Outdoor Mental Health & Outdoor Therapy

Outdoor Mental Health Interventions and Outdoor Therapy

Health, well-being and self-development has been a cornerstone of the impact and value of outdoor learning practices for many decades. Over recent years, we have seen an exponential growth in therapeutic outdoor initiatives and programmes being developed and utilised for mental health and well-being benefits.

Traditional terms such as adventure therapy, wilderness therapy, nature therapy and outdoor counselling, have more recently been joined with a plethora of wider terms, such as eco-therapy, forest bathing, and a Natural Health Service, to name a few. All of these terms are taking claim to some kind of health benefit (physical or psychological) for getting outdoors.

This Institute for Outdoor Learning (IOL) statement purposefully sets out a view on competence when combining mental health and well-being interventions with outdoor learning.

The primary goal was to develop a model that could support organisations and individuals who provide and utilise services for mental health and well-being in an outdoor setting. The statement has been strongly informed by mapping current practice in the United Kingdom.
It has been created to ensure that those engaging outdoor learning services to improve mental health and well-being can do so with confidence and trust in what they are offered.

Support for the Statement

First we change the environment, thereafter the environment changes us.”

Winston Churchill

BSLM believes that introducing the ‘greens and blues’ of outdoor environment can be life-changing. We interact with our microlevel environments or settings including schools, workplaces, homes and neighbourhoods. That interaction shapes our behaviour – sometimes adversely affecting aspects of our mental health. Creating healthy outdoor environments and interacting with them will lead to positive changes in our mental health.

Together with IOL we encourage this development by influencing not only the individual but also educational and health systems, the food industry and society’s attitudes. Outdoor Health as an intervention is at least as powerful as any other – and fun to boot!

Dr Rob Lawson, Chairman

British Society of Lifestyle Medicine

Calls to Action

Use the model to better communicate and value different types of practice.
Critically review delivery using the indicators of good practice.
Use the model to enhance communication between participants, providers, managers and stakeholders.
Improve pathways for people to access the benefits of the outdoors and outdoor therapy.
Champion the wider adoption and development of a research informed approach.
Contribute to the practical application and development of relevant resources, education, and training.
Challenge behaviour and attitudes to create an accepting, inclusive and positive culture for mental health and wellbeing in our communities and workplaces.

Download the Model

The authors encourage widespread use of the model as a way to differentiate between three core zones of practice both outdoor professionals and psychological professionals may operate within whilst working outdoors.

To Reference this statement:

Richards, K., Hardie, A., & Anderson, N. (2023). Outdoor Mental Health Interventions and Outdoor Therapy. Institute for Outdoor Learning Statement of Good Practice. (Version 2). Carlisle: Institute for Outdoor Learning.

Research and Reports

To reference this statement:

Natural Outdoor Environments and Mental Health: Developing Sustainability Indicators

IOL is delighted to be part of a Research Team who have been awarded funding from the MARCH Network to assist in this 2020-2021 research project. The work continues to build on publication of the IOL Outdoor Mental Health Interventions Statement of Good practice.

The aim of this project is to develop Sustainability Indicators for the effective and equitable use of outdoor natural environments, in the treatment of mental health problems, and the promotion of mental health. Case-studies and consultation with stakeholders will be used to elicit a contemporary and adaptable sustainability framework that can be practically applied and can be used to understand the evolving impact of COVID-19 upon these factors. Overall, this will help better equip different sectors in utilising outdoor natural environments as a mental health asset.

RESEARCH TEAM LEADS: Dr Kaye Richards (Liverpool John Moores University); Dr James Fullam (University of Exeter)
CO-INVESTIGATORS: Dr Alison Greenwood (Dose of Nature); Neal Anderson (Institute for Outdoor Learning); Dr Linda Allin (Northumbria University Newcastle); Dr Chris Loynes (University of Cumbria); Andy Hardie (VentureTrust)

The MARCH Network is one of 8 national networks funded by UK Research and Innovation (UKRI) as part of the 2018 Cross-Council Mental Health Plus call to further research into mental health.

Workforce Mental Health

It is essential that in the application of this model, mental health agendas are not simply seen from a beneficiary perspective. Mental health and well-being relates to all aspects of life and work, from the quality and safety of the physical environment, to how workers feel about the organisation and their work, the culture at work and their personal mental health, mental distress or mental illness. The model offers ways in which the mental health and well-being of the workforce can be supported using the benefits of the outdoors.

Psychological therapies have a longstanding commitment and requirement for reflective supervision of their practice with clients. This is personally supportive and protects the client by upholding high standards of effective, safe and ethical working. It has wider benefits for professionals, for example including the prevention of burnout. Engaging in regular supervision of practice with someone suitably experienced and competent is good practice for all roles and the benefits are a cornerstone to developing best practices in application of the model.

