Outdoor Therapies

An Introduction to Practices, Possibilities, and Critical Perspectives

Nevin J. Harper, Will W. Dobud, Nevin J. Harper, Will W. Dobud

• Publisher: Routledge
• Year: 2020
• eBook ISBN: 9781000192681
• Edition: 1
• Topic: Psychology
• Subtopic: Psychiatry & Mental Health
• Index: Psychology

Drawing on the leading voices of international researchers and practitioners, Outdoor Therapies provides readers with an overview of practices for the helping professions.

Sharing outdoor approaches ranging from garden therapy to wilderness therapy and from equine-assisted therapy to surf therapy, Harper and Dobud have drawn common threads from therapeutic practices that integrate connection with nature and experiential activity to redefine the "person-in-environment" approach to human health and well-being. Readers will learn about the benefits and advantages of helping clients get the treatment, service, and care they need outside of conventional, office-based therapies.

Providing readers with a range of approaches that can be utilized across a variety of practice settings and populations, this book is essential reading for students, practitioners, theorists, and researchers in counseling, social work, youth work, occupational therapy, and psychology.

Part I

Foundations

Chapter 1

An Introduction to Outdoor Therapies

Nevin J. Harper and Thomas J. Doherty

Introduction

The Institute for Outdoor Learning in the United Kingdom recently released a statement of good practice for outdoor mental health interventions (Richards, Hardie, & Anderson, 2019). This publication, endorsed by the British Society of Lifestyle Medicine, provides guidelines for the “combining of mental health and well-being interventions with outdoor learning” (p. 1). This effort by Richards and colleagues exemplifies the desire we see among our international colleagues for a stronger confluence between psychological services and practices in the realm of environmental education, outdoor adventure, and nature-based therapies. In assembling this book, we hope for a similar outcome. We present this collection of outdoor therapies to assist mental health practitioners worldwide to go outside, be present to the elements, see the beauty in the forests, walk on the beaches, and explore health and well-being among the varied landscapes and species of their home places.

There is potential for great depth in thinking about the philosophy, ethics, and practice of outdoor therapies as forms of ecotherapy and as applied forms of environmental psychology (see Doherty, 2016; Doherty & Chen, 2016). On the surface, outdoor therapies obviously have philosophical and stylistic differences from commonly practiced indoor approaches. Outdoor therapies also have a different neuropsychology; we know that being active in stimulus-rich natural environments affects our brains and bodies differently than a sedentary and office-bound experience does (Berman, Stier, & Akcelik, 2019).

For our survey, we were interested in established outdoor therapeutic approaches that share common practices such as place-based learning, embodied experiences, therapeutic adventure, and nature-based stress reduction. We were also interested in revealing mental health practices that include nature and the outdoors as an active ingredient of healing. We predict that readers who take in the scope of outdoor therapy activities in this text—with chapters on wilderness therapy, horticultural therapy, equine therapy, outdoor occupational therapy, surf therapy, etc.—will come away with a new vision for counseling and therapy practice in the 21st century. We hope practitioners will try these experiences for themselves and reflect on the opportunities afforded to those they serve.

A Note on Culture and Privilege

In our approach to outdoor therapy, we were attentive to issues of cultural competency, bias, and privilege. There are many cultural lenses through which to view nature and outdoor experiences. These range from utilitarian ‘wise-use’ viewpoints that assume human dominance and mastery over nature to more humanistic and holistic approaches that assume kinship and shared value between humans, nature, and other species. This dominance-kinship tension is as old as humankind, reflected in historic and modern Indigenous cultures, and ethical debates about sustainability in technologically developed societies.

Few people are taught the skills to reflect on their environmental identity and values. So, these beliefs often remain implicit—leading to well-meaning but unconscious biases and unexamined privilege. If one has grown up with a utilitarian mindset that sees nature as a distant or threatening force to master, it is very difficult to imagine a safe experience of kinship and interbeing with nature. Conversely, if someone has grown up with healthy access to green spaces and developmental experiences in nature, it is easy to take these gifts for granted.

Why Take Therapy Outdoors?

Clients do not always find alignment between their needs and what is offered in therapy. In the case of young people, for example, half of the attempts at therapy fail (Neumann et al., 2010). While we cannot explain this problem in its entirety and researchers have attempted to do so (Garcia & Weisz, 2002), we can say confidently that a range of effective alternatives are available. This book describes a number of outdoor approaches to counseling, therapy, healing, wellness, and health promotion that positively contribute to psychosocial well-being, and physical, cognitive, and emotional functioning (Mygind et al., 2019).

This book also explains how outdoor therapies can bring the benefits of being outdoors into the counseling and therapy process and illustrates these benefits by describing a variety of unique approaches. We reconceptualize therapy to suggest that we, as a species, are endowed with an innate longing to be connected to nature and are often, by design, healthier and happier when we have access to compatible natural settings. Active engagement of the body in natural environments can mediate the process of therapy and contribute to its health-promoting outcomes (Maller, Townsend, Pryor, Brown, & St. Leger, 2005). At base, we propose that the mindset for and setting of outdoor therapies comprise an ideal approach to health and well-being for many (Wilson, Ross, Lafferty, & Jones, 2009; Wolsko & Lindberg, 2013). This is a shift in practice for therapists that requires additional knowledge and a willingness to alter conventional practices (Jordan & Marshall, 2010).

