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​Therapy takes different forms. For many patients at Oregon State Hospital's Junction City campus, revitalizing a barren courtyard into a garden blooming with life has offered unexpected lessons in responsibility, working in community and personal growth.

Time patients spend in the garden is part of a therapy group OSH occupational therapist Mia Boessen offers throughout the year. She intentionally uses seasonal themes and related chores as an analogy for patient's physical health, mood and self-care.

“In winter, there's more rest and planning, reflecting, so you're ready for spring. In spring, it's an exciting time. We do more grounding work. How do you not get carried away and focus on the growth you've made," she shared.

As patients look toward fall, where they reap the harvest and benefits of their hard work, they're approaching full summer mode.

“In summer, we're watering and weeding. That can be boring and repetitive, but that's a lot of recovery – maintenance and having a healthy routine," Boessen said.

The space is called the “Prairie Quad" – though with the flowers and vegetable life sprouting in the space, it should be renamed Meadow Quad, joked one of the patients who gardens with the group every week. On one side of the yard, pumpkin, cantaloupe and a mix of peppers and miscellaneous plants thrive. Several raised beds are scattered throughout – spinach, tomatillo, bird chilis, kale, strawberries, raspberries, carrots, basil, lettuce, onion and garlic. Seasonal flowers also bloom around the garden's perimeter.

“What's not to enjoy?" said Isaac, one of the many patients in the garden therapy group. “For me, gardening has always been a part of my life, and this gives me an opportunity to teach others because I have practical experience."

The garden has also helped build community and teamwork among patients by being a healthy outlet for them to connect with nature and develop skills that will help them in their daily lives, Boessen said. After the harvest, the learning continues through cooking lessons with new and healthy ways to prepare what they've grown.

As an occupational therapist, she uses a lot of hands-on activity to help patients build skills to help them in their recovery and prepare to return to their communities. Her own enjoyment of gardening led her to develop the activity into a therapeutic option for patients.

“Occupational therapy is about the activities that we do day-to-day that occupy our time and how that builds our mood, self-esteem, confidence, level of independence," she said. “Through the garden group, they're helping to write the plans about what we will grow and where we will plant it. So, they're also learning about organization, memory recall and how to set goals and follow through on them."

Issac shared that he knows it's helping him in other ways, too. Because of his gardening experience, he recognizes he often makes suggestions that may not align with Boessen or other group facilitators' goals with the group or what they think everyone may be ready to tackle.

“It's been an opportunity for me to hone my coping skills," Issac said.

During their group time together, Boessen encourages their work. Some days patients who attend the weekly garden group may just want to enjoy the sunshine and growth around them. Boessen encourages patients to experience the garden in the way that they need to, understanding that nature is its own therapy, too.

On one recent sunny day, she gauged a patient's mood with a simple question.

“Would you like to pull weeds?" she asked.

“Not really."

“You want to enjoy the sunshine? That's fun, too," she said with encouragement. “We did all this work to enjoy the garden."

From nearby another patient good-naturedly joked with their peer who did not want to weed, “Next week, you're weeding." A few laughed and small pockets of conversation continued as patients took initiative in different areas of the garden. Some watered. Others pulled weeds while some inspected the progress of the growing plants.

Boessen called out to them with a question of the day – a lesson of sorts.  

“I have a survey," she told them. “Why did you decide to come today?"

Then, she listed off a series of options from them to choose from. Each response linked to research that shows the social and therapeutic benefits of gardening: better physical health, improved mental health, opportunity to connect with others, to learn new skills and to connect with nature.

Patients nearby took turns calling out their responses:

“Keep my mind busy."

“Keep my mind off of stuff."

“To be outside and connect with nature."

The impromptu survey didn't stop anyone's work, and Boessen checked on a Brussels sprout plant and delivered some news that the small group wasn't too excited about.

“This one needs to go," she said and explained the plant was crowding out others that had grown larger than the smaller sprout.

As she yanked out the plant, she said what's often difficult for anyone to learn: “Sometimes, you have to pull things out to grow. It's a life lesson."