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Dissertations and Theses
Summer 8-11-2015
The Shared Experiences of Counselors Who Practice in Natural
Environments
Bonnie King
University of New Orleans, bonniecking@yahoo.com
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University of New Orleans Theses and Dissertations. 2031.
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The Shared Experiences of Counselors Who Practice in Natural Environments
A Dissertation
Submitted to the Graduate Faculty of the
University of New Orleans
in partial fulfillment of the
requirements for the degree of
Doctor of Philosophy
in
Counselor Education
By
Bonnie C. King
B.A. St. Edward’s University, 2006
M.A. Texas State University, 2011
August, 2015
Dedication
I would like to dedicate this dissertation to the professionals who participated in my
study. Thank you for sharing your wisdom, expertise, and most of all, your passion for serving
clients in nature.
I would also like to dedicate this dissertation to my parents, Marcia and Frank (Pancho
Rey) King. Mom, you have taught me that spending a lifetime in service to others is the most
rewarding and fulfilling way that we can fill our short time on earth. Your example of giving to
others in your life has inspired me to strive to live my life in the same spirit of service. The
values you ingrained in me inspired me to make the decision to become a counselor. Dad
(Pancho Rey), you have taught me to be true to myself, to seek out my own path, and to value
creativity in my work and life. Thank you for unapologetically being you.
Finally, I would like to dedicate this dissertation to my friends, who have supported me
throughout the dissertation process. Without you I would have been “crying in my beer” alone.
Better to cry over wine, with friends!
ii
Acknowledgements
To my dissertation chair, Dr. Herlihy: Dr. H, your support has been incredible from the
beginning of this process, to the end. You have encouraged me to expand myself professionally,
and you have encouraged me to examine my beliefs and values as they pertain to counseling. I
have respected you from the moment I started this program, and I am lucky to have developed a
relationship with you. Your authenticity and genuineness have taught me about the type of leader
I want to be for others. I aspire to inspire others, the way you have me.
To my methodologist, Dr. Dufrene: Thank you for supporting me so much throughout
this process. Your attention to detail, your patience with my scattered process, and your effort
and dedication to helping me get through it means more to me than you know. Your painstaking
effort to guide my methodology and deal with my numerous errors was deeply appreciated. I
cannot thank you enough.
To Dr. McKinney: Thank you for inspiring me to engage with nature-based research in
the first place! Your dissertation gave me the courage to pursue my true passion and interests.
I’m excited to consult and collaborate with you in the future about our respective nature-based
practices.
To Dr. Kristen Dickens: You were my first friend in New Orleans, and a helpful co-
worker, writing buddy, and confidant. Thanks for being there through the hard times and
providing guidance and friendship throughout this process. I’ll be calling on you in the future for
humorous interludes during moments of stress.
To Dr. Lyons: It has been a joy working alongside you in the family therapy class. I
learned so much from your engaging and interactive lessons about what kind of professor I
iii
would like to become. You have always helped me to feel relaxed around you, due to your
positive and non-judgmental personality. Thank you for your unrelenting support.
To Dr. Watson: I’m so glad that I have been able to get to know you a little bit better the
past two semesters in supervision. Your passion and vision inspire me and frankly, “crack me
up.” Keep fighting the good fight, “Prince of Darkness.”
To my mother, Marcia King: What can I say to thank you for all you have done for me in
life? You are my best friend, my counselor, and my unconditional supporter. You have literally
and spiritually picked me up off the ground when I have needed it most. You have been an
unending source of love and strength. I love you, and I am so grateful that you are a part of my
life.
To my Dad, Pancho: “Keep on Rockin’ in the Free World!” Can’t wait to have some jam
sessions ‘round the fire pit! Four Kings Ranch, here I come! Love you!
To Elise Johns: I’m so lucky that you ended up on this journey with me. I would not have
been able to get through the past four years without you by my side. At Milestones, UNO and the
streets of NOLA, you have been “my person.” I look forward to collaborating with you in
business and in life.
To Latrina Raddler and Candace Park: My girls! Thank you for being such fantastic
supporters and friends. I’m grateful to have met life-long friends in this doctoral program. You
two have been such important women to me throughout this process. I respect and admire you
both, and I look forward to continuing to lean on you and supporting you in the future. I’m
excited to continue to learn and grow from our friendship.
iv
Table of Contents
List of Tables………………………………………………………………………………....…viii
List of Figures …………………………...……………………………………………………….ix
Abstract……………………………………………………………………………………………x
Chapter One…….……...….………………………………...…………………………………..1
Introduction…………………………………………….………….…………………………….1
Background………………………………………….…………………………………..………1
Natural Environments and Mental Health…………….……………………..………………….3
Conceptual Framework………………………………………………………………………….6
Biophilia Hypothesis and Disconnect with Nature…………………………………...…………6
Existential Therapy…………………………………………………………….………………..7
Statement of the Problem…………………………………………………………….………….9
Purpose of the Study……………………………………………………………….…..……..…9
Significance……………………..……………………………………………..…...…………..10
Research Questions……………….………………………………………………………...….10
Overview of Method……….…………………………………………………………………..11
Limitations and Delimitations………………………………………….………………………12
Assumptions of the Study……………………….………………………………………..……13
Definitions of Terms…………………………………….……………………………..………13
Organization of the Document………….……………………………………………………...14
Chapter 2……………………………………………………………...………………………….15
Introduction…………………….…………………………………………………………….…..15
History of Nature's Cure……………………………………….…………………………...….15
Benefits of Spending Time in Nature……………………………………………...……….….17
Nature as Health Promoter……………………………………………………………….….....18
Holistic Wellness and Natural Environments………………………………............………….22
Counseling in Natural Environments……………………………………………….……….....23
Nature Therapy………………………………………………………………………...………24
Ecopsychology and Ecotherapy……………………………………………….…………….26
Wilderness Therapy/Adventure Therapy……...………………………………….…………27
Walk and Talk Therapy……………………………………………………….…………….30
The Biophilia Hypothesis………………………………………………….……….………….32
Counseling in Natural Environments: Ethical Considerations…………….………….……….34
Confidentiality and Informed Consent……………………………………………………..…..35
Boundaries………………………………………………………………………………….….36
Appropriateness of Fit……………………………………………………………………....….37
Training, Cost and Efficacy………………………………………………………............……38
Summary………………………………………………………………………..……….……..39
Chapter Three………………………...…………………………………………………………..40
Methodology………………………………………………………………………..……………40
Introduction………………………………………………………………………………………40
Purpose…………………………………………………………………………………………40
Qualitative Research……………………………………………………………………...…....40
Phenomenology…………………………………………………………………………..….…42
Research Questions……………………………………………………………………..…...…43
v
Participants………………………….……………………………………………………….….44
Participant Profiles…………………………………………………………………………..….45
Sequoia…………………………………………………………………………………...…..45
Redwood…………………………………………………………………………..……..…..46
Chestnut…………….………………………………………………………………………..46
Madrone…………………………………………………………………………..……...…..46
Orchid…………………………………………………………………..……………..……..47
Camellia…………………………………………………………………..……………...…..47
Blue Gum……………………………………………………………………………..……...48
Selection of Site……………………………………………………………………….……….48
Researcher Positionality Statement……………………………………………………....…….50
Data Collection………………………………………...……………………...……….………51
Data Analysis………………………………………...……………………...…...……….……53
Validation Procedures………………………………………………………………………...….53
Member Checking……………………………………...……………………...……….………55
Peer Debriefing………………………………………...……………………...……….………56
Peer Review………………………………………...……………………...…….……….……57
Transferability……………………………………...……………………...……..………….…57
Chapter Summary…………………………………….……………………………….……….57
Chapter Four………………………………………………...……………………...……………58
Summary of Procedures…..………………………...…………...……………...………...……58
Individual Case Analysis……………………...……………………………………….………58
Sequoia……………………………………...…………………………………………..……59
Redwood……………………………………...………………………………………...……64
Chestnut…………………………………………………………………………...……..…..69
Madrone…………………...……………………………………………………..………..…76
Orchid……………...……………………………………………………..…………….……83
Camellia…………………...…………………………………………..…………..…………89
Cedar……………...……………………………………………………………..………...…93
Blue Gum……………...………………………………………………………………....…101
Cross-Case Analysis………………………………………………………………………….106
Major Tenets………………………………………………………..…………………..…..106
Training and Ethical Concerns………………………………………………………….….107
Benefits…………………...……………………………………………………………...…109
Motivations for Using Nature………………………………………….……………..…….110
Beliefs about Human Connection with Nature……….……………………………….....…111
Counselor's Role………………...…………………………………………………….....…112
Spirituality………...…………………………………………………………..……….…....112
Validation Procedures…………………...……………………………………….………...…113
Member Checking……...…………………………………………………………….…….…113
Peer Debriefing………………………………………………………………………….……114
Peer Review………………….…………………………………………………...……...…...114
Transferability……………………………………………………………………….…...…...115
Analysis of Supplemental Materials.………………………………………………............…115
Overarching Themes and Themes from Supplemental Materials………….…….……….…..117
Findings by Research Question………………………………………………………...…….118
vi
Additional Findings………………………………………...…………………………….…..125
Summary…………...……………………………………………………………...…….……125
Chapter Five……………………...………………………………………………………......…126
Purpose of the Study and Research Questions………………………………….……….……126
Summary of Procedures………………………………………………………….…..……….126
Discussion of Findings in Relation to the Literature.………………………...………….…...128
Biophilia Hypothesis…………..…………………………………………………..……….…128
Existential Therapy…...……………………………………………………………...……….129
Major Tenets…………...………………………………………………………...............…129
Training and Ethical Concerns………………………………………………..……….....…131
Benefits……...……………………………………………...............................................…134
Motivations for Using Nature……………………………………………………..………..135
Beliefs About Human Connection with Nature………………………………..………...…136
Counselor's Role………………………………………………………………………....…137
Spirituality……….……………………………………………………………..………...…139
Implications and Recommendations………………………………………………….………139
Implications for Counselors and Other Mental Health Professionals………………….……..140
Implications for Counselor Educators…………………...…………………………………...141
Recommendations for Future Research………………………………….…………….……..142
Limitations…………………………………………………..………………………….…….142
Personal Reflections………………………………………….…………………………….…143
References……………………………………………….…….………………………………..146
Appendix A…..……………………………………………………………………………..155
Appendix B..…………………………………………….………………………………….156
Appendix C…………………………….…………………..……………………………….158
Appendix D……………………………..………………………………………..…………160
Appendix E……………..…………………………………………………………………..161
Appendix F………………………..………………………………..……………………….163
Appendix G…………………………..…….……………………………………………….164
Vita…………………………...…………………………………………………………………165
vii
List of Tables
Table 1...………………………….………………………………………………………….…..49
Table 2………...………..………………………………………………………………..………60
Table 3……………………………………………………………………..…………….………65
Table 4………...…………..………………………………………………………………..……70
Table 5…...………………………………………………………………………………………77
Table 6……...……………………………………………………………………………………84
Table 7………...…………………………………………………………………………………89
Table 8…………...………………………………………………………………………………94
Table 9………………...….…………………………………………………………….………102
Table 10……...………………………..…………………………………………………..……106
Table 11……………...……..……………………………………………………………..……116
Table 12…………...……..………………………………………………………………..……116
viii
List of Figure
Figure 1….……………………………………….…………………………………..........……145
ix
Abstract
The purpose of this qualitative, phenomenological study was to gain a deep understanding of the
shared experiences of therapists who provide counseling in non-traditional, natural environment
settings. Eight participants shared their experiences about counseling in nature. The primary
research question for this study was: What are the shared experiences of counselors who provide
nature-based counseling? A review of the literature of nature-based counseling provided benefits
to spending time in nature, descriptions of various types of nature-based counseling, and ethical
and legal issues that affect nature-based counselors.
Semi-structured interviews comprised of open-ended questions were used to collect data
by phone and through the use of video conferencing software. Audio taped interviews were
transcribed and analyzed for key words, descriptive terms, and themes. Additional materials
provided by counselors were analyzed for themes and overarching themes. A cross-case analysis
yielded seven super-ordinate themes. The research question and sub-questions were addressed by
the super-ordinate themes.
The super-ordinate themes are: 1) Major Tenets, 2) Training and Ethical Concerns, 3)
Benefits, 4) Motivations for Using Nature, 5) Beliefs About Human Connection With Nature, 6)
Counselor’s Role, and 7) Spirituality. I employed validation procedures throughout my research
to ensure accuracy during the data interpretation, which included clarification of my biases,
member checking, peer debriefing and peer review, and the use of “thick, rich description.”
Implications for counselors and counselor educators are presented, with recommendations for
further research. Personal reflections of the researcher were provided.
Keywords: Nature-Based Counseling, Counseling, Nature Therapy, Wilderness Therapy,
Adventure Therapy, Wellness
x
Chapter One
Introduction
In this chapter, the background is provided for the study of the shared experiences of
therapists who practice counseling in natural environments. A brief description of the
development of psychotherapy and counseling is presented to provide a historical context for the
emergence of a newer approach, counseling in natural environments. The benefits of spending
time in nature are described. Research questions are presented and an overview of methodology
is offered. The conceptual framework, problem, purpose, significance, limitations and
delimitations, and methods of the study are explained. Assumptions and definitions of terms as
well as the organization of the document is presented.
Background
One of the primary treatments utilized for addressing mental health concerns is
psychotherapy or “talk therapy,” which was created by Sigmund Freud (Paris, 2013) and
emerged as a form of treatment for psychological concerns around the year 1900. “Talk therapy”
or psychotherapy became popular as a way to work through subconscious desires and issues, and
helped individuals work through personal dilemmas. Since the development of Freud’s
psychoanalytic practice, many different theories and modalities of psychotherapy have emerged.
Whereas Freud focused on internal drives, the past, and the subconscious as areas for
introspection, other schools of thought have emerged, such as behavioral/cognitive behavioral,
humanistic, and postmodern theoretical approaches (Gladding, Herlihy & Lee, in press).
The 1950s saw the emergence of rational emotive behavior therapy (REBT), which was
developed by Albert Ellis, and person-centered therapy created by Carl Rogers. REBT focused
on changing thoughts and behaviors of clients to help them live healthier lives (Gladding et al.,
in press). Rogers’ style of therapy was based on the premise that, if certain therapeutic conditions
1
exist, clients will naturally move toward goals. Family therapy, led by Virginia Satir, Murray
Bowen, and others (Gladding et al., in press), also became popular.
The cultural, political, and attitudinal shifts that occurred in the 1960s also spurred
changes in the counseling profession by illuminating a need to address multicultural
competencies to more effectively serve a diverse array of clients (Gladding et al., in press)
Further, feminist theory emerged as a result of the women’s liberation movement (Brown, 2008).
Frankl, Perls, and Rogers led the humanistic counseling movement or the “third force” in
counseling, which focused on the human tendency to move toward personal wellness, self-
actualization, and personal strengths of the client, rather than viewing mental health concerns in
terms of illness or deficit (Gladding et al., in press).
In the 1970s, group counseling emerged as a prominent trend, as did more defined styles
of the “big three” schools of counseling practice: psychodynamic, cognitive/behavioral, and
humanistic counseling. In the 1980s, more counselors started identifying themselves as
“eclectic,” meaning that they pulled from a variety of theories to serve a diverse client population
in ways that seemed most effective, despite some criticism for this method (Corsini & Wedding,
2008; Granello & Young, 2012). Furthermore, many theorists and counselors at the time were
attempting to connect theories, instead of choosing one over another (Gladding et al., in press).
In the 1990s, the trend of unifying theories continued in conjunction with an increased
awareness of the importance of multicultural counseling, termed the “fourth force” in counseling
(Pederson, 1991). Multicultural counseling became a broad framework that can be utilized with
any type of counseling theory. Currently, counselors utilize a wide variety of counseling theories
in practice (Corsini & Wedding, 2008; Gladding et al., in press; Hanna, 2011; Omer & London,
2
1988). Much variety exists in the types of therapy that a client may receive when seeking
services.
Many creative approaches to counseling such as drama therapy, art therapy, and play
therapy are being practiced. Postmodern approaches, developmental and integrative theories, and
other approaches are being added to counselor training curricula (Gladding et al., in press). In
addition, knowledge has been increasing in the fields of eco-psychology, wilderness therapy,
walk and talk therapy, and nature therapy as alternative forms of counseling that can be used to
help treat problems of living and mental health concerns.
In this study, I sought to understand more deeply the practice of counseling outdoors. The
goal was to explore the essence of the experience and to describe the perceived usefulness of
utilizing the natural environment with counseling clients, as well as to identify areas where more
attention may be needed with regard to training, regulation, or ethical considerations. The hope
was that this study would yield implications for counselors and counselors in training who want
to utilize the natural environment in their counseling practice, or who would like to improve their
existing counseling practice in natural environments. Mental health counselors are beginning to
recognize the benefits of incorporating the natural environment into counseling sessions. In the
following section, benefits of spending time in natural environments are discussed.
Natural Environments and Mental Health
Many psychological benefits can be realized by spending time in a natural environment
(Louv, 2005), including improved self-concept (Schreyer et al.,1990) lower stress levels,
increased emotional health (Leather, Pyrgas, Beale & Lawrence, 1998) and deeper connection to
meaning, purpose, and spirituality (Roscoe, 2009). Researchers also have noted improved job
satisfaction in jobs with more green space (Kaplan, 1993; Kaplan & Kaplan, 1989), improved
3
behavior and decreased symptoms of ADHD in children (Kuo & Taylor, 2004), and decreases in
anxiety disorders, depression, and other physical health problems for individuals living near
green space (Maas, Verheij, De Vries, Spreeuwenberg, Schellevis, & Groenewegen, 2009). Maas
et al. (2009) studied more than 300,000 Dutch medical records and found that the more green
space that existed around a person’s residence, the less likely the person was to experience
depression and/or anxiety (Maas et al., 2009).
Activities such as tending community gardens and involvement in ecological preservation
can elicit feelings of connection to community through acts of giving to the environment, which
can increase feelings of self-worth and holistic wellness (Brymer, Cuddihy & Sharma-Brymer,
2010; Pilisuk, 2001; Reese & Myers; 2012). Counseling opportunities that involve projects such
as engaging in beautification projects and gardening, provide activities through which clients and
counselors can feel connected to and responsible for something larger than themselves.
Activities such as these allow for the fostering of social interest, one of Alfred Adler’s keys to
mental health and wellness, and feelings of connection to community (Brymer et al., 2010;
Corsini & Wedding, 2008; Reese & Myers, 2012; Wakefield, Yeudall, Taron, Reynolds &
Skinner, 2007).
More importantly, human beings depend on the health of the natural environment in order
to survive. Recently, researchers have focused on understanding the link between nature and
mental health, and the ways in which humans may be dependent on nature for spiritual and
emotional needs as well as survival (Friedmann & Thomas, 1995; Frumkin, 2001; Katcher &
Beck, 1987; Maller, Townsend, & Pryer, Brown & St. Leger, 2006; Roszak et al., 1995; Wilson,
1984). For most of our evolutionary history, humans have lived solely off the land, near bodies
of water, which provided necessary hydration for humans, animals that humans ate, and plants.
4
The adaptive behaviors learned in natural environments, such as fears related to dangerous
stimuli, perpetuated survival. Wilson (1984) conjectured that humans also have a natural
emotional connection or attraction towards living things that they, “innately seek out that, which
is life giving, and innately desire a connection with nature and life-giving sources” (p.1).
Although it may seem intuitive that nature has restorative effects on mental
health, researchers are just starting to look more closely at the role that natural environments can
play in the treatment of mental health problems. There is a dearth of literature on the benefits of
nature with regard to counseling provided by licensed professionals. The literature that exists is
heavily focused on wilderness therapy. Wilderness therapy is a type of therapy in which clients
receive a variety of services in a natural environment, participate in self and group sustaining
activities, have time alone in nature, engage in exercise, and build relationships with therapists
and other group members (Caulkins, White & Russel, 2006). Wilderness therapy has been a
popular treatment modality for adolescents and has expanded as a discipline to treat a wider
variety of mental health concerns. Although wilderness therapy has been used to treat mental
health concerns, it differs from traditional therapy, not only with regard to setting, but with
respect to training as well. No professional license is required to practice wilderness therapy
(Scott & Duerson, 2010).
Counseling in nature utilizes the innate therapeutic benefits of the outdoors by providing
a natural environment in which to process issues and engage in experiential counseling activities.
The insightfulness and deeper meaning one can experience by spending time outdoors can be
beneficial to the client engaged in counseling in a natural environment (Roscoe, 2009).
Experiences such as outdoor and group activities can increase self-efficacy, self-esteem, and
creative self-expression (Berger, 2006). The use of metaphor is also abundant in this type of
5
counseling and can lead to deeper processing of emotions, goals, and strengths (Reese & Myers,
2012). The natural environment and the possible activities and relationships that may ensue in
natural environments can facilitate a non-threatening, stigma-free environment in which the
counselor can be viewed as simply another person, instead of a threatening authority figure
(Becker, 2010).
Conceptual Framework
The biophilia hypothesis and existential psychotherapy were merged to provide the
conceptual framework that undergirds this study. Existential therapy is a humanistic
philosophical framework that guides therapeutic practice (Corey, 2005). Biophilia is an
evolutionary socio-biological theory created by Edward O. Wilson (1984) that describes humans’
intrinsic connection to the natural world. The following sections describe the biophilia
hypothesis, existentialism, and how the two interweave in a way that describes humans’
connection and, conversely, their cultural and spiritual disconnect with nature.
Biophilia Hypothesis and Disconnect with Nature
Spending time in natural environments is beneficial to individuals in a variety of ways.
The biophilia hypothesis may provide an explanation for why humans may have an inherent
connection to the natural world and environment. The biophilia hypothesis, proposed by Wilson
(1984), asserts that humans have an inherent biological and emotional connection to nature.
Humans have an evolutionary tendency to relate with life giving things or the natural world due
to an inner biological need (Kellert, 1993), or “…the innate tendency to focus on life and lifelike
processes” (Wilson, 1984, p.1). Wilson argued in the biophilia hypothesis that an ingrained form
of human learning and development linked to the evolution of humanity is directly related to
nature, that the learning and adaptive survival strategies humans learn based on the natural world
6
are important for human survival and genetic fitness, that personal fulfillment and meaning can
be attained through a relationship with nature, and that care and conservation of nature and
biodiversity are of great importance (Kellert, 1993).
Biophilia theorists also assert that humans have a spiritual and psychological connection
with the natural environment. Wilson’s theory describes the importance of preserving
biodiversity from the perspective of the material goods that the natural world produces for
humans as well as from an ethical, moral, and spiritual perspective Kellert (1993).
By gaining a deeper understanding of the biophilia hypothesis, the ways in which
spending time in nature can be beneficial to those experiencing counseling in nature can be
further conceptualized and understood. Furthermore, the theory provides an explanation for why
humans may benefit from spending time in natural environments.
Existential Therapy
Existential psychotherapy can be described as a philosophical viewpoint, which guides
the therapeutic process, as opposed to a set of clearly defined techniques (Corey, 2005). The
theory is focused on meaning making, authentic living, and personal choice and responsibility.
Existential therapists believe that individuals experience suffering when they live out of
alignment with their true purpose, or when they experience a lack of meaning (Corey, 2005).
This conceptual framework is appropriate because of natural parallels between existential theory
and the ever-evolving, turbulent human relationship with the natural world. The focus on
meaning making in existential theory was an appropriate fit with the method used for this study,
phenomenological research, which will be described in greater detail in Chapter Three.
Ecopsychologists have recognized a distinct disassociation that occurs in the relationship
that humans have with nature. Technology and industrialization have led humans away from
7
connecting with that which is life giving, the natural environment around them (Adams, 2005).
Existential therapists would describe this personal feeling of emptiness or meaninglessness as an
existential vacuum or anxiety due to the lack of meaning or non-connection that exists between
oneself and the natural environment (Corsini & Wedding, 2008). Heidegger asserted that “Self
and world are not two beings, as subject and object, also not as I and you, but self and world are -
in the unity of the structure of Being-in-the-world - the fundamental determination of Dasein
itself” (as cited in Zimmerman, 1986, p. 27). Dasein refers to existence, and in this quote
Heidegger is discussing the unity between the concept of “self” and the world. By connecting
this concept to the natural world, the assumption is that, as humans, we are nature and our
authentic selves are intrinsically connected to the world around us (as cited in Adams, 2005).
We are animals inhabiting the earth, yet our desire to control the earth and manipulate the world
around us, though it has become normal, leads to an ego-based separation of the self and an
autonomy that separates the individual from nature (Adams, 2005).
A major goal of existential therapy, according to Heidegger is to assist the client to
access, and find peace in the authentic self. “Who we are is this revelatory openness, and thus
being authentically human is letting other beings (including nature) be: “To let be—that is, to let
beings be as the beings which they are” (as cited in Lynch, (Ed.) 2001, p. 304). Humans, by
respecting and attempting to preserve nature in its natural state, can experience a spiritual
connectedness to self and the world. The hectic and fast-paced lives of many citizens in the
United States leave little time for self-reflection, spending time in nature, and striving to preserve
nature. Adams (2005) asserted that the domination of nature through development leaves a
spiritual emptiness in the individual. Therefore, a re-connection with nature and acceptance of
oneself could be the keystone of existential counseling practice in natural environments.
8
Statement of the Problem
Although studies have been conducted on the benefits of green space and natural
environments on mental health (Brymer et al., 2010; Caulkins et al., 2006; Frumkin, 2001;
Katcher & Beck, 1987; Kuo & Taylor, 2004; Pilisuk, 2001; Maas et al., 2009; Reese and Myers,
2012; Roszak et al., 1995; Caulkins et al., 2006; Wilson, 1984), a literature search revealed very
few studies in which researchers attempted to discern how knowledge of these benefits might be
utilized and applied to counseling. According to Scott and Duerson (2010), concerns have been
raised about the lack of research regarding effectiveness and training, accreditation, and lack of
regulation of various practices that occur outdoors, particularly wilderness therapy. The goal of
this research study was to more deeply understand nature-based counseling in order to gain more
information regarding specific counseling practices that take place in nature. An additional aim
of this study was to contribute to the counseling literature by demonstrating that licensed
therapists are utilizing nature-based practices and finding them beneficial for clients, thereby
promoting the legitimacy of nature-based psychotherapeutic practices.
Purpose of the Study
The purpose of this qualitative, phenomenological study was to gain a deep
understanding of the shared experiences of therapists who provide counseling in non-traditional,
natural environment settings. My hope was that a greater understanding of the benefits of
incorporating the natural environment into counseling would yield implications and suggestions
for counseling practice that can benefit both clients and counselors, and lead to a deeper
knowledge regarding the benefits of spending time in nature. Therefore, the target population for
this study was mental health professionals who practice counseling in a natural environment.
9
Significance
Results of the research study could enhance counselor practice by exposing counselors to
the benefits of connecting with nature. Nature’s benefits include improved mental health and
self-concept (Leather et al., 1998, Shreyer et al., 1990), a deeper connection to spiritual aspects
of self such as meaning and purpose (Roscoe, 2009), and decreases in depression, anxiety, and
other mental health concerns (Maas et al., 2009). The hope was that this study might elicit
implications for counseling practice. Although the purpose of qualitative research is not to
generalize results, this study elucidated a deeper understanding of the phenomenon of counseling
in nature and the benefits that clients could receive from counselors practicing in natural
environments.
Research Questions
The primary research question for my study was: What are the shared experiences of
counselors who provide nature-based counseling? The sub-questions are:
1. What is nature-based counseling?
2. How does nature-based counseling differ from other types of therapy?
3. What benefits and/or risks do counselors believe clients may experience when
engaging in nature-based counseling?
4. What factors do counselors think elicit change in clients who participate in nature-
based counseling?
5. Are there ways that nature-based counseling can be improved?
6. What are the ethical concerns that counselors must consider with regard to nature-based
counseling, and if so, how can they be addressed?
