Therapeutic Nature Based Therapy: Nature as a Healing Partner

Ecotherapy

As our technological society advances and urbanizes, it is apparent that we are putting distance between ourselves and how our ancestors once lived. Could it be that perhaps our distance from nature could be having an impact on our psyche? There are some that aim to bridge this divide by bringing humans back to their roots, in nature. Nowhere is bridging this divide more important than in the therapeutic work that counselling professionals do.

Ecotherapy is the name given to a form of experiential therapy that incorporates counselling interventions in the natural world to improve the client’s growth and development. There are wide ranges of treatment programs, which aim to improve mental and physical well-being through doing outdoor activities in nature. Examples include nature-based meditations, physical exercise in natural settings, horticultural therapy, adventure therapy, conservation activities and therapeutic nature-based counselling.

What is Therapeutic Nature-Based Therapy

Therapeutic nature-based counselling is an aspect of ecotherapy that has shown great results for work with individuals and/or groups. It encompasses working with clients in a natural setting with an end goal of individual and/or family wellness. This style of therapy has a close relationship to family systems theory in that both theories recognize the inter-relatedness of being and our surroundings. Nature is viewed as a healing partner in the counselling process. For instance, when an individual is depressed, they often retreat into indoor spaces, isolating themselves from the world around them. Using a nature therapy approach can help encourage individuals to move outdoors while still engaging in therapy.

Further, nature-based counselling helps cultivate awareness in individuals as they explore their relationship to themselves, others and their sense of place in the world and natural surroundings.
The fundamental process for therapeutic practices in nature is the reconnection to nature as a reconnection to self. (Jordan, 2009)

Effectiveness

Research on the effectiveness of therapeutic based nature therapy is limited but encouraging. However, there has been considerable research into the effects of individuals spending time in forests. Several studies demonstrate the unique factors that forests can have on individuals and the counselling process.

In Japan, a very popular and well-studied concept is Shinrin-Yoku or forest bathing. This involves the simple health improvement strategy of immersing oneself into a forest. The effectiveness of this practice is well documented with benefits such as immune function enhancement while in contact with forest environments. It also has been shown to lower elevated stress levels when in natural environments (Lee et al, 2012).

The therapeutic rationale for having experiences within nature is to encourage clients to awaken their senses. An important step in truly grounding oneself through distress. Buzzell and Chalquist (2009) cite enhanced self-concept, self-esteem and self-confidence as benefits to therapeutic nature-based therapy. They also believe that to facilitate treatment of mental health issues or improve family relationships, employing nature is a potent therapeutic intervention. It has been shown to improve mood, anxiety, stress, and depression. It has also been demonstrated that it works well for a variety of ages. Nature therapy is about utilizing these demonstrated benefits in order to help facilitate a client’s therapeutic goal.

The traditional office setting can be seen to be an intimidating experience for some clients. The face-to-face interaction can be off putting and cause unease in some. Moving therapy to an outdoor space can alleviate this as some people experience nature therapy as less intimidating than an office setting.

Doucette (2004) outlines the nuances of walk and talk therapy as walking outdoors whilst engaged in counselling. Walk and talk therapy happens outside the usual confines of an office space. In Doucette’s research with adolescents, therapist and participants met over 6 weeks, once per week for 30-45 minutes or walking outdoors on school grounds. This research found considerable improvements on individual’s moods. Participants discussed what had happened that week and they were taught strategies during the sessions, which included ways of managing stress and painful situations, positive self-talk, mental imagery and through focusing techniques to reduce stress.

Considerations

Moving from the confines of the traditional four walled therapy space involves some considerations in order to be successful. It is important that during the initial client assessment that any initial fears about the outdoors be discussed. Comfort levels with the weather can vary and are important to mention. If the client gets cold easily, it obviously best to avoid the outdoor space when the temperature dips down. Client safety in outdoor spaces is important and so it is recommended that simple well-worn paths, which do not have any obstacles, are best.

