Early on in her career as a professional counselor, Sally Atkins was working with a client who was suicidal and experiencing severe depression. Progress was painfully slow, and after several sessions, Atkins feared she and the client had reached an impasse. “As a kind of last resort, I said out of my frustration, ‘Let’s just go hiking and talk in the woods.’ I simply had this instinct that she needed to move because she was so stuck in her life,” remembers Atkins, a member of the American Counseling Association.

Atkins had occasionally taken brief walks with other clients to help put them at ease, but this was not a typical stroll in the park. The two women embarked on a strenuous hike that lasted nearly six hours. And out on the trail, in the open air, they were finally able to capture the sense of forward movement that had eluded them in the confines of the counseling office. “I felt like something happened by virtue of us being out there,” Atkins says. “It was a marathon therapy and sharing session.”

After finishing the impromptu outdoor adventure, Atkins asked if there was anything the woman could take from the hike and apply to the difficulties she was facing in her life. “Just being outside gave her a sense of emotional comfort, and she said her problems felt small when compared with the immensity of the natural world,” Atkins says. “She was proud of the physical strength she had shown on the hike, and it made her think that perhaps she also had the emotional strength to keep going when things were rough in her life. The experience also made her realize she needed to take one step at a time rather than focus on the enormity of the whole problem. That was a major shift for her. After that experience, she was more willing to explore new possibilities and found new energy for dealing with her life.”

The experience also signaled a shift in Atkins’ approach to counseling. “It really was a turning point for me in becoming more interested in and aware of the connection between nature and mental health,” she says. Atkins went on to develop the first class in ecotherapy for graduate counseling students at Appalachian State University in Boone, N.C., where she is a professor of human development and psychological counseling and coordinator of expressive arts therapy. “In teaching and in counseling, we (Atkins and ACA member Keith Davis, her coinstructor for the ecotherapy class) use nature-based experiences to help clients and students find resources for personal growth and development and to enhance their experience of relatedness with each other and with the non-human world. We see the processes of change as observed and experienced in the natural world as a model for human change and growth. … It’s not for every client or every situation, but so many clients and students tell us that they take solace in nature.”

Outside the office walls

When Rick Carroll broke into the profession in 1993, many of his clients were juveniles receiving court-ordered counseling. “I noticed right away that they didn’t want to be there,” he says. “I also noticed that if I put down my pen and paper and walked outside with them, the whole stigma of counseling kind of flew out the window. Taking them outside the walls of the counseling office was beneficial.”

Today, Carroll is a licensed professional counselor with his own private practice, and he also provides counseling services for the Children’s Advocacy Center of Bristol/Washington County, Va. Rare is the day that he doesn’t get outside with clients, either providing walk-and-talk therapy sessions at a wetlands park near his office or leading an experiential counseling group for adolescent boys. Typical group activities include caving, golfing and navigating a high-ropes obstacle course.

Carroll is a believer in incorporating nature into the counseling process for a variety of reasons. On one hand, he says, being out in nature rather than inside a counseling office can make the therapeutic process feel less threatening to clients. Many of Carroll’s clients are children who have been abused, neglected or exposed to domestic violence situations. “Eye contact can be very intimidating for these kids – or for any client for that matter,” says Carroll, a member of ACA. “If they’re not having to look you in the eye, they have a greater chance of disclosing. They want to tell their stories, and walking in the park or engaging in some other activity outdoors as we talk makes it easier for them. Going outside is not a panacea for everyone’s problems, but it gets them into a place that’s neutral.”

On the other hand, Carroll has found that being outdoors typically enhances the rapport-building process with certain tough-to-reach clients, particularly those young men who don’t consider counseling to be “masculine.”

“Most adolescents don’t think they have any problems that they need help with,” he says. “But when you’re out in nature, that includes insects and reptiles and poisonous plants. Kids kind of think of it as a risky thing, and that appeals to them. Some of the best counseling sessions I’ve had were with kids who didn’t even realize they were in counseling because we were outdoors.”

In fact, Carroll says with a laugh, the outdoor activities that are central to his experiential approach have made counseling sound very appealing to certain adolescents. In the course of counseling, Carroll took a middle-schooler on an outing to a cave. The next time Carroll dropped by the school, one of the boy’s friends approached Carroll and said, “I need to come see you. I’ve got some problems.”

