Cooking interventions as a therapeutic tool in psychiatric care

Cooking as an activity has historically been deeply embedded in human evolution, culture and social life, as it strengthened early human bonds and it is one of the factors that contributed to the foundation of communal life (Wrangham et al. 1999). Making food requires a combination of social interaction, creativity, physical coordination and cognitive planning and, nowadays, it goes beyond the fulfillment of biological survival. Despite the increased usage and the easy accessibility to ready-made meals, we remain fascinated by cooking as a social, creative and emotional practice (Wolfson et al., 2016). The growing interest in cooking shows and cooking competitions, culinary content creators, online recipes and viral recipes videos, may hint at the possibility that cooking fulfils needs beyond nutrition, such needs for social connection and psychological well-being.

In recent years, cooking interventions as structured group activities have been advanced as a potential therapeutic tool in mental health and rehabilitation institutions. Farmer, Touchton-Leonard and Ross (2017) emphasize in their systematic review that cooking’s potential psychosocial effects have only just begun to be investigated. They reviewed the scientific literature on cooking as therapeutic interventions and synthesized 11 studies examining cooking’s psychological outcomes. These studies included community-based programmes and clinical programmes, from communal kitchens to inpatient psychiatric wards. Even though most of the studies used small sample sizes and had some methodological limitations, results overall showed that cooking interventions have a positive influence on self-esteem, mood, socialisation and quality of life.

The first area of a patient’s wellbeing being impacted by cooking interventions appears to be confidence and self-efficacy, the belief that one can be competent and achieve results. Research (Haley and McKay, 2004) shows that patients who participated in baking groups reported higher confidence, concentration and coordination. Producing a tangible and shareable product gave them a sense of accomplishment. Similarly, Herbert et al’s (2014) analysis of “Jamie Oliver’s Ministry of Food 10-weeks community program”, highlighted significant improvements in participants’ self-esteem and reported feelings of accomplishments. Notably, these findings highlight the potential of these cooking interventions for patients that report low-self efficacy and who struggle with not seeing immediate results with other forms of therapies.

Secondly, cooking interventions seem to consistently affect mood and anxiety levels. In Hill et al.’s study (2007), nearly 40% of patients felt less anxious after cooking sessions. These effects might be due to the fact that making food involves a sensory immersion, finding a rhythm and the anticipation of rewards. Cooking distracted participants from ruminative thoughts, acting as a behavioural activation technique, which would follow the approaches of Cognitive Behavioural Therapy (CBT). Further studies (Fitzsimmons and Buettner, 2003) on patients with dementia, found significant reductions in agitation after cooking sessions. Making food can ground patients into meaningful routines, reducing restlessness and promoting engagement. Both mechanisms can be translated to psychiatric patients struggling with disorganisation and/or limited cognitive capacity. Lastly, 10 weeks cooking interventions have been shown to positively affect mood and reduce negative feelings (Barak-Nahum et al., 2016). These improvements were partially mediated by more intuitive and mindful eating habits, but the authors concluded that cooking interventions contributed directly to boosted moods and social satisfaction.

Thirdly, cooking is inherently communal. It invites cooperation, conversation and sharing. Across most studies on cooking as a therapeutic intervention, one of the most consistent benefits was socialisation. In community kitchens (Crawford & Kalina, 1997; Engler-Stringer & Berenbaum, 2007; Lee et al., 2010), cooking opened the way to mutual support, teamwork, friendship formation and a sense of belonging. For individuals struggling with loneliness and marginalisation, which can exacerbate other psychological symptoms, cooking can become a valuable tool for inclusion. Further benefits of cooking interventions on socialization were observed six months post-interventions by Herbert et al. (2014), who noticed that participants were still cooking collaboratively back at home. These findings suggest that cooking can favour lasting social behaviour change and its resources could be easier to transfer once the patients leave the clinic and go back to their daily lives.

