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Outdoor Therapy is not new, but it grew in popularity during the 2020 global health crisis, as a way to access face-to-face therapy from the safety of outdoor spaces. Advertised by many as “walk and talk therapy” or simply “outdoor therapy”, this way of working is much richer and layered than it may first look. In this post, I’ll try to bring clarity to this beautiful way of working that I have grown fonder and fonder of. You will learn:

  • what outdoor therapy is
  • the origins of outdoor therapy
  • types of outdoor therapy
  • what it helps with
  • what to look for when approaching an outdoor therapist

What is outdoor therapy?

Outdoor therapy is an umbrella term to describe a variety of therapeutic offers that happen outside of the constraints of four walls. This can take many different forms and places. From city parks to remote hilly areas, outdoor therapy ranges from sitting on a bench in an urban green setting to more adventurous therapeutic programmes such as bushcraft or rock climbing. Depending on your preference, needs and resource availability, outdoor therapy offers such a great variety to meet you where you are at. 

picture of a rocky hillside, with a rock roof on the left, and the green hill side on the right, representing adventure and wilderness therapy

History of outdoor therapy

In 1992, cultural historian Theodore Roszak coins the term ecopsychology in his book “The voice of the earth”. In Hayley Marchall’s review of Linda Buzzell and Craig Chalquist’s book “Ecotherapy: Healing with nature in mind”, “ecotherapy is solidly rooted in ecopsychological philosophy, which posits that our disconnection from our natural surroundings forms the basis for much of our ‘dis-ease’”. Ecotherapy is applied ecopsychology.

Nowadays, outdoor therapy operates in the context of radical social theory and practice of counselling and psychotherapy, ecological activism and much more. For an in-depth reading on the origin of the term ecopsychology, you can read more on the International Community for Ecopsychology website. 

Furthermore, outdoor therapy has its roots in indigenous knowledge and wisdom, with its symbols, rituals and ceremonies as well as an intimate and organic relationship with the other-than-human world. Unfortunately, the industry of outdoor therapy has been familiar with cultural appropriation and misrepresentation especially in the field of adventure and wilderness therapy. It is important to mention and recognise the role that indigenous communities continuously occupy to model a way of being in nature that most outdoor programmes aspire and are inspired by. Therefore, I find it paramount to critically approach the history of outdoor therapy to include this if we want to contribute to the health and wellness of the sector. 

For a critical view of wilderness therapy and the issues of cultural appropriation, I do recommend reading “Decolonising wilderness therapy” by Anchored Hope Therapy.

A fair distinction

The Institute of Outdoor Learning offers a three-zone model for understanding what working outdoors entails. This distinction is particularly helpful when navigating different therapeutic offers and choosing the one that works best for you. There are different elements at play, one being the level of competence of the person leading the session outdoors in terms of knowledge and skills in the field of mental health and outdoor learning. 

Furthermore, we need to look at how nature is integrated into the session. How much are we tapping into the world around us? How much is this part of our conversations when working therapeutically in the outdoors? According to the way we answer, we may range from sessions that mirror the work done indoors (such as “walk and talk” therapy or “outdoor therapy”) to more structured and organised outdoor programmes that include nature or nature-inspired symbolism in the therapeutic encounters.

No matter the type of therapy offered, nature always participates in the sessions, gently accompanying us in our journeys of self-exploration, whether we actively and explicitly bring it into our sessions or quietly experience it in the background.

hilly green area with a bothy in the centre. The bothy was used during a wilderness therapy trail in scotland

Types of outdoor therapy

Based on the definition of outdoor therapy and the thorough three-zone model offered by the Institute of Outdoor Learning, outdoor therapy takes many names. In the following paragraph, I will try and summarise them for you. A word of caution: due to the variety of activities that can be carried out outdoors, I am aware that the following list won’t be comprehensive, but it is a fair attempt to encompass a much richer and boundless reality. 

