Family Counselors and Therapists Recommending Nature Programs Nature Rx

In 2013, officials in Melbourne, Australia, assigned the city's trees ID numbers and email addresses to make it easier for citizens to report problems such equally fallen limbs and unwieldy branches. However, Melburnians used the email-a-tree-service for another purpose: to talk directly to the trees. They sent emails to the trees expressing their honey and appreciation, and they also treated the trees equally friends, discussing topics such every bit school tests, tree biology, construction work and politics.

This unexpected exchange underscores the human want to reconnect with nature, notwithstanding urbanization and technology oft distance people from the natural earth. "Nowadays, nosotros're spending shut to 90 percentage of our time indoors," says Megan Delaney, an assistant professor in the Section of Professional Counseling at Monmouth University in New Jersey. "This is a major shift in how we employ our time. And some of that has to do with how we alive. We are in our cars. We are in our offices. … We don't walk anywhere anymore."

This disconnect comes at a toll because nature plays a function in our mental health. In fact, a prescription of nature may be merely what the counselor ordered. Inquiry suggests a possible link between increases in obesity, diabetes and attention-deficit/hyperactivity disorder (ADHD) symptoms and a lack of outside time, says Patricia Hasbach, a licensed professional counselor and clinical psychotherapist with a private practice in Oregon.

Delaney, who has a pocket-sized private practice in New Jersey and recorded a podcast on ecotherapy this past year for The Thoughtful Advisor (thethoughtfulcounselor.com), says enquiry also suggests a connection between the increment in anxiety and low in children and their disconnection from nature. "There'south been a loss of this free play," Delaney argues. "If [children] go outside at all, it's controlled."

Nature isn't a panacea, but even going outside for equally fiddling as five minutes a solar day will provide a heave to well-beingness, Delaney contends. In addition, exposure to nature can help improve relationship skills, reduce stress and aggression, help with the ability to focus, reduce symptoms of ADHD, improve impulse command and even improve fetal growth and birth charge per unit, she says.

Unwilding ecotherapy

Despite the positive benefits, the idea of incorporating nature into counseling often overwhelms clinicians and clients because they assume it ways wholeheartedly embracing the "wild" — packing up their belongings and taking a solo hike on the Pacific Crest Trail (à la Cheryl Strayed) to "observe themselves." For others, the very thought of "wilderness" or "nature" raises fears of the possible dangers, ranging from bug bites and sunburn to life-threatening injuries and encounters with dangerous animals.

The give-and-take ecotherapy often evokes a common myth of being fully immersed in the natural earth, living and sleeping on the ground, says Delaney, an American Counseling Association fellow member whose volume Nature Is Nurture: Counseling and the Natural World is under contract. "That's not what [ecotherapy] is virtually," she argues. "It's most our reconnection to our relationship with nature in whatever grade that feels right for yous. It could be a window box with your tomato plant plants. … I think that dispelling that myth is of import."

Ryan Reese, an assistant professor of counseling at Oregon State University-Cascades, agrees that a misconception often surrounds the idea of integrating nature into therapy. "[Clinicians] don't have to take clients out into a wilderness setting in order for it to be EcoWellness or ecotherapy," he says. "It tin can exist at a park or walking on a trail that'due south apartment."

Thus, expanding counselors' and clients' definition of nature becomes key, Reese argues. "We all are going to define nature in our own sociocultural, political context. How I ascertain nature is probably going to exist different than [for] somebody who grew upward in downtown Manhattan."

Reese, who has a private practice in Oregon, finds that broadly defining nature is beneficial, especially for clients who lack access to more traditional natural settings such every bit rivers, woods and mountains. To reach this, he says, counselors might work with clients to aggrandize their assumptions about nature past asking if it could include a local park, their backyards or even a view of trees from an office window.

When Delaney presented at the ACA 2017 Briefing & Expo in San Francisco on wellness and nature, she was shocked that approximately 150 people attended. At the end of the presentation, several clinicians approached Delaney and stated they were already conducting nature-based counseling but wondered if they were doing it correctly. To which she responded, "If it feels skillful, you are probably doing it right."

"People are doing [ecotherapy] intuitively and don't know the theory behind it," she continues. "They probably are taking their clients exterior. They probably are prescribing nature. They're probably doing things with kids in natural spaces. Peradventure they bring their dogs into the office. … When they read the science and research behind information technology and the theory … [they] get it."

