Ann Thompson, Author at Hopewell Therapeutic Farm

Meet Kelly Flynn, Garden and Landscape Manager

Posted on January 7, 2025October 15, 2025 by Ann Thompson

A journey towards the Peace Corps led to traveling with a van of hippies, volunteering on organic farms in over half a dozen states, trips to Texas and South Dakota, and much more for Hopewell’s Garden and Landscape Manager Kelly Flynn. You could say that the path had many twists and turns, all leading home with some new direction.

While still in school for her Bachelor of Arts in Art Therapy and Studio Arts from Ursuline College (2018), Kelly planned to go into the Peace Corps. She found after much research that positions in the Peace Corps were highly competitive and required a lot of experience. It was then decided that volunteering would be a great start to gain that experience.

A Turn Towards Horticulture

Kelly’s first volunteer opportunity was through the Worldwide Opportunities on Organic Farms (WWOOF), an educational organization where one can learn agricultural skills through work in exchange for room and board. “I began my volunteer work on a farm in Richfield, Ohio when a week after I had started, I met a van of ‘hippies’ who arrived to also volunteer. I worked with them for two weeks before I was invited to join them and I jumped on the opportunity. I took a leave of absence from my job and worked with them for over a month, traveling and camping every night. We went to upstate New York, Vermont, Rhode Island, and back to New York, working on farms for various times at each,” she remembered.

The next year she accepted a job with AmeriCorps State/National working with the Boys and Girls Clubs of America, teaching natural sciences to kids K-2 in Texas. She also found placements on a community garden in New Orleans and completed a farm apprenticeship in Tampa, Florida.

“Throughout all the places my work and volunteering took me, my main goal was to help others in an accessible and substantial way,” Kelly stated. Upon returning to Northeast Ohio, she realized that she would find it fulfilling to work in Agricultural Education. She pursued a Master of Science in Agricultural Education (Kansas State 2022). She also became certified as a Master Gardener through The Ohio State University’s extension program in 2019. “Every year I complete at least 25 volunteer hours. I also do 10 hours or more of continuing education through classes and tours of local growing establishments. I’ve learned more about setting up greenhouses, irrigation, and lighting, which gave me insight into what I bring to Hopewell for better growing,” she said.

Working With People With Mental Illness

When asked about what motivates her to work with people with mental illness, Kelly replied, “I have an autistic family member with high support needs. Growing up alongside that I naturally found myself working with individuals with developmental disabilities and issues with mental health. When I first started, I wanted to help others but had not decided on a specific population. As I followed my career path, I found my way into that niche and when I arrived at Hopewell, I knew I had found a home. I am lucky that my career encompasses my lifelong enthusiasm for gardening and my desire to work in a therapeutic setting.”

The primary aspect of Kelly’s job is educating residents in a safe environment where they can learn, try new things, and make mistakes. She explained, “There is no failing when gardening in an environment like Hopewell – just a lot of experimenting and learning from mistakes and new challenges. Horticulture and gardening are skill sets in which you start somewhere – really anywhere – and build on what you learn. For many individuals, the most gratifying part of gardening is the end result. By the end of the season, seeing plants develop and grow is a great confidence booster after all the work that was put into it. Along the way there is a lot of immediate and mid-term satisfaction planting, weeding, and watching things grow. Of course, there’s also the joy of being out in nature and working on Hopewell’s beautiful grounds.”

All are welcome to join the Garden Crew with Kelly for any reason. She said, “Some individuals who get involved with Garden Crewdevelop an interest in learning about plant science and agriculture, some like the work involved as there is a good mix of detail work and bigger projects, sometimes they come just to keep busy with others. There are a lot of sensory experiences when gardening. Some residents just like the physical part of it – working in the soil can make you feel grounded – and gardening in general helps you be more active. There is also a socialization aspect. Even if residents don’t want to talk, they can work side-by-side with others to complete unified goals. Being outside is its own reward. Recently a resident with no garden/plant experience who has been joining Garden Crew said, ‘I didn’t realize how much I’d like working with plants. They are pretty interesting!’”

While some residents find comfort in the similar daily routines on the Housekeeping and Farm crews, others look forward to the changing types of work on the Garden Crew. “There are periods when we’re all doing hard work such as shoveling, mulching, and prepping the soil to grow crops, but other days there’s lighter work such as seeding, weeding and pruning. This year the Garden Crew started a native pollinator garden and saved the seeds. All of this involves a little bit of learning as well,” Kelly explained.

Contributing to the Hopewell Community

Kelly coordinates with Food Service Manager and Wellness Educator Jenn Miller on what vegetables, fruits, and herbs to grow to assist the farm nutrition program. “For example, we grew 606 pounds of tomatoes this year of which many have been canned to be used throughout the rest of the year. We harvested over 91 pounds of lettuce, 70 pounds of onions, 144 pounds of yellow squash, 140 pounds of zucchini, 70 pounds of watermelon, and much more. That saves significant money on the food budget.

“In the winter, we propagate house plants, start seeds indoors, grow herbs in the conservatory, and propagate some cold weather crops such as spinach, radishes, beets and lettuce in a hoop house. We often experiment to see if things work or not.”

This winter, Kelly will take over maple sugaring with Theresa Merten, Farm Animal Manager and Program Facilitator. “That’s quite a fun farm project and lots of people get involved. We order supplies, watch the weather to determine the optimal time to tap the maple trees in our sugarbush, and organize residents and staff to help with tapping. Then we harvest the sap, boil, and bottle the syrup. My favorite part is taste-testing the freshly boiled syrup while it’s still warm.”

