Outdoor Therapy: A Brief Introduction

Outdoor therapy has gained a lot of interest in the last several years and I frequently receive inquiries about the work I do. At the time of my own formation of an outdoor therapy private practice, the path wasn’t yet formed, and I would argue, is only starting to clear up with more exploration and use.

People differ over language and what to call this practice because each has its own nuance and implications. We settled on the term “outdoor therapy” (which wasn’t showing up in the literature at the time) because it felt like the most broad, open, and flexible way to explain this type of work.

A brief overview of common terms:

Please note: in this writing we are only exploring therapy within the mental health field.

Outdoor Therapy with Wildernew: As noted above, our definition of outdoor therapy is broad and we believe this term is most easily understood by the general population. At times, outdoor therapy sessions look like “walk and talk” where we simply take therapy sessions outdoors and walk while processing. Movement helps us process things differently, allowing both sides of our brain to communicate better (bilateral stimulation), which facilitates integration and healing. At other times, sessions may be more experiential in nature, helping clients by exploring/facilitating safe connection, practicing distress tolerance, grounding, and mindfulness, building curiosity, exploring social dynamics, the use of metaphor to help make sense of our experience, and sometimes even skill building to help build confidence. Additionally, outdoor therapy emphasizes the research that demonstrates improved physical and mental health as a result of strengthening our connection with the natural world. From our perspective, having a strong clinical background is the foundation for the work and natural settings provide an incredible environment and tool to facilitate the therapeutic process.

Adventure Therapy: This is a broad term that is popular in the outdoor therapy field. It often includes outdoor/nature based therapy with an emphasis on experiential techniques involving a sense of adventure, risk, and challenge. More often than not, adventure therapy takes place in group settings compared to 1:1, though both are common. There is a newer certification available called Certified Clinical Adventure Therapist (CCAT) offered though the Association for Experiential Education (AEE).

Wilderness Therapy: Similar to adventure therapy, experiential techniques are a part of the wilderness therapy experience. Often, wilderness therapy takes place within the context of a treatment center which takes adolescents or adults into the wilderness for extended periods of time. Disconnecting from technology and modern conveniences provide opportunity to connect with self, others, and nature, as well as helps us regulate, establish self-care routines, build confidence, and cooperate in a team setting.

Nature Therapy: Use of local parks and green spaces provide the backdrop for therapy. Depending on your source, nature may be seen as a “co-therapist” and the therapist acts out of their own experience with nature to facilitate clients reconnecting with themselves and the natural world. The focus is on healing through connection, restoration, and play in a natural environment.

Ecopsychology: Ecopsychology places an emphasis on connection and the interconnectedness in nature and humans with nature. One premise is that we are only as healthy as our environment, and human suffering, in part, is a result of negative effects on the environment. Ecopsychology is often associated with environmentalism and political activism.

Forest Bathing/Shirin Yoku: Rooted in Japan, the term Shirin Yoku translates to forest bath. Significant levels of stress and distress with high suicide rates, Japan began researching the effects of spending time in nature, specifically beneath a canopy of trees, on our physical and mental health. The forest IS the therapist in this case, and a human may guide the process. Ritual may be part of the process and the walk in the trees is typically quite slow. There is a certification program for someone to become a Forest Guide (note: not a licensed therapist) through the Association of Nature and Forest Therapy. In many countries, doctors are now prescribing patients time outdoors to improve physical and mental health.

Walk and Talk: This is a popular option and where many traditional psychotherapists begin. Therapy is taken outside and takes place while walking, sometimes around the office building, sometimes in a local park.

Horticultural Therapy: Gardening and activities involving plants are the basis for therapy. It may involve planning, planting, caring for, propagating, harvesting, and cooking with items from a garden.

Equine and Animal Assisted Therapy: Horse(s) or animal(s) are included in the therapeutic process to help facilitate skill development, coping with depression, anxiety, and trauma, and are often rooted in Attachment Theory where the animal helps co-regulate.

Outdoor Behavioral Health: a more technical term that is broad to encompass several of the above ways of supporting individuals and groups in outdoor settings.

I hope this helps clear the path for others to branch out into outdoor therapy. If you have any questions, feel free to send us a message. One of these days, I will put together a list of recommended resources that have been helpful on my journey as I researched, read, dreamed and planned my outdoor therapy practice.