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Overview of Method
Although Chapter Three describes my methodological procedure in greater detail, in this
section I describe briefly the chosen methodology for the study, including steps I took to recruit
participants and engage them in the research study. I used a qualitative, phenomenological
research methodology. Qualitative research, according to Creswell (2007), is best for
understanding the meaning of a phenomenon, whereas quantitative methods are best used when
trying to determine cause and effect of results that are generalizable to the public (Flick, 2009).
The qualitative research procedure is inductive and allows for varied perspectives and layers of
understanding. Qualitative research is the best fit for this research study that provides an
illustrative description of the shared experiences of counselors who practice therapy in nature. I
utilized a phenomenological methodology. Phenomenological, qualitative research has a strong
focus on meaning making, (Creswell, 2007) and emphasizes the importance of meaning in trying
to gain a deep understanding of people and their experiences. Therefore, I believe that
phenomenological research was best suited for this study, as my goal was to understand the
“essence” or shared truth of the participants’ perspectives of the phenomenon (Creswell, 2007).
To locate potential participants, I contacted therapists through Google searches, by
contacting authors of articles written by practitioners, and by searching websites such as “find a
therapist.” I also used snowball sampling by recruiting participants through other participants. I
then contacted those individuals to inquire whether they might be interested in participating in
the study.
After making contact with participants and obtaining informed consent, I scheduled
interviews with my participants. All interviews occurred by phone and video chat such as Google
Hangout, Face TIme and Skype. Data was collected using semi-structured interviews with
11
individual participants. I also collected supplemental materials that the therapists provided, such
as promotional materials, website information, and any documents that therapists provide to their
clients.
Interviews were audio recorded and transcribed. I analyzed all data collected to generate
themes and overarching themes by utilizing a six-step process generated by Bernard and Ryan
(2010). A cross-case analysis of the themes and overarching themes was conducted and super-
ordinate themes were derived from the data. Supplemental materials provided by participants
were analyzed, which supported many of the super-ordinate themes. Validity measures were
utilized, including: clarification of researcher biases, member checking, peer debriefing, peer
review, and the use of “thick, rich description” (Creswell, 2007, p. 208)
Limitations and Delimitations
The study conducted was qualitative in design; therefore, one of the limitations is that the
results are not generalizable due to the small sample size. Furthermore, much variation exists in
the types of nature-based psychotherapeutic practice, which could have affected the results.
Another limitation of the study could have been researcher bias. As a counselor and lover of
nature myself, I worked to acknowledge and bracket my personal biases; however, there is a
chance that my biases may have affected the themes found in this study. This study was
delimited to a sample of eight licensed mental health professionals who practice counseling in
outdoor environments. This sample included walk and talk therapists, wilderness therapists,
nature therapists, ecopsychologists, and adventure based counselors. The participants all had a
master’s degree or higher, and were licensed to practice psychotherapy in the state in which they
reside.
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Assumptions of the Study
Assumptions in scholarly research, according to Simon (2011), are phenomena that are
out of the researcher’s control, but without which the research would not exist. Therefore, my
basic assumptions must be addressed and disclosed. I assumed that counselors in this study
practice this type of therapy because they believe it is beneficial to clients. Furthermore, I
assumed that the participants answered the questions truthfully, and that they were honest about
credentials and meeting the sampling criteria.
Definitions of Terms
Adventure Therapy: The use of activities such as, games and high adventure activities and group
activities, with a philosophy that promotes cooperation and meets adventure challenges as
opportunities for personal growth (Itin, 2001).
Biophilia: An “innately emotional affiliation of human beings to other living organisms” (Kellert
& Wilson, 1993, p. 31). Wilson asserted that this is hereditary and woven into a complex set of
rules that humans have learned out of evolutionary necessity. For most of human history, humans
depended on this instinctual and learned set of skills for survival.
Ecopsychology: The blending of psychology with ecology. The goal of ecopsychology is to
connect mental health to ecological concerns and that by connecting to and caring for the natural
world, humans will be more psychologically and spiritually healthy (Roszak, 1992).
Nature Therapy: “A therapeutic approach, taking place in nature, using non-verbal and creative
methods to extend common therapeutic practices in ways that can include a dialogue with
nature” (Berger, 2008, p. 8).
Social Interest: One of Alfred Adler’s keys to mental health and wellness through feelings of
connection to community (Brymer et al., 2010; Reese & Myers, 2012; Wakefield et al., 2007).
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Walk and Talk Therapy: A type of counseling that combines walking and talking during the
therapy session (Brown, 2012).
Wilderness Therapy: There are approximately 38 unique programs considered wilderness
therapy under the broad category of wilderness experience programs. Wilderness therapy can be
best understood as a treatment and education program with goals of increasing physical and
mental health through outdoor immersion and adventure based activities for a specific period of
time, combined with survival skills, education, and therapeutic reflection (Houston, Knabb,
Welsh, Houston, et al., 2010).
Organization of the Document
This dissertation is divided into five chapters. Chapter One presents an overview of the
study, including: introduction, natural environments and mental health, conceptual framework
including the biophilia hypothesis and existential theory, statement of the problem, purpose,
significance, research questions, methods, limitations and delimitations, assumptions, and
definition of terms. Chapter Two contains a literature review, which supports the purpose of the
study. Chapter Three describes the methodology of the research study. Chapter Four presents the
findings. The last chapter, Chapter Five, includes a discussion of the findings and themes
discovered, a summary of the study, limitations of the study, implications, and suggestions for
future research.
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Chapter 2
Introduction
In this chapter, a review is provided of literature that is relevant to counseling in natural
environments. The chapter provides a history of human recognition of the healing benefits of
nature, current research on nature’s benefits, and an overview of the types of nature-based
counseling practices such as nature therapy, ecopsychology and ecotherapy, and wilderness and
adventure therapy. The biophilia hypothesis is explored, as well as the application of ethical
considerations to outdoor counseling practices.
History of Nature’s Cure
Nature’s healing properties have been recognized in ancient communities for thousands
of years (Berger & McLeod, 2006). Members of ancient communities used plants for medicine
and shamans were doctors for physical, emotional, and mental ailments (Berger & McLeod,
2006). Roman doctors recommended garden strolls for those with melancholy or other mental
illnesses and recommended that those with digestive illnesses surround themselves in spaces
with ample natural light (Selhub & Logan, 2012). According to Hongxun, 1982 and Shepard
(1967) it appears that humans in early communities valued contact with nature as evidenced by
the gardens of ancient Egypt, Mesopotamia, and China (as cited in Kellert & Wilson 1993).
In a modern context, subtle links to the use of the natural environment for treatment of
mental health concerns can be discerned before “talk therapy” emerged as an accepted practice.
Freud was known to take walks through the streets of Vienna with his first clients before the
boundaries and structure of psychoanalysis emerged (Jordan & Marshall, 2010).
Olmsted (1865), an American architect and urban planner, believed that nature was
restorative and essential to physical and psychological health. He influenced city planning
15
throughout the United Stated and Canada, and featured green space and parks prominently in his
designs (Olmsted, 1865). Olmstead believed that nature had the capability to inspire, mend, and
refresh the human mind. This belief became the basis for preserving areas of natural green space
as well as planning cities intentionally to preserve space that could provide natural respite for
their citizens (as cited in Ulrich, Simons, Losito, Fiorito, Miles, & Zelson, 1991). Olmsted
asserted that the natural environment subconsciously entered the psyche to promote peace and
well-being, improve physical health, and even extend life expectancy (Olmsted, 1865).
Muir, a writer and advocate, spent an entire lifetime extolling the virtues of nature. The
work of Muir, creator of the Sierra Club, led to the creation of the national parks system in the
United States. Muir found a spiritual connection to God in nature as well as a connectedness
among all things in the universe, stating that “When we try to pick out anything by itself, we find
it hitched to everything else in the universe” (Muir, 1911, p. 110).
Muir’s writing reflected his fervor and he spent his adult life traveling and adventuring to
many of the natural wonders in the world including the Sierra Nevada mountain region and
Alaska. He was influenced by the ideas of Ralph Waldo Emerson and shared ideas with him
through letters: each helped the other to refine their respective naturalist and transcendental
perspectives (Muir, 1911). While naturalists around the turn of the 20th century recognized a
connection between the natural world and well-being, mental health practitioners were also
beginning to recognize the positive influence on patients of spending time outdoors (Kaplan,
1989).
In 1905, doctors in a mental hospital in New York first noticed a link between improved
mental health and exposure to being outdoors when, due to a fear of tuberculosis outbreak,
infected patients were moved to tents outside the hospital grounds. The patients who stayed in
16
the tents experienced marked improvement in mood, social interest, and physical and mental
health in general. Doctors were so delighted with the outcome that they erected another tent and
filled it with patients, who improved so dramatically that many of them were discharged at the
end of the summer. As a result, tent therapy emerged in the early 1900s and became the
precursor to group and nature-based therapies (Kaplan, 1989).
Around the same time period that tent therapy was emerging, Erikson offered his research
about developmental stages of human development. Erikson encouraged his clients to spend time
in nature and did so himself (Kinder, 2002). Wilderness therapy developed and emerged
throughout the 20th century. Wilderness therapy started as a summer camp for youth, and has
existed in some form for over 120 years (White, 2011). In the 1970s, adventure therapy,
ecopsychology, and ecotherapy emerged as popular therapies to treat a variety of clinical issues
and are still used to treat various mental health concerns (Itin, 2001).
Benefits of Spending Time in Nature
Spending time in nature has many physical and psychological benefits for individuals
(Louv, 2005; Maas et al., 2009; Ulrich et. al, 1991). Philosophers, urban planners, and writers
throughout history have contended that spending time in nature can enhance human restoration
and wellness (Brymer et al., 2010; Gullone, 2000; Olmstead, 1865; Roszak et al., 1995; Suzuki
1997). Many emotional benefits arise as a result of spending time in nature, such as increased
well-being, decreased stress, and an increased ability to recover from stress (Leather et. al, 1998;
Ulrich et al., 1991).
Other benefits of spending time in nature include a more positive mood, increased self-
esteem (Shreyer et al., 1990; Maller et al., 2006), and a deeper connection to spirituality or
meaning and purpose (Roscoe, 2009). Researchers have also noted that in jobs with more green
17
space, the satisfaction of employees increased (Kaplan & Kaplan, 1989; Kaplan, 1995) and
morbidity rates for those living near green space for diseases such as depression and anxiety
disorders decreased (Maas et al., 2009). It has also been shown that in children with Attention
Deficit Hyperactivity Disorder (ADHD), symptoms decreased after exposure to natural
environments (Kou & Taylor, 2004). Social interest, feelings of self-worth, and holistic wellness
can be fostered by spending time tending community gardens and preserving the environment
(Brymer et al., 2010; Reese & Myers; 2012; Pilisuk, 2001). The following subsections will
review the research on the benefits of spending time in nature.
Nature as Health Promoter
Maas et al. (2009) studied the relationship between living near green space and the
occurrence of disease in Denmark. The researchers studied more than 300,000 Dutch medical
records and found that the more green space present around a person’s residence, the less likely
the person was to experience depression and/or anxiety (Maas et al., 2009). The researchers
determined that loss of green space resulted in poorer health in many realms, not just mental
health. “For 15 of the 24 disease clusters, the annual prevalence rate of disease was lower in
living environments with a higher percentage of green space in a 1 km radius. This relation is
apparent for diseases in all seven disease categories. It is strongest for anxiety disorders and
depression” (Maas et. al, 2009, p. 969). The prevalence of anxiety and depression decreased for
populations with more access to green space.
As previously mentioned, exposure to nature can help individuals recover from stress.
Ulrich, Simons, Lisoto, Fiorito, Miles & Nelson (1991) recognized that urban environments can
place stress on individuals due to overcrowding, air pollution, and community noise. They
sought to understand if some environments provide an opposite, positive affect on mental well-
18
being. The goal of the study was to test how exposure to natural environments fostered or
hindered stress. After exposing subjects to stressful video clips and measuring stress responses
and subsequently exposing the participants to tranquil natural scenes, the researchers found that
natural environmental scene exposure had positive effects on recovery to stressful stimuli, as
compared with control groups. Stress decrease in subjects was evident in both physiological tests
as well as the verbal reports. The verbal reports indicated that participants showed decreases in
feelings of fear, anger, and aggression and increased feelings of positivity. The researchers took
into account the fact that not all exposure to natural environments elicits positive responses, as
many scenes in nature are stressful and violent (Ulrich, et al. 1991). However, the peaceful
scenes did have a positive effect on the stress recovery of individuals, which the researchers
suggested may have many implications for urban planning, counseling, education, and other
fields focused on community wellness (Ulrich, et al. 1991).
Kaplan (1995) described the possible reasons for the positive effect on individuals of
peaceful, natural scenes. After describing the phenomenon of attention fatigue or an inability to
focus due to mental exhaustion and stress, he discussed ways in which to recover. Kaplan
suggested that sleep and restorative environments can help people recover from attention fatigue,
and elucidated the criteria for a restorative environment as including: 1) being away, or finding a
physical escape or mental break; 2) fascination; 3) extent; or having a richness and depth; 4)
compatibility, or the environment must fit the intention. He believed that a soft focus and
tranquility can come from spending time in a natural environment, which can be a restorative
element to assist in recovery from attention fatigue and stress.
Leather et al., 1998) studied the effects of sunlight on job-related stress for workers. They
concluded that the amount of light had little to no impact on job workers’ stress levels, but that
19
natural sunlight did have a positive effect on workers’ general well-being, decreased their
intentions of quitting, and increased their overall job satisfaction Leather, et al., 1998).
The Health Council of the Nederland (2004) has begun an investigation and review of
research as it pertains to nature’s positive influence on mental health. Though the committee
recognized the need to further research these links, they proposed multiple areas in which nature
can affect mental health: 1) recovery from stress and attention fatigue; 2) encouragement of
exercise; 3) facilitating social contact; 4) stimulation of development in children; 5) stimulation
of personal development and 6) a sense of purpose.
Researchers also have demonstrated that a personal connectedness to nature relates to
happiness and life satisfaction by contributing to mood in positive ways. Mayer, Frantz,
Bruehlman-Senecal and Dolliver (2009) focused on three questions: (a) whether there was a
connection between exposure to nature and positive mood (b) whether exposure to nature assists
in the process of reflecting on a life problem, and (c) whether there is a difference between real
and virtual nature with regard to the positive benefits of mental health. The results of the study
suggested that the individuals in a natural environment were more successful at reflecting and
sorting through life’s problems than those who experienced simulated natural environments or
those in an urban environment. Although both simulated and natural environments had positive
benefits on mood, the natural “in vivo” environments had a greater impact on mental health
(Mayer et al., 2009).
Community gardening has also been shown to have a positive impact on the health of
participants with regard to self-esteem, life satisfaction, and physical activity levels, as compared
to non-gardeners (Brymer et al., 2010). According to D’Abundo & Carden, 2008, and Harris,
(2009) gardening is also linked to increased social and physical wellness (as cited in Brymer et
20
al., 2010; Williams & Greenleaf, 2009). An explanation for the increased positive aspects of
wellness that come with horticultural activities, according to Brymer, et al. (2010), is the
opportunity for social interest and caring and nurturing of the environment.
Kuo and Taylor (2004) found that residents living near green space were more capable of
focusing and that they had more positive moods about their life circumstances than those who
did not have as much access to green space. Kuo and Taylor (2004) also found that children
benefit from the restorative effects of spending time in nature. They hypothesized that tasks that
require one to direct energy including unwanted thoughts, stimuli, or impulses submit the brain
to fatigue. This can make it increasingly difficult for even those without ADHD to focus.
Kaplan (1970) found that spending time in natural environments decreases mental
fatigue and therefore helps individuals mentally focus. Kaplan (1995) asserted that tasks and
situations that require one to deliberately direct attention or inhibit unwanted stimuli, thoughts,
or impulses draw on a shared mechanism that subjects the individual to ADHD as well as
“attention fatigue” (p. 170). Kaplan asserted that symptoms of ADHD can be seen in individuals
without a diagnosis when they are experiencing attention fatigue. Kaplan concluded that stimuli
in natural environments are less taxing on the individual and give the individual something to
focus on mindlessly, thereby decreasing fatigue.
Kuo and Taylor (2004) sought to determine whether activities in which children
participated in natural environments had any effect in reducing symptoms of ADHD. A group of
452 children were studied. Parents rated their children’s levels of ADHD symptoms after
completing the activities. The results indicated that green outdoor settings had the largest impact
on symptom reduction as compared to indoor activities or built outdoor activities, such as
activities that occur on the playground or other man-made structures. This was true for children
21
and adolescents ranging from age 5 to 18 and in all socio-economic groups studied. Overall, the
implications of this study were that spending time in green space can decrease symptoms of
ADHD in children (Kuo & Taylor, 2004).
To summarize, benefits of spending time in natural environments have been found, and
the relationship that a person has with the natural world and how that can affect mental health
have been discussed. In the following section, an eco-wellness model created by Reese and
Myers (2012) is presented that describes ways in which the natural environment can enhance
wellness.
Holistic Wellness and Natural Environments
Many wellness models have emerged in the counseling literature that view humans
holistically, from a comprehensive, strengths-based perspective. This differs from treating
symptoms that emerge from an illness or deficit based model of approaching mental health.
According to Myers, Sweeney, & Witmer (2000), wellness is “a way of life oriented toward
optimal health and well-being, in which body, mind, and spirit are integrated by the individual to
live life more fully within the human and the community” (p. 252, as cited in Reese & Myers,
2012). Adler asserted that spirituality is the central aspect of wellness and that self-direction,
love, friendship and work are also pivotal aspects to wellness (Reese & Myers, 2012). Brymer et
al., (2010) defined wellness as “…a lifestyle that encourages ultimate health” (p. 22).
Reese and Myers asserted that previous wellness models accounted for environmental
circumstances, such as geographic location and specific dwellings, without specifically
addressing the natural environment. The gap found in most wellness models is the effect that the
natural environment has on the wellness of individuals (Reese & Myers, 2012). Reese and Myers
addressed this deficit through an eco-wellness model. They proposed three different aspects of
22
eco-wellness: “1) access to nature; 2) environmental identity; 3) transcendence” (Reese &
Meyers, 2012, p. 401). They also highlighted the importance of environmental equity regarding
access to green space. After illuminating barriers to green space access that exist in low-income
communities, they asserted the opinion that more balanced access to green space, regardless of
income, can have a positive impact on community wellness (Reese & Myers, 2012).
Reese and Myers (2012) also described the phenomenon of transcendence as a peak
experience that involves a deep connection to oneself, the natural environment, and others.
Transcendence is described as an experience of awe, connection, and an increased awareness of
oneself and others that promotes an expansion in feelings of self-acceptance and tranquility
(Reese & Myers, 2012; Sweatman & Heintzman, 2004). The researchers also argued that a
strong environmental identity promoted well-being through increased access to the natural
environment, as well as a fostering of social interest for those involved in preservation and
beautification activities (Reese & Myers, 2012).
Literature has been reviewed as it pertains to the history of psychotherapy, the history of
nature-based therapies, the benefits of spending time in nature, and an Eco-wellness model. The
following section of this chapter will focus more specifically on counseling practices that occur
outdoors: nature therapy, ecopsychology and ecotherapy, wilderness and adventure therapy, and
walk and talk therapy.
Counseling in Natural Environments
From the 1970s to the present, a variety of counseling modalities that occur outdoors
have gained increasing attention. These practices include nature therapy, ecopsychology,
wilderness therapy, and walk and talk therapy. These approaches to psychotherapy all recognize
23
the benefits to mental health of spending time outdoors (Berger, 2008; Brown, 2012; Houston, et
al., 2010; Houston, et al. 2010, Roszak,1992).
Nature Therapy
Nature therapy, created by Berger, is a theoretical approach that acknowledges nature as
not only an alternative setting for therapy, but also as a fluid and enlivened partner in the
therapeutic process (Berger & McCleod, 2006). Nature therapy, an experiential approach that is
creative and postmodern, is rooted in a humanistic theoretical perspective and incorporates art
and dance elements as well as rituals, aspects of shamanism and mind-body practices, gestalt-
style experiments, and narrative therapy.
The environment provides a neutral place for clients to participate in a relationship with
the therapist; the environment is neither owned nor controlled by the therapist. This differs from
the traditional office setting, as it allows the client to choose and take ownership of the space.
Choosing the space can be a pivotal and empowering decision for a client, particularly for a child
with a psychological need to express self or build trust, or for an adult client attempting to regain
control, self-esteem, and self-empowerment. This choice allows the client to show the therapist
where the boundaries in the relationship may be and builds a relationship with the environment
itself (Berger & McCleod, 2006).
The relationship to the space can be culturally significant to the client. “Sacred space”
has been an important part of ritual and spiritual healing ceremonies of many cultures throughout
history (Berger & McCleod, 2006). Nature therapy utilizes ritual and ceremonies that can be
important to individuals who are searching for truth and integration. Nature therapy is more
experiential than traditional “talk therapy.” Nature therapists have the option to use the naturally
occurring processes in nature as therapeutic tools. For instance, Berger (2006) described a group
24
separation ceremony in which the therapist distinctly chose a sunset setting on a beach at a time
when the tide would be shifting. The natural environment provided parallel experiences of
change that were occurring in the lives of the participants such as death, rebirth, change, and
growth. “In this respect, each part of the nature—the landscape, the elements, the weather,
animals, and so forth—has a specific resonance on the client, inviting the client into an inner
process.” (Berger & McLeod, 2006, p. 87).
Another key component of the nature therapy framework is an opportunity to use nature
as a third party in a relationship. In this respect, counselor, client, and nature are all in a
relationship and the therapist utilizes the natural surrounding intentionally. The therapist can play
an active role and use nature as a setting or background, or the therapist can sit back and provide
a presence as mediator or supporter while the client is actively engaging with nature (Berger,
2004, 2005). The goal of this triadic relationship is to help clients connect to body, mind, and
soul, to help them reach a more authentic place within themselves (Berger, 2008). Once clients
connect with nature and engage in a relationship with it, with the right intervention, metaphor
and natural cycles that occur in nature can be easily connected with the narratives of their lives.
Nature therapy is a flexible and creative approach, and its principles can assist the
therapist in choosing settings that can aid the client as well as expand therapist interventions and
perspectives. It is flexible enough to be tailored to the needs of the client and setting. Yet, as with
all practices, there are limitations. Some individuals may not be physically healthy enough to
participate in adventures, rituals, or hikes outdoors. However, Nature therapy can be adapted for
these populations, as for instance in sitting by the window while engaging in talk therapy while
using metaphors to express feelings in the immediate moment (Berger, 2008).
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In addition to physical limitations, psychological limitations can affect a client’s
appropriateness for this type of work. A natural setting that is out of the therapist’s control, with
few clear boundaries, can be problematic in some respects. According to Berger (2008), this can
be anti-therapeutic for clients who have a strong need for control, hierarchy, or strong
boundaries. Clients with PTSD, extreme anxiety, or difficulties with reality perception may not
be appropriate candidates for this type of work. The lack of ability to control the environment
could trigger a PTSD episode or create fear in a client without the ability to remain aware of the
present reality. Finally, unexpected elements such as thunder crashing, rain, or even an
unexpected loud noise could reactivate a trauma (Berger, 2010).
In conclusion, nature therapy is a framework for therapeutic practice that takes place in a
natural environment and is based on a humanistic philosophical perspective. Using elements of
drama therapy, gestalt techniques, shamanism, and ritual, the practitioner uses the natural
environment as a partner in therapy and an imperative element in the therapeutic process. The
benefit of this type of work is the potential for clients to have a visceral and metaphorical
experience that evokes greater insight and awareness (Berger, 2008, 2010; Berger & McCleod,
2006).
Ecopsychology and Ecotherapy
The term “ecopsychology,” first coined by Roszak in 1992, considers the psychological
health of communities and individuals within the context of the natural environment. Rozsak
connected the health of people to the health of the natural environment in recognition of the
dependence of humans on the natural world for survival. Environmental psychology traditionally
studied the relationship between human-built and natural environments (Tripoli, 2009).
26
Ecospsychology is evolving and is flexible enough to encompass a variety of activities
and even variations in definition. Some activities of ecopsychology include providing therapy in
natural environments, exploring environmental identity and balance with fast-paced
contemporary lifestyles, and exploring eco-anxiety, or fear related to the deteriorating state of the
natural environment. Ecopsychologists may suggest self-care or relaxation strategies in a park or
green space (Tripoli, 2009).
Ecopsychology is more a perspective taken by the therapist than a specific, prescribed set
of interventions or approaches (Tripoli, 2009). This approach questions Western philosophy and
values such as materialism, objectivism, and individualism as well as traditional modalities of
psychotherapy (Davis & Atkins, 2004). Clinebell (1996) asserted that ecotherapy is the
application of ecopsychological principles to psychotherapy (as cited in Davis & Atkins, 2004).
The practice of ecotherapy focuses on a collaboration and a reciprocal relationship with the
environment as opposed to a dominant, separate, and individualistic relationship with the
environment (Davis & Atkins, 2004; Garrett & Garrett, 1996; Tripoli, 2009).
Wilderness Therapy/Adventure Therapy
Wilderness therapy has a more extensive history than other contemporary, nature-based
psychotherapeutic practices. Wilderness or adventure therapy can be traced back to the 1800s
when organized camping expeditions were created for affluent youth who attended boarding
schools during summer breaks (Eells, 1986). The focus was on shaping behavioral and character
development through experiences with the outdoors. McNeil (1957), a psychiatrist, described
“therapeutic camping,” asserting that these early camping excursions were therapeutic from the
start. He believed what made these camps therapeutic was the modeling by adults, structure, and
the character-building activities.
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The first organized outdoor summer camp for youth was the Gunnery School in
Connecticut in 1861; the second was Camp Chocorua in New Hampshire in 1881. Both camps
were marketed to wealthy young boys with intentions of teaching principles such as physical
strength, strength of character, masculinity, responsibility, resourcefulness, and independence
(Eells, 1986; White, 2011). In the late 1800s many camps for youth were created throughout the
United States with similar intentions. These camps were not explicitly used to treat mental health
conditions.
In 1907 a former military hero in England named Baden Powell created the largest youth
camping organization, the Boy Scouts. The motivation for creating the Boy Scouts sprung from
his belief that young men were unprepared for the military and lacked self-discipline and respect.
The Boy Scouts became a training camp to teach boys skills that would serve them in the
military and foster personal character. The Boy Scouts of America was created in 1910 by
Boyce who, while traveling in the United Kingdom, was so impressed with a boy scout who
assisted him that he decided to learn as much as he could about scouting and bring it to the U.S.
The Boy Scouts of America became the largest organized outdoor character education program
for boys, and still thrives (White, 2011).
In contrast to the Boy Scouts who focused on character building and military training, the
first camps for youth with the specific intent of treating psychological concerns were created in
the 1920s and 1930s: Camp Ramapo in 1920, Camp Wawokiye in 1926, and Camp Wediko in
1936. Camp Ramapo was staffed with counselors and psychiatric social workers and was
supported by the Jewish Board of Guardians. It is still operating as the longest-running camp
used for the treatment of children (White, 2011) with “social, emotional or learning problems”
(Ramapo for Children, 2013, p.1).
28
Camp Wawoyike, a camp for boys, was supported by the Cleveland Child Guidance
Clinic and the Presbyterian Union and was staffed by six graduate students studying in mental
health counseling fields as well as a psychiatrist. The camp is no longer in existence (White,
2011). Camp Wediko, created by a physician from the Massachusetts General Hospital in 1935,
treated children and was staffed by previous hospital staff, including a physician, psychiatrist,
psychologist, and two psychotherapists as well as ten camp counselors. The camp is still in
existence as a camp for children with emotional and behavioral adjustment concerns. The camp
is a 45-day residential, therapeutic experience based on a clinical model, which includes
collaboration, family connection and support, and supportive relationships with each child
(Wediko Children’s Services, 2012).