At that place is growing interest in ecotherapy amid counselors and, thus, more options for training, says Hasbach, an ACA member who teaches ecotherapy at Lewis & Clark College in Oregon. Her continuing education course, "Prescribing Nature: Incorporating Ecotherapy Methods Into Your Clinical Practice," apace fills up with professional counselors and therapists from all over the land.

Reese, an ACA member who occasionally offers a 1-day workshop on interventions and ideals for integrating the natural world into therapy, recommends that counselors accept training courses to help them consider things they might not think near otherwise. For example, he has noticed that his boundaries can modify when he is outdoors with a client. Because he feels calm and relaxed, he is more susceptible to getting lost in the dazzler of nature and being less focused on what is going on with the client. He advises clinicians to be aware of how the counselor-customer interaction might differ in an outdoor setting versus an indoor setting.

"Information technology's not that you don't allow yourself to engage in the experience too. It'south just making sure that the customer is ultimately who you're there for and non yourself," Reese says. "Sometimes, I just get the vibe [from people who want to] do this outdoor piece of work … that it's more than about the clinician than information technology is about the client." Thus, counselors need to be mindful of their own reasons and motivations for incorporating nature into their practice.

More than a 'cute backdrop'

"Ecotherapy is one of those techniques that therapists and counselors can have in their toolbox, but they too need to know how to use it finer," Hasbach asserts. Ecotherapy goes across only walking in nature or playing with a dog, she points out. Instead, she explains that information technology involves a triadic relationship between the client, the counselor and nature.

Thus, nature operates every bit a therapeutic partner. "[Nature] is an active agent in the piece of work that nosotros're doing with our clients. It's not just a beautiful backdrop," Hasbach says.

Hasbach, a pioneer in the practice of ecotherapy, has co-edited two books on the subject — Ecopsychology: Scientific discipline, Totems and the Technological Species and The Rediscovery of the Wild. She stresses the importance of incorporating a "nature language," which is a way of speaking nearly patterns that represent how humans collaborate with nature in meaningful ways, such as sleeping under the night heaven. "These interactive patterns can exist really powerful if [clinicians] use them skillfully and intentionally in asking clients to comprise them into some of their homework," she says.

Hasbach had one client who was struggling with the end of an of import relationship. Hasbach knew the client was a adept photographer, and then she asked her to accept photographs of the sunset while contemplating the end of this relationship. The client'south journal of the feel reflected the similarity between the ending of the light and her relationship. Without being asked, the client also brought in a portfolio of sunrise pictures to discuss how this was also a new beginning for her — which was going to exist Hasbach's next consignment.

Nature tin can as well operate every bit a metaphor in therapy. "There [are] metaphors in nature every mean solar day nearly things that nosotros're going through in our lives that can exist powerful," Delaney points out.

For example, Reese asked a client who had severe anxiety to identify with a department of the path they would walk. The customer picked a picnic tabular array with a view of a river. "We would become there each time, and we would talk about his view of that experience and his view of himself in that experience and how it continued to change. … Over fourth dimension, he would go at that place on his ain, and to me, that was the existent special part," Reese says.

Hasbach keeps a handbasket of 20-25 nature objects such as stones, feathers, shells and pieces of bark in her function. When clients are struggling for words, she asks them to run across if whatever of the objects depict what they are feeling. Hasbach once had a client who was depressed virtually a breakup, but the client initially had a hard time talking about information technology. Hasbach asked the client if anything in the basket resonated with her in that moment, and the customer picked out a naturally woven ball of vines. She said she felt similar her life was a tangle and empty within, but like the ball of vines. "Information technology was just a prop that allowed her to be able to begin to talk about what she was feeling," Hasbach says.

Nature tin also be a metaphor for resiliency, Delaney points out. "After a … forest fire, the woods regrows. It starts over. It regenerates. It heals. Those are things we can talk virtually with our clients — existence able to meet how nature is reborn from even that horrific experience. … [The client's] natural trend as a natural being or animal being is to exist resilient and to finds ways of growing and rebuilding."

Connecting through nature

Reese also finds that engaging nature as a co-facilitator helps with building trust betwixt the counselor and client. "Whether we are out in [nature] or nosotros're talking about information technology within, that's what we're connecting through. We're talking about [the clients'] nature connection," meaning what they like doing outdoors. "We become for a walk. We just talk well-nigh other kinds of things, non their issues, and then, inevitably, what comes up are their issues," he explains.

