As the pandemic continues to change how we approach health care with services like telehealth on the rise, talk therapy is also evolving with the times in fascinating ways. Outdoor therapy, or traditional talk therapy sessions held outside, has become an increasingly popular option over the last year.
Since outdoor therapy offers a COVID-safe, socially distanced alternative to meeting in person for mental health care, many therapists and patients are choosing to opt for this type of service—weather permitting, of course. Plus, outdoor therapy can be a great alternative to meeting over Zoom, which can cause "Zoom fatigue" for some people, the very real feeling of being drained and tired after a video call (or multiple calls).
While outdoor therapy has been a smart solution during the pandemic, it also has a number of physical and mental health benefits that make this type of service likely to stay for good. Here's everything you need to know about outdoor therapy, including how it works and how it can be just as productive—if not more productive—than traditional talk therapy, in-office or virtual.
What is outdoor therapy, and how does it work?
Outdoor therapy, or mental health care held outdoors, is a behavioral treatment strategy that combines nature with traditional talk therapy. Therapists and patients can choose to meet outdoors simply to social distance, or they can take short walks or hikes during their sessions.
"I usually take clients on a semi-private walking trail," says Michael Alcee, PhD, New York–based psychologist. On this trail, clients catch glimpses of the Hudson River and even make their way through a rose garden, all while exploring the psyche and anything on their mind that they want to share. "It's a refreshing alternative to staring at each other on a Zoom screen."
While outdoor therapy is the umbrella term for this strategy, it can sometimes be called ecotherapy, nature therapy, or wilderness therapy, depending on the form. Though outdoor therapy has been in practice for several decades, the COVID-19 pandemic has breathed new life into this service, bringing it into the mainstream as a regular option.
Outdoor therapy encourages productive sessions.
"Outdoor therapy has a way of helping clients and therapists stay in the present moment," Alcee says. "People seem to be freer and more open to explore and disclose when they are walking." That's because walking can significantly increase creative output—up to 60 percent, according to one study—meaning both therapists and clients can see new solutions in different lights (literally).
Plus, a little bit of healthy distance may help some clients become more self-reflective. "In contrast to staring directly into their therapist's eyes in-person or on a screen, they get to allow their thoughts and feelings wander," Alcee continues.
Nicole Lacherza-Drew, PsyD, a New Jersey–based psychologist, adds that outdoor therapy can significantly boost communication. "Rapport is a very important component of therapy, as is the willingness of the patient to talk," she says. "For some individuals, being outside provides a little bit of a distraction and is less intense than sitting across from the provider in the stereotypical room with chairs and a couch." This can feel "more authentic and comfortable" for many patients, she explains.
Outdoor therapy can also alleviate Zoom fatigue, a growing phenomenon as we continue to work and learn remotely. Dr. Lacherza-Drew explains that with many people staying inside all day, even with most COVID-19 restrictions lifted, having a chance to move around and get outside can also be beneficial for clients. "Many people get tired of being inside and in front of a computer screen all day," she says. "Zoom fatigue is a real thing, and if you have an alternative to yet another meeting on a screen, it can improve your mood just by doing something different and giving your eyes a rest."
The Health Benefits of Outdoor Therapy
Studies regularly show how nature and being outdoors can improve our health. Researchers have found that spending just a little over an hour outdoors can decrease self-reported rumination, which is associated with a heightened risk of depression and other mental illnesses. Being surrounded by nature also has the potential to increase happiness, subjective well-being, positive social interactions, and a sense of purpose in life, in addition to decreasing mental distress.
"Outdoor therapy can be beneficial for easing mild depression and anxiety and for getting your body moving in a healthy way," says Katie Ziskind, LMFT, a Connecticut-based marriage and family therapist. It can also boost your physical health, which is directly connected to mental health (Alcee says many outdoor therapy sessions net him and his patients 10,000 steps, which some believe is the optimal amount of steps people should take each day).
Ziskind also says spending time outdoors can increase your exposure to vitamin D3, a deficiency of which can lead to increased depression. Therefore, engaging in outdoor therapy can not only benefit you from the talk therapy perspective, but it can boost your overall wellness.
In addition, outdoor therapy can provide a much-needed respite from the distractions, technology, and chaos of everyday life. "We are constantly being overstimulated with media, noise, and the use of our devices throughout the day," says Reverend Connie L. Habash, MA, LMFT, a California-based counselor and author. "Going outdoors and reigniting this inherent sense of connection to the natural world thus alleviates depression, which is often spurred by feeling disconnected."
Habash also calls nature a "co-therapist"—meaning patients have two therapeutic outlets to lean on—which makes outdoor therapy potentially just as effective, if not more effective, than in-office or Zoom therapy.
"There is so much to interact with," she explains. "If a client becomes distracted by agitating thoughts or emotions, there are sensory elements readily available to bring them back into the present moment and calm their anxiety."