In addition to gardening, Kelly is a musician who plays in bands with her husband. She brings her talents to the Musical Journey interest group and plays bass so coordinator Bob Weirich can play piano with the residents. One of her goals is to travel with her husband from LA to Seattle, up the coast. She also wants to do more art. She makes jewelry focusing on metalsmithing and enameling.

Kelly finds working at Hopewell to be extremely rewarding. “I love seeing the joy on people’s faces when they realize that all the hard work they did amounts to so much. Planting a seed and watching it grow. Growing a plant and producing food that goes to our kitchen to feed our community.” She continued, “Towards the end of the season, a resident looked over our garden and said, ‘Wow, we grew all of this!’ That realization is what I strive for.”

Exposure and Response Prevention Therapy in the Therapeutic Community

Posted on December 23, 2024October 15, 2025 by Ann Thompson

By Nicole Holmes, LISW-S

Exposure and Response Prevention (ERP) therapy is a highly effective treatment for Obsessive Compulsive Disorder (OCD). It engages individuals in confronting their fears and breaking free from the cycle of obsessive thoughts and compulsive behaviors present within OCD. The Hopewell ERP group provides structure, guidance, encouragement, and support within a therapeutic environment.

What is Obsessive Compulsive Disorder?

Obsessive Compulsive Disorder is a diagnosis in which people have unwanted thoughts and fears (obsessions) which cause them to perform repetitive actions and behaviors (compulsions). The obsessive thoughts are sometimes referred to as intrusive thoughts because they are not wanted and often do not align with the person’s own sense of self or morality. OCD is often categorized into different subtypes including checking, counting, contamination, pedophilia, symmetry, scrupulosity, and false memory.

Let’s look at one common situation. An individual with OCD might have an obsessive thought of “my door might be unlocked,” which results in a compulsive “checking” behavior such as returning home multiple times to test that the door is locked. The obsessive thought that the door might be unlocked creates a sense of uncertainty that is so distressing it feels intolerable for those with OCD. The compulsive behavior of checking that the door is locked provides temporary relief of that distress, thus creating a cycle that does not end.

Everyone may occasionally forget if they locked their door or perhaps left the stove on, resulting in a need to come home to check. However, with OCD, these thought patterns and behaviors tend to be so intense that they significantly impact a person’s ability to perform daily activities and diminish their quality of life.

What is Exposure and Response Prevention?

Exposure and Response Prevention, or ERP, is a form of Cognitive Behavioral Therapy that is specifically designed to help people suffering from OCD, although it can be useful for other diagnoses as well like social anxiety. Under the supervision of a specially trained therapist, ERP works to expose individuals to their obsessive or intrusive thoughts while delaying in engaging compulsive behaviors or mental acts. The goal is to build tolerance and habituate to the feelings of uncertainty that exist when exposed to the obsessive thought (Exposure) without engaging in the compulsion (Response Prevention). This is done through repeated and often graded exposures that trigger the distress connected to the obsessive thought while delaying the ability to engage in the compulsion.

Going back to our situation of “my door might be unlocked” and applying ERP to it could look a few different ways. One way would be to postpone checking the door for a predetermined amount of time and once that time has ended allowing the checking compulsion to occur. The goal would be to gradually increase the amount of time postponing the checking compulsion until it no longer provides a sense of relief from the distress. Another way might be to add a “ritual tax” where you must engage in another task whenever you engage in the checking compulsion. This might look like putting your hands in the air and spinning in a circle twice while saying “I’m engaging in a compulsion” every time you check to make sure the door is locked. The goal of this would be to make the checking compulsion less appealing to the point that the uncertainty (distress) of “my door might be unlocked” is the favorable option.

What is a Therapeutic Community?

The philosophy of a therapeutic community is that each resident feels empowered to be an active participant in their own recovery as well as in the recovery of other residents through any and all day-to-day activities. Therapeutic community at Hopewell shows up in the daily care of farm animals, the caretaking of our grounds, and support given and received within therapy groups. Staff and residents alike engage in meals and community building activities together. The ideology behind a therapeutic community is the cornerstone to Hopewell’s program model.

How Does a Therapeutic Community Impact ERP Therapy?

Hopewell’s therapeutic community naturally provides a level of support for those engaging in the difficult work of recovery, especially exposure work. ERP work should always be somewhat challenging and at times even daunting. Willingly putting oneself into a triggering situation can be very distressing, which is why ERP should always be done with a specially trained therapist.

At Hopewell, individuals benefit from the support of both trained staff and the entire therapeutic community. ERP group members can be seen wandering the grounds together, supporting one another as they engage in exposures. ERP group at Hopewell looks a little different every day. Most days members are doing exposure work in group with the support of other group members. Participating in group exposure work can include doing exposure lotteries, where group members create exposure slips and put them in a box to draw from at random. Another activity is the wheel of exposure, where group members spin a wheel. If it lands on a hard, medium, or easy exposure they will then engage in it with the support of the group.

The organic experiences one naturally has while a member of the Hopewell community translate into applicable exposure work. The Hopewell community supports those in ERP in building their mental fitness naturally while gaining support socially.

2024 Annual Report

Posted on December 18, 2024 by Ann Thompson

2024 was a year of transition and a year of remarkable resilience and progress. The generosity of donors directly supports our ability to admit individuals regardless of financial means. Your contributions made that possible. Thanks to you, we can say “yes” more often — to provide comfort, stability, therapy, and a pathway toward healing for those who need it most.