The next major milestone that occurred for the wilderness therapy movement was a result
of the creation of Outward Bound in 1941. The activities included boat training, athletic training
and compass skills, rescue training, and character building. Outward Bound was introduced to
the United States in 1961 (White, 2011).
The 1960s saw an increased focus on survival skills in wilderness settings through
Outward Bound and other programs. The 1970s saw the introduction of programs aimed at youth
who had been involved in the court system, such as Outward Bound, VisionQuest Outreach, and
Expedition Outreach. The 1980s saw trends in “for profit” survival therapeutic programs
providing services to youth. In the 1990s research was conducted on wilderness therapy and
professional organizations emerged to regulate the practice and reduce the risk to participants
(White, 2011).
Currently, wilderness therapy programs vary with regard to the type of program offered
by specific organizations; however, the practices are traditionally known as treatment and
29
education programs with goals of increasing physical and mental health through outdoor
immersion and adventure-based activities. Participating clients are immersed in a natural setting
for a specific period of time, while utilizing survival skills, receiving education, and engaging in
therapeutic reflection (Houston et al., 2010). Many professional organizations exist related to
wilderness therapy practices, including the Outdoor Behavioral Healthcare Industry Council
(OBHIC), the National Association of Therapeutic Wilderness Camping (NATWC), and the
accreditation and research organization, Association for Experiential Education (2007).
Walk and Talk Therapy
Walk and talk therapy is, as the name suggests, a type of counseling that occurs outdoors
while walking with clients. Rooted in the social ecological theory created by Bronfenbrenner in
1979, the therapy recognizes that all clients are a part of and effected by many different systems
within their communities. This approach to therapy, heavily influenced by Roger’s client
centered therapy, is strength based and solution focused with a primary goal of helping clients
utilize skills that will help them accomplish goals. Walking outdoors helps clients benefit from
the physical and psychological benefits that are gleaned from interaction with the natural world.
Exercise, an activity that promotes well-being, is a critical element of walk and talk Therapy
(Doucette, 2004).
The only formal research studies on walk and talk therapy, have been conducted by
Doucette (2004) and McKinney (2011). McKinney (2011), conducted a qualitative study with
the aim of generating a theory for walk and talk therapy. Her research generated a framework
defining walk and talk therapy as a therapeutic practice that occurs while walking outdoors,
requires no formal training that differs from traditional therapeutic training, and involves a
nature-based setting. She also concluded that traditional psychotherapeutic practices occur in a
30
nontraditional, outdoor environment. McKinney asserted that the emergence of the approach
stems from a counselor need for options, from nature deficit, and from a need to address the need
for exercise in client populations. In her interviews with therapists, she found that their
perceptions of the benefits of the approach included speeding up the therapeutic process due to a
non-threatening environment, self-care, nature benefits, and different types of processing that
occurred outdoors while reaping exercise benefits (McKinney, 2011).
Doucette (2004) studied eight adolescents aged 9 to 13 from a school in Canada for eight
weeks in order to determine if a weekly walk and talk therapeutic intervention had a positive
effect. The intervention included weekly counseling sessions that occurred while walking.
According to Doucette, the intervention had positive effects and students were able to utilize the
skills learned in therapy as well as benefit from the exercise outdoors in which they participated
in during the research intervention. More research is necessary, particularly studies with control
groups for specific behaviors, with and without walking and with and without the element of the
outdoors, to obtain a deeper description of how these elements influence the therapeutic process
(Doucette, 2004). In summary, walk and talk therapy is a psychotherapeutic practice in which
the therapist and client walk outdoors while engaging in talk-therapy. The approach takes into
account the systems in which clients live and how those systems affect the client (Doucette,
2004).
In this section of the chapter, the literature has been explored related to the history of
humans turning to nature for healing, benefits of spending time in nature, and the various types
of psychotherapeutic practices that occur outdoors (nature therapy, ecopsychology and
ecotherapy, wilderness therapy, and walk and talk therapy). In the following section, Edward
31
Wilson’s biophilia hypothesis will be discussed to describe why humans have such a strong
connection to nature.
The Biophilia Hypothesis
The theory of biophilia contends that there is an inherent form of human learning and
development that resulted from human evolution in relation to the natural environment (Kellert,
1993). The learning and strategies that early humans used for survival were important for genetic
fitness throughout history, when humans were more intimately dependent upon immediate
natural resources surrounding them for survival (Kellert, 1993).
The biophilia theory was created by Wilson, an award winning Harvard biologist,
considered the “father of sociobiology” (E.O. Wilson Biodiversity Foundation, 2013). He
conjectured that the human characteristic of altruism and many other human personality
characteristics had an evolutionary purpose and may have been genetically passed down for
survival (Kellert, 1993).
Wilson contended that human social behavior is derived from innate characteristics that
have been shaped through evolution. Wilson (1984) described biophilia as “the innate tendency
to focus on life and like-like processes” (p. 1). Wilson asserted that there is a biologically based
connection to the natural world and that humans are inherently wired to be attracted to life
processes. The link is cognitive, emotional, aesthetic and spiritual. Therefore, his assertion is that
humans’ lives are diminished when engaged in an unhealthy destructive relationship with the
environment (Kellert, 1993).
Wilson’s theory includes the acknowledgement of learning rules, but it also encompasses
emotional connection, fulfillment, and meaning making that can be achieved by humans’
relationship with nature through conservation, preservation of biodiversity, and aesthetic
32
experiences in nature (Kellert, 1993; Wilson, 1984). Human history is new in comparison to the
history of the human species, which began millions of years ago. The era of communities,
technology, and agriculture, which became the basis for our contemporary globalized and
industrialized world is relatively new. As a result, the survival skills we previously depended on
are still present, but are underutilized. The contemporary world has progressed too rapidly to
extinguish these traits through evolutionary genetic selection and they are still present in humans
(Kellert, 1993).
Biophilia theorists question the spiritual and psychological consequences for humans as
they pertain to failure to preserve the natural environment. Adherents to the theory espouse the
importance of preserving biodiversity for the purposes of material, ethical, and moral benefits
that the natural world provides to humans. Kellert (1993) stated that an underlying ethical
question comes from the consequences of destroying the biodiversity of the planet, such as who
decides when, how, and why a species is destroyed.
Kellert (1993) also stated that a cultural benefit can be received through preservation of
the earth. The history, emotional attachment, creation myths, and learning benefits of nature
influence humans positively. The biophilia theory asserts that humans have an innate connection
to the natural world through a set of learning rules that were evolved through the evolutionary
history of man to perpetuate survival. The theory calls for increased connection to the natural
world through preservation and personal experiences in nature, to increase mental health,
preserve biodiversity, and increase spiritual fulfillment (Kellert, 1993).
The previous sections of this chapter have described the history of nature’s healing
benefits, the benefits of spending time in nature, various types of psychotherapeutic practices
which occur outdoors, and the biophilia hypothesis, which describes a possible evolutionary link
33
between humans and the natural environment. The following section will describe the ethical
concerns and considerations that occur for therapists practicing psychotherapy in natural
environments
Counseling in Natural Environments: Ethical Considerations
Many benefits of counseling and spending time outdoors have been identified (Berger,
2004, 2005; Berger & McCloud, 2006; Brymer et al., 2010; Kou, 2001; Caplan, 1967; Kaplan &
Kaplan, 1989; Kaplan, 1995; Kou, Taylor & Sullivan, 2001; Kou & Taylor, 2004; Jordan &
Marshall, 2010; Reese & Myers, 2012; Roszak, 2001; Roszak, Gomes & Kanner, 1995; Suzuki,
1997; Sweatman & Heintzman, 2004; Tripoli, 2009; Ulrich, 1983; Ulrich et. al, 1991). Nature-
based counseling is a diverse and fairly new practice for psychotherapeutic professionals. While
varied, nature therapy, ecopsychology, wilderness therapy, and walk and talk therapy all have
some basis in the belief that nature has positive effects on mental health. However, ethical
considerations exist and must be taken into account to protect client welfare and uphold the
highest practice standards even in a non-traditional setting.
Although a variety of licensed professionals practice psychotherapy in natural
environments, I utilized the American Counseling Association’s (ACA) 2014 Code of Ethics, as
well as the Association for Experiential Education’s (AEE) Ethical Guidelines for the
Therapeutic Adventure Professional (EGTAP), to frame some of the ethical concerns that are
prevalent in this type of work. The choice of these particular ethical codes comes from my
professional identification with the counseling profession. (EGTAP) will also be utilized in order
to frame specific ethical concerns that arise in nature-based counseling. The EGATP (2007) was
chosen due to its direct link to outdoor and adventure therapy practices.
34
Some of the primary ethical concerns that have been addressed in the literature on
outdoor therapy include client confidentiality, informed consent, and boundaries, as well as
appropriateness of fit for nature-based counseling (Berger, 2008; Scott & Duerson, 2010). A
concern also been expressed that there is a dearth of research regarding the efficacy of
wilderness therapy and even less research on other nature-based approaches, as well as concerns
about cost, training, and accessibility (Scott & Duerson, 2010).
The EGTAP provide ethical guidelines that are specific to outdoor and adventure based
counseling. The code acknowledges some of the same ethical concerns as have been raised by
Berger (2010) and Scott and Duerson (2010), such as confidentiality and informed consent
(EGTAP, 2007, 5.4). Other concerns addressed include physical well-being, assessing risk
accurately (EGTAP, 2007, 5.8), and using discretion and appropriately informed consent with
regard to physical touch (EGTAP, 2007, 5.10). The code further elucidates guidelines for ethical
management of unsafe behavior (EGTAP, 2007, 5.6). Physical needs of participants are a
concern, in that outdoor and adventure based professionals need to make sure that accurate
planning has occurred with regard to basic necessities such as food, water, and shelter, and that
basic necessities are not withheld as a punitive measure (EGTAP, 2007, 5.5).
Confidentiality and Informed Consent
Confidentiality is a concern of every counseling practitioner, but it becomes a unique
concern when working with clients outside a secure office environment. While confidentiality is
addressed generally in the EGTAP (2007), the unique concerns that come up in uncontrolled
outdoor settings are not addressed in the code, such as ways to handle seeing someone a client
may know, ensuring that clients have a safe space when exploring material that could leave them
35
emotionally vulnerable, or how to ensure that others cannot hear the client-counselor
conversation.
The ACA Code of Ethics (2014) requires counselors to discuss confidential information
only in protected and private settings and to share information with others only when the client
has given formal consent (2014, b.1c. & b.3.c). This can be a challenge for counselors to uphold
if they are practicing in a public, natural space, or if they are on a weekend-long retreat in the
wilderness. However, steps counselors could take include the option to speed up or slow down if
near a crowd while walking, move to a quiet area where the client cannot be heard by the public,
or intentionally choose areas that are more private and confidential (Becker, 2010). The inability
to guarantee complete confidentiality can be addressed with the client when explaining limits of
confidentiality as part of the process of informed consent (ACA, 2014, a.2.a.).
Informed consent and the unique limits of confidentiality in a natural environment must
to be explained fully to the client to give the individual the right to choose whether or not this
type of counseling is appropriate for the work he or she would like to achieve (EGTAP, 2007,
4.4). Making the natural environment component optional could also be a solution, to empower
clients as to when and if they feel comfortable sharing personal information in a natural
environment.
Boundaries
In a natural environment, the counselor is not only a confidant and trained helper, but can
also become trail guide, activity coordinator, tent pitcher, and cook (Becker, 2010). Assuming
multiple roles has the potential to result in a positive therapeutic relationship with the client
(Herlihy & Corey, 2006).
36
Multiple roles can be beneficial, because the client can view the counselor as a complex
human being, interacting in deeper ways than the professional taking notes across the room with
a degree hanging on the wall. This characteristic can lead to increased openness on the part of
the client and helps to eliminate the stigma of getting help (Becker, 2010). However,
professional and personal boundaries can blur when multiple roles are present. It is important for
counselors to maintain appropriate relationships with clients. Issues of equal time and treatment
(if in a group setting) and defining when therapy is actually occurring versus engaging in an
activity that could be therapeutic (such as simply walking outdoors) is of ethical concern and
deserves attention and awareness on the part of the counselor (Becker, 2010).
Appropriateness of Fit
As has been noted by Berger (2009), not all clients are appropriate for nature therapy.
This caveat can be applied to similar practices such as wilderness therapy, ecopsychology, and
walk and talk therapy, as they all occur in uncontrollable environmental settings and entail some
level of physical risk. Some individuals may not be physically healthy enough to participate in
long outdoor walks, ceremonies, or metaphorical outdoor rituals. Berger (2010) encouraged
adapting the experience to meet the needs of clients with physical barriers to participation in
intense nature-based counseling experiences; however, it is important to use sound judgment to
avoid harming clients who could be at risk for injury.
Primary ethical concerns are to avoid harming clients, to prevent harm when possible, to
decrease or ameliorate unanticipated harm to clients, and to respect the dignity and rights of
clients (ACA, 2014, A.4.a; EGTAP, 2007, 4). While physical health can be of concern for some
clients, therapists must also consider psychological appropriateness of fit for nature-based
counseling (Berger, 2008). Natural counseling environments are out of the mental health
37
professional’s control and there are few physical boundaries. While this provides both flexibility
and freedom that can be therapeutically beneficial, Berger (2010) acknowledged that some
clients with a need for strong boundaries in order to feel safe or a need for control may not
benefit from such an environment.
Clients with diagnoses such as Anxiety Disorder or Post Traumatic Stress Disorder or
those with challenges with reality perception may find an uncontrollable environment
threatening. Unpredictable environmental elements such as construction noises, thunder or rain,
trees falling, or animal sounds could trigger and reactivate a trauma (Berger, 2008).
Training, Cost and Efficacy
Wilderness therapy researchers have cited ethical concerns associated with wilderness
therapy. These concerns also have implications for other nature-based counseling practices. Scott
and Duerson (2010) have cited the lack of state regulation, accreditation, and training obtained
by wilderness therapy guides. Neglect and abuse have occurred in wilderness therapy programs,
and mistakes that have led to injury and even death (Scott & Duerson, 2010). Wilderness
therapy is also a very expensive form of treatment, which makes it inaccessible to those without
the means to afford it.
Additionally, little research exists regarding the effectiveness of wilderness therapy
(Scott & Duerson, 2010). While the nature of the type of counseling as well as outcomes are
addressed in the EGTAP code (2007, 4.3), the code is vague with regard to the use of evidence-
based forms of treatment. This creates concerns for licensed professional counselors, as
professionals have an ethical obligation to use techniques and counseling skills that are grounded
in theory and have been studied empirically (ACA, 2014, c.7.a). Due to the lack of regulation of
38
the various types of counseling in nature, it is imperative that counselors inform clients of the
lack of research on this specific type of counseling (ACA, 2005, c.7.b).
Summary
This chapter reviewed the literature that pertains to counseling in natural environments
for the treatment of mental health concerns. The review included the history of the use of the
natural environment for life enhancement and health, as well as the benefits of spending time in
nature. An overview of the different types of therapeutic practices that currently occur in natural
environments was provided. The biophilia hypothesis, created by Wilson, was presented as a
biological explanation for humanity’s innate connection with the environment. Finally, the
ethical issues that can arise as a result of practicing counseling outdoors were described, as well
as suggestions for addressing these concerns. My research provided an in-depth description of
counseling in natural environments based on the perspectives of the therapists who practice
counseling in natural environments. My intention was to paint a picture of the practice so that
practitioners and counselors in training are provided with a description of the practice as well as
an awareness of areas of the practice that can be improved.
The following chapter will provide: the purpose for the research study, the rationale for
the choice of methodology, a discussion of the methodology, and information about participants,
research questions and methodology. My goal was to understand the nature of practicing therapy
outdoors. I was interested in the shared experiences of counselors who engage in nature-based
therapy and what this yields for counseling practice.
39
Chapter Three
Methodology
Introduction
In this chapter the purpose of the study, rationale for qualitative research, participants,
research questions, and procedures is provided. Furthermore, data collection and analysis
methods are described, as well as the measures that were put in place to ensure reliability and
validity.
Purpose
The purpose of this phenomenological study was to describe the essence of the
experiences of counselors who provide nature-based counseling. A major goal of my data
collection was to obtain rich information that illuminated the “essence” of the shared experiences
of counselors who practice outdoors. By gaining a deeper understanding of the shared
experiences of counselors providing counseling in non-traditional, natural environment settings,
my intention was to obtain information that yielded implications for counseling practice.
Qualitative Research
I utilized a qualitative approach in my research to gain a deeper understanding of
counseling provided in natural settings. Qualitative studies attempt to attribute meaning,
understanding, and paint a picture of an experience, problem or phenomenon. I was inductive
and allowed participant observations to be emergent and objective, without losing sight of the
fact that my presence impacted the environment of which I was a part (Creswell, 2007).
Qualitative research, according to Creswell (2007), is best for exploring the meaning of a
particular topic, as the research is flexible and inductive; whereas quantitative research is best
employed when determining cause and effect or large-scale results through the use of
40
questionnaires and surveys (Flick, 2009). Counseling provided in a natural setting is a relatively
new phenomenon and is varied in practice. Providing a descriptive base of knowledge to the
literature can be beneficial for counselors interested in practicing this type of counseling and may
provide a definitional base for future qualitative and quantitative research.
Qualitative studies are useful in creating textural descriptions that offer meaning and rich
descriptions of the phenomenon being studied. Creswell (2007) stated that a qualitative
researcher makes philosophical assumptions and that these assumptions must be explicitly stated.
These assumptions and philosophical views lead the researcher to choosing a type of
methodology. I value the varied meanings of participants and believed that I could gain a deeper
understanding of the phenomenon by using a qualitative, inductive approach to data collection
and analysis. Furthermore, qualitative researchers value and take into consideration historical
and cultural settings of participants as well as the researcher’s bias and the social influence
present in the perspective of the participants (Creswell, 2007).
Meaning making is an important component of phenomenological research (Creswell,
2007). Phenomenological, qualitative research, appealed to my desire to understand the intrinsic
connection between mental health and natural environments as well as my personal philosophical
views on truth and the importance of meaning in understanding people and experiences.
Therefore, I believe that phenomenological research was best suited for this study due to the
connection that counselors (i.e., participants) made between the environment and their varied
experiences, which all influence the truth and portrayal of an experience. Furthermore,
existentialism is similar to phenomenology, in that they both place importance on meaning
making to more deeply understand a phenomenon (Creswell, 2007).
41
Phenomenology
The purpose of a phenomenological study is to understand the essence of an individual’s
experience (Creswell, 2007). Discovering the shared experiences of counselors who have
provided therapy in nature helped me to better understand nature-based practices. I approached
the data objectively by staying open to the information provided by participants and by staying
aware to avoid influencing themes with personal biases. I was also open to the deeper meaning
of the data that the participants provided (Converse, 2012).
Phenomenology stems from the philosophies of Edmund Husserl, expanded on by
Heidegger, Gadamar, and Ricoer (Dowling & Cooney, 2012), and originates from the Cartesian
tradition of a mind-body split (Creswell, 2007; Dowling & Cooney, 2012). The mind-body split
refers to the difference between the instinctual survival mechanisms of the body and the
intentions of the mind. Husserl asserted that the mind-body split occurs due to intention (as cited
in Dowling & Cooney, 2012). The mind is intentional and connected to an object, or something
outside of the self. If someone has a psychological need for something, that person needs an
object; if he loves someone he loves an object. The body is independent of intention, as there is
no thought or object attached to a heart beating, or an organ functioning. Husserl asserted that
because the human mind creates meaning that people then attach to objects, intention and
meaning could not be studied empirically (as cited in Dowling & Cooney, 2012). Husserl’s
desire was to understand the intentions, thoughts, and meaning of humans to get a greater
understanding of the world, which led to the development of qualitative research (as cited in
Dowling & Cooney, 2012). Modern researchers of Husserl’s approach include Giorgi,
Polkinghorne, Moustakas, Van Manan, Van Kaam and most recently, Garza and Polio et al.’s
work on existential-phenomenology (as cited in Creswell, 2007; Dowling & Cooney, 2012).
42
According to Bernard and Ryan (2010), phenomenological researchers commonly adhere
to the following six-step process to conducting a research study: 1) identifying the phenomenon
to be studied, 2) identifying and bracketing biases, 3) collecting narratives about the
phenomenon by those experiencing it through open ended questions and using probes, 4)
identifying essentials of the phenomenon through intuition after bracketing bias, 5) laying out the
found themes in writing using quotes from the data, and 6) repeating the steps until all
information that can be gathered is found and no new data emerge. In using their first step, I have
identified the purpose of my study as understanding the “essence” of participants’ experience
(Creswell, 2007). Therefore, I will get what Creswell (2007) refers to as a “fresh” perspective by
using an existential-phenomenological methodology, as the intent of my study is to understand
more about the shared experiences of counselors who provide counseling outdoors.
Research Questions
The primary research question for my study is: What are the shared experiences of
counselors who provide nature-based counseling? The sub-questions are:
1. What is nature-based counseling?
2. How does nature-based counseling differ from other types of therapy?
3. What benefits and/or risks do counselors believe clients may experience when
engaging in nature-based counseling?
4. What factors do counselors think elicit change in clients who participate in nature-
based counseling?
5. Are there ways that nature-based counseling can be improved?
6. What are the ethical concerns that counselors must consider with regard to nature-based
counseling, and if so, how can they be addressed?
43
Participants
The participants consisted of eight purposefully selected, licensed mental health
professionals who practice nature-based counseling. Morse (1994) recommended a minimum of
six participants in a phenomenological research study in order to gather enough rich data from
which to generate themes. I used a purposeful method of selecting participants. Purposefully
selecting participants helped me to ensure that I got useful information from the most appropriate
informants, to generate a description of counseling in natural environments (Creswell, 2007).
The participants were interviewed for information to elicit rich and thorough descriptions
of the phenomenon. The participants were recruited through general internet searches using
search terms such as nature-based counselors, ecopsychologists, and counseling outdoors. I also
emailed a nature therapy interest group, of which I am a part, through the Southern Association
for Counselor Education and Supervision. Two members of the interest group agreed to be
interviewed. Furthermore, upon finding and contacting one individual through an internet search,
who stated that he no longer practices outdoors, a natural snowball sampling occurred, when he
copied the initial email I sent to four of his colleagues, two of whom became my participants.
Snowball sampling is when a researcher accesses potential participants through the
information received by a previous participant (Noy, 2008). Other participants suggested
colleagues; however, no other individuals who were referred by other participants in the study
chose to participate. My initial searches were intended to find nature-based therapists near my
own geographical location; however, I was unable to find therapists who practice in natural
environments. Therefore, I utilized a wide geographical region to include participants from
across the United States. Criteria for participation were that each participant was required to :(a)
have a master’s degree in a mental health field, (b) be licensed in the state where she or he
44
practices therapy, (c) provide counseling in outdoor environments, and (d) have been practicing
in a nature-based setting for at least two years. The next section provides a brief description of
the participants that chose to be included in this study. I have used pseudonyms in order to
protect the identity of the participants.
Participant Profiles
Sequoia
Sequoia is a Licensed Marriage and Family Therapist in California, who was referred to
the study by a colleague. I found the colleague through a general internet search, and he passed
on my email to four other individuals, because he is currently a full-time academic and does not
have a counseling practice at this time. Sequoia was the first person to respond, and make herself
available for the interview. She chose to be interviewed by phone. We spoke by phone on April
25, 2014. I found out that she was one of the progenitors of the Ecopsychology movement. She
also shared that she has a 150 acre garden in which she sees her clients. She shared freely a
wealth of information related to ecopsychology and eco-grief.
Redwood
Redwood was the second person to respond to the email sent from the same colleague
that referred Sequoia. Redwood has a private practice in the San Francisco Bay Area. She
practices somatic ecotherapy. She is a Licensed Marriage and Family Therapist and has training
in dance and somatic forms of therapy, as well as Hakomi. Redwood chose to use Face Time,
which was beneficial to me as a researcher, because I noticed immediately that she had a very
expressive demeanor and used her hands often to gesture. We conducted the interview on April
25, 2014. I could tell by her body language that she moved with grace and ease, her dancer
training was quite apparent. She shared openly, and I noticed that she was formulating and
45
further defining her practice, as she answered the questions on the interview protocol. Redwood
was enthusiastic and passionate about her practice, and shared her website with me. The
interview lasted approximately one hour, during which she turned her computer screen around at
one point to share a view of her rose garden.
Chestnut
Chestnut was the third person to be interviewed. I found him through a general internet
search, and he chose Face Time for his interview. Chestnut lives in Oregon and has been
practicing for over 30 years. He was in the process of retiring when we spoke on April 26, 2014.
He was incredibly passionate and cerebral with an abstract and artistic approach to the ways in
which he described his work and practice. He shared that the interview helped him think about
what his future contributions to the field might be at such a transitional time for him in his
professional career. He shared a wealth of information about his personal experiences in nature
that were spiritual for him and that influenced him to incorporate nature-based experiences into
his practice. He shared a variety of techniques and meaningful perceptions of the human
connection to the natural world.
Madrone
Madrone lives in Oregon. He is a Licensed Professional Counselor, with an eco wellness
practice. Madrone is also a counselor educator. He shared that he has been incorporating nature
into therapy for about three years. Madrone was found through the nature-based counseling
interest group that was created through networking at a conference for the Association for
Counselor Education and Supervision. He responded almost immediately to the request and gave
consent to participate in the study. Madrone and I used Google Hang Out to video conference on
April 25th, 2014. It was snowing in Oregon at the time of our interview, and at one point he
46
turned his computer to show me the falling snow. Madrone has a clearly defined eco wellness
practice and he approaches the work from a scholarly perspective as well as from the viewpoint
of the practitioner. He shared a wealth of information related to ethical considerations and the
intentional use of the natural environment in his counseling practice. Madrone has a clearly
defined theoretical grounding for his practice and he is continuing to research in the area of
counseling outdoors.
Orchid
Orchid is a Licensed Clinical Social Worker in the San Francisco Bay Area. She has a
private practice in her home that includes a garden space. She gives clients the option to
incorporate nature in their therapy sessions in a few ways, by sitting in the garden and through
mindfulness activities. Orchid and I connected through Face Time on April 29, 2014. She shared
that she is a cognitive behavioral therapist and that she utilizes mindfulness techniques. She also
shared that she has a background as a wilderness guide in wilderness therapy programs.
Camellia
Camellia is a Licensed Professional Counselor and Licensed Marriage and Family
Therapist in Florida. She incorporates creativity and spirituality into her counseling practice. She
does not necessarily describe herself as strictly a nature-based counselor, even though she
incorporates elements of nature into her practice regularly. She and I spoke by phone on May 9,
2014 for approximately and hour. I noticed that she utilizes nature creatively and even thinks
about nature in a different way. For instance, she will sometimes utilize the classical elements
such as fire, water, air and earth in a metaphorical way. She also utilizes sand tray therapy as a
connection to nature.
47
Cedar
Cedar is a psychologist in Australia who has been incorporating nature into his therapy
practice for about 25 years. He is mainly an academic, and does research on nature and mental
health. We conducted our interview through Skype on May 29th, 2014. He shared that his
training and experience included stints as wilderness guides and adventure based guide work.
Due to his research, he had well thought out answers to questions, as it is clear he has pondered
these issues on a deep level. It is clear he is passionate about the topic and shared a variety of
issues related to theory, ethical considerations and the broad range of counseling activities that
can occur.
Blue Gum
Blue Gum was referred by Cedar to participate in the project. I reached out to him to see
if he would participate by email upon receiving the recommendation. We interviewed via Skype
on June, 6th, 2014. Blue Gum is a Licensed Clinical Social Worker who has been in practice for
approximately 10 years, with five years in his adventure therapy private practice. He engages in
two-week long expeditions, eight times per year with adolescents and kids. He shared a great
deal about his experiences and what inspires him as a social worker and adventure therapist. He
was able to share a great deal about his process as a therapist and his perceptions on ways to
approach this type of counseling.
