoms, activity and occupation needs to be carefully selected and adapted to suit each individual so as not to frustrate or cause stress through performance pressure or realisation of inability. The social environment needs more careful management and may not be such an active process towards outcomes for all and the practitioner will need to lead and be more autocratic in their style.
For a person with mild mental ill health, occupation, and activity to support them to feel as if they can have a choice, control, develop routine, meaning and purpose may be more valuable than time in nature alone. The social environment may become more actively valuable in supporting outcomes; in line with the recovery model, supporting the person in rebuilding relationships and trust in others. Here the practitioner will more likely adopt a facilitative and democratic approach to their role.
A vocational focus could have potential value in some mental health contexts, for example, it could be a more valuable model type in adolescent and children’s mental health. Here the practitioner has outcomes beyond health to manage: the attainment of vocational outcomes which could include horticulture certificates or work-ready learning outcomes. Again, activity and occupation may become more valuable, and balancing the session schedule towards this is needed to achieve desired outcomes.