Why your outdoor therapist’s indoor training matters most

The world of therapy has long been plagued by issues of nomenclature. Even with well-established categories such as counselling, psychotherapy, psychoanalysis and even counselling psychology, the defining lines between them can become really quite blurry when you try to genuinely demarcate where one starts and another ends.

As a trained counsellor, with a long history of interest in the different therapeutic approaches and extensive experience as a client with professionals claiming at least three of those titles, even I feel confused.

The nature, length and level of training is often cited as being one of the main points of meaningful distinction, as are factors such as the depth and duration of client work, with counselling (often seen as being a short to medium term practice best used for emotional support with difficult life issues – a treatment for ‘the worried well’) at one end of the spectrum and psychoanalysis (perceived as being ‘deeper,’ often lasting for years, if not decades, and potentially making use of several sessions a week) at the other. 

But there are many instances in which even these distinctions begin to falter: counsellors can work long-term and at depth. Some psychotherapists have undergone less training than some counsellors. Some psychotherapists are more academically oriented than some psychologists. And in certain instances, there may be no appreciable difference between the disciplines as experienced in the room, by the client, beyond the character and temperament of the therapist.

Inject into this already infinitely complex melee something new, and in its own way extremely broad, and you’ve got, well, a whole new set of questions that don’t provide ready answers.

Enter: therapy in nature

Several years ago, I entered the counselling space. My first ever client on placement requested that we move our work outdoors. I was surprised and, at that time, had no idea that this was even possible, but felt like there would be some clinical justification for it in this instance, so I put in a request to my agency manager.

To my surprise (and, in hindsight, immense gratitude), she OK’d it and so on one torrentially rainy August afternoon we stepped out into the local park, and in a single session made more progress than we had been able to in the previous ten. 

There was no turning back. I was hooked, and since then have worked with many clients outdoors, both as a practitioner within addiction and mental health services, as well as within my own private practice, where I work with people bringing a wide range of different difficulties and concerns.

But the further I’ve got into this way of working, the more acutely aware I’ve become of some of the issues of naming and verifying the validity of what I do. 

Just as above, I chose to rest on the term ‘therapist’ as an acceptably non-commital, yet adequately descriptive, umbrella term for all the distinct-yet-different practices I grouped together, the phrase used in the title – ‘therapy in nature’ – is the one I feel best describes the particular set of collective practices that I personally operate within. Namely, therapy that is conducted outdoors in settings that are, in the widest possible sense of the term, natural. 

Variously labelled nature-based therapy, nature therapy, ecotherapy, green therapy, forest therapy and, perhaps best known, walk-and-talk therapy, there is a long tradition of practitioners taking their clients outdoors as a means of utilising the well-documented and subjectively evident positive effects that nature has on a wide range of aspects of our well-being. 

COVID accelerated this trend, but we should not see this as simply a contemporary fad – to do so discounts the work of a number of conscientious and dedicated practitioners who laid important foundations in bringing in the possibility of this way of working into the clinical mainstream, starting as far back as the mid-20th century, but beginning to meaningfully crystallise into something with a collective identity and shared, if somewhat vague and disparate, philosophy in the 1990s. 

But despite this, the field has never truly unified and very little by way of formal theoretical frameworks exists. So all those different labels I mentioned? Unfortunately, they carry very little weight, at least not in the way that the established modalities of counselling and psychotherapy do. 

What makes something a recognised modality?

Psychodynamic, person-centred, CBT, gestalt, ACT, compassion-focused therapy, TA, confusing as all these different names may be, if you are unfamiliar with the staggering array of types of therapy available in our modern world, they nonetheless fulfil the following criteria:

• Coherent theoretical framework – a clear explanation of how change happens.
• Defined techniques and interventions – specific, replicable practices tied to the theory.
• Training and competence standards – agreed pathways for learning and practising safely.
• Empirical or clinical validation – some evidence (research or clinical) supporting effectiveness.
• Community of practitioners – professional networks, supervision, publications, ongoing development.
• Distinct identity – a recognised name, philosophy, and set of goals that differentiate it from other approaches.

At present, there are no nature-based therapies that fulfil all of the criteria named above. Therefore, we might say that nature is the setting, not the qualification. If someone is only a Nature Therapist without a foundational modality (like CBT or Person-Centred), they are essentially a guide without a clinical map.

There are beginning to emerge some signs of the potential for a genuine nature-based modality, rather than just one of the other types of therapy, but done out in nature. As of yet, however, these are unable to be practised as standalone methods of delivering therapy. Nature-allied psychotherapy, formulated by Beth Collier, who delivers a year-long diploma at her nature-therapy school, is one such example, or Caroline Brazier’s 10-Directions Ecotherapy Training, for example.

Does this mean I shouldn’t do therapy outdoors?

Absolutely not, but it is critical to always check that a professional you are seeking to work with can provide evidence of their credentials. In the UK, this is at least a Level 4 Diploma, Undergraduate Degree or Master's in counselling and/or psychotherapy, as well as membership of a professional body that belongs to the professional standards register, such as BACP, NCPS or UKCP where possible.

Therapy in nature can provide so much that, for some people, therapy indoors simply cannot. There are many who just aren’t suited to the method of delivery of traditional therapy. It can be particularly effective for men, young people, autistic people or those with ADHD and for people who just feel safer to connect and share emotionally within the outdoors. The fact that nature-based therapies are contributing to the wider field by reducing barriers and providing new options for those who may have previously been excluded from the help that counselling can provide is something that I feel passionately in favour of.

I know that I’m not alone, and in the current landscape where an increasing reliance on technology (particularly the rise of AI, perhaps the most significant addition to the therapy landscape in recent years) is serving to distance us from both other people and the natural world, I believe that nature-based, real human experiences such as these therapies may provide will become an ever more in demand, and ever more essential in providing a meaningful corrective to this trend.

So take your therapy into the wild, but just make sure the person walking beside you has a solid professional foundation beneath their feet.