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Table 1
Personal Characteristics Demographics
Participant
Sequoia
Redwood
Education
Masters-
Marriage and
Family Therapy
Master’s-
Marriage and
Family Therapy
License/State
LMFT-CA
LMFT-CA
Registered Dance
Movement
Therapist
Years in
Practice/Nature-
Based Practice
30+/25+
19 yrs./7 yrs.
Employment
Private Practice
Private Practice
Chestnut Ph.D
LPC-OR
30+/25
Private Practice
Madrone
Orchid
Camellia
Cedar
Blue Gum
Ph.D
Master’s of
Social Work
Master’s of
Counseling
PhD-
Psychology
Master’s of
Social Work
LPC-OR
NCC
LMSW-CA
LPC-FL
LMFT-FL
Psychologist-
Australia
LCSW-Australia
5 yrs./3 yrs.
3 yrs./2 yrs.
9 yrs./9 yrs.
25+ yrs./25+ yrs.
10 yrs. /5 yrs.
Academic/Private
Practice
Private Practice
Private Practice
Academic/ Private
practice
Private Practice
Selection of Site
Although I would have liked to conduct the interviews at the site at which participants
actually practice, such as a nature trail, park, or woods, access to the setting was dependent upon
my ability to travel. I was unable to conduct interviews in person, so I used Skype, Google
Hangout, and Face Time (i.e., video chat software) as well as phone interviews to complete the
interviews. Doing the interviews by phone and through video chat allowed for me to reach
participants all over the globe. I interviewed two participants who are currently living in
Australia. I was able to view some of the participants’ views of nature from their office windows.
The environmental circumstances during these interviews yielded a sensory experience for the
49
participant as well as myself, in addition to verbal descriptions of the phenomenon. For example,
a participant showed me her rose garden, a particular location used for therapy. Creswell (2007)
stated that one of the unique elements of collecting data in qualitative research is to actually
observe the participants while they are experiencing the phenomenon.
Researcher Positionality Statement
While there are some variations in and different types of phenomenological studies, all
assume that reality is based on the experience and the meaning of the individual. Therefore,
researchers suspend their personal biases and judgments, a process known as bracketing, and
provide textural and structural descriptions of individuals’ experiences of the phenomenon being
studied (Creswell, 2007; Hamill & Sinclair, 2011). Bracketing or withholding researcher bias
while conducting research is a major component of the phenomenological research plan in order
to look objectively at the phenomenon being studied (Hamill & Sinclair, 2010). Although the
researcher can never be removed entirely, biases were disclosed, to focus on the meanings of the
participants’ experiences and stay objective throughout the data collection and analysis. The
philosophical roots of phenomenology focus a great deal on intention, meaning, and the
assumption that a phenomenon has not occurred unless a subject has experienced it (Sadala &
Adorno Rde, 2002).
Using Bernard and Ryan’s (2010) second step when conducting research, I identified and
bracketed my biases. I have personal opinions about the connection between mental health and
spending time outdoors. I have a great deal of experience communing with nature. I have
conducted group counseling and individual counseling outdoors. I believe that humans depend
on the natural environment for all resources (i.e., oxygen, food, water) needed for survival, but
that people also gain tranquility, peace, and a return to a source of vitality and strength when we
50
spend time outdoors. We gain self-respect and connectedness when we protect and care for the
natural environment. We experience an aesthetic and artistic appreciation for nature’s beauty as
well as a sense of spiritual fulfillment and awe when we contemplate how small we are in
comparison to the vast expanse of the starry universe or a 300-foot, 1,000year-old tree.
Additionally, I have a bias that contemporary society has evolved to a point at which it
has become inconvenient to connect to that which gives us life. Modern technology allows us to
drive from building to building, turn on synthetic lights and sit in front of computer screens and
then get in our cars and drive to our sheltered and separated homes. We can live for days without
experiencing much of the natural world. Therefore, I also believe that there can be a
psychological reprieve for humans who make a conscious effort to connect more with the natural
environment. I am biased in favor of spending more time in natural environments and assume
that counseling outdoors may be beneficial as well.
Data Collection
Utilizing Bernard and Ryan’s (2010) third step, I collected narratives through the use of
interviews about the phenomenon by those experiencing it through open-ended questions and
using probes. Collection of participants’ narratives about the phenomenon included interviews
and examples of data sources such as website information and promotional materials. I utilized
information provided on participants’ websites, as well as any documents participants provide to
clients that they will share with me, such as brochures, promotional materials, or informed
consent forms. I analyzed these materials, by looking for key words that contributed to themes
that emerged in the participants’ interviews.
After obtaining university IRB approval, I contacted each participant by email or phone
to ask if they would like to participate (see Appendix A). I provided participants with an
51
explanation of the purpose of the study, of the approximate time of 60 minutes needed to conduct
the interview, and of how the information would be used once the data was collected.
Participants were emailed the informed consent upon expressing interest (see Appendix B).
All participants provided written or verbal consent to participate. Once consent was
received, I scheduled semi-structured interviews that took approximately 60 minutes. Because all
participants lived out of the state (two lived out of the country) I utilized software such as Skype,
Face Time, and Google Hangout to complete the interviews. The sessions were audio recorded,
with special attention given to informing participants about confidentiality and limitations to
confidentiality as it pertains to online interviewing and storage. Upon immediate completion of
the interviews, I took hand-field notes to add additional observations or information that seemed
important.
Participants’ narratives were collected using semi-structured interviews with individual
participants. I asked each participant a set of similar demographic questions and interview
questions, which can be found in Appendix C. The interviews contained open-ended questions
that addressed the research questions. The purpose was to yield the most objective and
meaningful information possible, while allowing for individual input and some improvisation
based on the information gleaned from the informant through the use of probes (Bernard &
Ryan, 2010).
Due to the sensitive nature of therapy as well as confidentiality concerns for clients, I was
careful to ask questions that did not pressure participants to break client confidentiality, and to
uphold respect and trust between the research participants and myself. To further protect
confidentiality of the data collected, I password protected my laptop, where I kept the audio
recordings of the interviews and the data. I received only electronic supplemental materials,
52
which were stored in a separate folder on my computer. Participant-chosen pseudonyms were
used, and any identifying information has been altered to protect participants’ confidentiality.
Data Analysis
After collecting the interviews and other materials that were analyzed such as information
collected from participant websites, brochures provided by the participants interviewed, my field
notes, and any other materials participants provided to clients that they provided; I hired a
transcriptionist to transcribe all interviews. The transcriptionist signed a confidentiality
agreement to keep all information confidential. The fourth, fifth and sixth step of Bernard and
Ryan’s (2010) six-step process that I used helped me identify the essentials of the phenomenon
through preliminary themes and the “essence” of the study based on intuition, laying out the
themes I find in writing using quotes from the data, and then repeating the steps until all
information that can be gathered is found and no new data emerged.
After transcribing, I read through each individual transcript and identified key words and
emergent intuited themes in each independent transcript. Key words and themes were identified
and separated, and quotes from the data were used to support the themes. Once I had themes
from each of the participant’s transcripts and documents collected, I grouped the themes into
overarching themes. I then looked for themes that emerged across all transcripts and documents
through a cross-case analysis. While generating themes, I looked for repetitions, metaphors and
analogies and key words. Next, the supplemental materials provided by participants were
analyzed and compared with the super-ordinate themes that emerged in the cross-case analysis.
Validation Procedures
When no new data emerged, I employed validation procedures, which included the use
of, clarification of my biases, member checking, peer debriefing, peer review and the use of
53
“thick, rich description” (Creswell, 2007, p. 208). It is important as a researcher to present data
that is meaningful, objective and truly representative of the phenomenon under examination, as
the themes and knowledge that emerge from the research data often become used as a base for
future research and practice (Creswell, 2007). I engaged in reflective practices to evaluate my
own research biases (Creswell, 2007). In order to uphold credibility and dependability,
bracketing was utilized to disclose my own biases before presenting results. I clarified my biases
by writing field notes immediately after data collection reflecting my personal bias. I disclosed
my personal biases in the analysis of the research themes as well as utilized a constant
comparison method in order to ensure personal objectivity.
As a researcher, I took measures to remain as objective as possible to examine the
phenomenon of counseling outdoors through the perspective of my participants. The specific
ways in which I accomplished objectivity were through self-awareness and a focus on the
intention and meaning of the participants’ experiences with counseling in nature. I took field
notes with a focus on being mindful of the qualities that successful bracketing researchers
possess. According to Hamill and Sinclair (2010), the qualities of a successful bracketing
researcher include transparency, self-critique, and a self-awareness approach (willingness to
accept peer and participant feedback).
As recommended by Hamill and Sinclair (2010), it is important as a researcher to be
transparent about personal bias. As I collected and analyzed my data, I was transparent about my
biases that humans have an intrinsic connection to nature and that clients may benefit from
counseling outdoors, while experiencing the connectedness to outdoors and nature. In my field
notes, I bracketed and documented my biases enabling my awareness of how they may be
impacting my research.
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By understanding my biases through writing before I approached the data, I was able to
compare the themes and pertinent data that emerged with my own perceptions to make sure I was
not transferring my biases onto the field notes collected about the participants’ interviews. In
order to stay self-aware, I wrote down my personal experiences, biases and reflections after each
interview, so as to effectively bracket my own experience and biases. As a researcher, I
constantly approached the data with an inquisitive perspective to stay self-aware throughout the
data collection and analysis process.
Member Checking
Member checking is the process of taking the research findings back to the participants in
order to get participant feedback on the accuracy of the themes found in the data (Bernard &
Ryan, 2010). Member checking is used throughout the research process to ensure that the results
received are based purely on the participants’ contribution, as opposed to that of the researcher
(Hamill & Sinclair, 2010). By utilizing this method, I had the opportunity to see if the findings
resonated with the participants and if the portrayal of the phenomenon could be enhanced before
moving toward more concrete stages of solidifying themes and findings for the dissertation
research (Bernard, & Ryan, 2010).
I member checked by providing each participant a list of themes that emerged from his or
her transcript through email. I then gave them an opportunity to reflect on the themes that
emerged in order to identify whether or not the themes seemed generally congruent with their
experience. Furthermore, I was open to any feedback that was contradictory to the themes I
generated, and how that might have influenced my results (Bernard, & Ryan, 2010; Creswell,
2007). I achieved this by contacting participants and sending them the themes I generated from
their interviews. I asked if they agreed with the themes and if they had anything else to
55
contribute. Once participants provided feedback, I incorporated their feedback into the analysis
of the data.
Peer Debriefing
Throughout my research, I depended upon the guidance of a peer debriefer and asked that
they specifically check for researcher bias that may be interfering with my objectivity throughout
the research process or the data results. I debriefed throughout the data collection process and
during the data analysis process with a peer to process possible biases to effectively bracket
(Creswell, 2007).
Peer Review
As suggested by Bernard and Ryan (2010), I utilized the peer review method of ensuring
validity to ensure accuracy of my interpretation of the interviews. Utilizing a peer review method
of validation, as suggested by Creswell (2007), helped me focus more objectively on my study
by incorporating the opinions of other skilled, non-biased researchers. The peer reviewer was a
Licensed Professional Counselor, who is enrolled in a doctoral program in counseling, and who
has training in both counseling and qualitative research.
Once themes were generated, but before I wrote up the results or got feedback from
participants through member checking, I asked one peer to review the themes I had identified, as
well as the interview questions. I shared my personal biases with the peer reviewer verbally
before the reviewer read the themes. I asked for feedback on the reviewer’s perceptions of the
themes I generated, and to point out anything that seems like a personal bias that may have
emerged in the themes. This helped me ensure validity and continuously facilitate an objective
review of the data.
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Transferability
The final validation technique I used was the use of “rich, thick descriptions” from the
data, which is described as detailed descriptions that allow the reader a comprehensive
understanding of the setting and the phenomenon, in order to determine how the information
obtained from the study can be “transferrable” or otherwise applied to similar situations
(Creswell, 2007, p. 208). This means that the phenomenon are described in such great detail that
the reader can determine whether the practice or description of the phenomenon can be applied
to their personal practice or research.
Chapter Summary
In this chapter, the purpose of this research study, research questions, participants,
methodology, and rationale for qualitative research and phenomenological inquiry were
provided. Furthermore, data collection and analysis methods were described in detail as well as
the bracketing and other measures put in place to ensure reliability and validity.
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Chapter Four
Results
The purpose of this qualitative, phenomenological study was to gain a deep
understanding of the shared experiences of therapists who provide counseling in nature-based
settings. Semi-structured interviews were used to gain participant perspectives on the
phenomenon of counseling in natural environments. Bernard and Ryan’s (2010) six-step method
of conducting phenomenological research was utilized to guide the data collection and analysis.
Validation measures included bracketing bias, member checking, peer debriefing, peer review,
and the use of rich, thick, description (Creswell, 2007).
This chapter is divided into five sections. First, a summary of procedures is presented.
Second, an analysis is presented of each individual case study. Third, the results from the cross-
case analysis are described. Fourth, the supplemental materials provided by participants are
analyzed. Finally, the findings are used to analyze the primary research questions and sub-
questions.
Summary of Procedures
After each interview was transcribed, an analysis was conducted and pseudonyms were
assigned to each participant to protect confidentiality. In adherence to the Bernard and Ryan’s
(2010) six-step process, each transcript was analyzed by listening to and reading the
transcription, to generate themes based on ideas and key words. The themes were supported by
quotations from the text. As a validation procedure, the themes were sent by email to participants
for member checking. The email message to participants can be found in Appendix D. Themes
were then clustered into overarching themes and the themes and overarching themes were placed
into tables.
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Individual Case Analysis
This section provides an overview of each participant’s interview, a table of the themes
and overarching themes found in each interview, and a narrative description with quotations
from the text that support the themes. The cases are presented in the order that the interviews
were conducted.
Sequoia
Sequoia is a Licensed Marriage and Family Therapist (LMFT) in the San Francisco Bay
Area of California. She has been an LMFT for over 30 years and has incorporated ecotherapy
into her practice for 25 years. Sequoia is a seasoned ecotherapist who has contributed to a variety
of texts that describe and support her practice. Her passion for ecopsychology is rooted in her
personal identity, as well as in her professional experiences. She has spent years educating other
professionals who have experienced or would like to experience ecopsychology. She chose to be
interviewed by phone. It was clear from the beginning of our conversation that not only was she
well versed in incorporating nature into psychotherapy, but that she was one of the progenitors.
As we talked, I found myself delighting in her stories of working with prominent
environmentalists, and I could almost smell the fruit from her 150-acre farm, therapy space, and
garden. Analysis of her interview resulted in 15 themes and 5 overarching themes (see Table 2).
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Table 2
Overarching Themes and Themes for Sequoia
Overarching Themes
1. Beliefs About Human Connection with
Nature
2. Major Tenets
3. Training
4. Motivations for Using Nature
5. Benefits
Themes
1. We are Animals
2. We are Less Well When Disconnected From
Nature
3. Nature Exists in the Body
1. Define and Strengthen Human Relationships
with Nature
2. Garden Creates a Context for Therapy
3. Addresses Eco-Grief and Eco-Anxiety
1. Need for Training is Student Driven
2. Few Formal Training Programs
3. Legal and Ethical Concerns
4. Limitations
1. Intellectual Connection Between Systems
Theory and Environmentalism
2. Personal Healing in Nature
3. Ecopsychology Texts from the 1990’s
1. Both “In-Vivo” and Synthetic Nature is
Beneficial
2. Benefits Mood and Physical Health
In the first overarching theme for Sequoia, Beliefs about Human Connection with Nature,
she described her belief that humans are primates and animals, and are therefore nature. She
believes that because We Are Animals (theme 1), that We Are Less Well When Disconnected
From Nature (theme 2). She stated:
We don’t realize that we’re animals too and that we’re caged in a way all the
time….Somehow we forget we’re primates. This is not how we
live naturally. Ok, we can survive, but is it causing some of the illnesses that are
an epidemic in our culture.
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Regarding Theme 3, Nature Exists in the Body, she explained: “…what about the nature in your
body, what about the wild psyche, the wild blood stream. You know, we’re not in control of all
this stuff, it’s wild.” Sequoia had strong opinions about how people are inherently connected to
nature. Her counseling approach seeks to honor that inherent connection, by helping clients
reinvigorate their connection to nature.
Sequoia has formulated Major Tenets, overarching theme two, which is described in three
themes. First, her goal as expressed in theme 1, Define and Strengthen Human Relationships
with Nature, is to help people reconnect with themselves by connecting to nature. She hopes that
“…doing eco-therapy work with the client [will help them] articulate their preferred focus of
nature connection.” She also stated that, “…helping people define nature is another big issue.”
Second, she shared that a preferred focus of nature connection can vary from recognizing a pet as
a connection with nature, to helping clients recognize the ways they personally connect.
In theme 2, Garden Creates a Context for Therapy, she described the use of her garden in
her counseling practice, which sprang from a commitment that she and her husband made to
create a more sustainable and eco-friendly lifestyle for themselves. She works with almost all her
clients in her haven of trees, edible plants, and flowers. Theme 3, Addresses Eco-grief and Eco-
Anxiety, highlights another major tenet of her practice, which recognizes environmental issues
that are of concern in society and how clients might be responding or reacting to these concerns.
She shared that many clients come to her with depression and anxiety related to the current state
of the environment. She called these negative reactions to the environment Ecogrief and
Ecoanxiety. She acknowledged the significance of ecogrief and ecoanxiety in her work when she
stated
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An area that’s really growing is this whole issue of people’s feelings about what’s going
on, on the planet. This has a lot of things that people talk about. ecogrief, ecoanxiety, and
a lot of therapists are starting to turn their minds to helping people with this issue.
In her practice, clients can freely process ecogrief and ecoanxiety if they are experiencing these
phenomena. She addresses this issue by empowering clients to work on beautification, activism,
and preservation projects, so that they can take action and feel efficacious about their
contribution to creating a more sustainable planet.
With regard to Sequoia’s opinions about Training, overarching theme three, she observed
that more Ecopsychology programs are emerging even though there are still very few. This
overarching theme was reflected in four themes. She shared that the Need for Training Is Student
Driven (theme 1) and that Few Formal Training Programs (theme 2) are available. Her
sentiments pertaining to themes 1 and 2 were reflected when she stated:
It’s obviously a growing list, but people are scrambling and it’s being student driven. In
other words, students are asking for this training, it’s not like that many people are
saying, oh, I should start a department of eco-psychology. Like, no, students are saying,
how can I get trained in this?
The third theme was Legal and Ethical Concerns Related to Ecotherapy. Because Ecotherapy is
such a new practice, Sequoia expressed concern regarding a lack of guidance from professional
organizations regarding legal and ethical issues. She also discussed Limitations to Ecotherapy
(theme 4). She believes that the main limitations are public perception and a lack of receptivity
in society in mental health fields as well as in society in general. She stated, “…The roadblock I
can think of is the fact that it’s difficult to communicate with traditional psychology and
traditional psychotherapy and counseling about what this is and why it’s a good thing.”
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Overarching theme 4, Motivations for Using Ecotherapy, describes Sequoia’s personal
motivations for starting to incorporate nature into her counseling practice and contains three
themes. Sequoia painted a lively picture of theme 1, Intellectual Connection between Systems
Theory and Environmentalism, when she described how her identity, training, and personal
moments of healing in nature inspired her to infuse nature into her therapeutic practice. When
she started as a therapist in the 1960s she was learning about family systems theories and became
an avid environmentalist in her personal life. She started to wonder if humans could benefit not
only from understanding their family systems, but also from taking into account their physical
and natural environmental systems.
A moment of clarity occurred during a moment of Personal Healing in Nature (theme 2)
that changed her perspective on psychotherapy. “I had moved to Santa Barbara and we were
doing some really intense gardening, and suddenly I began to realize that it [the act of gardening]
was actually beginning to shift the mood, and suddenly it all made sense to me and I realized,
well, I need to be doing this [ecotherapy].” This moment shifted her ideas about what
psychotherapy could be for her clients. She looked into the ecopsychology texts from the 1990s
(theme 3) and began formulating and implementing principles of ecotherapy into her therapeutic
practice.
The Benefits of Ecotherapy, overarching theme 5, emerged when Sequoia shared that
both “In-vivo” and Synthetic Nature (theme 1) are beneficial. She discussed the benefits of
immersing one’s self in-vivo in nature, and in gardening specifically: “…and there’s now
research that there is sort of some antidepressant thing in the soil, which is very weird.” She also
discussed the benefits of synthetic exposure to nature when she added, “you know that there’s
research that people looking at a picture of nature on a hospital wall is effective.” Sequoia
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recognized that nature Benefits Mood and Physical Health (theme 2) of her clients, which is the
reason she provides these benefits directly to her clients by using her garden as a therapy space.
Redwood
Redwood is a Licensed Marriage and Family Therapist in the Bay Area of California. She
described the type of nature-based counseling that she practices as somatic ecotherapy. She is a
registered dance therapist and has studied Hakomi, which she has incorporated into her practice,
for nine years. She does not have formal training in nature-based counseling, but she attended the
School of Lost Borders, which focuses on rites of passage and expanding students’ perspectives
on where they fit in the natural world. She also attended a class at a local university that
addressed nature connection as it relates to counseling. Redwood has been a marriage and family
therapist for 19 years and has been infusing nature into her practice heavily for the past seven
years. Redwood chose to be interviewed via Face Time. I found her to be an extremely
passionate and enthusiastic participant. Her case yielded 12 themes and 4 overarching themes
(see Table 3).
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Table 3
Overarching Themes and Themes for Redwood
Overarching Themes
1. Major Tenets
2. Spirituality
3. Training
4. Ethical Concerns
Themes
1. Somatic and Kinesthetic Experiencing of
Nature
2. Relationship with Client and
Relationship with Nature
3. Hakomi/Mindfulness
1. Spiritual “Calling” to Share the Practice
with Others
2. Improves Mood, Attention and Focus
3. Increases Client Spirituality
1. Trainer has a Deeply Integrated
Relationship with Nature
2. Limitations
3. Trainers are Activists
1. Confidentiality
2. Managing Physical Risk and Liability
3. Not Pushing a Nature Agenda
Redwood believes that somatic ecotherapy stems from a deeply ingrained human
connection with nature. She shared her belief that humans have had a connection with the earth
for thousands of years and that ecotherapy is ancient: “On another level it’s ancient, because of
course indigenous people were in their body. You know, connected [to the earth] through their
senses, and all that, and so… some different shamanic and spiritual people actually did do this
[intentionally spent time in relationship with nature].”
Overarching theme one describes the Major Tenets of her practice. The three main
themes placed under this category were theme 1, Somatic and Kinesthetic Experiencing of
Nature, theme 2, Relationship with Client and Relationship with Nature; and theme 3,
Hakomi/Mindfulness. Theme 1, Somatic and Kinesthetic Experiencing of Nature, addressed the
65
experience of helping clients connect with themselves in nature, somatically and kinesthetically.
Redwood described the importance she places on incorporating the body into the therapeutic
process: “…Because of who I am and what my orientation is to the world, it’s [somatic
ecotherapy] primarily kinesthetic, movement oriented, energetic awareness kinds of things, and
expression...” Redwood is a trained dancer and dance therapist who believes that great healing
can occur when people are aware of the insights their bodies can provide to their inner mental
states. She explained the bodywork she facilitates for clients,
…helping people to feel how their body feels next to a tree, ... or how do they
experience the actual sensation of the air on their skin or their feet on the ground...
So orienting them, and grounding them, and helping them to come into their body
more when they’re outside
Theme 2, Relationship with Client and Relationship with Nature, was expressed in Redwood’s
view of the therapist’s role
To help the client feel safe, to help the client feel, learn, and experience various
ways to enter into their own issues somatically… There’s also teaching them to
do it on their own, to help them continue that connection with nature for when
they need it, to model it.
Redwood stated that her practice includes the incorporation of Hakomi therapy and mindfulness
into her work with clients (theme 3).
It’s basically mindfulness practice that’s also body centered …it’s having people
turn inward, from looking outside, closing their eyes and going inwards to
sensations, feelings, memories, thoughts, experiences inside and begin to follow
those. What happens is, that it takes them to a lot deeper of a level than just
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talking about things, and it helps them to get to whatever core issue is going on.
The practice is based on acceptance, non-judgment, and somatic awareness. While she
incorporates unique elements such as the use of nature, Hakomi, and somatic awareness into her
practice, she is careful to stay true to client needs by tailoring her practice to their specific
concerns. She stated, “…it just feels, it’s very, very specific to their needs and their issues, and
so the techniques and the interventions are just exactly for them.”
In overarching theme two, Spirituality, Redwood described the spiritual benefits of
participating in somatic ecotherapy, as well as her motivations for incorporating nature into her
counseling practice. In theme 1, Spiritual “Calling” to Share the Practice with Others, she
described a spiritual moment that occurred while meditating in a grove of trees.
I literally got a sense from this particular grove of trees that I had, that I knew to
an extent, that they said, you need to share this with other people. And I was like,
no way, this is my time alone, I’m doing this so I can get away from people! I
need my space! … And little by little, I kept feeling that call, and so I said, ok, I’ll
see what I can do.
This moment of insight shifted her view of the purpose of her work and how she would share her
relationship with nature with the world. From that moment, she began to intentionally
incorporate nature into her therapeutic practice, although she was a bit resistant at first to sharing
with others her personal healing time in nature.
Theme 2, Improves Mood, Attention, and Focus, highlighted the benefits of spending
time in nature as they are reflected in the research literature.
Richard Louv has all this information about how children calm down when
they’re in nature, there’s all these somatic [benefits], it lowers stress, it lowers
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depression, it lowers your cortisol rates, your blood pressure. You know, there’s
just a million different physiological kinds of proofs that being out in nature
supports us as more balanced human beings.
Theme 3, Increases Client Spirituality, emerged throughout the interview. “…There’s a
spirituality that comes into people, and they can’t help but feel some awe and some gratefulness
outdoors. What else happens therapeutically, is that… it helps people become more connected in
the world versus isolated.”
Overarching theme three, Training, reflects Redwood’s belief that it is imperative that a
Trainer Has a Deeply Integrated Relationship with Nature (theme 1). “I would say that a huge
thing would be that the person has deeply integrated their own relationship with the earth, and
that they’re doing it [somatic ecotherapy] on an ongoing basis.” Theme 2, Limitations, included
limitations of counseling in nature that could be addressed in training. Redwood identified one
limitation as lack of public knowledge about what the practice entails or how it could be
beneficial for clients. She shared that while the field is growing, a dearth of understanding of
Ecotherapy still exists. She noted that “… 20 years ago most people didn’t know what the word
somatic was, now most people don’t know what the word eco-therapy is.” She explained that
roles of the therapist include educating clients on the benefits and providing experiential
activities to help expose them to the practice. Finally, Redwood expressed her belief that
Trainers are Activists (theme 3). “I think there should be some kind of activism in the training,
because part of what… the whole field is about is changing consciousness towards taking better
care of the earth…”
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Overarching theme 4, Ethical Concerns, included three themes: theme 1, Confidentiality;
theme 2, Managing Physical Risk and Liability; and theme 3, Not Pushing a Nature Agenda.
Redwood shared that one way to manage concerns for Confidentiality (theme 1) would be to
have ongoing conversations with clients regarding their comfort level about sharing personal
information in a space that may not be confidential. Other ethical concerns pertained to
Managing Physical Risk and Liability (theme 2), and Not Pushing a Nature Agenda (theme 3).
Redwood expressed “…concerns about liability if someone gets hurt” (theme 2). She also
discussed the importance of “balancing the therapist’s desire to do it outside [the counseling
session] with the client’s actual need to have that,” to ensure that the decision to utilize nature is
not based on the therapist’s wishes (theme 3).
Chestnut
Chestnut holds a Ph.D. and is a Licensed Professional Counselor (LPC) in Oregon. He
refuses to name his chosen form of nature assisted counseling practice, as he believes naming the
practice might mislead clients and other professionals. He does not want to narrowly define his
practice because he believes it encompasses a philosophical worldview rather than a set of
prescribed interventions with a set framework. Chestnut has been an LPC for over 30 years and
helped start the licensing system in Oregon. He has been infusing nature into his therapy
practice for over 25 years.