Carroll also incorporates nature into his work with clients of all ages because of its versatility and flexibility. “Reality therapy, choice theory, behavior modification – you can pull from any number of approaches and use them in conjunction with nature,” he says. “I’d like to see more counselors add nature to their toolboxes. I’d like to see it recognized as a legitimate intervention and acknowledged as a resource that can help a variety of issues.”

Reeling kids in

Barbara Flom, an associate professor in the University of Wisconsin-Stout School of Education, believes school counselors could and should make better use of nature in their work with students. “It’s a huge untapped resource. Nature is free, it’s available, and our kids really need it,” says Flom, an LPC who is a member of both ACA and the American School Counselor Association. “As a school counselor for 15 years and, before that, a teacher of children with emotional and behavioral disorders, I observed the powerful calming and focusing effects of nature with a wide variety of students. I didn’t know then about the research on nature’s therapeutic benefits, but I saw its impact firsthand with my students. Most of the research is targeted at reducing aggression and building social skills, particularly with kids who are struggling with behavioral issues or feelings of connectedness.”

As a school counselor, Flom helped to run a Hooked on Fishing program that brought students outdoors to fish at the town lake. The program proved successful on a number of levels, from modifying behavior and improving students’ academic performance to helping students develop social skills and a sense of connectedness to their peers. For instance, the school’s Anglers Club targeted a group of fifth-graders who were chronically behind academically. “Each week in spring, if these students managed to be on track with their homework, they went fishing off the lake bank behind our school during the Friday noon hour,” Flom says. “They made their goal every week. The outdoors can be a powerful motivator.” Some of the school’s most challenging students were assigned to maintaining the fishing equipment and came to Flom’s office to restring the fishing poles. “Students who had been on the margins academically, socially or behaviorally really shone as leaders and role models in the natural setting,” Flom says. “We can really empower those kids who are connected to the outdoors by showing them that their skills are valued.” In addition to acting as a behavior incentive, she says the program served as a resiliency and coping tool for many of the children.

In some instances, the outdoors can help level the playing field for students who don’t feel as though they measure up socially or academically. “The (Hooked on Fishing program) was a great equalizer,” Flom says. “You could have a Ph.D. or be nonverbal, but the fish didn’t know that.”

Another school counselor in Flom’s area currently runs an after-school fishing program and has noted that many of the students who participate are not involved in any other school activity. “He’s using the program as a bridge-building opportunity for these students,” she says. “It gives them a place to fit in and find connection and a reason to want to come to school in the morning. As school counselors, we’ve got to find ways to reel in these students who aren’t connected socially, who are struggling behaviorally or academically, and nature can often provide us that window.”

A habitat for healing and growth

Counselors and other helping professionals are missing out when they don’t recognize the valuable role the natural world can play in the healing process, says John Swanson, a longtime ACA member who is recognized as a pioneer in the field of ecopsychology. “Nature can be a wonderful sanctuary for the healing of grief and loss. It can also heal us emotionally, in part because nature is nonjudgmental,” he says. “It can accept and receive all of a client’s feelings and pent-up energies, no matter how raw.”

Swanson, the author of Communing With Nature: A Guidebook for Enhancing Your Relationship With the Living Earth, recalls one instance in which he was running a men’s group and seeing group members individually. One of the men had made his fortune in the fish industry in Alaska but had seen his marriage dissolve in the process. In addition, as a boy, an older sibling had sexually abused him while his parents turned a blind eye. Raised in a puritanical, immaculate and orderly home, he had never learned how to deal with his anger, so it continued to build and fester throughout his adult life. Now an imposing man standing 6 feet 4 inches tall and weighing in the neighborhood of 260 pounds, he had a problem with pent-up rage.

“I tried to figure out a way to help him get his rage out without him destroying my office,” Swanson says. “So we created a plan.” The next time the man came for counseling, he told Swanson, “The plan worked out great. I went to the beach and rearranged furniture.”

What the man had done was visit a deserted beach in winter along the Oregon coast, where he proceeded to spend the night tossing large pieces of driftwood back into the roaring surf. The driftwood, Swanson explains, represented the home furniture the man would have liked to have taken his anger out on because of what had happened to him. “He also tossed ‘mom’ and ‘dad’ into the surf – figuratively,” Swanson says. “Truly letting his rage out would have been unsafe and socially unacceptable in a lot of places, but this allowed him to finally begin releasing some of the anger from his life and move forward again.”

Carroll has occasionally employed a similar tactic with young clients who have experienced abuse or who have problems processing their anger. For instance, he and the client might walk through the woods pretending to be samurai warriors. The client can then use his “sword” (a large stick found during the walk) to strike at objects in his path, releasing some anger in the process.