"[Nature] doesn't explicitly gauge you," Reese continues, "[so] that offers … a pathway for people presenting with trust challenges, which [are] ofttimes based in relational trauma." The fact that clients can talk and process in a space where no i is critiquing or yelling at them tin can be restorative and healing, he adds.

Reese has been piloting the Angling for Wellness project with an alternative treatment customs for people presenting with adverse life experiences. He explains that for clients dealing with complex trauma, building trust and engaging in conversation straight can be difficult. So, Reese integrates fishing as a means of creating a nonjudgmental space that bolsters wellness and mindfulness.

While teaching clients the mechanics of fly-casting and the full general principles of fishing, Reese talks about beingness open to experiences and accepting of one'southward self in the casting process. If clients get frustrated, Reese checks in with them and ofttimes slows the process downwards. Once, when a client was upset that he wasn't communicable any fish, Reese asked him to put down the fishing rod and pay attention to what was happening for him in that moment. Adjacent, he invited the customer to detect ane affair he found cute or appreciated around him. Later, he processed what this experience was like for the customer and what it brought up. Together, they identified patterns around the customer'south frustration tolerance and behaviors in his life.

"The nature slice is a window into people's challenges [and] presenting problems, and information technology's also this amazing coping resources, especially when people can develop an effective connectedness with it," Reese says. "The goal is that [clients] brainstorm accessing some of these outdoor resources on their own without [the counselor]."

Some nature-based techniques work well with certain mental wellness issues. For example, Hasbach has plant that walk-and-talk therapy is often effective with teenagers and people who are dealing with anxiety and social skills deficits. These clients typically find information technology more comfortable to walk side by side with the counselor rather than sitting and looking at each other face-to-face, she says.

Hasbach also believes that nature-based interventions are effective for clients with posttraumatic stress disorder. "It's a mode of helping [clients] recognize this calming effect that nature tin have and this sense of belonging considering many times, they feel very disassociated. And then, this sense of belonging to something bigger than [themselves] can be very helpful," she explains.

Integrating nature into holistic wellness

Even after dispelling the myth that ecotherapy must involve complete immersion into a natural setting, counselors still might find it difficult to recall of nature-based techniques that work well in part settings. After realizing there wasn't a clear guide on how to intentionally incorporate nature into a traditional counseling setting, Reese, along with the late Jane Myers, who was a leading proponent of wellness in the counseling profession, adult the EcoWellness model. It explores the extent to which one's connection to nature affects wellness. The model includes vii domains — concrete access, sensory access, connexion, protection, preservation, spirituality and community connexion — that are correlates of wellness.

The EcoWellness model "is not necessarily a specific intervention. … It's more of a way of thinking or conceptualizing how to be effective in integrating this human-nature connection into counseling," Reese says. Other wellness models practice not explicitly mention the nature connection, but nature is another part of wellness and a way to aid in the healing process, he adds.

Because enquiry clearly shows the health effects of nature contact, Reese encourages all counselors to include nature-based questions (for case, how much fourth dimension clients spend outdoors, what clients bask outdoors) in their intake process, even if they simply enquire clients about their experience outdoors in the context of do or physical wellness. He argues that if a customer's relationship with nature isn't included in the intake process, and then counselors are missing out on a vitally important function of holistic health.

Reese addresses the seven domains of EcoWellness with all of his clients by having a conversation with them nearly their experiences with nature. "My goal is to develop a pretty contextualized understanding of what that person's connection with nature is like, how they benefit from it [and] how they don't benefit from it," he says.

Hasbach also weaves in a few questions in the intake session to gain a better understanding of clients' histories and current interactions with nature. Sometimes the answers to these questions also reveal details well-nigh clients' family unit life, she adds, such as hunting with their grandfather or hiding in the forest to escape violence in the home. Her questions include asking what recollections clients have about being outside in nature equally a child, what their family members' views were of the natural world, what clients similar to do outdoors now and how often they engage in that.

Too often, clients' connections to nature are left out of the conversation. These initial nature-based questions demonstrate that it is an appropriate topic and invite clients to discuss it in a therapeutic setting, Hasbach explains. In add-on, the questions assistance counselors decide the best approach for integrating nature into therapy based on the client's personal experiences.

Hasbach also finds eco-genograms to be a helpful technique for discovering clients' connections to nature. Counselors ofttimes use genograms to encourage clients to think and talk about their family histories in more than depth, merely, traditionally, simply people are included in genograms, Hasbach says. With eco-genograms, clients can include pets or fifty-fifty natural elements such as mountains or rivers that were important to them. They can also include facts such as living virtually a farm, having a garden or hunting their ain nutrient, Hasbach explains.