Chestnut chose to be interviewed through Face Time. He has been studying counseling
and Ecospychology for many years. He was well versed in his theoretical approach and on
incorporating nature into the practice. His case yielded 15 themes and 5 overarching themes (see
Table 4).
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Table 4
Overarching Themes and Themes for Chestnut
Overarching Themes
Themes
1. Beliefs About Human Connection with Nature
1. Humans are Mammals and Primates
2. Humans Can Benefit from
Reconnecting to Their Bodies.
3. Humans are “Hard-Wired” for Nature
Connection
2. Major Tenets
3. Training
1. Ecological and Biological Context for
Therapy
2. Nature as a Thou
3. Awakening Body Connection with the
Earth
4. Externalized, and Environmental Focus
vs. Internal Focus
1. Safety and Physical Risk
2. Importance of the Relationship
3. Ethical Concerns
4. Limitations
4. Motivations for Using Nature
1. Life Changing Experience in Nature
2. Intellectual Exploration
5. Benefits
1. Counselor/Client Relationship
2. Client Liberation
Chestnut brought passion, creativity, and a sense of activism to his interview. His Gestalt
theoretical orientation and the Ecopsychology movement inform the structure of his nature
assisted counseling practice. The first overarching theme to emerge was based on his core Beliefs
About Human Connection with Nature, which included three themes: 1, Humans are Mammals
and Primates; 2, Humans Can Benefit from Reconnecting to Their Bodies; and 3, Humans are
“Hard-Wired” for Nature Connection.
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Chestnut adhered to an evolutionary understanding of humans when conceptualizing the
human relationship with nature. Theme 1, Humans Are Mammals and Primates, and theme 2,
Humans Can Benefit from Reconnecting to Their Bodies, were described when he stated:
So when you think of yourself as a mammal and a primate as well as a
homosapien, and you understand that you are a living organism and if you put
yourself into nature…and coming to awaken your inner sense of your body, all
the sensualities of it, all of the sense of sight and smell and all of that, is key,
because a lot of our modern culture is based on desensitization of the human
body.
His practice encourages exploration of the senses and finding awareness through one’s body in
nature. He referred to common negative coping skills that people use to desensitize the body,
including addictions, consumerism, and escapism through technology.
Chestnut shared the belief that Humans are “Hard-Wired” for Nature Connection (theme
3). “…We’re hard-wired for this, and we lost our connection; and shamans 1000s of years ago,
and people drawing in caves, knew a lot more about it than we did. So there’s that
anthropological and paleo-anthropological understanding.” He asserted that, although
contemporary humans have lost touch with that connection, humans are still capable of accessing
an inherent connection to nature.
His beliefs helped shape the second overarching theme, Major Tenets. He described the
major tenets of his practice.
I think the four core ingredients are: 1) a large ecological, biological context for
therapy, 2) relating to nature as thou, 3) reconnecting with one’s body as a living
organism, and 4) an extraspective rather than an internalized approach, with
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sensory awareness and coming in touch with your body to balance that tendency
to get overly introspective about your personal concerns. So I’d say those are the
core ingredients to the approach.
To elucidate theme 1, an Ecological and Biological Context for Therapy, Chestnut explained,
“I’ve adopted an ecological framework, a biological context for understanding human beings and
their health.” It also includes his understanding of humans as animals, “…understanding your
body as an organism. So that you think of yourself as a mammal and a primate, as well as a
homosapien.”
Theme 2, Nature as a Thou, referred to the counselor’s and client’s relationship with
nature. This can include strengthening and bringing awareness to a human connection with
nature. Chestnut’s approach is to extend the client/counselor relationship to encompass the
natural world.
I find that I can look at that I-thou mode of relating, of relationships, and extend it
beyond the personal one. For example a client may have a pet. And they may take
that pet for walks as part of their own coping mechanisms for living in the world.
And so there are some ways in which I can pick up on that and highlight those
healing aspects of what’s already going on in their life.
Chestnut works to find the nature connection that clients are already comfortable using, to help
clients strengthen their bond with the natural world.
Theme 3, Awakening Body Connection with the Earth, encompassed Chestnut’s belief
that humans can benefit from reconnecting with their bodies. He uses sensory awareness to help
clients connect with their bodies in nature: “I’m often dealing with their experiences and their
sensory awareness and their openness to experiences, so I think that awakening of the body
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aspects that happen in therapy are highlighted in my approach.” In addition to sensory awareness
and experiences in nature, he identified yoga and other types of bodywork as beneficial.
Theme 4 reflected Chestnut’s belief that it is important to have a broad Externalized and
Environmental Focus vs. Internal Focus for client conceptualization. He described his approach
as firmly “rooted” in his Gestalt theoretical orientation.
…He [Perls] talked about the organismic environmental field, which is that
systems theory stuff. So if you look at the core of my approach, it just naturally
came out of what I was already doing. It just broadened the context of
relationships to include the natural world.
Chestnut described his belief that clients are immersed in a complicated world with many
interacting institutions, cultural paradigms, communities, families, and other systems. His
approach acknowledges how the natural environment and client systems impact the mental
health of clients served.
The third overarching theme that emerged from Chestnut’s interview, Training, included
four themes: 1, Safety and Physical Risk; 2, Importance of the Relationship; 3, Ethical Concerns;
and 4, Limitations. Chestnut spoke of the importance of addressing Safety and Physical Risk
(theme 1) when counselors practice in areas that might be physically treacherous. He also
stressed the importance of having proficient clinical skills and good relationship building skills,
as addressed in theme 2, Importance of the Relationship. He stated, “…The relationship-
building skills, that’s at the core of it, if we aren’t training people with an eye on that, we’re not
looking in the right place.” Throughout the interview he stressed that the most effective change
agent in nature-assisted psychotherapy is the relationship.
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Theme 3 addressed Ethical Concerns related to nature-assisted psychotherapy. He
stressed the importance of not pushing a nature agenda on the client. “I have to work within what
they ask me to do. That isn’t to say that my larger framework can’t be helpful; it just means that
if they came to me to talk about their marriage, they’re probably not going to want to go on a
vision quest.” He works from a series of assumptions about the world and how clients can
benefit from a nature connection; however, he does not infuse nature-based activities into his
work with clients who do not want to work on their relationship with nature.
Chestnut identified some Limitations (theme 4) of the approach. One limitation included
a lack of receptivity to nature-assisted psychotherapy. “People don’t come to you with that as
one of their mental health goals, to heal their relationship with nature.” He acknowledged that
some progress is being made, but that there is “…a huge, what they call in the sociology
business, cultural lack, in terms of really understanding what this is all about. And that creates all
kinds of challenges…” Chestnut noted that the public has struggled to understand this practice
and why nature assisted psychotherapy may be beneficial to them.
The fourth overarching theme to emerge was Motivations for Using Nature, which
included theme 1, Life Changing Experience in Nature, and 2, Intellectual Exploration. I was
moved to hear Chestnut’s description of the spiritual experience that shifted his worldview and
compelled him to start incorporating nature into his counseling practice. “So my backpacking
experience became a vision quest and the key to that was finding a personal power spot, where
you walk into the wilderness until you find your place in nature.” He stated, ”If you get a major
personal experience that reorients you and your belief systems about how the world functions
and how it can be healing in different ways, you want to share that with the world.”
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Through research and personal exploration with clients, as explained in theme 2,
Intellectual Exploration, Chestnut wrote a self-help book on how to incorporate nature into the
lives of clients to share with others the gifts he had received on his vision quest. His book is “a
self-help book, or helping translate to the general public about how they might experience nature
as, as I would call it, a living subject an I-thou, rather than a natural resource, as an ‘it,’ as
something to be exploited.”
The final and fifth overarching theme to emerge was Benefits, which included two
themes: 1, Counselor/Client Relationship; and 2, Client Liberation. Chestnut stated that the most
important benefit that emerges in his practice is the Counselor/Client Relationship (theme 1).
I guess my origins and beliefs are that it comes out of an intimate I-thou
relationship with a very talented, loving and well-trained therapist, who can help
people process their life experiences in ways that they can heal, and learn to live
lifestyles that are nurturing rather than destructive.
Chestnut’s desire is to create a relationship with clients, extend that relationship to encompass
nature (if the client so desires), and ultimately help clients facilitate change in their lives. In
theme 2, Client Liberation, he espoused that,
I think if we’re good therapists, people get liberated, that ways they’ve been
stopping themselves or undermining themselves or trying to please other people
or, all of those barriers can be handled in such a way that you’re just liberated,
you can go and lead your life.
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Madrone
Madrone holds a Ph.D. and is a Licensed Professional Counselor in Oregon. The type of
counseling he practices is called eco wellness counseling. Madrone has been counseling for five
years and has been incorporating nature into his practice for three years. We completed the
interview through video conferencing software called Google Hangout. Madrone indicated that
eco wellness is a topic he has been actively researching for many years. He has created and is
conducting research on an eco wellness model. He had a well-articulated research agenda,
theoretical perspectives, and practical knowledge related to eco wellness. His case yielded 13
themes and 5 overarching themes (see Table 5).
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Table 5
Overarching Themes and Themes for Madrone
Overarching Themes
Themes
1. Beliefs About Human Connection with
Nature
1. Humans Have an Inherent Connection with
Nature
2. Nature Connection Can Help improve
Holistic Wellness
2. Major Tenets
1. EcoWellness
2. Intentionality and Assessment
3. Collaborative, Co-Creative Process
3. Training
1. EcoWellness and Counselor Training
Programs
2. Confidentiality
3. Minimizing Physical and Psychological Risk
4. Motivations for Using Nature
5. Benefits
1. Personal Healing in Nature
2. Personal Disconnect From Traditional,
Indoor Counseling
1. It is Beneficial to Spend Time in Nature
2. Relationship Helps Clients Shift Core
Beliefs
3. Externalized Focus Decreases Stigma
One of the first things I noticed about Madrone as we began the interview was his strong
professional identity as a counselor and counselor educator. He frequently mentioned that he
focuses on strengths, wellness, and a holistic approach to counseling. Madrone lives in Bend,
Oregon, which he described as picturesque and packed with hiking trails. His unique location
allows him to connect with nature and his clients in a way that might be impossible in a larger
city. It was snowing on the day of our interview, which was pleasant for me, as he was able to
turn his camera toward the window in his office to show me the towering trees and silently
falling snowflakes.
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The first overarching theme, Beliefs about Human Connection with Nature, illuminated
Madrone’s strong views about human relationships with nature. In theme 1, Humans Have an
Inherent Connection With Nature; he acknowledged his belief in the ecopsychology movement,
as well as the biophilia theory, or the belief that humans have a natural, evolutionarily emotional
connection to nature (Kellert, 1993). “I really identify with the eco-psychology movement, in
particular, Biophilia…I think that we have a pretty strong intrinsic connection with the natural
environment.”
He also stated his belief in a holistic connection people share with all things, including
nature, which is portrayed in theme 2, Nature Connection Can Help improve Holistic Wellness.
“Another foundation of it is really in line with counseling philosophy, which is, we’re all holistic
beings, we’re all connected with ourselves, other people, other living organisms, non-living
organisms, and our connection with nature is one avenue of that.”
Overarching theme 2, Major Tenets, emerged when Madrone illustrated the definition
and structure of eco wellness counseling. One of the unique aspects of Madrone’s practice is that
he sees clients almost exclusively outdoors after the initial assessment. Unlike other participants
who included both indoor and outdoor sessions in their therapeutic model, Madrone is focused
on spending his sessions in nature as frequently as possible. He stated that many people seek his
services when other types of traditional psychotherapy have been unsuccessful.
He defines eco wellness (theme 1) as, “one’s sense of appreciation, respect for and of, the
natural environment, contributing to one’s sense of holistic wellness. I think even a precursor to
that is connecting with ourselves, others, and the natural environment.” He believes that greater
health and wellness can be achieved when people respect and connect with nature. He views
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nature as a co-facilitator in the therapeutic process, and conveyed that the interaction among the
counselor, client, and natural world can bring rich information into the counseling relationship.
Madrone was adamant about Intentionality and Assessment (theme 2) as a major tenet of
eco wellness counseling.
I think I spend probably at least two sessions [in assessment], the first session is
always spent indoors, about an hour and a half. The second session typically
happens outside, but still the assessment really kind of continues on and just really
exploring, ok, if we’re doing this, if you and I are working together, how are we
going to be intentional with what we’re doing out here?
Client and counselor goal alignment and assessment of progress throughout the counseling
process are important to Madrone. He also discussed the ethical importance of intentionality in
his eco wellness counseling practice. Madrone actively writes in-nature interventions and goals
into his treatment plans and assesses how nature can be applied to serve each client in a deeply
meaningful way.
Theme 3, Collaborative, Co-Creative Process, illuminated the nature of the counseling
relationship. Madrone identified the counseling relationship as a co-creative process in which the
client and counselor work as equals to set goals, achieve milestones, and process feelings.
My role, I see it as being similar to my approach, or my philosophy in traditional
counseling. I call it counseling, not therapy, because to me it’s a real co-learning
process, where we’re collaborative, I’m an expert on the process, I see myself, as
I have something unique, or special to offer with eco wellness, and maybe
different ways of addressing core beliefs and helping people change, but the
person is an expert on themselves.
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Madrone’s approach respects the inherent strengths of clients and their ability to self-direct
change, with the help of a caring relationship with a counselor.
He extends the co-creative nature of the counseling process to the natural world and the
incorporation of nature into the counseling process. “I see nature as like a co-facilitator in the
process….I’m trying to facilitate a connection with the natural environment that can bolster and
catalyze healing.” Madrone described multiple relationships occurring in orchestration with one
another. The relationship that the counselor has with the client, the relationship that the counselor
and client have with nature, and the relationship that the counselor and client have with
themselves in nature all affect the counseling process, motivating the client and counselor into a
mutual process of change.
Training and Ethical Concerns addressed in overarching theme three, included three
themes. Theme 1, EcoWellness and Counselor Training Programs, refers to his opinion that eco
wellness could be infused throughout the curriculum in counselor education programs due to the
profession’s broad focus on wellness. Theme 2, Confidentiality, and theme 3, Minimizing
Physical and Psychological Risk, are other important issues related to training that Madrone
addressed. Madrone identified how he manages limitations to confidentiality (theme 2), and how
he minimizes and discusses risks with clients (theme 3) before developing a specific treatment
plan for them. “Thinking about it, there’s a lot of time I spend upfront with my clients on the
phone and in person, exploring their…any kind of trauma or fears associated with the natural
environment, talking about medical illnesses, any allergies people have, concerns about
confidentiality…” Madrone utilizes thorough assessment to address concerns and limitations
related to physical risk and confidentiality. Finally, Madrone pointed out that because few people
are practicing eco wellness, most trainers will be learners themselves. He stressed that
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intentionality is one of the most important aspects of the practice to impart to trainees. The more
intentional the intervention, the more ethical and effective it is likely to be.
When asked why he started using this type of practice, Madrone explained why
counseling in nature was a better fit for him than counseling indoors. The two themes included
in overarching theme four, Motivations for Using Nature, are: 1 Personal Healing in Nature; and
2, Personal Disconnect from Traditional Indoor Counseling. Madrone has relied on nature for
personal healing throughout his life (theme 1). He became intrigued by the thought of using
nature in counseling when he realized that people were sharing personal things with him in
nature settings.
Nature has been part of my own healing and part of my own development.…When I
started to get intrigued by it, I was doing some fly-fishing teaching in Alaska for a
number of summers. And when people got on my boat, they just started to open up.
Madrone realized that the nature setting itself, combined with a caring relationship, facilitated
sharing even outside the counseling relationship. He kept this experience in mind throughout his
counselor training program and started infusing eco wellness concepts into his practice as soon
as he had the chance. He felt disconnected to the traditional talk therapy model.
I think my connection with the natural environment, my lack of connection with
traditional counselors and therapists and psychologists, also myself as a
developing clinician, I didn’t feel very connected…[to], what at times felt like a
contrived space of being inside.
He explained that some people, like himself, can feel more comfortable outside an office,
particularly if they have felt intimidated or stigmatized by the traditional counseling space.
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Benefits are addressed in overarching theme five. Theme 1, It is Beneficial to Spend Time
in Nature, reiterates that exposure to nature improves peoples’ mood, which is supported by
research. Madrone states, “…the quantitative research is so clear on just how beneficial it is to
be exposed to a natural environment for 10 or 15 minutes or 30 minutes, in and of itself [for
improved mental health outcomes].”
Other benefits of spending time in nature, according to Madrone, included improved
views about the self, a change of core beliefs, and improved attention span. These benefits are
discussed in theme 2 Relationship Helps Clients Shift Core Beliefs, and 3, Externalized Focus
Decreases Stigma.
Clients feel better about themselves, they feel more effective, their core belief
shifts from, ‘I’m not worth it, to I’m worth it some percentage of the time. You
know, before I thought I was completely unlovable, you know what, maybe I am
lovable. Or you know what, I am lovable.’
Madrone believes that this shift occurs primarily due to the relationship. He described how he
believes change occurs.
I’m still a strong believer in the relationship. I think that ultimately it’s the counseling
relationship that impacts the chang, but I also believe that then translates, and is
connected to one’s connection with the environment, or with how they’re conceptualizing
nature as well.
The relationship that the client and counselor have with nature can also enhance the
relationship between counselor and client. Theme 3, Externalized Focus Decreases Stigma,
elucidates the decreased stigma that being outside can inspire. He indicated that being in a free
space and walking side-by-side instead of face to face can take the pressure off of the expectation
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to share. “…When we get outside there’s just something that’s very liberating and freeing about
that, where there is not as much of an expectation.” He conveyed that the current culture
discourages some people, men in particular, from sharing their feelings. He believes that for
some clients in traditional counseling, sitting with a counselor with the expectation of sharing
personal details about their lives can seem foreign. He noticed that his clients feel less pressured
when in a neutral outdoor space he described as “freeing.”
Orchid
Orchid is a Licensed Clinical Social Worker in the Bay Area of California. Her practice is
called nature assisted psychotherapy. Orchid has been a social worker for three years, and she
has been incorporating nature into her practice for two years. Orchid opted to be interviewed via
Face Time. Orchid started her career as a wilderness therapist and guide. Her experience as a
wilderness therapist inspired her to go to school for social work. Orchid chose to be interviewed
via FaceTime. Her interview yielded 11 themes and 5 overarching themes (see Table 6).
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Table 6
Overarching Themes and Themes for Orchid
Overarching Themes
Themes
1. Major Tenets
1. Nature and Mindfulness are Tools
2. Garden is a Therapeutic Space
2. Cognitive Behavioral Therapy
1. Theory and How Change Occurs
2. Therapist’s Role
3. Motivations for Using Nature
1. Wilderness Therapy Experience
2. Personal Healing that Occurred in Nature
4. Training
1. Need Specific Training
2. Ethical Issues
3. Limitations
5. Benefits
1. Alternative Perspectives Gained by Utilizing
Nature
2. Mood stabilization
Orchid practices cognitive-behavioral psychotherapy (CBT) and incorporates elements of
nature into her counseling practice while providing a safe space for therapy. Her use of
mindfulness stood out in the interview. The first overarching theme, Major Tenets, described the
structure of Orchid’s practice. Orchid began conceptualizing her practice through her experience
as a wilderness field counselor. She refined the tenets of nature assisted psychotherapy in an
ecotherapy certificate program. Theme 1, Nature and Mindfulness are Tools, was explained by
Orchid: “so… I use both mindfulness and the nature-assisted work, as a tool within a CBT
framework.” Nature and mindfulness serve as adjunctive tools to the primary work, CBT.
Theme 2, Garden Is a Therapeutic Space, emerged when Orchid described the importance
of the garden space she uses for therapy.
One important component for me is having a healthy natural setting in which to
practice. So I actually feel that it’s really important for the way I practice to not
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just use metaphorical representations of nature, but to be actually in nature, and in
a healthy natural system.
She provides clients the option to sit inside her home-based office or in the garden, based on
their comfort level with either setting.
Overarching theme two, Cognitive Behavioral Therapy (CBT), was mentioned
throughout the interview. Theme 1, Theory and How Change Occurs, is described.
So in the way that I practice, the primary change agent isn’t necessarily nature
itself, it’s really the CBT model, so in that model, change occurs through
examining faulty patterns of thought and dysfunctional behavior patterns, and
then challenging those or looking for alternatives.
She reiterates in theme 2, Therapist’s Role, that she adheres to the role of a CBT therapist. She
sees herself as “being a collaborator, coach, subject-matter expert, an empathic listener, all of the
things that a regular CBT therapist would be.” With regard to the use of nature and mindfulness,
she models helpful mindfulness exercises and ways to capitalize on the benefits of spending time
in nature.
Orchid described her passion for the outdoors and her life experiences that influenced the
decision to incorporate nature into her practice. In overarching theme three, Motivations for
Using Nature, and theme 1, Wilderness Therapy Experience, Orchid explained these
inspirational life experiences. “I worked as a field counselor [wilderness guide], so this was
before I got my master’s, and that’s actually what prompted me to get a master’s in social work,
because I was interested in becoming a therapist at one of the wilderness therapy programs.” She
was inspired by the work she was doing at the wilderness therapy site and had aspirations of
becoming a wilderness therapist.
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My vision of becoming a therapist was really to do wilderness-based work with
people. So I think I came to it through a little bit of a different route than most
people. It’s been pretty integral to my orientation from the beginning.
Though she eventually took a different path, the training and inspiration she received through her
wilderness counselor experience is relevant to her practice today.
Orchid articulated that another motivation for using nature in therapy stems from her own
personal healing in nature, as explained in theme 2, Personal Healing that Occurred in Nature.
When asked about her motivations for using nature assisted psychotherapy, she stated:
“…Nature has been a really powerful healing place for me, so I believe that it can be for others
too, maybe not for everyone, but for a lot of people. So I just wanted to share that resource with
others.”
Training, overarching theme four, includes three themes: 1, Need Specific Training; 2,
Ethical Issues; and 3, Limitations. Orchid shared that because the practice of incorporating
nature into psychotherapy is so new, practitioners Need Specific Training (theme 1) and could
benefit from more clarity and definition. “I think it would be helpful if people who are interested
in this field could go into a training program knowing what it is that they’re going to learn and
knowing what it is that they want to learn.”
Orchid articulated some Ethical Issues (theme 2) that pertain to incorporating nature into
psychotherapy. Her biggest concerns are related to physical safety of clients and the need for
therapists to carry appropriate insurance. “So I have a concern that a lot of people who are doing
this work don’t have the training as outdoor leaders to deal with medical emergencies if they
come up. They’re not carrying accurate insurance.” Her wilderness therapy experience informs
her view, as she made these points about the pertinence of training therapists in developing
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emergency action plans, of having applicable and appropriate insurance, and of coordinating
with local land agencies to make the experience as legal and safe as possible for clients.
Theme 3, Limitations, addressed a limitation that could be addressed in training. The
uniqueness of being in nature, while beneficial, can cause some concerns with regard to
protecting client confidentiality. Outside public space is often located in the city.
I’m in a city and so even though it’s a private garden and I’ve taken pains to kind
of block the view from any of the other houses, still the sound could carry..... So
that is a limiting factor, …but it’s just kind of what it is and so it’s just
depending on people’s comfort level whether they want to sit outside or not.
She gives clients the option of choosing to be outdoors or in her indoor, confidential therapy
space as a way to deal with the inability to provide total confidentiality to her clients.
After clarifying her perspectives on training, Orchid provided opinions about the Benefits
of her practice in overarching theme five. In theme 1, Alternative Perspectives Gained by
Utilizing Nature, Orchid stressed that nature is a tool for helping clients gain perspective on a
problem or situation.
I think what makes it different is that it allows for opportunities that wouldn’t be
present in a traditional therapeutic environment, for clients to gain perspective on
their difficulties. So maintaining a sense of connection to a healthy world, outside
of the treatment room, and allowing them to see alternatives to the problem.
Orchid believes that nature is beneficial for Mood Stabilization (theme 2).
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I think it’s a really powerful tool for self-soothing, for anxiety management, and
on the other side, I think for people that are hyper-aroused, it can help to bring
down the level of arousal, and people who are experiencing depression or like
suboptimal levels of arousal, it can actually help to invigorate and energize.
Camellia
Camellia is a Licensed Professional Counselor and Licensed Marriage, Family and
Couples Therapist in Florida. She has a private practice and does not have a name for her nature-
based counseling practice. Camellia has been incorporating nature into her practice for the entire
nine years she has been a counselor. Camellia chose to be interviewed by phone. She was
inspired to start using nature in her practice years ago, after taking a course in spirituality,
creativity, and holistic wellness. She now teaches the course. She also shared that her identity
influences her decision to infuse nature into her counseling practice. Her case yielded 12 themes
and 5 overarching themes (see Table 7).
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Table 7
Overarching Themes and Themes for Camellia
Overarching Themes
Themes
1. Beliefs About Human Connection with
Nature
1. There is Therapeutic Value in Nature
Connection
2. Our Bodies are Part of Nature
2. Counselor’s Role
1. Counselor is a Co-Journeyer or Co-
Adventurer
2. Facilitator of Immediacy
3. Major Tenets
1. Use of Metaphor
2. Utilizing the Senses and Guided Imagery
3. Sand Tray
4. Ethical Concerns
1. Physical Safety
2. Not Pushing Nature Agenda
3. Limitations
5. Benefits
1. Vulnerability
2. Discovering Personal Strengths
Camellia’s work includes use of experiential and creative techniques with clients. She
includes nature metaphors and outdoor activities in her repertoire. Her view of human connection
to nature also influences the way that she practices.
Camellia believes that spending time in nature has always been beneficial for humans, as
is expressed in overarching theme one, Beliefs about Human Connection to Nature. Theme 1,
There is Therapeutic Value in Nature Connection and theme 2, Our Bodies are a Part of Nature
were addressed when she stated, “I think that the therapeutic value of being in nature has been
prevalent since the cave peoples. It’s just based on who we are, we are part of nature.” Camellia
highlighted her belief that Our Bodies are a Part of Nature when she discussed her reasons for
using guided imagery techniques with clients. She stated, “So the guided imagery is just taking
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you into the present moment and connecting with your body, which, our bodies are part of
nature.” She believes that by accessing the body, she is accessing a part of nature.
In Overarching theme two, Counselor’s Role, Camellia defined the role of the counselor.
In theme 1, Counselor is a Co-Journeyer or Co-Adventurer, she described the role of the
counselor. “To be both a guide and also just to be with them [clients] and moving them along,
someone who could point things out along the way or deepen the experience that they’re on, like
a co-journeyer, co-adventurer.” She views the counselor’s role as that of an insightful facilitator
of experiences that encourage growth and change. She also views her role as a Facilitator of
Immediacy (theme 2). “I think that nature-based therapy really helps you to be in the present
moment. …You integrate the present moment into the past or the future or whatever it is that
you’re trying to deal with.”
Camellia illustrated the ways she incorporates nature into her practice in overarching
theme 3, Major Tenets, which included themes 1, Use of Metaphor; 2, Utilizing the Senses and
Guided Imagery; and 3, Sand Tray. Although Camellia resisted the urge to define her practice,
she did share some common core experiences that she often provides in her work. “How do I
define it? I don’t really define it, I just offer experiences.” She facilitates moments of “…
metaphor, present-moment awareness, and trust in utilizing the senses.” Camellia’s focus is on
creating experiences that help clients explore their concerns through the senses, immediacy, and
the use of metaphor.