Many individuals who were abused or bullied or felt alienated escaped to nature as a form of sanctuary when they were children, Swanson says. “And as adults, I prescribe that back to them – retreating to nature to find comfort, healing, answers.”

In other cases, nature provides the proper setting for clients to achieve a fresh perspective, embrace new possibilities and discover (or rediscover) long-hidden strengths and sources of joy. Swanson, who himself embarks on an annual vision quest to “reorient my life and review how I’m doing,” recalls leading a therapy group composed of adult children of dysfunctional families. After 10 weeks of group sessions, the group went on a weekend retreat along the Oregon coast, where they participated in outdoor activities together. One of the group members was a librarian in her 50s. “When we were out on the beach, she just took off running,” Swanson says. “She was like a gazelle, graceful and quick as she ran in and out of the waves. She had a delightful smile on her face, which was such a contrast to the woman we had known in group. As a child, she had escaped the oppression of her dysfunctional family by running wild and free in her outdoor activities and after-school sports. This romp on the beach became a turning point for her. She began to take more risks and pursue more opportunities to embrace again these kinds of embodied physical activities that allowed her to reclaim that sense of abandon and freedom she had lost as an adult.”

“The natural world is the most common environment for what (Abraham) Maslow described as peak experiences, as well as for growth experiences,” Swanson asserts. “Our sense of awe in nature is often so powerful that we can be transformed by it.”

Carroll possesses similar beliefs concerning nature’s ability to effect positive change in clients. Eight years ago, he started a group called Compass for adolescents who have been abused or neglected. The group mixes experiential, cognitive behavioral and narrative therapy approaches, and group members spend several sessions discussing family dynamics and setting goals. The group also places a heavy emphasis on outdoor team-building exercises. Activities include exploring a cave with a certified spelunker and navigating a high-ropes course 40 feet in the air.

“Many of these kids’ lives are saturated with chaos and stress,” Carroll says. “When I take them out of that environment and put them into nature where they can see wildlife or the wonder of a cave, those events create the peak experience moments that Maslow talked about and, for the moment at least, nothing else matters to them. I believe there are spiritual, psychological, social and biological components to being out in nature, so this approach to counseling is also holistic.”

Even proponents of incorporating nature into the counseling process admit that it is difficult to put an empirical measure on its effectiveness in treating common problems such as depression. However, based on pre- and post-testing, individuals in Carroll’s Compass group generally get along better in school, exhibit more mannerly and compliant attitudes at home and show increased self-confidence overall after completing the program. Thanks in part to those measures of effectiveness, Carroll has been successful in securing funding for Compass for eight years, with nearly 60 adolescents completing the program during that time.

Feeling disconnected

“It’s interesting to me that when I talk with people who are battling depression and ask them about the times when they feel least depressed, they talk about when they go on walks or on vacation,” says Keith Davis, as associate professor and coordinator of the clinical mental health counseling program at Appalachian State. “And you very rarely hear someone say they spent their vacation in a high-rise. It usually involves some sort of outdoor element or activity. To me, that suggests an innate pull to the outdoors.”

In addition to being a counselor educator, Davis provides counseling to clients experiencing anxiety or depression. He likes to conduct imagery work with these individuals, asking them to describe a special place where they feel best. “I swear, 100 percent of the time, that place is in the outdoors, sitting on a mountaintop or by a lake,” he says. “It’s always tied to nature. It’s never, ‘I’m sitting in my living room or in my car.’ Still, I don’t think we understand how deep nature’s impact really goes.”

A growing literature base is exploring not only nature’s potential for addressing certain behavioral, psychological and emotional problems but also the possibility that society’s growing disconnect with nature is a major contributor to – if not the direct cause of – many of those problems. In his influential book Last Child in the Woods published in 2005, journalist Richard Louv compiled a wide body of research and coined the term “nature-deficit disorder” in proposing that direct exposure to nature is essential for healthy childhood development as well as the overall physical and emotional health of individuals of all ages. “Nature-deficit disorder describes the human costs of alienation from nature, among them: diminished use of the senses, attention difficulties and higher rates of physical and emotional illnesses,” he wrote.

In addition to attention-deficit concerns, Carroll has noticed a rise in Asperger’s-type symptoms, including social isolation and an inability to judge social cues, among his adolescent clients. Like many professionals, he believes a link exists between these problems and adolescents’ increased exposure to cell phones, computers, iPods, video games and other technology.