One criticism of the growing ‘nature immersion for health’ literature is that many recommendations or studies do not specify what encompassed the specific ‘nature’ conditions and exposure (Barnes et al., 2019). In this regard, you will find references throughout the chapters signifying positive outcomes that are awaiting replication and further development to enable wider practice. This is a common challenge for research in outdoor therapies, as well as all psychological studies. The power of outdoor therapies is only being revealed by theorists and practitioner-researchers willing to tackle the issue (see Fernee, Gabrielsen, Andersen, & Mesel, 2017). A second related criticism of the research on the benefits of exposure to nature is that little is known about long-term outcomes (Norwood et al., 2019), although knowledge is building on this front as well (Annerstedt & Währborg, 2011).

Our intention in compiling the practices described in this book is to share with readers the significant potential of outdoor approaches to health, healing, and well-being. We hope to inspire professionals in human-service and educational fields to consider engaging in these practices. We refrain from universal claims—such as ‘being outdoors is good for everyone’ or ‘nature is healing.’ Nature is a place where one can get a painful sunburn, become lost and scared, or become an environmental refugee in the wake of climate disasters. We acknowledge the limitations, both real and perceived, to moving a counseling practice outdoors, and yet advocate and encourage consideration to try.

Outdoor Therapies in Our Current Societal Context

In traditional societies, healing and medicine is based on herbal, spiritual, and community-oriented activities; it is all encompassing, holistic, and integral (Moodley & West, 2005). Across the world, some groups still adhere to these perennial practices while others are rediscovering them. However, healing practices in most ‘developed’ societies have shifted away from the realm of ‘shaman-herbal-natural’ and toward a ‘medical-clinical-pharmaceutical’ model. This is touted as advancement yet can also be seen as a loss: Loss of knowledge, loss of meaningful practice, loss of ways of being, and loss of ability to deal with illness in a natural way. Parallel to these shifts in healing practice, we are witness to an unprecedented and rapid acceleration of information sharing and technological advancements in modern societies. Living in a world of technological artifice can leave people functionally disconnected from experiences in the natural world, inhibit their knowledge of ecology, and promote an attenuated or even unhealthy relationship with the environments that sustain us on this planet (Harper, Harper, & Snowden, 2017).

Human societies have never experienced such heightened access to global knowledge sharing and movement of resources through multinational capitalism. Yet, collectively, we are plagued by persistent and growing mental health crises, sedentary lifestyle diseases such as diabetes and obesity, and a displacement of peoples due to genocide, political collapse, environmental crisis, and the ongoing effects of colonization on Indigenous peoples (Silove, Ventevogel, & Rees, 2017). A half-century ago, futurist Alvin Toffler (1984) proposed a condition called ‘future shock’ to describe “the shattering stress and disorientation that we induce in individuals by subjecting them to too much change in too short a time … Our technological powers increase, but the side effects and potential hazards also escalate” (p. 12). Currently, with the impacts of the global climate crisis added to rapid technological change and normative environmental estrangement, we are now concerned with issues such as ‘nature-deficit disorder,’ ‘eco-anxiety,’ and ‘solastagia.’ Whether we will be able to adapt rapidly enough is in question.

If we take a selected snapshot of our current state of health, we can see a troubling reality:

• More than 55% of the population of earth now lives in urban settings (United Nations, 2018); North Americans spend approximately 90% of their days indoors and 5% in their cars (Klepeis et al., 2001). This places significant demands on our directed attention and other cognitive resources to safely and effectively navigate urban spaces (Kaplan & Berman, 2010).
• Accelerated rates of child and adult screen time are correlated with decreases in physical activity (Duncan, Vandelanotte, Caperchione, Hanley, & Mummery, 2012).
• Mental health and sedentary lifestyle diseases are rising in North America in what is considered an epidemic, including one in five youth diagnosed with anxiety or depression, and many more undiagnosed due to sub-threshold symptoms (Merikangas et al., 2010; Poitras et al., 2016; Wilmot et al., 2012).
• Global populations and life expectancy continue to rise across industrialized countries (Kontis et al., 2017), yet these gains are tempered by inequality across race and gender, with some groups being left behind (Geronimus, Bound, Waidmann, Rodriguez, & Timpe, 2019).
• Climate crises impact mental health with increased incidence of despair, anxiety, and sense of loss world-wide (Doherty & Clayton, 2011; Fritze, Blashki, Burke, & Wiseman, 2008).

The social and physical ‘built’ environments we spend time in have also been identified as important to human health. We can see this in environmental scans where toxins and air quality are measured; standing desks are being installed in offices to improve the health of sedentary workers, and plants and soothing colors are used for interior decorating to increase focus and wellness. If all these are indicators suggest our innate desire for more natural living (Kellert & Wilson, 1995), we ask why then is it often difficult to propose moving counseling and psychotherapy outdoors? Being outdoors is a necessary and integral part of human health which has been ignored by mainstream mental health promotion and therapy for too long. A growing body of evidence now supports time and activity in nature as positive for population health and well-being (Burls, 2007; Mygind et al., 2019), and to ameliorate specific mental and social health issues (Kondo, South, & Branas, 2015; Shanahan et al., 2019).

Our text is founded on a clear cultural critique: We, in modern technological societies, have ignored the role of nature and natural living for humans for too l...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Acknowledgments
• About the Contributors
• Disclaimer for Practice
• Part I Foundations
• Part II Practices
• Part III Critical Perspectives and Conclusions
• Index