Theme 2, Utilizing the Senses and Guided Imagery, occurred frequently throughout the
interview. Camellia disclosed that two primary ways she utilizes the senses and bodily awareness
are through guided imagery (theme 2) and the use of Sand Tray (theme 3). She allowed me to
personally experience a guided imagery exercise that she uses frequently with clients, to provide
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an example of how she helps clients become aware of the senses (theme 2). As we discussed the
exercise, she harkened back to an image she used in the activity by asking me, “Do you feel like
you got a little message from a bird?” Though I didn’t receive a metaphorical message from a
bird, I became more aware of my own body, and got a clear sense of how she incorporates nature
into her counseling practice even when she is indoors.
Sand Tray, theme 3, is a major way that Camellia incorporates nature into her counseling
practice. Camellia keeps the sand tray in her office in a specific spot to help facilitate a
connection with nature for her clients. She believes that the sand tray is therapeutic.
I believe that it’s very calming and soothing. Sand just really has a wonderful
temperature, and it’s very therapeutic…even if they don’t put anything into the
sand, to just kind of run your hands through, as you’re talking, it has this, just
really powerful, subtle, kind of indescribable effect, it’s not even known or overt,
it’s just happening by having the sand there.”
In overarching theme four, Ethical Concerns, Camellia identified ethical concerns that can occur
when incorporating nature into counseling. Because she works with adolescents, the first ethical
concern she expressed was related to the Physical Safety of clients (theme 1). She explained that
sometimes she engages in challenge activities with adolescents, and she worries that they may
get hurt by engaging in risk taking activities when they are outside of session. She stated, “I
don’t want to empower them to the point that they think that they can disregard safety. I want
teens to engage in activities for their benefit, rather than doing something just because it’s scary
and illegal or something.”
Camellia is also mindful about making sure not to push her own nature agenda, as is
expressed in theme 2, Not Pushing Nature Agenda. She stated, “I think if I was pushing some
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sort of agenda on them because I wanted to do something in nature, like if they really just wanted
to talk, and I wanted to do something more like infusing nature.” Focusing on client needs is
paramount for Camellia, and she is mindful not to engage in nature-based techniques if they do
not serve the client.
Camellia shared the practical limits of nature-based counseling practices in theme 3,
Limitations. She is limited by the specific geographical landscape in which she lives. For
example, she uses many metaphors about mountains, even though there are no mountains in
Florida, where she resides and practices. Another limitation she described in theme 3 is related to
public perception. She stated that not all clients understand or are open to the experiences, which
could hinder counselors’ ability to incorporate elements of nature into their practice. She
attributes this to the possibility that people are afraid to get out of their comfort zones and try
something new.
There are Benefits (overarching theme five) for clients who engage in nature-based
counseling. She shared that Vulnerability (theme 1) and Discovering Personal Strengths (theme
2) are the biggest benefits to nature-based counseling. When asked about beneficial outcomes her
clients experience, she stated, “vulnerability… I think it’s a very healing experience, cathartic
experience to be able to be vulnerable.” Furthermore, she is able to discover the client’s personal
strengths through nature-based counseling (theme 2). She helps clients by “…utilizing the
immediacy of the challenge of the moment or the adventure, to highlight strengths and help them
access their skills.” For Camellia, the keys to change and progress with clients lie in her ability to
help clients feel safe enough to be vulnerable, and focusing on strengths.
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Cedar
Cedar is a Registered Psychologist and research professor in Australia. He has been a
psychologist for 30 years and has been incorporating nature into counseling for 25 years. As an
academician and professor, Cedar’s research agenda is focused on nature-based experiences and
health. He has a background in mountaineering and canoe instruction, and has engaged in a
variety of extreme outdoor sports. Cedar’s life experiences and professional opportunities led in
a natural progression to the infusion of nature-based counseling techniques into his practice.
Cedar loosely refers to his form of nature-based counseling as “the psychological benefits of
nature-based experience.” Cedar is a researcher and trainer of therapists and researchers
interested in infusing nature and elements of nature into counseling. This case yielded 14 themes
and 6 overarching themes (see Table 8).
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Table 8
Overarching Themes and Themes for Cedar
Overarching Themes
1. Beliefs about Human Connection with
Nature
2. Major Tenets
3. Motivations for Using Nature
4. Benefits
5. Boundaries
6. Training
Themes
1. We are a Part of Nature
2. Humans Have Lost Their Relationship
With Nature
1. Three Dimensional Structure with a
Number of Continuums
2. Representative Design
3. Relationship among Participants,
Training and Environment
1. Pastoral Upbringing
2. Professional and Outdoor Sports
Training
1. Both “in-vivo” and Synthetic Nature
Benefits Mood and Physical Health
2. Nature Changes Relationship Dynamic
1. Questions Traditional Psychotherapeutic
Boundaries
2. Multicultural Implications
1. Need for Specific Training
2. Ethical Concerns
3. Limitations
Cedar has been defining and researching the ways in which nature-based experiences can
connect with psychology practice for his entire career. When discussing the origins of nature-
based experiences, he harkened back to an earlier time in human history when humans were
intrinsically more connected to nature. It began in prehistory “…when we experientially
appreciated that relationship and how we were part of something larger, that’s where it started.
It’s been utilized in so many different ways in so many different cultures over the years.” He
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believes that humans have appreciated and recognized their connection to nature since before
recorded history.
His belief about the origins of nature-based experiences connects directly to overarching
theme 1, Beliefs about Human Connection with Nature. He believes that We Are a Part of Nature
(theme 1).
You very much realize that you’re part of the larger world, not connected to it,
because connected to it still sort of suggests that you’re separate from it, in the
same way you wouldn’t say “I’m connected to my arm”. You’re part of your arm
or your arm is part of you, so I think that some of the current dialogue is a little bit
strange at the moment, but you realize experientially that we are part of the
natural world.
He explained that, through industrialization and domination of the natural world, humans have
gradually separated themselves from nature. He believes nature-based experiences help people
reorient themselves with the natural world. He describes Theme 2, Humans Have Lost Their
Relationship with Nature:
And then gradually, as we tamed ourselves more, became less and less, or we
tried to control the environment more, we considered ourselves more and more
“other” to the environment, less and less part of our own particular environment.
Cedar lamented that humans’ relationships with nature have diminished through domination and
isolation from nature. This sentiment fuels his motivation for connecting nature experiences with
mental health and wellness.
Major Tenets (overarching theme two) explained the structure that defines his practice.
The sophisticated design for his practice encompasses the potential for a wide variety of
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experiences. He described the experience in theme 1 as a Three Dimensional Structure with a
Number of Continuums. Cedar’s three-dimensional structure includes adventure, physical
activity, and engagement with the natural world. Each of the three aspects of nature-based
experiences function on a continuum, allowing for considerable or very little engagement in each
domain. He provided an example of how the continuum might manifest in his work:
Another continuum that keeps this three-dimensional figure in place is the
physical activity continuum and that rolls right from standing to rigorous physical
activity. Again, depending on the context, if you’ve got a group of young people
then you might want a more physically active type of environment, but you might
have a very sedentary environment if you’re working with older people, or you’re
working in a different way with somebody, again sitting under a tree or something
along those lines.
He shared that many interventions are possible within the three continuums, and that the level of
adventure, physical activity and engagement with nature can vary, depending on the dynamics
present. Examples of possible activities he provided included mindfulness activities in nature,
climbing a tree, taking a walk, or engaging in a solo (a survival challenge activity).
The intensity of the activity can vary. This applies to the level of physical activity and
engagement with the natural world. Other examples of this structure might include sitting under
a tree and conducting counseling session, physical activity, or meditation on a mountain, with a
therapeutic goal attached to the intention of the activity. His definition also included what he
calls Representative Design (theme 2), which he defined as “creating a structure that represents
their [clients’] psychological and emotional life outside the therapeutic context.” This is another
way of engaging in thorough assessment, and applying the needs of the client to the design of the
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intervention, so as to incorporate the needs and specific concerns of the client into the treatment
plan.
Theme 3, Relationship among Participants, Training and Environment, addressed other
elements that can define nature-based experiences. Cedar explained that both the therapist and
clients are affected by the environmental elements present, in addition to the counselors’ level of
training. For instance, a mountaineer and a hiking expert might provide different experiences
than a therapist without formal outdoor training, just as a social worker might provide something
different than a psychologist or licensed professional counselor. Therefore, an experience is
created by the interplay among the training the therapist has received, the unique elements that
the participants bring to the experience, and the elements present in the natural environment.
Cedar described his Motivations for Using Nature in overarching theme three, and
provided information about his personality and background in theme 1, Pastoral Upbringing.
Cedar was born and raised on a farm in Wales, so he was immersed in nature from the time he
was very young. The experience helped him understand the rhythms of life in a unique way.
Okay, so I reckon the people that are important in my particular experience of this
and how to utilize it are my parents, my grandparents and people like that, who
actually, whether they realized it or not, facilitated this connection for me, this
sort of connection between, I don’t mean connection to the natural world, I mean
connection between the fact that being part of, the natural world actually has
benefits beyond having fresh air etc., that it has a broader benefit.
He reflected on his love of nature immersion, which has led him to attain a variety of adventure
certifications such as his mountaineering and canoeing. As addressed in theme 2, Professional
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and Outdoor Sports Training, his desire to merge psychology and nature formed his practice and
research agenda.
I actually started getting involved through my expertise in outdoor leadership and part of
doing that, part of the process of being in that kind of environment meant that I was often
working with people who were utilizing the outdoors in a therapeutic way; and then
alongside that because I was training as a psychologist as well, the two kind of aligned
and linked up.
Cedar chose to combine his passions and the insights he received through his outdoor leadership
experience to create a career that combines research, clinical practice, and training pertaining to
infusing nature-based activities into counseling practice.
The Benefits of his practice (overarching theme four) are numerous. He described
physical and mental health benefits associated with spending time in nature. In Theme 1, Both
“In-Vivo” and Synthetic Nature Benefits Mood and Physical Health, Cedar described:
There’s enough evidence out now that shows that things like self-esteem can be
enhanced, there’s enough evidence to show that it works for anxiety, depression is
possible, youth at risk, kind of all those multiple issues. There’s people I know
working on complex trauma…, there’s even research out there that shows these
kind of experiences are beneficial for a kid with ADHD, anger issues, all sorts of
things can be utilized within this kind of broad context.”
Cedar also suggested, in theme 2, that Nature Changes the Relationship Dynamic.
What the natural world does, is it provides opportunities to experience things
whilst you’re doing it that can be utilized in the therapeutic relationship. So two
people going for a walk in a park, their relationship is instantly, immediately
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different, than if two people are sitting in a room that’s already set up, you sit over
there, I sit over here…
He continued to discuss how the relationship is changed through activities in nature, mainly by
mitigating the power dynamic.
…The relationships are different. You know, a multi-day activity where you are
with each other 24 hours a day, you rely on each other, so you’re not sitting as the
expert in this particular area, listening to this person, but you’re both in situations
where you’re both challenged, and you’re both supporting each other to get
through at the other side. It’s a different kind of relationship.
The mutual dependence that can occur when engaging in adventure challenge type activities can
be therapeutic, by creating an egalitarian relationship as opposed to the expert and patient role
dynamic.
Cedar had strong opinions about Boundaries in psychotherapy (overarching theme five),
Theme 1, Questions Traditional Psychotherapeutic Boundaries, challenges the structure of the
“talk therapy” model. “Sometimes I wonder whether the artificialness of the boundaries that we
create in the therapeutic room, actually make that process harder.” Cedar presumes that more
sincere connection can be facilitated through nature-based experiences. In theme 2, Multicultural
Implications, he questioned the western model of therapy and acknowledged the wide array of
healing practices that occur in various cultures.
In many societies, in many cultures, the way that the psychological therapy is
undertaken, is in a completely different format. So this idea that we have in the
Western world of somebody who calls themselves an expert, to sit in a room and
work with you and then somehow you’ll be fixed, is relatively new, relatively
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Western, and you know, isn’t in fact the best way of doing it.
Cedar recognizes many cultural perspectives on healing that are not regarded in the Western,
traditional, therapeutic model, and explained his opinion regarding the benefits of engaging in
nature-based experiences.
In overarching theme six, Training, Cedar asserted the Need for Specific Training, which
should be offered at the university level (theme, 1), “because at the moment, the paradigms we
are exploring regarding working with clients are indoor paradigms, technique-based paradigms,
that may not fit this particular context.”
In theme 2, Ethical Concerns, Cedar conveyed some of his concerns related to a lack of
counselor awareness regarding personal limitations in nature and adventure challenge settings.
His concern is that if clinicians do not have proper training for outdoor activities in addition to an
awareness of their personal limitations, the excursion will be about the clinician and not the
client.
We have people who don’t have those skills go out on a multi-day thing and they
end up being the ones that the instructors have most of the struggles with, because
they can’t cope with multi-day expeditions, …and you know that self-awareness,
is a struggle because psychologists are trained to be experts, whatever that means,
and you’re putting yourself into a context where you’re not [the expert].
Another concern that Cedar shared was the overuse of activities in nature as a substitute for true
clinical substance. “So that becomes a crutch. When you’re working in this kind of environment,
you need to have enough knowledge and experience and expertise where the technique is
secondary.” Cedar believes clinicians must have proper training in both nature-based experiences
and clinical counseling, to provide ethical services to clients.
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The Limitations that Cedar identified (theme 3) included a lack of public or governmental
support. “There isn’t that sort of social support behind it to, you know, Government policies etc.
don’t support it, in a really sort of open way.” He also shared that it is difficult to get appropriate
insurance that covers both psychotherapeutic practice and nature-based experiences.
Blue Gum
Blue Gum is a Registered Clinical Social Worker in Australia. He has a private practice
that offers wilderness and adventure therapy expeditions in addition to outdoor counseling. Blue
Gum has been facilitating adventure therapy expeditions for 10 years, and has been a trained
social worker for the past six years. Blue Gum chose to be interviewed via Skype. Blue Gum
calls his practice nature infused social work, or adventure therapy.
Blue Gum was inspired to start using adventure therapy after working in an adventure
challenge character development program for adolescents. His experience inspired him to get his
master’s degree in social work and to continue to enhance his skills in a Ph.D. program. His case
yielded 11 themes and 5 overarching themes (see Table 9).
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Table 9
Overarching Themes and Themes for Blue Gum
Overarching Themes
Themes
1. Major Tenets
1. Adventure and Nature-Based Activities
2. Relationship Focus
3. Utilizes Metaphor
2. Counselor’s Role
1. Strength’s Based Approach
2. Facilitator of Adventure Challenges
3. Training
1. Defining Adventure Therapy
2. Appropriate Clinical Training
4. Motivations for Using Nature
1. Career Experience
2. Aligns With Personal Values
5. Benefits
1. Engaging
2. Reduces Resistance
Overarching theme one, Major Tenets, addresses the major foci of Blue Gum’s practice.
Blue Gum’s practice consists exclusively of adventure expeditions and counseling in nature.
Theme 1, Adventure and Nature-Based Activities, includes adventure expeditions that occur
multiple times a year in a group format, and nature and adventure activities that occur in regular
psychotherapy during other times of the year. Although these outdoors and nature-based
activities are the basis of his private practice, he shared that the most important aspect of his
practice is the Relationship Focus he creates with his clients (theme 2). “I think that really 90%
of what I do is about relationship, and if I can get that trusting relationship, you know, with the
things that we do with kids [adventure based counseling], they’re also really excited to actually
come, and be together and have that relationship.” He shared that the activities in nature can
make the sessions fun and engaging, and that they can enhance the relationship between him and
his clients. In theme 3, Utilizes Metaphor, he described another important component of the
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work that revolves around the use of metaphors with his clients, and he believes that nature
provides an abundance of metaphors.
I think that you can engage in metaphors that are in nature around us all the time…I think
the great thing about a metaphor is that you’re not exactly telling somebody what to do,
how to change, and prescribing some treatment plan, but if you can come up with
metaphor, it’s a bit less confrontational.
Many challenges may become present when clients are camping and engaging in extreme
adventure challenges. The challenges they experience can then be used to highlight an area of
personal growth that pertains to their life outside the challenge expedition.
In overarching theme two, Counselor’s Role, Blue Gum asserted that the most important
role of the counselor is to utilize a Strength’s Based Approach (theme 1). “…the therapist’s
strength is eliciting the client’s strengths. So [a goal is] helping the client come to terms with the
assets or resources they have, in order to put those to good use.” Being in nature, the therapeutic
relationship, and a focus on client strengths are the important change agents in adventure
therapy. Theme 2, Facilitator of Adventure Challenges, focused on the counselor’s role as a
facilitator of adventure in the counseling process. “I think if they can see that we’re genuine
when we’re doing the kind of adventure and outdoors stuff and being outside, that it is different
than that kind of traditional environment.” He finds the adventure challenges engaging for
adolescents, who comprise most of his clientele.
His opinions about Training, as addressed in overarching theme 3, included themes 1,
Defining Adventure Therapy; and 2, Appropriate Clinical Training. He believes that because few
people engage in adventure therapy, and the practice varies so widely, practitioners have
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difficulty Defining Adventure Therapy (theme 1), and determining the Appropriate Clinical
Training to become a nature therapist (theme 2).
I think the adventure therapy industry goes through this all the time with people
wanting to be called adventure therapists, and then what on earth does that mean?
Do I actually need a degree to be called an adventure therapist? And obviously I
think the answer to that is yes, but there’s probably a lot of people that would say,
well I know what I’m doing on the adventure side of things, aren’t I just good
enough to do it?
Blue Gum expressed concern over a lack of appropriate mental health training for adventure
therapists and espoused the importance of specific training, particularly in crisis situations. “…If
someone has an actual episode, or if someone has a panic disorder, or even you know, if a
student presents with suicidal ideation, you really want good training and sound practice with
that.”
Blue Gum discussed his motivating factors for infusing nature into his social work
practice. Overarching theme four, Motivations for Using Nature, addressed the moments of
inspiration that led him to his work in adventure therapy. A confluence of factors in his life
influenced him to serve others as a social worker and specifically as an adventure therapist. In
theme 1, Career Experience, Blue Gum reflected on the work experience that inspired him to
become an adventure therapist. When Blue Gum was 18, he thought he might want to be a fire
fighter, which led him to volunteer after hurricane Katrina in New Orleans. During that
experience, he heard about an opportunity to work with youth who were “at risk.” He spent the
summer involved in the adventure based youth reform camp.
…It actually probably filled a gap in my life more than any of the kids, just
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seeing a whole community of people that worked together and tried to be better
people. I just thought, this is amazing, and it was all in the outdoors, very
metaphor focused, really values based…
This experience inspired him to obtain the social work training to help others. He now runs an
adventure therapy practice in Australia. He also expressed that he was drawn to how genuine the
camp felt. He stated that he feels most genuine when he is practicing adventure therapy, and that
the practice is very much Aligns with [his] Personal Values (theme 2).
The Benefits of Adventure Therapy are described by Blue Gum in overarching theme five.
Blue Gum shared that Adventure Therapy is Engaging (theme 1) and Reduces Resistance (
theme 2). Blue Gum noted that Adventure Therapy engages clients (especially adolescents) in
the therapeutic process.
I think that being outside, being in nature…making the process fun for young
people, they’re not going to be interested in what we have to say or our
processes, if it’s not engaging, if it’s boring and things like that.
His opinion is that if adolescents “buy in” and engage in the process, more effective therapeutic
work can occur. Blue Gum stated his opinion that “I think being in the nature and being outside
and even just doing things together, the experiential side of it, it just, I think it just reduces
resistance a lot.” He believes that the therapeutic alliance is enhanced when engaging in
adventure-based activities. Blue Gum works with adolescents and he believes that the time spent
in nature is one of the key factors to encouraging engagement and reducing resistance in his
work with clients.
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Cross-Case Analysis
After analyzing each case to identify themes and overarching themes, and after member
checking and peer review of themes, I conducted a cross-case analysis of the overarching
themes. This resulted in seven super-ordinate themes that distilled the essence of the shared
experiences of those who practice counseling in nature or infuse nature-based techniques into
their psychotherapeutic practice. The super-ordinate themes are: 1) Major Tenets, 2) Training
and Ethical Concerns, 3) Benefits, 4) Motivations for Using Nature, 5) Beliefs about Human
Connection with Nature, 6) Counselor’s Role, and 7) Spirituality (see Table 10).
Table 10
Cross-Case Analysis of Seven Super-Ordinate Themes from All Participants
Super-ordinate
Themes
Major Tenets
Total
8
Training and
Ethical Concerns 8
Benefits
7
Motivations for
Using Nature
6
Beliefs About
Human Connection 5
With Nature
Counselor’s Role 2
Spirituality
1
Total
Major Tenets
Sequoia Redwood Chestnut Madrone Orchid Camellia Cedar Blue Gum
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
5
3
5
5
x
4
5
x
5
5
The first super-ordinate theme, which emerged for all eight participants, was Major
Tenets. This super-ordinate theme described the most important goals and the basic structure of
each participant’s type of nature-based psychotherapeutic practice. All participants described a
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structure that focused on the relationship between client and counselor and the infusion of nature
into the therapeutic process. Chestnut’s tenets are presented as an example of the structure
described by many of the participants.
I think the four core ingredients are a 1) large ecological, biological context for
therapy, 2), relating to nature as thou, 3), reconnecting with one’s body as a living
organism, and 4) an extraspective approach with sensory awareness, and coming
in touch with your body to balance that tendency to get overly introspective about
your personal concerns.
Sequoia described her beliefs that underlie ecotherapy when she stated, “For me, eco-
therapy involves an awareness that humans are not separate from or superior to the rest of nature
that we’re an integral part of nature.” She described a major goal of Ecotherapy as helping
clients “to articulate their preferred focus of nature connection.” Redwood has a somatic
approach, so she focuses on helping clients connect with their bodies in nature.
Because of who I am and what my orientation is to the world, it’s primarily kinesthetic,
movement oriented… I would say that that’s some of the template that I start with
outdoors, and so, helping people to feel how their body feels next to a tree and then kind
of develop that.
Although the approaches vary, all participants provide psychotherapy in nature, with a focus on
helping clients strengthen their relationship with the natural world. Furthermore, all therapists
shared that the therapeutic process is specific to client needs. As Redwood described, “…it just
feels, it’s very, very specific to their needs and their issues and, so the techniques and the
interventions are just exactly for them.”
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Training and Ethical Concerns
The second super-ordinate theme was Training and Ethical Concerns. All eight
participants discussed concerns about training or ethics, which included identifying limitations of
the approach, as applied to their specific nature-based counseling practice. Although opinions
varied with respect to training, many participants acknowledged the lack of availability of formal
training and the need for further definition of the practice, to ensure that practitioners are
practicing most effectively. Redwood called for modeling, and shared her view that it is
important for trainers to have a deep relationship with nature. “I would say that a huge thing
would be that the person [trainer] has deeply integrated their own relationship with the earth and
that they’re doing it [somatic ecotherapy] on an ongoing basis.”
Limitations, which emerged under the super-ordinate theme, Training and Ethical
Concerns identified by the participants included a lack of knowledge in the psychology
community or the general public about the practice of infusing nature into counseling. When
Redwood was asked about limitations, she asserted: “Oh, that people just don’t know what it is,
you know, it’s like 20 years ago most people didn’t know what the word somatic was, most
people [now] don’t know what the word eco-therapy is.” Another limitation related to
geography, in that that not every therapist has access to favorable weather conditions or certain
geographical landscapes that could be useful in therapy. For example, not every counselor has
access to mountains or the ocean. The therapists also had to deal with the limitation that this type
of counseling practice is an inappropriate fit for some clients. Madrone noted “…like any
approach, a limitation is that it’s not a good fit for everyone.”
Major ethical concerns addressed by participants included confidentiality, managing
physical and emotional risks, and not pushing a nature agenda on clients who do not desire to
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engage in nature-infused practice. Some suggestions for mitigating these concerns were utilizing
thorough assessments and using informed consent to screen for physical and psychological
barriers that might prevent the client from engaging in nature-based activities. Additionally,
many participants stressed the importance of making plans to address barriers to confidentiality
before taking clients outdoors. Madrone had some pertinent insights with regard to addressing
the balance between the benefits of engaging in nature-based practice for clients and the
therapist’s desire to infuse nature into therapy. He expressed his ethical concern as the question
of “how much of this is my own agenda?” It was important to him that he work to separate and
distinguish his own healing in nature from that of the client. The outcome, as he expressed it, is
that “I typically walk away feeling…really good about that, I feel like it was focused on the
client and as a byproduct, I get to learn and grow too.” Madrone believed that, with self-
awareness, clinicians can be mindful when offering potentially beneficial nature-based
counseling, without pushing an agenda that is not in the best interest of the client.
Benefits
All participants except Redwood shared the super-ordinate theme of Benefits of Using
Nature-Based Counseling. Benefits included improved mood, enhanced counselor client
relationship, and decreased stigma. Orchid discussed the benefits of spending time in nature. “So
I think it can be really helpful for self-regulation, for mood stabilization, along with exercise…”
Cedar discussed how the relationship dynamic is shifted by incorporating nature into the
counseling session. “I think one of the major benefits is that ”…it repositions the relationship….
But also what the natural world does is it provides opportunities to experience things…that can
be utilized… in the therapeutic relationship.” Madrone believed that stigma is decreased and that
people open up more easily in nature. He stated that most of his clients have tried traditional
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counseling, but that it wasn’t a good fit for them. He noted that “there is a stigma associated with
traditional counseling services, and they just don’t want it, they want something different; they
like walking side by side, or sitting facing the river, or looking at the mountains or whatever.”
Motivations for Using Nature
Throughout the interviews, it was apparent that participants had strong motivating factors
for beginning to incorporate nature into their practice, which is reflected in the third super-
ordinate theme, Motivations for Using Nature-Based Counseling. Six participants (all except
Redwood and Camellia) described motivating factors that influenced their practice. The three
most common motivators were personal healing in nature, work opportunities in nature that led
participants to choose the work, and consumption of research and intellectual materials that
inspired participants. Six of the eight participants described a personal moment of healing that
occurred for them in nature, which motivated their use of nature-based counseling. Chestnut’s
personal moment of healing in nature was a Vision Quest he took in the mid-1980s. The
experience reoriented his identity and place in the world. He noted that, “If you get a major
personal experience that reorients you and your belief systems about how the world functions
and how it can be healing in different ways, you want to share that with the world.” This was a
common sentiment among the participants. They wanted to change the lives of their clients, and
they believed that infusing nature into their practice might help clients in a manner similar to
how they were personally helped by spending time in nature.
Other sources of motivation included professional opportunities that helped participants
make a connection between healing and nature, and intellectual connections about the benefits of
infusing nature into counseling by staying abreast of research. Madrone explained the moment
that he connected his personal healing in nature with the potential for helping others.
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Nature has been part of my own healing and part of my own development….When I
started to get intrigued by it, I was doing some fly-fishing teaching in Alaska….
When people got on my boat, they just started to open up…
Madrone has had mentoring opportunities with a prominent researcher in the field of
ecopsychology, Thomas Doherty. He uses his Eco-wellness framework because it is supported
by research. He explained that he is excited about his “eco-wellness framework…, it’s a
research-based kind of way to approach clients….”
Beliefs about Human Connection with Nature
Five participants shared strong opinions about the connection that humans share with
nature, which constituted the fifth super-ordinate theme, Beliefs about Human Connection with
Nature. Sequoia, Chestnut, Madrone, Camellia and Cedar described their belief that humans
have an inherent connection with the earth, and that humans have depended on this connection
throughout the course of history to best survive the elements of nature. Sequoia and Chestnut
expressed the sentiment that humans are animals that have evolved into complex creatures,
interacting on many levels. Redwood, Camellia and Cedar shared the belief that we (humans) are
nature, as we are comprised of natural and organic elements. Redwood explained,“…we are
actually nature because we’re made of water and minerals and air and all that, so that, that’s a
piece of it. So that we have an affinity with, a natural affinity with the natural world, because we
are it, part of it.” Chestnut expressed that “we are hardwired for this [nature connection].”
Madrone shared that connection with nature can help clients find another path towards holistic
wellness when he stated that “another foundation of it is really in line with counseling
philosophy, which is we’re all holistic beings, we’re all connected with ourselves, other people,
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other living organisms, non-living organisms, and our connection with nature is one avenue of
that.”