It is imperative that the therapist knows the area well before embarking with clients in an outdoor space. The therapy should be the focus, not trying to navigate both of you back from an unknown path.

The confidentiality piece is important and needs to be addressed at the initial assessment. While the four walled office space provides you with a contained, private venue for intimate discussions and limited interruptions, the outdoor space brings with it other challenges. For example, it should be discussed what the client is comfortable with when other people are encountered on the trail. Would they prefer to stop conversation, lower their voice, or continue talking?

Case study

Michael was a bank teller. His past counselling experiences had not been positive. Michael mentioned that his previous counselling sessions had brought up very difficult feelings that he did not know how to handle. At assessment, Michael talked about his family history, which included how his mother and father’s marriage had been unstable with numerous splits and walkouts. He noted that his father was very volatile in his family interactions while his mother had been very self-absorbed. Michael had grown up with a poor sense of self, quite often adapting himself to others’ needs and wishes in order to be liked. Michael was mistrustful and it was apparent that he felt attacked and persecuted through the therapist standard line of assessment questioning. There were long pauses and silences in the subsequent sessions and Michael reported feeling very ambivalent about therapy. The therapist suggested they might meet outdoors and walk together, as the sessions indoors felt so difficult, and for them both to see how this felt. They met at a local municipal park, walked, and talked as they made their way through a quiet forest loop. In the session, Michael talked more about how he felt and the session went well. At the end, the therapist asked Michael how he felt about this way of working. Michael report that he found it much easier to talk without the room and the eye contact of the therapist and that compared to his previous experiences of therapy it was much easier to open up and share with the therapist outdoors which they were walking. In subsequent sessions, they met in forest locations, walked, and talked. The therapist also found it easier to tune into Michael on an embodied level and make contact with him more easily than he had done indoors. At times, Michael would stop and make eye contact with the therapist when he had an important thing to say in therapy. As the sessions progressed, Michael was more able to initiate contact in this way in the therapy and began to be more able to stay in touch with painful feelings whilst moving outdoors.

Integrating Nature into your counselling practice

Incorporating therapeutic nature-based therapy into your practice is not for every client or clinician but there are many that would benefit from the alternative setting for therapy. When you think of those resistant clients that really struggle in the traditional setting, it can be worth it to look for new spaces to engage them in therapy. By incorporating nature in a relational way into your practice, this can support new internal perceptions which help individuals to reflect, challenge and support new ways of thinking on their therapeutic journey. Nature has been healing through the times and so, an important consideration for clinical work. As society becomes more urbanized, it will be important for therapeutic work to remember the inherent connection we have to the natural world. As Abrams so eloquently describes in his book The Spell of the Sensuous, “By acknowledging such links between the inner, psychological world and the perceptual terrain that surrounds us, we begin to turn inside-out, loosening the psyche from its confinement within a strictly human sphere, freeing sentience to return to the sensible world that contains us.”

For further reading:
– Ecotherapy: Healing with Nature in Mind – Linda Buzzell and Craig Chalquist
– Nature and Therapy: Understanding counselling and psychotherapy in outdoor spaces – Martin Jordan
– Eco psychology – nature as therapist http://counsellingbc.com/article/ecopsychology-nature-therapist
– Back to Nature – Martin Jordan https://www.academia.edu/1502225/Back_to_Nature

References:
Abrams, David (1997). The Spell of the Sensuous: Perception and Language in a More-Than-Human World
Doucette, P.A. (2004) Walk and Talk: an intervention for behaviourally challenged youths. Adolescence 39(154), 373-388.
Jordan, Martin. (April 2009) Back to Nature. Therapy Today
Jordan, Martin (2015) Nature and Therapy: Understanding counselling and psychotherapy in outdoor spaces

Juyoung Lee, Qing Li, Lisa Tyrväinen, Yuko Tsunetsugu, Bum-Jin Park, Takahide Kagawa and Yoshifumi
Miyazaki (2012). Nature Therapy and Preventive Medicine, Public Health – Social and Behavioral Health, Prof.
Jay Maddock (Ed.),