In working with these clients, Carroll often takes them outdoors and has them sit down, close their eyes and describe what they hear. “These ADHD kids who supposedly can’t attend to anything suddenly stop and look around in awe,” he says. “It calms them down and grounds them. It soothes them. I think it’s more of a spiritual thing than an emotional thing.” Atkins believes individuals from every age group are at increased risk of having their senses numbed because of technological bombardment. “That’s why it’s important for counselors to tap resources that are inherent in the natural world to help people who are struggling,” she says. “We live in a time and a culture where we live separate from nature. But being in the natural world calls us to be present in a sensory way that enlivens us both emotionally and physically.”

Adds Swanson, “Counselors need to look for opportunities to extend (Martin Buber’s) I-Thou mode beyond our species and help clients reconnect with their surroundings. It’s prescribing them to get out of the rat race and smell the flowers, to bicycle to work rather than spending time in their car bubbles, to create beauty in the home by spending more time gardening.”

Swanson says modern culture has cut most people off from the natural rhythms of life, creating a sense of disharmony in the process. “We’re not going to be happy campers if we’re out of synch with nature,” he says. “We’d be much better off if we started the day watching the sunrise and ended the day watching the stars rather than watching TV, listening to the birds sing rather than listening to the radio. These natural cycles are much more soothing and organic than following digital clock time and chopping everything into minutes and seconds.”

Whether addressing graduate counseling students or working with clients, Atkins emphasizes the importance of learning not just about the natural world, but from it. “One of the fundamentals is observation,” she says. “Watching the natural world, the changing seasons, can teach us about change and the seasons of life. Sometimes, as a society, we think we need to have constant daytime to be productive. But it’s also beneficial for life to lay fallow sometimes.”

Davis raises the possibility that a renewed emphasis on “natural” education could result in fewer students being branded with an ADHD label. “I don’t think the traditional public school education and structure is consistent with the learning style of all kids, especially young boys,” says Davis, who started his counseling career as a school counselor. “I won’t go so far as to say that our growing disconnect with nature is the cause of depression and ADHD, but when I see boys out in nature, they’re not required to focus on any one thing. Instead, they can just focus on being outside in the elements. It’s active and action-oriented learning, and there’s no judgment placed on their level of interaction.” In fact, Davis is inclined to believe that society’s growing disconnect with nature has led to much of the dissatisfaction and disorientation that many people feel in their lives. “I go back to the idea that I think there is an innate instinct in people that calls them to nature, that is imbedded in our genetic code,” he says. “As we have gone from a tribal society to an agricultural society to an industrial society and now to a technological society, we’ve moved further and further away from our relationship with the natural world. But many people still yearn for that connection instinctually. However, they don’t necessarily relate that connection – or that lack of connection – to their overall wellness. We’re seeing some emerging literature on wellness in the counseling field, and part of wellness is living in harmony with your environment.”

A paradigm shift

That concept of living in harmony with the environment is especially important to Davis, Atkins, Swanson and other proponents of ecotherapy. As described by Atkins, ecotherapy takes the ideas inherent in ecopsychology – an integration of ecology and psychology – and applies them to therapeutic practice.

In an article in press for the Journal of Creativity in Mental Health on ecotherapy (“Ecotherapy: Tribalism in the Mountains and Forests”), Atkins and Davis write: “We hold the conviction that our connections with nature and the environment are vitally important for our personal well-being and for the well-being of the planet.” They later add that “The paradigm of ecotherapy posits that personal health is related to the health of the planet, not just physically but psychologically and spiritually as well.”

“The idea that personal mental health is not just the matter of an isolated individual but is related to the health of the planet is a crucial idea and challenges the assumptions of modern science,” Atkins tells Counseling Today. She adds that ecotherapy is in tune with indigenous cultural knowledge and healing practices, including those beliefs that preserve practices of environmental sustainability and connectedness to nature. Atkins and Davis point out that this emphasis makes ecotherapy a potentially attractive alternative for clients who struggle to find meaning or healing in traditional, Western-based counseling approaches that primarily focus on the individual as separate from the natural world.

Swanson, whose research led to the publication of “The Call for Gestalt’s Contribution to Ecopsychology” in 1995 in The Gestalt Journal, is of the same mind. “The navel-watching approach to counseling can be overly introspective,” he says. “We can build better therapy by helping clients to explore their extrospective relationships.”