It is important that employees support those struggling with mental health or well-being, to remain in and ‘thrive at work’. So the model can offer ways in which the mental health and well-being of the workforce can be supported using the benefits of the outdoors; perhaps through self-care activities, or by engaging a professional therapeutic service. It also serves to remind us that as an outdoor workforce we are not exempt from the everyday stigma and challenges of mental health. So we need to approach and address our attitudes to across all aspects of the sector with the same care, concern and respect we aim to offer our clients.

'How to take care of your staff's mental health in your workplace’ is an accessible guide designed by Mind to help all employers to understand and implement the six core standards recommended. The AAIAC document ‘Surviving a Career in Adventure Activities’ outlines some key working practices and practical steps instructors can take to look after their physical and emotional safety.

Co-authors

Neal Anderson MSc QTLS UKCPReg POL is a UKCP Registered Psychotherapist and Supervisor in private practice and chair of a Psychotherapy and Counselling Association. He has been working in the outdoors with young people and adults since 1993 and has specialised in youth development, leadership training and promoting the value of the outdoors for individual and community health and wellbeing. He is an Associate Lecturer with the University of Cumbria and was the former Professional Standards Manager for the Institute of Outdoor Learning. Neal currently leads an international charity committed to ending all forms of inter-personal violence, abuse and harassment in sports environments globally.

Dr Kaye Richards (CPsychol) is a Chartered Psychologist of the British Psychological Society, qualified outdoor professional, experienced researcher, and Senior Lecturer in Psychology at Liverpool John Moores University. She is leading a new MA in Counselling & Outdoor Therapy, and previously led a BSc (Hons) in Outdoor Education. She has diverse experience of developing adventure and outdoor therapy, training outdoor professionals, and has worked at the British Association for Counselling and Psychotherapy facilitating national research activity in psychological therapies. She is the convenor of the academic Journal of Adventure Education & Outdoor Learning, and has published across associated interdisciplinary areas.

Andy Hardie PGDip, FPsych, MBACP(Accred), LPIOL is a Forensic Psychotherapist and Supervisor registered with the BPC and accredited with the BACP. He has worked as a Therapist in the private, public and third sectors with groups, adults and young people. He has worked extensively with a focus on personal development with youth and marginalised groups in the outdoors. Since 2015 he has been developing wilderness and outdoor therapy approaches in Scotland. He has developed and delivered undergraduate and postgraduate courses in Adventure Therapy and an MSc in Counselling and is now Clinical Director of a charity delivering mental health services across Scotland.

Acknowledgements

We would like to thank the following individuals and organisations for their recent dialogue, contribution, and support to some of the thinking and development of this statement:

Dr Alison Greenwood, Dose of Nature, London.
Dr Barbara Smith, CAMHS Alder Hey Children’s Hospital, Liverpool.
Chris Frampton, South Lakeland Mind Outdoor Counselling Service, Kendal Therapy.
Hayley Marshall, The Centre for Natural Reflection, Derbyshire.
Lesley Dougan, Liverpool John Moores University.
Mark de Bernhardt Lane, Aquafolium
Mike Strang, Venture Trust, Scotland.
Dr Neil Bindemann & Dr Rob Lawson, British Society of Lifestyle Medicine
Outdoor Therapy workshop participants at the 2018 UK Outdoor Learning Sector Conference
Outdoor Mental Health Interventions launch participants at the 2019 Sector Strategic Forum
Dr Steff Revell, Otago Polytechnic, New Zealand.
Stephan Natynczuk, Spare Crab Adventure.

Future Developments

Version 2 of the statement was issued in November 2023 and responded to requests for greater information on planning and providing outdoor therapy, advice on contraindications, additional knowledge and skills statements for the indicators of outdoor and therapeutic competence, and improvements to the descriptors of Indicators of Good Practice with ethics in mind.

Version 1.3 of the statement was issued in October 2020 and added “Outdoor Therapy” to the title; examples of the three zones of practice on page 5; and extra detail to the figures on page 7 to describe "Intentional Integration".

Version 1.2 of the statement was issued in January 2020 and added clearer guidance on applying the model on Page 11.

Version 1 of the statement was launched at the 2019 Sector Strategic Conference on October 3rd in Birmingham.

In recognising that this is work is ongoing and to support the building of communities of practice, it is important that the mapping of all types of practice is developed. Future versions and associated publications of this statement of good practice will be published. This will include further resources and CASE STUDIES across different types of outdoor mental health interventions to help support developments in good practice. If you have a case study of good practice that you would like to share then please contact the authors.

The authors welcome ongoing dialogue in developing this work, so please forward any wider comments and views to them at IOL