Meet Kelly DiTurno, MSSA, MNO, LSW

Posted on December 16, 2024 by Ann Thompson

Kelly DiTurno joined the Hopewell team in February 2024. She brings a trauma-informed life course perspective to the person-centered care environment at Hopewell. She specializes in creating group psychoeducation experiences using various treatment modalities to help residents reflect on how the tools they are learning impact their ability to sit with difficult experiences in their life and treatment. Kelly noted, “Using language to empower others is great, but providing opportunities for residents to that same language to empower themselves is what really leads to change, in my opinion.” She encourages her clients to maintain a journal/care diary during treatment as a meaningful tool to narrativize their growth in the future.

Hands-On Involvement is in her Genes

The biggest influences on Kelly’s adult life and career have been access to great public education and learning how to be a caregiver for family from family members. Her grandmother Juliet’s example of being a lifelong caregiver informed her choice to study gerontology and social work. As a granddaughter in a family of Italian and Irish immigrants, the tradition of multi-generational living and care inspired Kelly’s interest in developing programming and supporting programs that met the needs of family members living, working and aging together.

Like her grandmother, Kelly attended public high school in Solon, Ohio, where she developed confidence in her leadership skills that allowed her to find purpose and meaning in her college career. At Miami University of Ohio, she developed an interdisciplinary academic degree allowing her to receive her BA in several overlapping areas of special interest: American studies, sociology and gerontology. This course of study helped her understand the role of location, class and culture in impacting health outcomes across the life course.

When asked how she ended up in a mental health career, Kelly noted, “I always assumed I would end up in academia because it felt like the only place to have the hard conversations I wanted to have. Then a professor of mine who knew me very well told me, ‘You don’t have to stay in school forever because you like school. You could be a very well-informed yoga instructor, for instance, if that’s how you make the most impact.’ That was revolutionary to me!” She remembered, “Later, when I was considering graduate programs, I pictured how my efforts would both impact my community and provide me access to community, which I really wanted more than anything. I decided that I did not want to write papers that would sit on a shelf. Instead, I chose to select a program focused on service delivery.”

Aligning with that value of service, Kelly attended the Mandel School of Social Work at Case Western Reserve University in Cleveland, Ohio. She completed an Aging-in-Place Interprofessional Leadership Practicum which engaged students in both theory and hands-on practice in the greater Cleveland area. In this transdisciplinary program, Kelly was one of many students from CWRU’s Schools of Medicine, Nursing, Dentistry and Social Work who collaborated with community members and clinical preceptors at the Veterans’ Association (VA) and Jewish Family Services Administration of Cleveland (JFSA). They provided in-home care consultation and social support to Holocaust survivors aging in place while completing coursework in the impact of trauma across the life course.

Kelly notes that one of the highlights of her CWRU career was an immersive study abroad program in Amsterdam, in which she studied Integrated Dual Disorder Treatment for Inpatient Settings (IDDT). This evidence-based practice improves the quality of life for people with co-occurring severe mental illness and substance use disorders by combining substance abuse services with mental health services. The program also focused on the cultural underpinnings of social tolerance and medical friendship that have allowed medication assisted treatment (MAT), and physician assisted suicide debt recovery and forgiveness policies to succeed in The Netherlands. Kelly also had the opportunity to travel throughout Europe for the first time during the program which she describes as life-altering.

Kelly completed her dual Master of Social Work and Nonprofit Administration at CWRU in spring 2019. Since then, she has served on transdisciplinary clinical care teams providing acute crisis response, adult behavioral health care, and death, grief, and loss support to patients and families across Northeast Ohio.

Applying Lived Experience as a Family Caregiver

Kelly spent much of her mid-20s to mid-30s learning from the men and women in her family how to be a caregiver. She applied that experience directly to her work after the deaths of her uncle in 2018, grandmother in 2022 and her father in 2023. Kelly’s aunts, uncles and mother all collaborated to support these three in what Kelly notes was an awesome labor of love. In the latter part of that time, Kelly was working as a grief counselor at Hospice of the Western Reserve. In late 2022, Kelly began providing caregiver and resident support group discussions at assisted living facilities in greater Cleveland, the first of which was Light of Hearts Villa in Bedford, Ohio, where she had worked and her grandmother had lived until she died.

Kelly notes that developing and presenting the content of her caregiving groups allowed her to connect to her father, who was a doting and precise caregiver to his own mother. In the days before her father’s sudden illness and death the next year, she learned about his project of tracing and understanding his own family history. “Life narratives are very important to my work. I’d love to finish compiling family stories. My brothers and I plan to eventually visit Italy in honor of my dad and grandmother to meet extended family,” she said.

Working with People with Mental Illness

When you talk to Kelly, you can’t help but be struck by how articulate she is, and this helps inform her work with residents. “I have found that I can utilize interpersonal connection, especially through language, to help remind them that they are not defined by their worst decisions.” she stated. “I also write letters of medical necessity for treatment in which I use language to empower other people. This is my calling right now.”

She continued, “I try to provide an open, neuro-affirming environment in therapy that allows residents to experiment with what makes them most comfortable. For example, I provide a lot of sensory tools such as stimming toys, blankets, and softer lighting, which allow residents to meet their sensory and biological needs so they can engage more fully in care. If it is more comfortable to walk and talk out of the office, then we do that, and incorporate the natural beauty at Hopewell as needed. Walk and talk therapy has evidence behind it that you can deal with hard to process thoughts more easily. These approaches help when residents have atypical nervous systems.”

A Hopewell Moment

When asked about a “great day” at Hopewell, Kelly remembered gathering on April, 8, 2024 with Hopewell residents, staff and their families to watch the solar eclipse, “The eclipse was such a humbling moment to witness as a community. In our Grief Processing Group, when we discuss non-death loss, we often talk about grieving the big monocultural moments that are so rare now, where everyone is bearing witness to the same event at the same time. Whether we are distracted by our devices (myself included) or simply too overwhelmed with grief to remain engaged in our communities before we all arrived at Hopewell, I think most of us agree that the slow, intentional pace of the farm allows us all to be more present for moments like this.”