Counselor’s Role
The sixth super-ordinate theme was the Counselor’s Role. Blue Gum and Camellia
shared this super-ordinate theme by specifically addressing the counselor’s role. Camellia
described the counselor’s role as that of a co-adventurer or co-journeyer. She viewed the
counselor as “both a guide and also just to be with them and moving them along, someone who
could point things out along the way or deepen the experience that they’re on, like a co-
journeyer, co-adventurer.” Blue Gum described the role similarly, but he added that one of the
main objectives is for the therapist to highlight client strengths. He explained that “…the
therapist’s strength is eliciting the client’s strengths. So helping the client come to terms with the
assets or resources they have in order to put those to good use.” Focusing on strengths and
serving as an egalitarian “co-adventurer” in the role of counselor can serve client needs
effectively, according to these two participants.
Spirituality
The final super-ordinate theme to emerge was Spirituality. Spirituality was discussed by
one participant, Redwood. Although Redwood was the only participant to speak about
spirituality, this super-ordinate theme stood out when she shared that spirituality emerges in
many ways for both the counselor and the client during somatic ecotherapy. She began practicing
as a result of a spiritual moment in a grove of trees that changed her world-view. She explained
that she “ literally got a sense from this particular grove of trees that I had, that I knew to an
extent, that they said, you need to share this with other people.” Her daily walk and meditative
time in nature “called” her to share with others the peace she found. She stated that her clients
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could increase their spirituality as well when engaging with nature or participating in somatic
ecotherapy. She believed that “a spirituality…comes into people that they can’t help but feel
some awe and some gratefulness outdoors.”
Validation Procedures
I employed validation procedures throughout the research to ensure accuracy during the
data interpretation. These procedures included clarification of my biases, member checking,
peer debriefing and peer review, and the use of “thick, rich description” (Creswell, 2007, p. 208).
I engaged in reflective practices to evaluate my own research biases (Creswell, 2007). To
uphold credibility and dependability, bracketing was utilized to disclose my own biases before
presenting results. I bracketed my biases by writing field notes reflecting my personal bias
immediately after data collection. I disclosed my personal biases in the analysis of the research
themes as well as utilized a constant comparison method in order to ensure personal objectivity.
By understanding my biases through writing before I approached the data, I was able to compare
the themes and pertinent data that emerged with my own perceptions.
Member Checking
Member checking is the process of taking the research findings back to the participants to
get participant feedback on the accuracy of the themes found in the data (Bernard & Ryan,
2010). By utilizing this method, I had the opportunity to see if my findings resonated with the
participants and if the portrayal of the phenomenon of counseling in nature could be enhanced
before moving toward more concrete stages of solidifying themes and findings for my research.
All participants provided feedback that helped shape the themes and ultimate synthesis of the
interpretation of the interviews.
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I member checked by providing each participant a list of themes that emerged from his or her
transcript through email. I then gave them an opportunity to reflect on the themes that emerged
in order to identify whether or not the themes seemed congruent with their experience.
Furthermore, I was open to feedback that was contradictory to the themes I generated, and how
that might influence my theory and results. I achieved this by contacting participants and sending
them the themes I generated from their interviews. I asked if they agreed with the themes and if
they had anything else to contribute. Once participants provided feedback, I incorporated their
feedback into the analysis of the data.
Peer Debriefing
Throughout my research, I depended upon the guidance of a peer debriefer whom I asked
to check for researcher bias that might be interfering with my objectivity throughout the research
process or the data results. I debriefed throughout my data collection process and during data
analysis and processed possible biases that emerged in order to effectively bracket those biases.
My peer debriefer helped me look at themes that may have been influenced by personal bias.
When my personal bias influenced the results, I reviewed the transcripts and themes and re-
interpreted the data to more accurately reflect the meaning of the participants.
Peer Review
As suggested by Bernard and Ryan (2010), I utilized the peer review method of ensuring
validity to ensure accuracy of my interpretation of the interviews. Utilizing a peer review method
of validation, as suggested by Creswell (2007), helped me focus more objectively on my study
by incorporating the opinions of other skilled, non-biased researchers. The peer reviewer was a
licensed professional counselor who is enrolled in a doctoral program in counseling, who has
training in both counseling and qualitative research.
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Once themes were generated, but before I wrote up the results or got feedback from
participants through member checking, I asked a peer to review the themes I had identified, as
well as the interview questions. I shared my personal biases with her verbally before she read the
themes. I asked for feedback on her perceptions of the themes I generated and asked that she
point out anything that seemed like a personal bias that may have emerged in the themes. This
helped me ensure validity and continuously facilitate an objective review of the data.
Transferability
The final validation technique I used was the use of “rich, thick descriptions” from the
data, which is described as detailed descriptions that allow the reader a comprehensive
understanding of the setting and the phenomenon, in order to determine how the information
obtained from the study can be “transferrable” or otherwise applied to similar situations
(Creswell, 2007, p. 208). This means that the phenomenon was described in such great detail that
readers can determine whether the practice or description of the phenomenon can be applied to
their personal practice or research. The use of “rich, thick descriptions” enabled me to learn from
participants, by focusing on the deeper meaning and details of their contributions. I was also
able to effectively filter my personal biases by focusing on the contributions of the participants.
Analysis of Supplemental Materials
At the end of each interview, I requested that participants share any supplemental
materials that they might have to help explain their specific counseling practices. Three
participants, Sequoia, Madrone, and Cedar, had materials. Sequoia provided a video; Madrone
provided a flyer; Cedar had a faculty profile; and Redwood, Orchid, and Blue Gum had websites
that I chose to analyze. I then analyzed these six pieces of data for themes and overarching
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themes to add to the richness and meaning of the data that emerged from the analysis of the
interviews (see Table 11).
Table 11
Supplemental Materials
Name of Participant
Type of Supplemental Material
Sequoia
Video
Madrone
Flyer for Eco wellness Course
Cedar
Faculty Profile
Redwood, Orchid, and Blue Gum
Website
Chestnut
No Materials Provided
Camellia
No Materials Provided
Table 12
Three Overarching Themes and Six Themes from Supplemental Materials
Overarching Themes
Themes
1. Beliefs About Human Connection with Nature 1. Humans Have an Inherent Connection
to nature
2. Major Tenets
1. Relationship Among the Client,
Counselor and Nature
2. Practiced Outdoors
3. Benefits
1. Improves Mood
2. Research Shows Spending Time in
Nature is Healing
3. Increases Intrapersonal Skills
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Overarching Themes and Themes from Supplemental Materials
The supplemental materials yielded three overarching themes: 1) Beliefs About Human
Connection with Nature, 2) Major Tenets, and 3) Benefits (see Table 12). All three overarching
themes of the additional material support the cross-case analysis of three of the super-ordinate
themes from participants’ transcripts. The first overarching theme, Beliefs about Human
Connection with Nature, included theme 1, Humans Have an Inherent Connection to Nature.
Sequoia’s on-line video describes “A common belief is that we are essentially interconnected to
all creatures, plant life, waters and people all over the planet.” This belief inspired participants to
incorporate or explore aspects of personal nature connection in counseling.
Overarching theme 2 described Major Tenets that emerged in the supplemental materials.
All supplemental materials described aspects of the Relationship Among the Client, Counselor
and Nature (theme 1). The first part of the theme that addresses the counselor/client relationship
is expressed on Redwood’s website. “Through working together, we develop a relationship of
trust and openness to follow what is most important for you.” Sequoia’s video defined
Ecotherapy. “Ecotherapy explores one’s relationship with the earth, its plants and creatures as a
therapeutic resource and an essential inquiry.” All supplemental materials mentioned that the
counseling can be practiced Outdoors (theme 2).
Benefits, explored in overarching theme three, included Improves Mood (theme 1),
Research Shows Support for Spending Time in Nature is Healing (theme 2), and Increases in
Intrapersonal Skills (theme 3). Sequoia’s video expounded on the research surrounding the
benefits of spending time in nature (theme 1 & 2), and Redwood’s website described that
Somatic Ecotherapy Increases Interpersonal Skills (theme 3). Some of the skills that clients
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improve according to Redwood’s website included “increased self-esteem, motivation and self-
reflection skills.”
Findings by Research Question
The primary research question for my study was: What are the shared experiences of
counselors who provide nature-based counseling? The sub-questions were:
1. What is nature-based counseling?
2. How does nature-based counseling differ from other types of therapy?
3. What benefits and/or risks do counselors believe clients may experience when
engaging in nature-based counseling?
4. What factors do counselors think elicit change in clients who participate in
nature-based counseling?
5. Are there ways that nature-based counseling can be improved?
6. What are the ethical concerns that counselors must consider with regard to
nature-based counseling, and if so, how can they be addressed?
The primary research question was answered through the cross-case analysis. The super-
ordinate themes of Major Tenets, Beliefs about Human Connection with Nature, Benefits, and
Training and Ethical Concerns reflected the shared experiences of counselors who practice
counseling in nature. Specific research questions that answered the broad research question
follow:
Sub-question #1: What is nature-based counseling?
Sub-question one was answered with the super-ordinate theme, Major Tenets. The super-
ordinate theme Major Tenets provided major tenets of each participant’s nature-based counseling
practice. All participants provided major tenets and definitions of their nature-based practice.
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Although the tenets and definitions differed, each participant described major tenets that
included psychotherapy with the primary focus on the relationship among the counselor, client,
and the natural world. Chestnut described his core tenets as an “ecological, biological context for
therapy,” engaging in an active relationship with nature, engaging the human body and treating it
as a living piece of nature, and an external approach to addressing problems.
Nature-based counseling was defined by the participants as a therapeutic relationship
among a mental health professional, the client, and nature. The participants focused on
strengthening the client’s relationship with nature, in order to help clients reap the benefits of
spending time outdoors. This was based on a belief that humans have an inherent connection to
the natural world. In fact, Sequoia, Redwood, Chesnut, Camellia, and Cedar described humans as
a part of nature. Redwood described her belief that “we are actually nature because we’re made
of water and minerals and air and all that, so that, that’s a piece of it. So that we have an affinity
with, a natural affinity with the natural world, because we are it, part of it.”
Sub-question #2: How does nature-based counseling differ from other types of therapy?
Sub-question two was answered with three super-ordinate themes: Major Tenets, Beliefs
about Human Connection with Nature, and Motivations for Using Nature. Participants reported
that their practices differed from traditional psychotherapy based on the counseling space in
which they practice (i.e., nature), and the use of nature in sessions. As addressed in Major
Tenets, every participant shared that he or she infuses some element of nature into counseling
practice. For example, Sequoia practices in her garden, and stated that “it actually creates a
different context for the therapy and sometimes it depends on what the client notices, if we’re
doing work here in my back garden, what they notice, what they’re drawn to, feelings they
have.”
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Five of the participants expressed strong beliefs about human connections with nature in
super-ordinate theme, Beliefs about Human Connection with Nature. These beliefs shaped the
participants’ motivations to infuse nature into counseling. The participants (Sequoia, Chestnut,
Madrone, Camellia and Cedar) believed that humans have an inherent connection to the earth;
that humans are animals and a part of nature. Camellia expressed her belief that “I think that the
therapeutic value of being in nature has been prevalent since like cave peoples. It’s just based on
who we are, we are part of nature.”
All participants, except Redwood and Camellia, had strong motivators for incorporating
nature into their practice that differ from motivators to use traditional psychotherapy. The three
main motivations for incorporating nature into psychotherapy described by participants were that
personal healing that occurred in nature, career or work opportunities that occurred outdoors, and
consumption of literature and research about incorporating nature into psychotherapy. With
regard to personal healing experiences in nature, Madrone stated that “nature has been part of my
own healing and part of my own development.” Blue Gum explained how career opportunities
influenced him to use nature in his practice when he shared his impressions of working for an
outdoor search and rescue program with youth. “It was all in the outdoors, very metaphor
focused, really values based, which I really liked…”
Sequoia described how consuming research and literature and a personal moment of
healing she experienced in nature helped her infuse nature into her counseling practice. “It was
something that I introduced into my practice in the late 1990s, after communicating with other
people, reading and also having my own aha moment in my garden.”
Sub-question #3: What benefits and/or risks do counselors believe clients may experience
when engaging in nature-based counseling?
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The benefits and risks of counseling in nature are addressed in two super-ordinate
themes: Benefits, and Training and Ethical Concerns. Seven of the eight participants spoke of
the benefits of counseling in nature which included improved mood, enhanced counselor client
relationship, decreasing stigma, and discovery of personal strengths. Cedar explained some of
the benefits that are supported by research:
…Things like self-esteem can be enhanced, …it works for anxiety, depression…,
youth at risk…. There’s people I know working on complex trauma, … there’s
even research out there that shows these kind of experiences are beneficial for
kids with ADHD, anger issues, all sorts of things can be utilized within this kind
of broad context.
The risks of nature-based counseling fell under super-ordinate theme, Training and
Ethical Concerns. All participants expressed concerns regarding training and ethical issues.
Some of the major overarching themes were related to confidentiality (expressed by Redwood,
Madrone Orchid, and Camellia), managing physical risks (shared by Madrone, Orchid, Camellia,
Cedar, and Blue Gum), and not pushing a nature agenda on clients who do not desire to engage
in nature infused practice (espoused by Redwood, Chestnut, Madrone and Camellia). Redwood,
when discussing confidentiality, noted that “when you’re living in the city and you’re using city
parks, if you don’t have your own private backyard to do it in, you know…it can be a little tricky
to do a very intimate session.”
With regard to physical safety, Orchid explained, “So I have a concern that a lot of
people who are doing this work don’t have the training as outdoor leaders to deal with medical
emergencies if they come up.” Camellia described the ethical concern of not pushing a nature
agenda, stating “I guess just if I was like pushing my own agenda on them, like they really just
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wanted to talk and I wanted to do something more like infusing nature…” Limitations of nature-
based counseling were also addressed in the super-ordinate theme, Training and Ethical
Concerns, and they included lack of knowledge in the professional mental health community,
geographical limitations, and the fact that nature-based counseling is not a good fit for all clients.
Sub-question 4: What factors do counselors think elicit change in clients who participate in
nature-based counseling?
Sequoia, Chestnut, Madrone, and Blue Gum described a belief that change occurs in the
relationship among the client, counselor, and nature. This was addressed in super-ordinate theme
Benefits. Blue Gum explains, “I think that really 90% of what I do is about relationship….”
Madrone discussed the interplay between the counseling relationship and nature, stating that “I
think that ultimately it’s the counseling relationship that impacts the change…I also believe that
then translates and is connected to …the environment or with how they’re conceptualizing nature
as well.” Chestnut firmly believed that “Nature is a Thou instead of an it.” In his counseling
practice the relationship with nature is what makes his counseling practice different and enlivens
the therapeutic process. He stated, “I find that I can look at that I-thou mode of relating, of
relationships, and extend it beyond the personal one.”
Sub-question #5: Are there ways that nature-based counseling can be improved?
Participants expressed that nature-based counseling could be improved through the super-
ordinate theme, Training and Ethical Concerns. All participants stated that training and attention
to ethical concerns could improve the practice in the super-ordinate theme, Training and Ethical
Concerns. Sequoia, Madrone, Orchid, Cedar and Blue Gum acknowledged the lack of
availability of formal training. Sequoia, Madrone, Orchid, Cedar, and Blue Gum addressed the
need for further definition and intentionality of training in nature-based practices, to ensure that
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practitioners are practicing effectively. Sequoia described the lack of available formal training
when she stated, “Right now there is very limited training available in nature-based
psychotherapy, so most people who do this work have come to it through a process of blending
two different areas of expertise together into one.”
Madrone expressed a need for intentionality in nature-based counseling, stating that “ to
me it’s just like I’m learning a lot about it, and the most important piece is just teaching people to
do this with intentionality.” Sequoia, Redwood, Chestnut, Madrone, Cedar, and Blue Gum
expressed that nature-based counseling practice is so new that regulating and defining the
practice could improve service provision. Blue Gum expounded on the need to further define and
regulate the practice of nature-based counseling, and on the questions that emerge when trying to
define the practice.
Do I actually need a degree to be called an adventure therapist? And
obviously I think the answer to that is yes, but there’s probably a lot of
people that would say, well I know what I’m doing on the adventure side of
things, aren’t I just good enough to do it? So it’s a hard thing to say.
Sub-question #6: What are the ethical concerns that counselors must consider with regard
to nature-based counseling, and how can they be addressed?
This sub-question was addressed in one super-ordinate theme, Training and Ethical
Concerns. The major ethical concerns that participants shared were confidentiality, managing
physical and psychological risks, and not pushing a nature agenda on clients who do not desire to
engage in nature-based counseling. Participants addressed how they manage these concerns in
their own practices. Orchid noted that one of the limitations she faces is confidentiality; she
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addresses this concern by giving clients the option of choosing the session location, which is
determined by “people’s comfort level whether they want to sit outside or not.”
Madrone addresses this issue, as well as physical and psychological risk factors, through
assessment. He spends time upfront with his clients “on the phone and in person, exploring
their…any kind of trauma or fears associated with the natural environment, talking about
medical illnesses, any allergies people have, concerns about confidentiality.”
Chestnut addressed the issue of not pushing a nature agenda on clients when he stated,
I have to work within what they ask me to do. That isn’t to say that my larger framework
can’t be helpful; it just means that if they came to me to talk about their marriage, they’re
probably not going to want to go on a vision quest.
Additional Findings
Additional findings in this study included the super-ordinate themes, Counselor’s Role
and Spirituality. Although these super-ordinate themes did not specifically address the research
question and sub-questions, they did add to the detailed description of the shared experiences of
counselors who practice in nature.
Counselor’s Role
An overarching theme for two participants, Camellia and Blue Gum, was Counselor’s
Role. Camellia described the counselor’s role as that of a co-adventurer, or co-journeyer. She
explained that she sees the role as “a guide and also… to be with them and moving them along,
someone who could point things out along the way or deepen the experience that they’re on, like
a co-journeyer, co-adventurer.” Blue Gum described the role as strengths-based and as “helping
the client come to terms with the assets or resources they have in order to put those to good use.
So I think it’s really about evoking strengths.”
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Spirituality
Spirituality was a super-ordinate theme that contributed to the knowledge of nature-based
counseling. Redwood was the only participant with the overarching theme of Spirituality.
Redwood espoused that a spiritual connection can be present for both the clients and the
counselor when practicing in nature. She explained, “there’s a spirituality that comes into people,
that they can’t help but feel some awe and some gratefulness outdoors….I think it helps people
become more connected in the world versus isolated.”
Summary
This chapter provided an analysis of each case study, which included themes, overarching
themes supported by text, and a summary of each case. The themes were cross-analyzed, and
results of the cross-analysis were provided. The cross-analysis yielded seven super-ordinate
themes. The supplemental materials provided by participants were also analyzed, and six themes
and three overarching themes were presented that supported the cross-analysis. Finally, the
primary research question and sub-questions were addressed through analysis of the super-
ordinate themes, and additional findings were summarized.
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Chapter Five
Discussion
This chapter is divided into six sections. The purpose of the study is reiterated and the
research questions are restated. Procedures are summarized. Findings are discussed in relation to
the literature. Implications and recommendations are presented, The limitations of the study are
discussed. The chapter ends with my personal reflections.
Purpose of the Study and Research Questions
The purpose of this qualitative, phenomenological study was to gain a deep
understanding of the shared experiences of therapists who provide counseling in non-traditional,
natural environment settings. My hope was that a greater understanding of the benefits of
incorporating the natural environment into counseling would yield implications and suggestions
for counseling practice that could benefit both clients and counselors, and could lead to deeper
knowledge regarding the benefits of spending time in nature. The primary research question for
my study was: What are the shared experiences of counselors who provide nature-based
counseling? The sub-questions were:
1. What is nature-based counseling?
2. How does nature-based counseling differ from other types of therapy?
3. What benefits and/or risks do counselors believe clients may experience when
engaging in nature-based counseling?
4. What factors do counselors think elicit change in clients who participate in
nature-based counseling?
5. Are there ways that nature-based counseling can be improved?
6. What are the ethical concerns that counselors must consider with regard
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to nature-based counseling, and if so, how can they be addressed?
Summary of Procedures
Eight licensed therapists agreed to participate in this study, to share their experiences as
counselors who infuse nature into their psychotherapeutic practice. I obtained participants
through a combination of general Internet searches and snowball sampling. I found that
participants who were willing to share were incredibly enthusiastic and had colleagues who were
also open to sharing their experiences. All participants who agreed to be interviewed were sent a
consent form outlining limitations to confidentiality and informing them about taping and the
nature of the project. All participants gave verbal consent to participate.
All interviews were conducted through video conferencing software, (Face Time, Google
Hang Out, Skype) and by telephone. The interviews lasted approximately one hour. Upon
completion of the interviews, the interviews were transcribed. Themes and overarching themes
were derived from the interviews. Participants were sent themes and overarching themes, and
were given an opportunity to provide feedback.
I used Bernard and Ryan’s (2010) six step phenomenological method for conducting
research and utilized member checking, peer review, peer debriefing, and rich, thick description
(Creswell, 2007) for the purposes of validation. I conducted the data analysis by looking for
themes and overarching themes in each transcript, and supported the themes with text from the
interviews. I then conducted a cross-case analysis. The cross-case analysis yielded seven super-
ordinate themes: 1) Major Tenets, 2) Training and Ethical Concerns, 3) Benefits 4) Motivations
for Using Nature, 5) Beliefs about Human Connection With Nature, 6) Counselor’s Role, and 7)
Spirituality. I then repeated the analysis process with supplemental materials provided by some
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of the participants. The supplemental data served to support the super-ordinate themes found in
the interviews.
Discussion of Findings in Relation to the Literature
The findings indicated that, although nature-based practices vary widely, the super-
ordinate themes contributed to an understanding of the shared experiences of counselors who
practice in natural environments. A conceptual framework of the biophilia hypothesis and
Existential Therapy framed the research study. The seven super-ordinate themes found were: 1)
Major Tenets, 2) Training and Ethical Concerns, 3) Benefits, 4) Motivations for Using Nature, 5)
Beliefs about Human Connection With Nature, 6) Counselor’s Role, and 7) Spirituality.
Findings are discussed in relation in the following sub-sections and are related to the literature
pertaining to the conceptual framework of this study.
Biophilia Hypothesis
The biophilia hypothesis asserts that humans are inherently drawn to nature, and that
there is an inherent form of human learning and development that resulted from human evolution
in relation to the natural environment (Kellert, 1993). Wilson described biophilia as “the innate
tendency to focus on life and like-like processes” (1984, p. 1). Five of the participants
interviewed expressed a belief that humans have an inherent connection with nature. Madrone
stated, “I really identify with the ecopsychology movement, in particular, biophilia.” Others
referred more implicitly to the biophilia hypothesis. For example, Redwood believed that “we
have an affinity with, a natural affinity with the natural world, because we are it, part of it.”
These beliefs about human connection with nature influenced the motivations of participants to
incorporate nature into their counseling practice.
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Existential Therapy
The goal of existential psychotherapy, according to Heidegger, is to help clients explore
and accept their authentic selves (Lynch, 2001). Heidegger asserted that the self and the natural
world are not separate, but are integral pieces of “dasein” or existence (as cited in Zimmerman,
1986). Adams (2005) stated that as humans, we are nature and that our authentic selves are
intrinsically connected to nature. Adams (2005) also stated that our current relationship with the
earth which is dominating, or viewing nature as an object to conquer, is unhealthy and leads to a
psychological disconnect with nature that can hurt humans and nature. Five of the participants
shared this view through the theme Beliefs About Human Connection with Nature. For instance,
Sequoia described her belief about humans.
We don’t realize that we’re animals too and that we’re caged in a way all the time.
…Somehow we forget we’re primates. This is not how we live naturally. Ok, we can
survive, but is it causing some of the illnesses that are epidemic in our culture...
Major Tenets
Nature-based counseling incorporates nature into the counseling process. The literature
supports that nature is present in Nature Therapy, Ecotherapy, Walk and Talk Therapy, and
Adventure and Wilderness Therapy (Berger, 2008; Doucette, 2004; Houston, et. al, 2010,
Roszak, 1992). The eight participants in this study had varying licenses, training, theoretical
orientations, and level of engagement with the natural world; thus, their practices varied. For
these participants, nature incorporation occurred on a continuum from minimal nature
incorporation to full adventure immersion expeditions in nature. Cedar explained that the use of
nature can vary based on many factors, and can occur on a continuum. Cedar stated, “…So
further down the continuum is engagement-type of activity, where you really can’t undertake the
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experience you’re trying to facilitate without directly being involved or engaged in the natural
world.” Incorporating nature was a major tenet of the practices of all eight participants.
Extant literature suggests that the practice of incorporating nature into counseling is
based on client needs. Ronen Berger (2008) described nature therapy as “flexible enough to be
tailored to the needs of the client and setting.” The findings of this study support the expressed
need in the literature to tailor interventions and structure to the needs of the clients. All eight
participants expressed that the therapy must be in alignment with client needs. Redwood detailed
her views on the client-based structure as follows: “…it’s very, very specific to their needs and
their issues and, so the techniques and the interventions are just exactly for them.”
The ecopsychology literature purports that humans will be happier and healthier if they
strengthen and heal their relationship with the natural world (Rozsak, 1995). Rozsak recognized
a connection between the health of people and the health of the natural environment, due to
human dependence upon the natural world for survival (Tripoli, 2009). According to Berger
(2008), the “counselor, client, and nature are all in a relationship and the therapist utilizes the
natural surrounding intentionally.” Four participants described the counselor/client relationship
as being crucial to their therapeutic work, in addition to the relationship that the counselor and
client have with the natural environment. For example, Chestnut helps clients begin a
relationship with nature that feels right for them, explaining that “I find that I can look at that I-
thou mode of relating, of relationships, and extend it beyond the personal one.” He helps clients
become aware of and strengthen their own relationship with nature, in ways that fit the client’s
lifestyle.
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Training and Ethical Concerns
Scott and Duerson (2010) expressed concern over lack of regulation, training, and
accreditation as they pertain to wilderness therapy. A lack of proper precautions has led to abuse
and even death of clients on wilderness therapy expeditions. This concern is particularly
pertinent for counselors who engage in specific challenge and adventure-type activities that
might put clients at risk. Although the literature has focused primarily on wilderness therapy, the
concerns addressed in the literature are pertinent for any counselor who wants to practice
outdoors or engage in challenge activities with clients. The findings of this study support the
concerns expressed in the literature. All participants provided opinions regarding training and
ethical concerns related to nature-based counseling. For example, Orchid, whose background
includes working as a nature guide, expressed her concern regarding proper training for nature-
based counselors when she stated,“… So I have a concern that a lot of people who are doing this
work don’t have the training as outdoor leaders to deal with medical emergencies if they come
up.”
In addition to physical safety concerns existing literature has addressed psychological
risk factors that might prevent clients from being a good fit for nature-based interventions (Scott
& Duerson, 2010). Some clients that might not be a good fit for nature-based counseling include
clients experiencing unresolved trauma that could be triggered by loud sounds or certain
uncontrollable weather conditions, and clients experiencing psychosis or other severe
psychological mental health issues that might be exacerbated in an uncontrolled natural
environment (Berger, 2010). Lending support to the literature, participants in this study noted
that nature- based counseling is not a good fit for all clients. Madrone emphasized the need to
use thorough assessment to make determinations about appropriateness of fit for outdoor
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interventions. He stated that he spends time upfront with clients “on the phone and in person,
exploring their, any kind of trauma or fears associated with the natural environment, talking
about medical illnesses, any allergies people have, concerns about confidentiality.”
