Nature Therapy in the Rehabilitation Centre

Jay Clarke, psychotherapist, shares what happens at our Rehabilitation Centre in Merseyside.

I have worked for The Katie Piper Foundation for 7 years and I feel privileged to be part of a dedicated team of people. The Rehabilitation Centre is a relatively new service and is the UK’s first ever live-in rehabilitation centre for adult survivors of burns and scars.

The rehabilitation team develop individually tailored programmes for every survivor in consultation with them and their existing medics; programmes are focused around the wellbeing, needs and goals of the individual.   If, at the point of assessment, nature therapy is considered to be helpful for the survivor, some nature sessions with me are scheduled in, usually one near the beginning of admission and one towards the end of their stay at the centre.

The centre is situated within beautiful grounds in the countryside.  The air is fresh and there is a wide variety of beautiful trees, birds, plants and flowers and accessible paths and terrain. In a typical nature session, we would step outside into the grounds and converse about what the survivor thinks and feels and wants to focus upon, whilst strolling, sitting and engaging with nature.  If the person wishes, we can also do some mindfulness in nature too.

When we step outdoors into the natural world our internal nature can be influenced immensely.  Nature is naturally therapeutic; a plethora of research supports what we instinctively know about fresh air, movement, sensory delights, connectedness and communication; engaging with nature has been shown to have positive benefits for our health and wellbeing.  There is an abundance of symbolism and metaphor to be experienced in nature, which can be utilised in therapy sessions with powerful and meaningful outcomes.  Natural settings provide a very rich, reflective environment for therapeutic work and the grounds of the Rehabilitation Centre are a very peaceful and private place to connect with nature.  Survivors can also access the grounds in their free time.

Although studies have shown that exposure to green spaces can enhance our ability to recover from traumatic injuries, there is never any pressure for someone to have a meeting outside.  Sometimes the weather ‘up north’ can be a bit wild and the person may prefer a meeting indoors, or may feel tired as they are often just starting to build their physical fitness again.  In these circumstances we meet indoors, and sometimes we do a guided visualisation to a place in nature that is agreeable and relaxing, like a beach or forest.  The survivor can record the guided visualisation on their phone so they can access their special nature place whenever they wish.  Research shows there are measurable benefits from using nature-based guided visualisations, particularly in therapeutic contexts where there is no nature present in the actual surrounding environment. All visitors have lovely views of nature from their accommodation windows, which has also been shown to have measurable positive effects on patient health and wellbeing.

In our second meeting, towards the end of their programme, I notice significant differences in the survivors physical and psychological wellbeing; we work together so that they leave the programme with an increased understanding of how to support themselves and with enriched knowledge and confidence in their recovery.

I find the multi-dimensional approach of working with a team of highly skilled, caring, creative, and dedicated people and supporting burns survivors through utilising state of the art facilities and nature connection in recovery an incredibly inspiring and rewarding experience.

Visit Jay’s website to access nature wellbeing resources

One of our burns physiotherapists, Kay Fisher, tells us about her work with survivors.

I work in The Katie Piper Foundation Rehabilitation Centre in Merseyside. The centre is residential and supports the survivors of burns after their acute NHS care is finished. Survivors come to stay with us, typically for one month and I see them every morning, working with them to improve their fitness and help ease the impact of their, often very severe, burns and scars.

When people first come into the centre we work with them to draw up a list of goals covering what they want to achieve during their time with us. We review these goals on a weekly basis, ensuring that each person receives the most appropriate support for them during their stay. Although everyone’s goals are different there are usually common themes that run through them. Often people have been in hospital for weeks and even months so improving their fitness is usually a priority. Many also want to concentrate on increasing freedom of movement in a particular area, often restricted due to tight scarring and skin grafts, overarching things such as improving confidence and increasing independence are always key goals.

There is a whole team here working on different aspects of rehabilitation. My role involves working to support survivors using physiotherapy. This encompasses a few different activities depending on their specific goals. I am usually with someone for a whole morning, I will start off working on their overall fitness and core strength, improving fitness is essential in the journey back to health. I might do some pilates with them or some circuits and balance work as well as exercises to improve their muscle tone and function. I help them to work out on our multi gym, this records their fitness levels so we can track their progress and they can see how the effort they are putting in is paying off. Often people have very specific goals, such as improving their balance in walking up and down the stairs and we will work on specific exercises for this.

For the second half of the morning I will work on more hands on physiotherapy, using massage to increase mobilisation and to improve specific areas.  Sometimes people have back or neck problems caused by tight scarring and I will work to manipulate the area, easing out muscles and skin, just giving even a bit more flexibility can really help relieve painful areas. We also have some fantastic massage machines, these work like a vacuum to lift the skin, they help to ease the tightness of scars and improve the collagen in the skin which in turn improves the health of the skin, these are universally popular and everyone loves the impact they have on their scars.

It’s always amazing to me what a difference a month can make, survivors work so hard while they are with us and show such dedication in their recovery that the improvements to their physical health are usually significant. The centre really works to bring them out of themselves, they feel able to do things that they couldn’t before. But more than that, we understand the importance of empowering people during their stay, they leave us more confident and happier in themselves, but also able to continue their activities at home and therefore to maximise their recovery and to be more independent in their lives again. After the extreme trauma many of them have been through it’s great to be able to play a part in that.