When asked to describe the event, Kelly laughed, “We all went outside and ate sun chips and moon pies and were goofing around until the eclipse started. When people started shushing each other, I thought, oh no, will some of us miss it? Astoundingly, every person present, kiddos and adults, fell silent as the eclipse happened, completely silent. It was one of the coolest things I’ve shared with others, and it happened at work!”

Interests and Hobbies

Kelly has been involved in community theater, sketch and improv comedy and writing narrative nonfiction and poetry since high school. Currently she prefers to enjoy the art her friends are making in the community and supports them by producing, developing and promoting projects in greater Cleveland that center issues at the intersection of class and disability. A fun fact about Kelly is that she has a black belt in karate and has recently taken up boxing.

Outside of Hopewell, Kelly advocates for elder care policy and facilitates caregiving support groups for aging adults and their families. Since the recent losses in her family, she has been relishing time with her mother, twin brother, big sister and baby brother, her favorite people on earth. Kelly spends her weekends attending live music events, supporting local artists, writing, and playing with her nieces June and Ada. Some of her travel goals in the next few years are to visit more east and south Asian countries, the Mediterranean and Middle East, and to encourage her nieces to see as much of the world as they can.

Thank you, Kelly, for everything you do for Hopewell!

Combining Cognitive Behavioral Therapy and Farm-Based Therapy for Schizophrenia Treatment

Posted on December 12, 2024 by Ann Thompson

By Kelly M. DiTurno, MSSA, MNO, LSW

Schizophrenia is a complex mental health disorder characterized by symptoms including delusions, hallucinations, cognitive impairments, and emotional dysregulation. Traditional treatments primarily focus on medication, but integrating therapies such as Cognitive Behavioral Therapy (CBT) and Farm-Based Therapy (FBT) can offer a more holistic approach to treatment. The great task of Hopewell (and farm-based programs like it) is to continue to explore and refine how these two therapies can be used in tandem to aid individuals with thought disorders.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy is a structured, short-term psychotherapy that aims to change negative thought patterns and behaviors associated with mental health disorders. For individuals with thought disorders like Schizophrenia and Schizoaffective Disorder, Hopewell clinical staff practice the tenants of CBT toward several targeted ends:
Reality Testing: CBT assists patients in distinguishing between reality and their delusions or hallucinations. Therapists work with individuals to challenge distorted thinking and replace it with more rational thoughts.
Coping Strategies: The therapy equips individuals with tools to manage symptoms and stressors. Skills developed can include mindfulness, problem-solving, and relaxation techniques.
Social Skills Training: CBT can improve interpersonal relationships by enhancing communication skills and reducing social anxiety.
Relapse Prevention: By identifying triggers and developing coping strategies, CBT can help prevent relapses, promoting long-term stability.

Farm-Based Therapy (FBT)

Farm-Based Therapy, also known as horticultural therapy, involves therapeutic activities conducted in a farm or garden setting. The benefits of FBT for individuals with schizophrenia include:

Connection to Nature: Engaging with nature can have calming effects, reduce anxiety and promote emotional well-being. The sensory experiences in a farm environment can help ground individuals and provide a sense of peace.
Physical Activity: Farming activities often involve physical labor, which has been shown to boost mood and improve overall health. Exercise releases endorphins that can mitigate symptoms of depression and anxiety.
Routine and Structure: Farming provides a daily routine, which can be beneficial for individuals with schizophrenia. Having a structured schedule can help create a sense of normalcy and predictability.
Social Interaction: FBT often involves group work, fostering socialization and teamwork, which can combat isolation—a common issue for those with schizophrenia.
Skill Development: Engaging in farm-based tasks can enhance cognitive functioning and self-esteem through the acquisition of new skills and responsibilities.

Integrating CBT and FBT

Integrating CBT and FBT creates a comprehensive, dynamic and personalized treatment plan for each resident that addresses and provides adaptive support for both psychological and environmental factors affecting individuals with thought disorders. Some examples of how these two evidence-based models therapies can be applied to maximize benefit to the resident-in-community are often observed as follows:

Skill Application: Coping strategies learned in CBT can be applied in the farm setting. For instance, mindfulness techniques can be practiced while engaging in gardening, helping individuals stay present and manage anxiety.
Reinforcing Reality Testing: Farm activities can provide opportunities for individuals to practice reality testing in a safe, supportive environment. For example, if a patient experiences hallucinations while working on a task, therapists can help them process these experiences immediately afterward.
Building Social Skills: Group-based FBT can complement the social skills training aspect of CBT. As individuals interact with peers in a non-threatening environment, they can practice and reinforce social skills learned during CBT sessions.
Emotional Regulation: Both therapies can focus on emotional regulation. While CBT provides strategies to manage emotions, the calming effects of nature in FBT can enhance emotional stability, creating a synergistic effect.
Goal Setting: CBT emphasizes setting and achieving personal goals. In a farm context, individuals can set goals related to their farming tasks, allowing them to experience success and build confidence, which can improve their overall mental health.
Holistic Wellness: Combining physical activity in FBT with the cognitive strategies of CBT promotes overall wellness. Mind-body approaches can lead to improved mental health outcomes, including reduced symptoms of schizophrenia.

Practical Implementation

To effectively combine CBT and FBT, treatment programs like Hopewell utilize a specific set of clinical, administrative systems:Multidisciplinary Team: Involve professionals from various fields, including psychiatrists, psychologists, occupational therapists, and farm managers, to create a supportive environment that addresses diverse needs.

