Nature Based Therapy: Healing the Body, Mind, and Spirit

Spending as little as 20 minutes outdoors has been shown to reduce levels of the stress hormone cortisol and mitigate mental fatigue.

“I go to nature to be soothed and healed and to have my senses put in order.” – John Burroughs

For those of us who spend most of our lives between four walls, even a short trek into the Great Outdoors translates into health benefits that go well beyond strong lungs and legs. Cultivating a sense of wonder about the natural world exercises not only our physical muscles but our mental and spiritual ones as well.

The power of connection

Whether standing awestruck in front of the Grand Canyon or admiring the tenacity of a dandelion sprouting through cracks in the sidewalk, time invested in nature-based therapy returns high health dividends. Spending as little as 20 minutes outdoors has been shown to reduce levels of the stress hormone cortisol and mitigate mental fatigue.

The benefits go even deeper — literally. Many gardeners claim to feel happier and more relaxed when digging in the dirt, and those feelings aren’t purely psychological. Mycobacterium vaccae, a common bacterium found in soil, has been shown in studies to reduce stress chemicals and may have long-lasting anti-inflammatory effects on the brain.

A breath of fresh air

While outdoor activities don’t come without hazards (curious wildlife, seasonal allergens, inclement weather, etc.), “green exercise,” or activities that take place outside, may offer ancillary benefits that can’t be replicated by similar activities indoors.

Exposure to vitamin D boosts mood, supports immune health, increases muscle function, and assists in brain cell activity. Additionally, taking regular breaks from HVAC-filtered air and city pollution to spend time outdoors can help reduce the risks of chronic respiratory illnesses.

The endless playground

Outdoor play is a critical part of a child’s healthy development. From honing gross and fine motor skills to fostering creativity and a sense of connection with the natural world, exposure to outside activities from a young age can help a child grow in ways that an exclusively indoor education can’t replace.

In fact, researchers have found that children with attention-deficit hyperactivity disorder (ADHD) who walk in a park for 20 minutes can improve their symptoms as effectively as if they took a dose of prescription medication.

A case study in forest bathing

Device-free, you wander through the leaf-littered path of an old growth forest. You have no schedule, no time constraints. You listen to the birds overhead and the wind in the trees. The soil under your feet is damp and smells sweet. The stream, when you find it, is cold and clear and wakes you up better than a shot of espresso.

This hypothetical walk describes the Japanese practice of shinrin-yoku, or forest bathing. Not merely a walk in the forest, shinrin-yoku is the conscious and contemplative practice of immersing oneself fully in nature’s sights, sounds, smells, textures, and other sensations.

Research into shinrin-yoku has shown that forest environments promote lower concentrations of cortisol, lower pulse rate, lower blood pressure, greater parasympathetic nerve activity, and lower sympathetic nerve activity than do city environments. Additional research found positive emotional, cognitive, and behavioral changes among forest bathing participants, with many participants discovering meaningful metaphors for their own life experiences in the ebb and flow of nature’s rhythms.

Nature Rx

Across North America, healthcare professionals are incorporating the healing benefits of nature into their regular practice. Programs like the National ParkRx Initiative in the U.S. and PaRx in Canada provide national park passes, informational handouts, toolkits, and practical resources with the goal of connecting patients to nature.

“There’s almost no medical condition that nature doesn’t make better,” said Melissa Lem, a Canadian physician and director of PaRx.

Providers participating in these programs have the option to prescribe time out in nature to their patients, with the standard prescription of “two hours a week, at least 20 minutes at a time.”

Outdoor therapy

In occupational therapy literature, the use of gardening as a therapeutic intervention goes as far back as 1932. It’s not difficult to see why. Gardening is a meaningful, purposeful, and goal-oriented activity, often with tangible results. When leveraged as an occupation-based intervention, gardening is flexible in its implementation, translatable to various settings, cost-effective, and doesn’t require advanced training.

Although gardening as a therapeutic intervention has been around a while, nature-based interventions are generally not prevalent in most OT practices. Even so, a small but growing number of pediatric occupational therapists are beginning to incorporate the outdoors as a natural setting to facilitate the skills and abilities of children.

Jill Clancy, OTR/L, MS, CNS, a pediatric occupational therapist at a private out-patient pediatric clinic located in Massapequa, New York, has explored this idea in her “Learn Through Nature” enrichment class. In this program, she brings nature into the clinic for multi-sensory learning, motor skills development, and cultivating curiosity about the natural world.

The results of an eight-week occupational therapy intervention with 28 pre-adolescent at-risk youths embedding a nature-based intervention vs. a non-nature intervention found preliminary evidence for supporting the use of nature-based interventions in decreasing heart rate and increasing positive emotions. The inclusion of nature-based interventions in occupational therapy for at-risk youth contributes to occupational justice and engagement for this population.

The ConTiGO approach

Laura Park Figueroa, OTR, MS, developed the ConTiGO approach in 2015, out of her work with Outdoor Kids (OKOT). Located in Berkeley and Oakland, California, OKOT provides children’s OT services in small groups in nature. This approach encompasses the values of connection with family and friends (con) and transformation through therapy (t) in (i) the great outdoors (go).

The groups include 3-4 children receiving OT services addressing motor skill development, attention, social skills, or sensory processing, in addition to 1-2 “Peer Playmates.” OKOT also runs summer camps for children who can benefit from improved motor coordination, confidence, self-regulation, or social skills in a supportive outdoor environment.

his article was adapted from our sister site, Elite Learning, written by Carol Myers, OTR