Animal-assisted programmes

These therapeutic programmes do involve the presence of animals and they differentiate between therapies and interventions, where the former seeks to create a relationship with the animal and carried out by a qualified therapist. The latter offers space and encourages you to relax with the presence of an animal, known as animal-assisted learning, which has a different scope than therapy.

Adventure Therapy and Wilderness therapy

Adventure therapy is a type of experiential therapy that uses challenging adventure activities, such as rock climbing, canoeing, sea kayaking etc. to aid the therapeutic healing process. Wilderness therapy is a type of adventure therapy. As described by The Wilderness Foundation UK, wilderness therapy “deploys principles and practices of no force confrontation, challenges to comfort zones, open communication and transparency, team-based coalition-building, symbolic and metaphorical introductions, and leadership skills. In wilderness therapy, the wild environment can be seen as the co-facilitator of a change process, with the ‘therapist’ enabling, interpreting and supporting the process.” Additionally, the length of adventure and wilderness therapy programmes can go from one day to multi-day trails in the wilderness, involving activities, camping and walking in rural areas with a therapeutic focus in mind.

Therapy outdoors

Also known as “walk and talk” therapy or, more generally, “outdoor therapy”, this type of therapy is no different in how it is delivered than the one offered online or face-to-face. This term is usually used as an umbrella term to describe nature-based programmes and activities with a therapeutic goal. Most practitioners, though, use the term to describe their therapy practice in outdoor spaces. Nature then becomes a space in which therapy happens rather than something you would actively engage with as part of the therapeutic process. It’s important to mention here that the “walk and talk” term can feel quite limiting and ableist (and that is why I use the more generic “outdoor therapy” term to talk about the way I work, or “wilderness therapy”, according to what therapeutic model I am offering).

Therapeutic farming and horticulture

Also knowns as therapeutic gardening, this therapeutic programme is offered in farms or community gardens, and they use plants and gardens as a medium to foster healing and improve mental health.

A bench on a hilly side, allowing to view the horizon. There are branches on the upper part of the picture, covering the scene partially.

What does outdoor therapy help with?

Outdoor therapy can help with struggles around your emotional and psychological health. There is a substantial body of research supporting the healing power of nature. I am also confident in saying that during the past two years of the global health pandemic, we have also all heard, experienced first-hand or shared on public social fora how time spent in nature supported our physical, psychological and emotional well-being. 

There is also evidence of the importance of movement and how it is contributing to our overall personal sense of health and contentment. 

Among the different types of struggles that outdoor therapy can help you with, we can find anxiety and depression, issues around our relationship with food or substances and alcohol, low self-esteem, trauma and much more. 

Conclusions: what you need to know

Finding a therapeutic model that works for you can be quite daunting, whether it is therapy carried out in indoor spaces, online or outdoors. The complexity of outdoor therapy lies in the multitude of ways therapists interpret and implement ‘outdoor therapy’ in their practices. I hope that the questions below will support you in discovering how your therapist works with nature in open spaces.

  • What is the therapist’s personal and professional experience of the outdoors?
  • What certificate or diploma do they have in this area?
  • How do they work outdoors? What type of therapy do they offer?
  • How do they engage with the outdoors?
  • What does the therapist’s practice entail?
  • Where do they work?
  • What does the therapist have in place in case of adverse weather?
  • Does the therapist have a first-aid certificate for outdoor settings?

And if you are still unsure about how to go about finding a therapist, I wrote a blog post about it: I need help with my mental health, what do I do” and I have a dedicated page on my website called Outdoors, where I explain what a nature-led practice means to me. 

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3 thoughts on “What is outdoor therapy? An introduction to working outdoors

  1. Pingback: I need help with my mental health: what do I do?

  2. Breanna Vaughn says:

    I am in my final year of graduate school in the United States. My dream is to start a therapeutic program that utilizes nature as a healing form. I would love the chance to touch base with you and see how you started your practice.

    • Francesca Counselling says:

      Hi Breanna, thank you for connecting! Please contact me at my email address to discuss this further. I am based in the UK, so I may not have all the answers to starting a US-based service, but I am happy to offer tips 🙂

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