Multidisciplinary Team: Involve professionals from various fields, including psychiatrists, psychologists, occupational therapists, and farm managers, to create a supportive environment that addresses diverse needs.
Individualized Plans: Each individual with schizophrenia has unique experiences and needs. Tailoring the combination of CBT and FBT to fit these needs is essential for effective treatment.
Regular Monitoring: Continuous assessment of symptoms and progress through both therapies can help in adjusting the treatment plan as necessary. This ensures that the individual is receiving the most beneficial support.
Education and Training: Educating both the healthcare providers and the individuals involved in therapy about the benefits and techniques of both CBT and FBT can enhance engagement and outcomes.
Community Involvement: Involving families and community members in the therapy process can provide additional social support and reduce stigma, fostering an inclusive environment for recovery.

The combination of Cognitive Behavioral Therapy and Farm-Based Therapy in the Hopewell model presents a promising approach to treating individuals with schizophrenia. By addressing the cognitive, emotional, and environmental dimensions of the disorder, this integrated approach can enhance the overall effectiveness of treatment, improve quality of life, and promote recovery. Through careful implementation and personalizing the therapeutic process, healthcare providers can offer comprehensive support to individuals on their journey toward mental wellness.

Meet Nicole Holmes, LISW-S

Posted on December 3, 2024October 15, 2025 by Ann Thompson

A stint as a Hopewell dishwasher during college led to clinician Nicole Homes’ change in career. Over time, Hopewell worked its magic and Nicole’s life path moved from law to social work.

“Hopewell itself was my driving force and inspiration to work in mental health. I started working at Hopewell in 2008 as a dishwasher as I was finishing my BA. At that time I figured I would work for 6 months then go to law school. After graduation I realized that being an attorney was not for me, but I really loved the work that Hopewell did and my goals changed to a career in social work. While I was getting my master’s degree at Youngstown State (from 2010 – 2013), I stayed on at Hopewell as a program facilitator and shift lead.”

A program facilitator assists with direct care of residents: self-administration of medications, helping residents with cleaning their rooms and doing laundry, prompting them for different activities, and transporting them to appointments. Nicole was a program services supervisor during most of this time and was shift lead when all the clinicians and people in charge went home for the evening. Additional responsibilities included handling any crises that arose during her shifts.

When Nicole graduated with an MSW, she assumed the role of clinician. From 2013 – 2016, she was responsible for clinical matters including providing individual therapy, working with residents to create treatment goals, leading therapeutic groups, and communicating with families.

In 2016, Nicole felt it was time to broaden her experience, so she moved on to a position in the Youngstown City Schools. She then held a position counseling residents in nursing homes until the COVID lockdown happened in 2020 and nursing homes were supposed to be ground zero. By that time, Nicole had married and had a son on the way, so she was no longer comfortable meeting clients in nursing homes. She found another position doing outpatient therapy but she felt unfulfilled.

Meanwhile, Nicole’s husband, Jonathan (Mickey) was working at Hopewell, and they moved to staff housing in 2022. She missed the sense of community that she found at Hopewell. “I never felt disconnected from Hopewell when I left in 2016. I felt a drive to work there again and I was just waiting to come back.” In November, 2023, she learned that a part-time clinician position was opening and she was hired. She is now part of the admissions team, where she reviews records of potential admits to Hopewell and sometimes conducts intake assessment to help determine if Hopewell is a good fit for potential residents.

Nicole also works with the Exposure and Response Prevention (ERP) Group, facilitating 3 of the 5 meeting per week. ERP is intended for individuals with obsessive-compulsive disorder (OCD). “I trained with Dr. Charles Brady, a highly regarded OCD specialist that Hopewell utilized as a consultant. I am looking forward to more training through the International OCD Foundation.”

While Mickey has been working at Hopewell full time and pursuing a nursing degree, Nicole has been the primary caregiver for her toddler and young elementary school age child. She said, “Mickey and I named our daughter Clara. She isn’t named directly after Hopewell founder Clara Rankin, but we did like that it was a nod to where he and I met: Hopewell.” One of Nicole’s biggest hobbies is canning and preserving food grown in their family’s enormous garden: tomato sauce, pickles, zucchini relish, pickled jalapenos, jam, and salsa. She also loves to crochet, cook, and bake.

Fall is Nicole’s favorite time of year at Hopewell. “I love the crisp fall air and I look forward to picking apples and making fresh pressed cider. It’s not just tasting the delicious cider – it’s the process with residents and staff and engaged and working together in community among the beautiful trees,” she recalled.

Nicole believes the inclusivity of Hopewell’s therapeutic community is an invaluable healing tool for adults with mental illness. She said, “Hopewell is a special place; there is no other place like it. People who work here are dedicated, understanding, and passionate. As an organization, Hopewell is wonderful! I have never thought that I could not go to someone with a problem and feel like I wouldn’t be heard. The staff have always made me feel that as a person I am important. When I worked for other organizations, there was much less of a feeling of community and I felt like I was one of many. Here you are asked, what do you want to do, what do you feel drawn to? The quality of care is outstanding and staff can take ownership of what they want to learn and do to help our residents.”

The “Dogter” Is In: An Exploration of Animal-Assisted Therapy and the Role of Animals in Improving Mental Health

Posted on November 25, 2024October 15, 2025 by Ann Thompson

By Heidi Moser, LPC, Hopewell Clinician

Relationships between human beings and animals have existed since the dawn of time (picture a big wooden boat floating around the flooded earth with two of every creature). Throughout history animals have provided food and transportation, helped tend fields, herded and protected livestock, served as police officers, guided the blind, and moved into our homes and hearts. More recently animals have even taken on the job of therapist as part of a treatment modality, Animal-Assisted Therapy (AAT), that is gaining increased recognition and research attention.