“We sometimes get stuck with the concept that mental health exists between our ears,” he continues, “but in family systems theory, we look at how relationships can help our mental health. The next leap forward is to broaden this to include all of our relationships, including the human-nature relationship. It’s essentially moving to a living systems approach from a family systems approach. If our relationship with the natural world is healthy rather than abusive, then our human relationships are more likely to be healthy as well.”

Both Swanson and Atkins are adamant that ecotherapy not be viewed as simply another subspecialty of counseling. “It’s really a paradigm change – one that I’m hoping will become central to what we do,” Swanson emphasizes. “If we shrink this down to a subdiscipline of counseling or psychology, we’re doomed.”

The ecotherapy class that Atkins and Davis teach at Appalachian State explores how experiences in nature can lead to personal healing. Atkins says students have described the class to her as life changing, and many have gone on to incorporate nature and ecotherapy ideals into their own practice as counselors. “The class gives them a renewed appreciation of the power and beauty of the natural world and its application to their own self-care as well as to the care of clients,” she says.

In addition to participating in classroom discussions, students design personal medicine shields throughout the semester – an activity that reflects a tradition within the Eastern Band of Cherokee Indians, many of whom reside in a designated territory near Appalachian State. In making the shields, students collect items from nature and assemble them in whatever way they choose. “Traditionally, these shields were power objects that evoked a person’s strength, courage and vision,” Davis explains. “They always end up very unique to the student. They are something to remind us of who we are in the deepest sense and how we are connected to the natural world.”

The ecotherapy class also takes a field trip each year to engage in and design nature-based experiences and activities. Last year, students were challenged to build structures to survive in the woods. “Then we talked about how empowering that was,” Atkins says, “and discussed the symbolic applications to other areas of our lives.”

Speaking metaphorically

Many counselors, including those who rarely step foot outside the office, testify to the effectiveness of using symbol and metaphor to speak to clients on a deeper level. But perhaps nowhere is metaphor more powerfully presented than on nature’s stage, from the changing of the seasons to the caterpillar’s metamorphosis into a butterfly.

“The big lesson of nature is that everything is cyclical. That can be both comforting and scary,” says Atkins. “Regardless, nature has this way of putting our little individual, ego-centered stories into the bigger picture.” One of Davis’ favorite counseling techniques is to take groups to a stream or river, where he asks each individual to find a rock or stone proportionate in size to the challenge he or she is facing in life. Afterward, he asks group members to carry their rocks with them as he leads them on a hike. “It’s a metaphor to show them how their life challenges, the problems they hold on to, are weighing them down. It gets them thinking about ‘What choices do I want to make?’ If they come back with a pebble, I have them put it in their shoe,” Davis says, “because even the smallest little thing can be nagging at you and affecting every other area of your life. When they finally say, ‘I can’t go on any longer,’ I say, ‘OK, are you ready to let that rock go?’ or even ‘Can I carry that rock for you for a while?’ For some people, the lesson is that they need to be willing to let others help them with their burden.”

The exercise holds a different lesson for other individuals. On multiple occasions when leading families through this activity, Davis says, a mother or a father has volunteered to carry all the rocks as their family members get tired. “The question then becomes what’s the price you’re paying for carrying everyone else’s problems?” Davis says. “It provides them with a lesson about how that action affects their overall wellness.”

In his experience as a counselor and counselor educator, Davis says, both clients and graduate students have professed a fear of nature. “But I think a lot of getting people out into nature is helping them to get over their fears, expand their comforts zones and tap into some resiliency and strength they didn’t necessarily know they had. It’s exploring what their fear is really about. In many cases, their fear of some element of nature is very symbolic of fears and doubts that are paralyzing them in other aspects of their lives. It’s simply a window into something bigger.”

Atkins realizes that although many counselors may be interested in incorporating nature into therapy, they may also feel intimidated by the prospect of where or how to begin. “I don’t think you can take any client somewhere that you don’t go yourself, so I would first encourage counselors to get out there and experience the healing power of nature themselves,” she says. “I would also emphasize that the process of helping a person be more connected to nature can be really simple. It doesn’t have to involve a hike up a mountain. It can be simple and yet have layers of meaning. It can be symbolic and cleansing. There’s just no cookbook for this. Irving Yalom said to create a new therapy for every client, and nature offers us a world of opportunities to do just that.”

Jonathan Rollins is the editor-in-chief of Counseling Today. Contact him at jrollins@counseling.org.
Letters to the editor: ct@counseling.org.