Lastly, looking at more than the individual symptoms, cooking seems to more widely impact quality of life, here defined as the subjective sense of autonomy and fulfillment. In a study that looked at health-related quality of life (HRQOL) and well-being, participants reported significant improvements in their HRQOL and the effect was mediated by healthy dietary choices (Barak-Nahum et al., 2016). Combining cooking lessons and nutrition education promoted self-reported psychological well-being in elderly individuals up to four months after the intervention (Jyväkorpi et al., 2014). These results suggest that cooking interventions can have long-lasting effects on quality of life, reinforcing their potential role in holistic psychiatric care.

Several principles can be seen behind the psychological benefits of cooking interventions. First of all, cooking as an activity is goal-oriented and it engages a set of integrated processes. Participants in cooking interventions use a step-by-step approach that gives way to visible and concrete rewards to effort, which contrasts with the abstraction of many psychotherapies. Completing the cooking process can therefore reinforce agency and self-efficacy, an essential therapeutic target for individuals who tend to feel powerless or helpless in their daily life, a symptom commonly found in those who struggle with depression. Moreover, cooking as a task requires careful attention to sensory stimuli, such as smells, textures, colours, tastes, and an awareness of the present moment and one’s actions. Potentially, this can induce a flow state similar to mindfulness and grounding practices, during which the patients can experience calm engagement in the present moment and temporarily reduce rumination and anxiety. Furthermore, as we mentioned in previous paragraphs, a main aspect of cooking as a therapeutic tool is that it can favour and strengthen a sense of social belonging. Cooking naturally involves cooperation and sharing, which can reinforce social exchange. Patients have the chance to collaborate and test their communication skills by working together, giving way to a socially meaningful activity (Bogin, 1998). Lastly, cooking is an action tied to everyday life outside the clinic. As a therapeutic tool, it can therefore become a bridge between the clinic’s life and the outside. As an intervention, preparing food can create a structure and routine that is easily implemented once the patient returns to their daily life. Altogether, these principles make cooking a multimodal activity that provides a natural context for learning, mastery and social reward, crucial mechanisms in psychiatric rehabilitation.

Introducing cooking interventions in psychiatric care, such as the Verus Bonifatius Klinik, could yield multidimensional therapeutic benefits. Cooking interventions as a complement to existing treatments (psychotherapy, pharmacology and the additional therapies) could strengthen the clinic’s programme and improve patients’ treatment. The practical nature of cooking interventions makes it an activity accessible across diagnostic categories, such as mood, anxiety and trauma disorders. A structured program in a psychiatric setting might involve weekly or fortnightly, 90-120 minutes sessions led by cooking professionals and mental health professionals. The sessions should emphasize teamwork, creativity and reflection. Structuring the sessions around themes, such as comfort food, cultural exchange or celebration, could stimulate patients to reflect on memories, cultural identity and emotions. The cooking groups could lead to a final shared meal, reinforcing communal belonging and social rewards. For cooking interventions to be more effective, it is crucial to integrate them with therapeutic goals (e.g. patients diagnosed with depression could focus on re-establishing agency, pleasure and motivation). Moreover, making food as a therapeutic tool should emphasize continuity of practice outside the clinical setting. If patients take what they learned at Verus Bonifatius into their lives outside the clinic, cooking could serve as an essential bridge between institutional life and independent living.

To conclude, cooking as a therapeutic intervention represents a promising and multifaceted therapeutic approach in psychiatric care. The evidence summarised in this article indicates that structured cooking programmes can enhance self-esteem and agency, social connectedness, mood and quality of life across diverse populations. The benefits extend beyond nutrition, as cooking connects body and mind, it can provide a sense of agency and fosters human connection, all goals that align closely with the aims of psychiatric rehabilitation and care. At Verus Bonifatius, the kitchen could become a different type of therapy room, one filled with aromas, textures, collaboration and tangible results. In transforming the ingredients into delicious meals, patients can also transform themselves, reclaiming self-efficacy, pleasure and connections.

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