So what is AAT? What does it take to be a therapy animal? How is that different from a service animal? And what are emotional support animals? Read on as we explore these questions and more together.

Animal-Assisted Therapy (AAT) Definition

The American Veterinary Medical Association (AVMA) defines AAT as “a goal directed intervention in which an animal meeting specific criteria is an integral part of the treatment process. Animal-assisted therapy is delivered and/or directed by health or human service providers working within the scope of their profession. Animal-assisted therapy is designed to promote improvement in human physical, social, emotional, or cognitive function” (https://www.avma.org/resources-tools/avma-policies/animal-assisted-interventions-definitions). While the AVMA provides definitions and general guidelines for AAT, the AVMA is not a governing body of therapies involving animals. In fact, there is no one individual regulatory agency for the field.

What classifies an animal as a therapy animal can vary and depends upon the accrediting organization. Numerous organizations register or certify therapy animals and handlers. Some, like the Alliance of Therapy Dogs, certify canines only, while other organizations like Pet Partners (formerly the Delta Society) register multiple species of animals including guinea pigs, birds, and alpacas to name a few. Published information can be found in the Handbook on Animal-Assisted Therapy (now in its sixth edition) and the Standards of Practice in Animal-Assisted Interventions (https://therapyanimalstandards.org/), both of which provide best practices for individuals and organizations engaged in AAT.

Therapy animals must have proper training along with steady temperaments, and owners/handlers must be knowledgeable and able to work effectively with their pets. In addition to remaining under their handlers’ control, therapy animals must be able to remain calm and responsive in the presence of loud or unexpected stimuli, such as one might find in a public setting. A reputable certifying organization abides by published standards and will not grant status of therapy animal to just any pet (or owner). For instance, while my completely adorable Corgi, Ducky, is super friendly most of the time, she barks at kids in strollers and lunges at people on bikes when we are out walking. Such behavior effectively rules her out as a therapy dog (unless her lackadaisical owner works on habituating Ducky to these things, and even then, there are no guarantees).

Therapy Animals, Service Animals and Emotional Support Animals – Oh My!

Therapy animals and service animals have similarities, but service animals are often more specific in their function and go through more rigorous training and screening. Like therapy animals, service animals must meet certain criteria and be recognized by a certifying body. However, unlike them, federal laws allow for service animal provisions. According to the Americans with Disabilities Act (ADA) a service animal is defined as “any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability” (https://www.ada.gov/law-and-regs/regulations/title-iii-regulations).

Along with dogs, the ADA specifically recognizes miniature horses as service animals. According to the law, businesses and government agencies must make reasonable accommodations to allow a disabled person’s use of their service animal. It is important to note that the ADA is intended to provide legal protection for people with disabilities, not service animals apart from their owners. The law also requires service animals to be housebroken and under the control of their handlers at all times.

Hours and hours of work and expertise go into training a service animal, yet even then, not every animal that undergoes the training makes the cut. A steady temperament that is appropriate to the served person/population proves to be a major factor in whether that animal goes on to work as a service animal. For an interesting and in-depth look at what it takes to train (and become) a service dog, check out the Netflix documentary, “Inside the Mind of a Dog.”

Emotional support or assistance animal is a term used to describe an animal that provides emotional and/or physical benefit to their owner but does not necessarily have any formal training or certification like service and therapy animals do. While the ADA only allows provisions for service animals, the federal Fair Housing Act extends protection for disabled individuals and their emotional support or assistance animals. Once again, this law concerns individuals with disabilities, so if a person wants to move into apartment that does not allow pets, they need to have a documented disability in order to claim their pet is an emotional support or assistance animal.

Doctors and therapists are increasingly being asked to write emotional support animal (ESA) letters for clients. Whether or not an individual could be provided with an ESA letter depends on their diagnosis as well as the policy of their provider’s practice/agency on issuing such letters.

Animal-Assisted Interventions at Hopewell

So, how does all of this apply at Hopewell? Although Hopewell is first and foremost a working farm and does not offer Animal-Assisted Therapy per se, we do incorporate Animal-Assisted Interventions (AAI) into treatment, depending on a resident’s preferences and individualized service plan. The AVMA describes AAI as “a broad term that is now commonly used to describe the utilization of various species of animals in diverse manners beneficial to humans” (https://www.avma.org/resources-tools/avma-policies/animal-assisted-interventions-definitions).

At Hopewell residents can participate in Equine Assisted Learning, facilitated by Hopewell clinician, Annie Melinz, under the guidance of our Acting Executive Director, Colleen Welder, both of whom are avid horse enthusiasts and trained in this therapeutic modality. During this activity residents interact with the horses by walking with them, grooming them, and learning to read their body language and vocalizations. Residents also learn etiquette and manners around the horses and can gradually gain confidence through guiding the horses. Annie checks in with residents before and after the group and noted that residents report feeling more calm and “free” after working with the horses. The horses can also help residents process emotions through what they observe in the horses. Annie shared, “Horses can feel someone’s heartbeat from six feet away. Horses can pick up on and reflect how we are feeling.”

In addition, many residents and staff enjoy taking care of our resident horses (two minis and two full-sized), goats, pigs, turkeys, and numerous chickens. Residents feed the animals, clean their stalls, brush the horses, escort the horses and goats to the pasture, and feed and collect eggs from the chickens. Hopewell also has a herd of Belted Galloway cattle (picture giant roaming Oreo cookies that chew their cud and moo). Four calves were born this year! What a joy it was to see the little ones in the field among the herd. One of the calves, named Macy, was sadly rejected by her mother and had to be bottle fed. Needless to say there was competition among the Hopewell community when it came time to feed her.