Counselors shouldn't assume that anybody's early experiences with nature were positive, Hasbach warns. That is why asking about a customer's experience with nature as a kid during the intake session is important. If a client discloses that he or she had a frightening experience in the woods, then the counselor shouldn't have the client on a walk in the woods. "[Clinicians] accept to understand the client'south feel of the natural globe, simply like [they] have to sympathize the client'south experience of society, family [and] interpersonal relationships," Hasbach explains.

In fact, taking clients outdoors may not always be benign for them, Reese notes. 1 of his clients who had been assaulted by a man told Reese that she didn't feel comfortable working with him in an outdoor space. When they went back into the office, the dynamic shifted, and she felt safer.

Bringing nature within

In that location'south good news for counselors who are hesitant about taking clients exterior: They can stay within and still use ecotherapy.

"The logistics of … coming together in a park or going to a specific place for individual sessions can present a challenge for many clinicians," Hasbach notes. Instead, counselors can assign nature-based homework for clients to extend the therapeutic 60 minutes, she advises.

Hasbach and Delaney both find that nature-based assignments encourage clients to go outdoors, unplug from engineering science and contain the healing and restorative aspects of nature outside of the session.

For example, Hasbach sometimes asks clients to sit in their backyards or to take a walk on the beach and think nearly a question with which they've been struggling. She also uses a "special place" assignment in which clients select a special place that they concord to visit several times each week — during varied weather conditions and at different times of the day — for a specific number of weeks. This practise fosters heightened sensory perception, a reconnection with and expanded knowledge of a natural place, and a sense of belonging, Hasbach explains.

Counselors tin can also make their office spaces greener. Hasbach first realized the powerful influence of nature during an part session earlier she was intentionally incorporating ecotherapy into her practice. On this particular day, she forgot to plough on a water feature that she regularly used. During her offset session, the client noticed and asked nigh the absenteeism of the water sound.

This experience taught Hasbach to be mindful of the elements in her office setting. She nevertheless has a rock fountain that provides the soothing audio of trickling water, and she often brings in freshly cutting flowers. She has likewise purposefully arranged her function so that her clients face up a window overlooking a tree awning.

Inquiry supports this idea of greening the office space. As Delaney points out, high-quality natural light from windows has been shown to subtract employee discomfort and ameliorate productivity. As a result, she advises counselors to let in more natural light to their offices when possible, add plants, put up pictures of natural places and play nature sounds such as gurgling streams and distant thunder. Delaney even uses her calculator screen as a manner of displaying diverse nature scenes.

Technological nature

With an increase in urbanization and engineering science employ, people often can find themselves even more removed from the natural world and spending more time in front of screens than outside, Hasbach points out. According to a 2010 Kaiser Family Foundation study, children ages viii-18 spend more than vii.five hours a day on boilerplate with media. Mutual Sense Media reported that the corporeality of time immature children (up to age eight) spent on mobile devices tripled from 15 minutes a day in 2013 to 48 minutes a mean solar day in 2017.

"Technology is with u.s.a.," Hasbach acknowledges. "Nosotros are technological beings every bit well as natural beings. We have always been toolmakers, so it's not going away." Rather than fight that fact, counselors need to help clients reach a better residuum between their technological and natural selves. "Richard Louv [author of Last Child in the Woods: Saving Our Children From Nature-Arrears Disorder and The Nature Principle: Reconnecting With Life in a Virtual Age] … says, 'The more high-tech nosotros become, the more nature we demand,' and I think that speaks beautifully to the balance that we take to find," Hasbach reflects.

It is perhaps fortunate and so that technological nature — digital representations of nature, including nature music and videos — tin can accept benefits for one's well-beingness. Research suggests that technological nature has similar properties to the real thing, Reese says. Although existence out in nature is nigh constructive, technological nature is better than no nature at all, he adds.

In 2016, Reese co-authored a written report published in The Journal of Humanistic Counseling that examined the use and preferences of nature media accessed through YouTube and plant that people oft use nature media to help them sleep, report or destress. "People are still accessing a form of nature even in digital course and saying that they are benefiting from information technology," Reese says. This finding might help counselors and clients expand their concept of what nature can exist, he adds, specially for people who may non have easy access to outdoor spaces or those presenting with a astringent pathology such as paranoid schizophrenia or severe obsessive-compulsive disorder. Thus, for people with no access or express admission to nature, such every bit those in prisons, nursing homes or health care environments, technological nature tin can play an important role.