The lack of training available, and lack of research on the effectiveness of nature-based
counseling practices are issues that are found in the literature on Wilderness Therapy (Scott &
Duerson, 2010). This lack of training and research poses an ethical dilemma for licensed
professional counselors, because according to the ACA Code of Ethics (2014), they have an
ethical obligation to use techniques and counseling skills that are grounded in theory and have
been studied empirically (Standard C.7.a). Participants in this study articulated a need for
effective and intentional training programs. Cedar shared some pertinent insights on training,
stating that “I think we need expertise in this area to work, because at the moment the paradigms
we are exploring.., are indoor paradigms, technique-based paradigms, that may not fit this
particular context.”
Consistent with the literature, participants in this study expressed concern regarding
inadequate training in nature-based or adventure-based interventions. Examples include engaging
with clients in challenge activities in which the therapist is not proficient, and adventure guides
engaging in psychotherapy without appropriate training to handle the complex issues that can
emerge in counseling, particularly with regard to psychological crisis situations. Blue Gum
described his concern about therapists with improper training and the current lack of regulation
of adventure therapy programs.
I think the adventure therapy industry goes through this all the time with people
wanting to be called adventure therapists and then what on earth does that mean?
Do I actually need a degree to be called an adventure therapist? And obviously I
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think the answer to that is yes, but there’s probably a lot of people that would say,
well I know what I’m doing on the adventure side of things, aren’t I just good
enough to do it?
Confidentiality is an ethical concern addressed in the literature, and by participants in this
study. According to the ACA Code of Ethics (2014), counselors discuss confidential information
only in private settings and share information with others only when the client has given formal
consent (B.1c. , B.3.c). The Ethical Guidelines of Therapeutic Adventure Professionals
(EGTAP) propose a solution for the unique confidentiality concerns of nature-based counseling
through informed consent, with a focus on explaining the unique limits of confidentiality in a
natural environment. These limits must be explained fully to clients to give them the right to
choose if this type of counseling is appropriate for the work they would like to accomplish
(EGTAP, 2007, 4.4).
Participants in this study expressed confidentiality concerns related to handling situations
such as bordering a neighbor’s garden, seeing someone that a client might know while walking
on a trail, and managing extremely sensitive client information or emotionally sensitive content.
Participants addressed the issue by offering indoor sessions as needed, and by preparing for
situations in which someone might be recognized by someone else by creating a plan in advance.
Orchid shared that she offers both indoor and outdoor counseling in her practice due to the
limitation of her outdoor counseling space not being soundproof. She addresses the limitation by
giving the clients a choice about where the session takes place. She explains, “it’s just depending
on people’s comfort level whether they want to sit outside or not.” Other participants addressed
confidentiality explicitly in their informed consent procedures. Madrone shared how he handles
the potential confidentiality issues that may occur in his Eco-wellness practice, explaining that “I
133
spend a lot of time upfront with my clients on the phone and in person, exploring …concerns
about confidentiality. As soon as you leave the office setting, the client is vulnerable to breaches
of confidentiality…”
Not addressed in the literature, and therefore adding to the knowledge base, participants
shared ethical concerns related to not pushing their own nature agenda. Half the participants
discussed the importance of tailoring the amount of nature infusion to client needs and being
mindful to ensure that the counselor is truly serving the needs of the clients. Madrone shared his
concerns about pushing a nature agenda:
The ethical concern for me is like, how much of this is my own agenda? How
much of this is me doing my own work? So how do I separate that and how do I
distinguish that? And I think that’s so important.
Benefits
Many benefits of spending time in nature include improved mood, increased self-esteem,
and decreased stress (Leather et. al, 1998; Maller et al., 2006; Shreyer et al., 1990; Ulrich et al.,
1991). Rozsak, who coined the term echopsychology, believed that the health of a community is
connected to the health of the environment, and that the reciprocal nature of a healthy
relationship with the environment can enhance wellness (as cited in Tripoli, 2009). Mayer et al.
(2009) found that both simulated and natural environments had positive mood benefits, although
the “in vivo” environmental exposure had a more significant impact on mental health. The
benefits of spending time in nature described by the participants included improved mood (even
synthetic nature can improve mood); an enhanced relationship among the therapist, client, and
nature; increased attention span; and decreased symptoms of ADHD. These benefits described
134
by the participants align closely with findings in the literature. Improved mood was mentioned
by four of the participants in this study.
Cedar described the benefits of nature exposure in a variety of ways, including virtual
nature experiences. He noted, “…Experience of the natural world can work at… a multitude of
different levels. ….You know, recent research is quite clear that even looking at
virtual natural world can have benefits one way or another.”
Three participants mentioned the research of Kaplan (1995), who found that mental focus
improves for individuals who spend time in nature, which has implications for individuals with
ADHD or ADHD symptoms. While none of the participants has conducted her or his own
research to test these claims, the participants indicated that they are aware of the research as
evidence for the effectiveness of their practices. Blue Gum also explained that adolescents are
more engaged because of the adventure elements that he incorporates in his counseling practice.
He stated that adolescent clients are more willing to participate, and that adventure activities in
nature contribute to productive sessions. Making counseling fun is an important piece of the
rapport building process with Blue Gum’s clients. He explained, “they’re not going to be
interested in what we have to say or...our processes if it’s not engaging”
Motivations for Using Nature
The literature supports the assertion that nature is healing for humans (Louv, 2005; Maas
et al., 2009; Ulrich et. al, 1991). Thus, it is not surprising that all participants (except for
Redwood) had some sort of pivotal experience that changed their perspective so profoundly that
they decided to incorporate nature into their counseling practice. Many emotional benefits arise
as a result of spending time in nature, such as increased well-being, decreased stress, and an
increased ability to recover from stress (Leather et. al, 1998; Ulrich et al., 1991). Participants in
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this study described a healing vision quest, accidental and informal processing sessions while fly
fishing, and professional opportunities that just seemed to “fit.” Seven participants remembered
quite clearly a life-changing experience in nature that informed their practice. Madrone reflected,
“I was doing some fly-fishing, teaching in Alaska for a number of summers. And when people
got on my boat, they just started to open up. I wouldn’t pry or anything like that, they would just
start talking…”
Researchers have demonstrated that a personal connectedness to nature relates to
happiness and life satisfaction by positively influencing mood (Mayer et al., 2009). One
participant offered an example of this phenomenon; Chestnut described that a healing vision
quest he took in the 1980’s energized him and positively influenced his mood so profoundly that
it changed his world-view and counseling practice. He stated, “If you get a major personal
experience that reorients you and your belief systems about how the world functions and how it
can be healing in different ways, you want to share that with the world.”
Beliefs about Human Connection with Nature
One of the theoretical lenses through which this study was viewed was the biophilia
hypothesis, or the belief that humans have an inherent desire to connect with that, which is life-
giving (Kellert, 1993). Six of the eight participants mentioned this concept either directly or
through descriptive statements that aligned with the theory. The concept that, as humans, we are
nature because we are animals that have evolved from primates, and the belief that humans have
an inherent connection with nature, were the two concepts that emerged under this super-ordinate
theme. Chestnut described that “We could probably look at it, we’re hard-wired for this and we
lost our connection, and that shamans 1000s of years ago, and people drawing in caves, knew a
lot more about it [the inherent connection humans have with nature] than we did.”
136
Wilson (as cited in Kellert, 1993) asserted that there is a biologically based connection to
the natural world. He also espoused that humans’ lives are diminished when engaged in an
unhealthy destructive relationship with the environment. Lending support to this assertion,
participants in this study described the disconnect that has occurred for humans through
industrialization, as well as the inherent desire to connect with nature. Cedar described the
process of disconnection when he stated, “…As we tamed ourselves more, became less and less,
or we tried to control the environment more, we considered ourselves more and more other to the
environment, less and less part of our own particular environment.”
Five participants believed that we are a part of nature, three specified that we are animals,
and that, therefore, that there is no separation between ourselves and the natural world. Sequoia
expressed this sentiment when he stated:
We don’t realize that we’re animals too and that we’re caged in a way all the
time…Somehow we forget we’re primates. This is not how we live naturally. Ok, we can
survive, but is it causing some of the illnesses that are epidemic in our culture…
Five participants shared a belief that humans are inherently drawn to nature and that humans can
benefit from reconnecting with nature. This belief influences the decision to intentionally
incorporate nature into psychotherapeutic practice, to enhance the wellness of clients.
Counselor’s Role
The importance of the therapeutic relationship is emphasized in the literature on nature
therapy. Berger and McCleod (2006) described nature as an actual partner in the therapeutic
process. The ecopsychology literature also highlights the counselor-client relationship and
healthy relationships with the earth (Davis & Atkins, 2004; Garrett & Garrett, 1996; Tripoli,
2009). All participants in this study believed that the most important factor that led to change
137
was the counselor-client relationship. Participants asserted that nature can facilitate and
strengthen the bond between client and counselor, but regardless of the nature component,
relationship with clients was key. Chestnut stated, “I guess my origins and beliefs are that it
comes out of an intimate I-thou relationship with a very talented, loving and well-trained
therapist…”
In a similar vein, Madrone discussed the therapeutic relationship in addition to
relationships with nature:
…it’s the sense of both the client and myself are mutually vulnerable, we’re mutually
empathic, I think that contributes a lot to change that takes place…but I also believe that
then translates and is connected to one’s connection with the environment or with how
they’re conceptualizing nature as well.
The nature therapy literature describes the approach as flexible and creative, which can help
expand the therapist’s perspective, settings, and techniques (Berger, 2008).
Although the participants in this study agreed that change occurs through the relationship
among client, counselor, and nature, the role of the therapist varied slightly among participants,
thus reinforcing the flexibility described in the nature therapy literature. Orchid described the
role as that of a “co-creator” or “co-adventurer.” Blue Gum’s focus was on eliciting client
strengths. Chestnut described his co-collaborative approach by stating, “There is a co-creative
process out of that relationship that happens. So they walk in and they start, and I’m into
respecting and engaging their stories…”
Orchid’s approach was more similar to the wilderness therapy model, which originates
from character building programs designed to shape behavioral and character development
through outdoor experiences (McNeil, 1957). She viewed herself as taking on the role of an
138
expert or guide. When asked how she viewed her role she explained that she viewed herself as
“…a collaborator, coach, subject-matter expert, an empathic listener, all of the things that a
regular CBT therapist would be”. A variety of views exist regarding the role of the counselor, in
the literature as well as among the participants who practice nature-based counseling.
Spirituality
Roscoe (2009) asserted that spending time in nature can lead to a deeper connection to
spirituality, or meaning and purpose. Furthermore, wellness literature has acknowledged Adler’s
view, which asserts that spirituality is a pivotal component to wellness and overall mental health
(Reese & Myers, 2012). The super-ordinate theme of spirituality was present in Redwood’s
interview. She shared that clients experience a sense of awe, gratefulness, and a deeper
connection to themselves and their spirituality. Redwood stated, “There’s a spirituality that
comes into people, that they can’t help but feel some awe and some gratefulness outdoors.”
Implications and Recommendations
The findings of this study of the shared experiences of eight counselors who practice in
nature have implications for mental health professionals, counselor educators, and researchers.
The aim of the study was to “paint a picture” of the phenomenon of counseling in nature;
research has been conducted on the mental health benefits of spending time in nature, but very
little phenomenological research exists to describe the types of practices that occur in nature.
This study was framed through the theoretical lenses of the biophilia hypothesis and existential
psychotherapy. A rich description of the essence of the shared experiences of counselors who
practice in nature was produced.
139
Implications for Counselors and Other Mental Health Professionals
Based on the literature and supported by the opinions of the participants, many mental
health benefits can be harnessed by spending time in nature, whether by engaging in counseling
practice outdoors or prescribing “vitamin n” (suggesting that clients spend more time in nature)
as one participant, Sequoia, described. Madrone explained that research supports nature
exposure in therapy as beneficial to clients. Counselors can incorporate nature into their practice
to utilize the mental health benefits that nature can provide to their clients.
The essence of this practice contains many elements, and counseling in nature can mean a
wide variety of things to practitioners as well as clients. Participants in this study described a
variety of structures, theoretical orientations, and ways to incorporate nature into their practice.
Because there is such variety of theoretical orientations, styles, and levels of engagement with
nature, counselors can infuse nature into their practice in a way that works best for them and
their clients.
The participants in this study viewed the counselor-client relationship as the most
important instigator of change. The participants found that the relationship was enhanced by
spending time in nature, and their descriptions reflected many of the benefits cited in the
literature. Counselors, when constructing client treatment plans, can consider the benefits of
spending time in nature. Based on the individual needs and goals of the client, counselors can
incorporate the use of nature into their counseling practices to enhance client wellness.
Findings of this study suggested implications for ethical and legal issues, limitations to
the practice, and training. The primary ethical concerns of the participants included not pushing a
nature agenda if it is out of alignment with client goals, managing confidentiality concerns, and
lack of training. Counselors must be mindful of the ethical concerns that may come with infusing
140
nature into their counseling practice and take pains to address limitations and risks to the practice
through informed consent.
Implications for Counselor Educators
Participants in this study described a dearth of guidance in counselor training programs
regarding how to incorporate nature into practice. Orchid described a piece-meal approach that
she believes proficient counselors must currently take to become competent nature-based
counselors. She noted that “there is very limited training available in nature-based
psychotherapy, so most people who do this work have come to it through a process of blending
two different areas of expertise together into one.” The participants asserted that more advocacy
and education are needed to promote the practice of counseling in nature.
Furthermore, more firm ethical guidelines and training programs that teach those
guidelines can bring legitimacy to the practice of nature-based counseling by standardizing best
practices as they pertain to safety, insurance, and clinical competency. Orchid called for
intentional and flexible training programs to encompass the varied practices in which many
practitioners engage. Participants described a need for increased training on the benefits,
different types of practices, core beliefs underlying the need for this type of practice, best
practices, and ethical and legal concerns and obligations. Appropriate training for this type of
practice is necessary, and counselor educators could lead the training effort by developing ethical
guidelines and best practices for nature-based counseling practices, and by teaching the
coursework in counseling programs. The counseling perspective promotes a holistic wellness
model for working with clients, and research indicates that nature exposure is beneficial for
mental health; counseling programs could easily support and incorporate aspects of nature-based
counseling practices into counselor education training programs, both in traditional master’s
141
level counseling programs and through additional training certificates in nature-based
counseling.
Recommendations for Future Research
A review of the literature and the findings of this study indicate that there are major
benefits to spending time in nature. According to my participants, little support for the practice
exists in mental health professions. It would be beneficial for researchers to continue to
contribute both qualitative and quantitative research on various types of nature-based
psychotherapeutic practices and the effectiveness of those practices, to build credibility and bring
recognition to counseling practices that incorporate nature. Furthermore, additional examination
of the benefits of spending time outdoors would contribute to the knowledge base.
Specifically with regard to counseling, quantitative researchers could poll clients who
have participated in nature-infused counseling to discover what was beneficial about the practice
and to suggest areas of improvement. Qualitative researchers could explore the experiences of
counseling in nature from the perspective of clients, or provide in-depth case studies of each
different type of practice. For example, case studies on specific types of nature-based practices
such as Nature Therapy, Wilderness Therapy, and Ecotherapy could be beneficial for counselors
who want to incorporate nature into their practice. Researchers could also do follow-up studies to
determine the long-term effectiveness of nature-based counseling, as well as qualitative research
studies that allow clients to evaluate their nature-based counseling, and provide suggestions that
can improve the practice.
Limitations
A limitation of this study is that the results cannot be generalized due to small sample
size. However, the objective of phenomenological, qualitative research is not to generalize
142
results; rather, the aim is to describe the essence of a shared experience. Researcher bias is
another possible limitation. I had a personal attachment to the research, as I am an avid nature
lover who has experienced personal healing in nature. I utilized member checking, peer
debriefing, peer review, and rich thick description to minimize personal biases that may have
affected the data analysis. Furthermore, I was careful throughout the interviews to avoid leading
participants, sharing personal experiences, or interjecting my own views into the interviews.
Personal Reflections
I have great respect for the professionals who shared their experiences with me. I found
that all of them were extremely passionate, hard working, and inspired by the work that they do.
As a researcher it was my responsibility to bracket bias to honor the meaning of the participants’
contributions, and to adhere to the appropriate methods and procedures of phenomenological,
qualitative research. As a nature lover and counselor with a desire to infuse nature into my own
practice, I gained a great deal of information about how professionals in the field engage in
effective and ethical counseling practices outdoors. I also gained a deeper understanding of the
philosophical underpinnings and beliefs of the participants that drive them to engage in this type
of counseling practice. All participants had a uniquely passionate approach to their nature-
infused counseling practice, and I believe that they provide help to others in a multitude of ways
through their training, experience, passion, and insight. The following collage is a visual
representation of the super-ordinate themes found in the research study.
The collage below (Figure 1) depicts the following super-ordinate themes: Nature-Based
Counseling, Major Tenets, Training and Ethical Concerns, Motivations for Using Nature,
Benefits, Beliefs About Human Connection with Nature, Counselor’s Role, and Spirituality. The
collage represents the inherent longing for nature connection that humans experience, and the
143
isolation from nature that humans experience as a result of industry, modern living, and
technology. Ultimately a depiction of hope for a more sustainable world, the collage represents
the use of nature in counseling and its possible place in society at large.
144
Figure 1
Collage of Super-Ordinate Themes
145
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Appendix A
Initial Phone Call Request for Participation Protocol
Hello is this (Participant’s Name)?
My name is Bonnie King and I am a doctoral student at the University of New Orleans in the
Counselor Education Department. I am calling because I am incredibly interested in your work
as a psychotherapist who practices in natural environments. Can you tell me a little bit about
your work?
(Wait for Response)
Great, well the reason I am calling is because I am writing my dissertation of the perceptions of
licensed mental health professionals who utilize the natural environment in their clinical practice.
I would be interested in conducting an interview with you if you might be interested in
contributing to this research study. Your participation will involve being interviewed on one
occasion via face-to-face, telephone, or Skype™ for 60 minutes. You will speak to me and will
be (audio or video) taped to make sure that what you say can be typed. Your help would be a
fantastic contribution to the results of this study, which will be used for my dissertation,
publications, and conferences. This is an opportunity to provide your valuable knowledge to
contribute to the research literature. Do you think you might be interested in interviewing with
me?
(Wait for Response)
Thank you so much. I am hoping to complete my research within the months of December 2013
and February 2014. Upon verbal and/or written agreement from you, we can set up the
interviews based on your convenience. I will be sending an email with a little bit more
information about the project as well the risks and benefits of the study for you as a participant.
You can either provide verbal or written consent to participate in this study.
(Answer questions possible participants might have about the interview)
Thank you so much, and again I will send you a follow up email explaining the study. I so look
forward to our interview. I’ll speak with you soon. Goodbye.
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Appendix B
Emailed Letter of Interest/Consent Form
Dear (Participant’s Name),
I am a doctoral student at the University of New Orleans in the Counselor Education program,
under direct supervision of Dr. Barbara Herlihy (bherlihy@uno.edu/504-280-6662). I am
pursuing a qualitative research study about nature-based psychotherapy, or counseling that takes
place in nature. The information that you provide will be utilized in my final dissertation entitled,
Phenomenological Study of the Shared Experiences of Counselors who Practice Counseling in
Natural Environments.
I would like to interview you about the type of counseling you practice to gain a deeper
understanding of the particular type of psychotherapy that you practice. I would like to conduct
the interviews either face-to-face, Skype (online video conferencing) or via telephone. Face-to-
face is preferable if travel to your location is possible. I will make arrangements to meet you at
your convenience.
I am hoping to complete my research within the months of December 2013 and February 2014.
Upon verbal and/or written agreement from you, we can set up the interviews based on your
convenience. This is an incredible opportunity for me, and I look forward to conversations with
you regarding upcoming times for the interviews.
I am extremely excited to meet with you to learn about your perceptions of counseling in natural
environments. This process is not possible without your participation. After I have collected the
data gained from the interview I will send you the themes that I have analyzed from the
information you provided. If there are themes that I have not found or if there is any information
that you feel is important to add, you will have an opportunity to do so at that time. At the end of
the dissertation process, upon request, I will provide you with an executive summary of my
research findings.
In agreeing to participate in this study, you understand that:
1. The purpose of this study is to explore the shared experiences of counselors who practice
counseling in natural environments. Your participation will involve being interviewed on one
occasion via face-to-face, telephone, or Skype for 60 minutes. I will video or audio record the
interview to ensure that the interview can be transcribed for analysis. Once the study is complete,
the tapes will be discarded. Your real name will not be revealed in the study. Anything you say
can be used in the study.
2. One risk associated with this study is that you will be asked to share personal information
regarding your experiences. You may become tired or experience discomfort talking about your
experiences. You are free to request a break as needed or decline to respond to any question.
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3. The benefits of participating in this study for you personally are minimal; however, you will
be contributing to the scholarly research about the connection between psychotherapy and the
natural environment.
4. You do not have to participate and are free to stop the interview at any time without
consequence. Additionally, you are free to withdraw from this study at any point.
5. The results of this study will be used for my dissertation, publications, and conferences;
however, your name and identity will not be revealed. You will be assigned a pseudonym that
will be used in any reporting of your comments. The researcher will only know your name and
any transcriptions of this interview will be kept in a locked file cabinet accessible only to the
researcher.
6. Your participation is in this research study is voluntary and you will not be compensated.
Refusal to participate will involve no penalty. You may withdraw from participation in this
research study at any time.
7. If you have any questions about your rights as a participant in this research, or if you feel you
have been placed at risk, please contact Dr. Robert Laird, Institutional Review Board, at the
University of New Orleans at 504-280-5454.
If you would like to assist me in the collection of incredibly important information, please feel
free to contact me via phone, 512-297-5179 or email bcking@uno.edu. I would like to thank you,
in advance, for assisting me. Thank you for your time and attention to this request.
Sincerely,
Bonnie King, MA, LPC
Doctoral Candidate
Department of Educational Leadership, Counseling & Foundations
University of New Orleans, New Orleans, LA
bcking@uno.edu
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Appendix C
IRB Approval
University Committee for the Protection
of Human Subjects in Research
University of New Orleans
______________________________________________________________________
Campus Correspondence
Principal Investigator: Barbara Herlihy
Co-Investigator:
Bonnie King
Date:
March 27, 2014
Protocol Title:
“The Shared Experiences of Counselors who Practice in
Natural Environments”
IRB#:
03Mar14
The IRB has deemed that the research and procedures described in this protocol
application are exempt from federal regulations under 45 CFR 46.101category 2, due to
the fact that any disclosure of the human subjects' responses outside the research would
not reasonably place the subjects at risk of criminal or civil liability or be damaging to the
subjects' financial standing, employability, or reputation.
Exempt protocols do not have an expiration date; however, if there are any changes
made to this protocol that may cause it to be no longer exempt from CFR 46, the IRB
requires another standard application from the investigator(s) which should provide the
same information that is in this application with changes that may have changed the
exempt status.
If an adverse, unforeseen event occurs (e.g., physical, social, or emotional harm), you
are required to inform the IRB as soon as possible after the event.
Best wishes on your project.
Sincerely,
Robert D. Laird, Ph.D., Chair
158
UNO Committee for the Protection of Human Subjects in Research
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Appendix D
IRB Revision Approval
University Committee for the Protection
of Human Subjects in Research
University of New Orleans
______________________________________________________________________
Campus Correspondence
Principal Investigator: Barbara Herlihy
Co-Investigator: Bonnie King
Date: April 4, 2014
RE: “The Shared Experiences of Counselors who Practice in Natural Environments”
IRB#: 03Mar14
Your modification request was eligible for expedited review as the modifications did not
change the potential risk to the participants. Modifications listed below have been approved.
• _Utilizing a transcriptionist
Please remember that approval is only valid for one year from the approval date. Any
changes to the procedures or protocols must be reviewed and approved by the IRB prior to
implementation.
If an adverse, unforeseen event occurs (e.g., physical, social, or emotional harm), you are
required to inform the IRB as soon as possible after the event.
Best of luck with your project!
Sincerely,
Robert Laird, Chair
UNO Committee for the Protection of Human Subjects in Research
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Appendix E
Participant Interview Protocol
Participant # _______ Date: ________
Demographic Questions:
1. What is your educational background?
2. What certifications or licenses do you hold and in what state?
3. What professional association affiliations do you hold?
4. What type of nature-based therapy do you practice?
4. In what geographical region do you live and practice?
5. What is your training background specifically as it pertains to nature-based
counseling?
6. How long (years/months) have you been infusing the use of the natural environment into your
counseling sessions?
7. How many of your clients receive nature-based services?
Interview Questions:
1. How do you define the specific nature-based type of psychotherapy that you practice?
2. What makes (name of nature-based practice) different from regular talk therapy?
3. Describe a typical session.
4. How did you learn about (name of nature-based practice)?
5. Describe what you think are the origins of (name of nature-based practice)?
6. Who has been important in the field of (name of nature-based practice)?
7. What are the central components of (name of nature-based practice)?
8. How do you feel change occurs in this type of therapy?
9. What do clients say about this type of therapy?
10. What motivated you to start using (name of nature-based practice)?
11. What changes have you had to make as a therapist to practice (name of nature-based
practice)?
12. Do you utilize a specific therapeutic theoretical base in (name of nature-based practice)
practice?
13. Do you think your specific geographical location affects your practice? If so, then how?
14. What were the roadblocks in developing (name of nature-based practice) your practice?
15. Describe any obstacles or limitations of (name of nature-based practice) approach.
16. How do you handle obstacles or limitations of the approach?
17. What is the therapist’s role in (name of nature-based practice)?
18. What is the client’s role in (name of nature-based practice)?
19. What strategies or interventions are used in (name of nature-based practice)?
20. What is beneficial about (name of nature-based practice)?
21. What are some outcomes of (name of nature-based practice) for the client?
22. What are some outcomes of (name of nature-based practice) for the therapist?
23. What are your opinions about the training for (name of nature-based practice)?
161
24. Are there any ethical concerns that you have with regard to (name of nature-based
practice)?
25. If you do have some ethical concerns (name of nature-based practice), how do you think they
are best addressed?
26. Is there anything else that you would like to share about this therapy that you haven’t already
explained?
27. Are there any promotional materials, brochures or any other information that you might give
a client that you would be willing to provide me that you might be open to giving me to get a
more comprehensive understanding of (name of nature-based practice)?
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Appendix F
Confidentiality Agreement
I will be transcribing all interviews for Bonnie King’s dissertation entitled The Shared
Experiences of Counselors who Practice Counseling in Natural Environments. I realize that all
email and other electronic information provided to me, such as audio recordings are
confidential. I will not reveal any information I receive to other individuals in order to
protect the confidentiality of participants. I will take measures to protect any and all
information provided to me and I will destroy copies of transcripts or other related notes
upon providing the transcripts to Bonnie King.
Name of Transcriptionist: Esther Le Mair
Date: 22 April 2014
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Appendix G
Member Checking Email
Hello __________,
Thank you so much for taking the time to interview with me for my dissertation research entitled
Phenomenological Study of the Shared Experiences of Counselors who Practice Counseling in
Natural Environments. I have compiled a preliminary list of themes that have emerged from our
discussion. I will then cross-analyze the themes with other interviews and distill the themes
down into results that will attempt to convey the essence of the shared experiences of the
counselors interviewed.
That being said, I would like to give you the opportunity to provide feedback to me on the
preliminary themes that emerged from our interview. This is an opportunity for you to let me
know if there is anything about your practice that I missed or that you feel could be removed.
Your feedback is appreciated! Please respond by July 2, 2014 if you would like to alter, add or
remove themes. If I do not hear from you by then, I will assume that the themes generated are
acceptable to you. Thank you so much again for your participation and support for this project!
Have a fantastic day!
Sincerely,
Bonnie King
MA, LPC
Doctoral Candidate in Counselor Education
University of New Orleans
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Vita
Bonnie C. King was born in Dallas, Texas. She obtained her bachelor’s degree in Theatre
Arts from St. Edward’s University in 2006. In 2011, she graduated from Texas State University
with a master of arts in professional counseling. She entered the graduate program at the
University of New Orleans in 2011 to pursue a Ph.D in Counselor Education.
165