A resident who recently completed her treatment program and returned home to her family was asked how interacting with the animals at Hopewell impacted her treatment. She replied, “It gave me relief during the day, helping them. They helped with anxiety and calmed my nerves.” Noted among the experiences that stand out most for her was feeding the baby calf which she described as “special.”

Another opportunity to interact with living creatures at Hopewell includes weekday fish feeding at one of the two ponds on campus. Strange as it might sound, residents and staff particularly enjoy the appearance of four large catfish that seem to be able to tell time (or perhaps more accurately detect the presence of footsteps on the dock). One resident who regularly attends the fish feeding stated, “I think the time I started feeding the fish is when I began to participate more in other activities as well.” This resident was instrumental in naming all four of the catfish and knows them so well that he can easily pick out each one!

Animals appear to help facilitate residents’ engagement in the Hopewell therapeutic farm community through sharing in enjoyable activities involving the other living creatures who reside here. Connection with others is an important part of achieving and maintaining wellness, but for those struggling with mental health conditions, sometimes interacting with other people proves challenging. Connecting with and through animals can be more accessible for some, especially those who may struggle with social anxiety.

The Human-Animal Bond

All the above examples speak to the healing effect animals can have in our lives and demonstrate the power of the human-animal bond. It is well known that interacting with an animal can improve human physical health. Research has shown that spending time with animals can reduce stress and even decrease blood pressure. When one considers the mind-body connection, it makes sense that animals improve our mental wellness, too. People report less depression and anxiety after spending time with animals. Animals offer us companionship and can be a good cure for loneliness.

But one does not need to be a Hopewell resident or in an animal-assisted therapy program to reap the benefits of animal assisted interactions. While animals are certainly not for everyone, those of us who have ever loved a pet are well aware of the meaningful and unique nature of the human-animal bond. Taking care of an animal involves getting up off the couch to walk the dog, play with the cat, exercise the horse, etc. Pet owners experience a sense of responsibility and satisfaction in caring for something other than themselves.

Animals can make us smile and laugh, enriching our lives in countless ways. Aside from providing food and shelter, one might start to wonder whether we do as much for them as they do for us. Although they regularly communicate with us in other ways, if animals could speak our language what might they say about the human-animal bond?

Meet Heidi Moser, LPC

Posted on November 18, 2024October 15, 2025 by Ann Thompson

Heidi Moser’s favorite place on the farm is on the stone wall, pictured above. A resident recently added cairns to the wall, short piles of stones that guide hikers on otherwise unmarked treks in the wilderness. To a hiker, those cairns say, “This is the way.” It’s hard to believe but until recently, Heidi did not know what those cairns signified; however, it seems that they’ve been guiding her way forward all along.

The Journey Begins

Heidi’s pathway to Hopewell began after college when she lived in Manhattan. Her first introduction to the world of counseling was as an administrative assistant in the department of counseling and clinical psychology at Columbia University’s Teachers College. Eventually she realized she wasn’t really a city girl (as she puts it) and returned to Ohio to live near her parents. Imagine an invisible cairn showing the way – a first left turn in her journey.

“I looked back at my life and animals were very important to me. I didn’t want to become a veterinarian, so I pursued an Associates of Applied Science in Veterinary Technology,” Heidi said. “Most people think of vet techs as the nurses of the veterinary field, but I found a position at a diagnostic vet laboratory. I loved being a scientist and I stayed for 18 years.”

Heidi bought a home on the Mahoning River and discovered a new love of kayaking. “I love being in nature but I had never set foot in a kayak until I bought the house. I made my maiden voyage in my backyard,” she quipped. “Being on the water brings me a real sense of peace, tranquility, and connectedness to the natural world.”

Back to Psychology

In 2015 Heidi picked up a remote position at the A.K. Rice Institute, a nonprofit organization that studies how unconscious thoughts and feelings impact our lives when we are in groups. This brought her back to the world of psychology, and a realization that she needed to find more satisfying work. Cue another turn on the pathway.

Heidi returned to school, earning a Master of Science in Education in Clinical Mental Health Counseling in 2021. She worked in an outpatient substance abuse and counseling facility as well as a private practice, and earned her credential as a Licensed Professional Counselor (LPC).

Finding Hopewell

“At one point I found a Hopewell brochure and I started following Hopewell on Facebook. I remember saying to myself, ‘That’s my dream job!’” Heidi said. When she learned about a job opening, she applied and joined the team in February 2024. Those invisible cairns were leading her to a new resting place.

At Hopewell, Heidi provides individual psychotherapy and cognitive behavioral group therapy to residents. She co-facilitates a 12-step informed recovery group and a group using Exposure and Response Prevention (ERP) for Obsessive Compulsive Disorder, and she is training for certification in Eye Movement Desensitization and Reprocessing (EMDR).

“Every day at Hopewell has something to offer. I enjoy interacting with residents and participating in community activities. Taking residents on a nature walk is one of my favorite activities,” Heidi said. “It’s so cool to see people improving, making changes, and watching their lives improve. That’s an encouraging thing to see and it’s what keeps me going.”

The Traveling Life

Heidi has always carved out time to travel, looking for beautiful landscapes and nature both at home and abroad. A big believer in independent journeys, she often adventures solo. “I do a lot of homework in advance so I can be spontaneous and do my own thing. Even as a woman alone, that’s more appealing to me,” she said. To keep track of her travels, you’ll need a global map and some pins.