Hasbach was function of a study that incorporated nature imagery into a prison house that used solitary confinement to determine if information technology would touch the inmates' behavior and well-beingness. The inmates spent either 23 or 24 hours per day confined to individual cells. 4 or v times each calendar week, they were allowed to spend an hr alone in the exercise area (some other cellblock) or the recreation yard (a physical enclosure with the top open to the sky).

The prison installed a projector in the exercise cell. Half of the inmates were given the selection of watching a nature video during their hour of practise fourth dimension; the other half were not. The findings revealed a 26 percent subtract in trigger-happy offenses amidst the inmates who watched the nature videos. When Hasbach interviewed some of the inmates, she learned that the natural scenes had a restorative value for them. Some inmates said that when they were agitated, recalling the nature scenes helped them calm down. Hasbach explains that they were using the images to self-regulate.

Nonetheless, Hasbach is concerned that technological nature may get a convenient substitute, even when real nature is available, especially in schools. Instead, she stresses that counselors should incorporate technological nature only equally an augmentation to authentic nature.

Ethical considerations

Hasbach identifies confidentiality, avoiding harm and competency as three ethical considerations central to ecotherapy. Reese says he has encountered negative reactions about including EcoWellness in counseling in part considering some counseling professionals have concerns about how to implement it ethically. Thus, both Hasbach and Reese recommend that counselors who want to pursue nature-based work accept a solid programme for what they are doing, why they are doing it, what their hopes or outcomes are and how they tin can incorporate nature to be near beneficial to the customer.

In terms of confidentiality, counselors and clients demand to discuss the differences betwixt going exterior for a session and staying within the function, Hasbach says. Among questions to consider: What happens if yous and the client are discussing a sensitive issue on a trail and someone walks upwards behind you lot? What if you encounter someone whom either you or the client know? What happens if the client gets emotional on a trail?

Later having a discussion, Hasbach documents how clients say they want to handle these situations. Some clinicians might have it a step further and have clients sign a waiver, she notes. Counselors likewise need to ask clients virtually allergies or physical limitations and document those also. Reese spends at least two sessions indoors with clients discussing these possible scenarios and clients' concerns before he even thinks about taking them outside.

Physical safety is another big consideration when working with groups, Reese says. "[Grouping work] adds an chemical element of risk. You've got more people that you need to manage … so having a co-facilitator, having at least some other person in that location who can help, in my heed is really of import for the concrete safety [of clients]."

Counselors must be competent and prepared for the environment they are taking clients into, Hasbach emphasizes. Walking on a bike path or working in a garden outside a habitation role doesn't require as much physical competency as taking clients out past a river where they could exist walking on rocks and have a heightened level of wilderness, she explains. Whenever she goes outside with a customer, she takes a pocket-sized emergency bag with a jail cell phone, water and allergy medicine. She says the only time she has had to use this bag was when offering water to a client who had gotten emotional.

Finding a rest

Melbourne's email-a-tree initiative aimed to help with city maintenance, but information technology too revealed people's need to reconnect with nature and detect a balance betwixt their technological and natural selves. It also reaffirms Louv's merits that the more high-tech nosotros become, the more nosotros need nature.

"We are nature. We are a part of it, non apart from information technology," Hasbach says. Ecotherapy provides a healthy environment for counselors and clients, and it gives clients permission to admit that they are out of balance and need to alter, she continues. Ecotherapy also provides counselors and clients with tools to help clients residual the pace and stress of life, she adds.

For Hasbach, helping humans reconnect with nature and notice (or rediscover) their remainder is an exciting area for the counseling profession to explore. "When we really look at what is at the centre of people's well-being, the environment that we're in is function of that, so I retrieve ecopsychology and ecotherapy [have] a [function] to play."

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Lindsey Phillips is a contributing writer to Counseling Today and a UX content strategist living in Northern Virginia. She has written on topics including health, social justice and engineering. Contact her at consulting@lindseynphillips.com or through her website at lindseynphillips.com.

Letters to the editor:ct@counseling.org

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Opinions expressed and statements made in articles appearing on CT Online should non be assumed to represent the opinions of the editors or policies of the American Counseling Clan.

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Source: https://ct.counseling.org/2018/04/using-nature-as-a-therapeutic-partner/

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