She has visited Italy a couple of times and has made a few trips to Great Britain. Her last big trip abroad was just before the pandemic in March 2020, when she went to Iceland, rented a car, and drove the Ring Road around the entire perimeter of the country by herself. Heidi recalled, “It was quite the experience. Over ten days I saw incredibly beautiful fjords, glaciers, waterfalls, and even some reindeer on the winter tundra landscape.”

Heidi really lights up when she describes one of her travel bucket list items: walking the longest Pembrokeshire coastal pathway in Wales. “This is the most mind-blowing coastline in Britain. I’ve hiked part of it before but I’d love to hike the whole thing, which is 186 miles long. One website has broken down the hikes into chunks you can do in a day, then a bus takes you to overnight accommodations.” She’ll likely find plenty of cairns marking the pathway.

Care to Cycle?

Heidi’s love of professional cycling led to some stateside wandering experiences. She traveled in California and Colorado working as a marshal for week-long staged races. “It was really fun, riding around from spot to spot with a team of people in a van, seeing beautiful areas, then jumping out to direct the racers. Unfortunately, the pandemic put a fork in that as racing lost sponsorship,” she said. “Now I’d attend races as a fan: just walk up a mountain and watch a race go by.”

The Tour de France captures Heidi’s interest every year. “Another travel goal is to watch the first stage of the race, the Grand Depart, when cyclists often begin the race in other countries. Then I’d go to France, have a picnic in a field and enjoy a good French cheese as the riders go by.” Quite the relaxing visual!

Free time at home means hanging out and hiking in the woods with her two corgis, Patch and Ducky. Heidi used to go mountain biking but now finds it more enjoyable to travel with her bike. Recently she rode the trails with a friend in a beautiful area known as the Grand Canyon of Pennsylvania. If she gets lost or wanders away from a trail, you know she’ll be looking for cairns to guide her way home.

Hopewell and the Financial Dynamic

Posted on November 5, 2024 by Ann Thompson

By Savannah Schindelar, Admissions Coordinator

Families considering Hopewell for their loved one’s residential mental health treatment may raise concerns about financial arrangements. We are a nonprofit private pay facility with some limited access to insurance coverage and we understand that long-term treatment may strain the pocketbook. However, we pride ourselves in doing everything that we can to reduce the financial burden.

Insurance Coverage

One of the first questions families ask is whether Hopewell accepts insurance. Due to our average length of stay (6-9 months) and our niche type of care, we rarely see full coverage from any insurance provider. Here is a brief summary of the current options.

Commercial and Private Insurance: We are in network with Anthem Blue Cross/Blue Shield plans that are not Medicaid. We work to get authorization but coverage is never guaranteed.
Medicare and Medicaid policies unfortunately do not cover our room, board, and treatment costs. Those policies generally cover individual costs such as doctors’ appointments and medications.

Financial Assistance

Many generous donors and foundations support Hopewell’s programs, and fortunately we are able to offer significant financial assistance to those who are eligible. We ask all families who request financial assistance to fill out an application. We can then determine a percentage reduction to our daily rate, reducing the fees as much as 75%. At present, up to 85% of our residents receive some level of fee assistance in this way.

The Utilization Review Process

As a courtesy, for any individuals who have a commercial insurance provider, we will run a Verification of Benefits. This verification lets us know if a policy offers in- or out-of-network benefits. This is important for those residents who come from outside the state of Ohio, as out of state policies can differ in what coverage they offer for services outside of the providing state.

Families can learn about policy details ahead of time by calling the member services number located on the back of their insurance card. Member services is a great resource for inquiring about facilities that are in network with the insurance plan.

An important takeaway: Due to ever-changing provider/program relationships, we advise families to always check with their insurance provider AND the treatment program they are interested in to make sure this information is the same.

What does authorization entail?

Authorization for insurance coverage is not a guarantee of payment but rather a green light for services that could be covered by the insurance provider. Authorization is pursued within 24 hours of a resident’s admission to Hopewell. A call is placed to the insurance provider’s authorization line. Clinical information is given to the clinical case manager assigned. A determination is made by the clinical case manager on the basis of diagnosis, severity of symptoms, and need for residential level of care.

Upon approval, the insurance provider offers a number of days of treatment. At the end of the authorized days given, another call is made to either pursue further authorization or provide discharge updates to close the case.

Why does insurance provide such limited coverage at Hopewell?

Hopewell provides a residential level of care for mental health, a categorization that is common knowledge to insurance providers. However, most insurance companies are used to levels of care such as 7-10 day stays for inpatient care in crisis scenarios and involuntary admissions, or up to 30 days for stabilization and medication management. Hopewell does not provide these types of care; therefore, discussions with insurance providers often require educating them about our treatment model.

Hopewell offers a very niche, longer-term level of care (up to an average of 9 months) that does not have 24/7 observation, crisis admissions or a related medical component to the program outside of medication management services. Due to this, insurance often finds it hard to justify coverage as we are unique in our treatment for mental health.

Since Hopewell is a unique environment offering independence for our residents, an unsecured campus and freedom to make choices in their treatment plan, insurance will often ask why residents couldn’t simply participate in a Partial Hospitalization Program or Intensive Outpatient services. (Note: These treatment models are non-residential full and half-day programs, which Hopewell does not offer.)

Our clinicians do their best to thoroughly document clinical recommendations for residents. They are careful to explain the need for longer-term participation in our program to help give residents time to improve their living skills in a safe and stable environment.

A Final Word

I am dedicated to pursuing help for individuals who need the kind of residential care the Hopewell offers. The conversations that I have with most clinical case managers on the insurance end revolve mostly around educating about our type of our type of program. Every day I see Hopewell residents benefitting from the care that Hopewell provides. It takes a village, and I am happy to have this role in the community.

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