Catherine Freer Wilderness Therapy Expeditions: An Exploratory Case Study of Adolescent Wilderness Therapy, Family Functioning, and the Maintenance of Change

Nature-based interventions for vulnerable youth: a scoping review

Nature-based interventions hold promise for vulnerable youth experiencing mental, emotional, developmental, behavioral, or social difficulties. This scoping review examined wilderness therapy, animal assisted therapy, care farming, and gardening and horticultural therapy programs to raise awareness and guide future development of research and treatment options. Studies included in this review were identified through a systematic search of the literature informed by a scoping review framework. Studies were examined by design, sample, intervention, and key findings. The majority of studies were quantitative using repeated measures designs and were conducted primarily in the United States. Sample sizes were generally small. Interventions were residential and community based with varying degrees of duration. Outcomes were largely positive across a wide range of psychosocial and behavioral measures and often maintained post-treatment. We emphasize the importance of robust empirical designs, comprehensive description of the interventions and surrounding therapies, and identification of target groups.

Mapping the Concept, Content, and Outcome of Family-Based Outdoor Therapy for Children and Adolescents with Mental Health Problems: A Scoping Review

Outdoor therapy and family-based therapy are suggested to be promising interventions for the treatment of mental health problems. The aim of the present scoping review was to systematically map the concept, content, and outcome of combining family- and outdoor-based therapy for children and adolescents with mental health problems. The Joanna Briggs Institute methodology and PRISMA guidelines were applied. Eligible qualitative and quantitative studies were screened, included, and extracted for data. Seven studies were included. Findings from these studies indicated that family-based outdoor therapy programs have a positive impact on family- and peer relationships, adolescent behavior, mental health, self-perceptions (self-concept), school success, social engagement, and delinquency rates. However, participant characteristics, study design, and content and mode of delivery of the interventions varied substantially, hence preventing detailed comparison of outcomes across studies. In addition, most of the studies included few participants and lacked population diversity and comparable control groups. Although important ethical concerns were raised, such as non-voluntary participation in some of the programs, there was a lack of reporting on safety. This review indicates that a combination of family- and outdoor-based therapy may benefit mental health among children and adolescents, but due to the limited number of studies eligible for inclusion and high levels of heterogeneity, it was difficult to draw firm conclusions. Thus, future theory-based studies using robust designs are warranted.

Can Rehabilitation in Nature Improve Self-Perceived Interpersonal Problems? A Matched-Control Study

Self-perceived interpersonal problems are of central concern for researchers and individuals; they are at the basis of psychopathology and cause for subjective distress. In this study, we examine whether a group-based rehabilitation program in nature may reduce self-perceived interpersonal problems in a heterogeneous group of men declining participation in traditional rehabilitation offers. The intervention consisted of weekly meetings in nature, taking place over the course of nine weeks. Through a matched-control study including 114 participants in the intervention group and 39 in a treatment as usual group participating in traditional rehabilitation offers, we found that there was no statistically significant development in self-perceived interpersonal problems in the nature-based rehabilitation offer. Though promising with regards to a number of mental challenges, including relational challenges, nature-based group-rehabilitation may require a more elaborate and thoroughgoing intervention, including e.g., a therapist and more time to be an effective intervention against interpersonal problems. We conclude that perhaps due to the fundamental aspect of self-perceived interpersonal problems, exposure to nature, and being in a group of men in a similar situation for the duration that this intervention lasted, may not be enough to address such underlying perceptions of self.

"Recovering With Nature": A Review of Ecotherapy and Implications for the COVID-19 Pandemic

Connection with nature has been considered beneficial for psychological well-being since times of evolution. Differences in Indian and Western thoughts have viewed natural elements in different lights, varying between eco-centrism to anthropocentrism. The intrusion of technology and digitalized lives as a result of globalization has decreased connectedness with nature. Ecotherapy is a novel form of psychotherapeutic technique based on explicit environmental or ecological interventions. Social and therapeutic horticulture, animal-assisted interventions, care farming, green exercise, environmental conservation and wilderness therapy are some of the ecosystem-based approaches used in mental health. Based on the principles of positive and client-centered psychology, ecotherapy-related techniques have been shown to be effective in medical disorders like hypertension, obesity, post-surgical recovery and psychosocial conditions like depression, stress reduction, post-traumatic stress disorder (PTSD), attention deficit hyperkinetic disorder (ADHD) and adjustment disorders. The principles of ecotherapy have been integrated into other psychotherapeutic techniques for better efficacy. This review attempts provides an overview of techniques, applications and challenges related to ecotherapy in psychology. The implications of its use during the ongoing Coronavirus 2019 (COVID-19) crisis, social isolation and consequent psychosocial aftermath are also discussed.

Family Enrichment Adventure Therapy: A Mixed Methods Study Examining the Impact of Trauma-Informed Adventure Therapy on Children and Families Affected by Abuse

Child abuse is epidemic in the United States and has dire long-term consequences. Innovative interventions are needed to address the negative cognitive, affective and behavioral effects of child abuse. This mixed-method study examined if adventure therapy is 1) an effective mental health intervention for child and adolescent survivors of abuse and neglect, and 2) an effective intervention for families affected by abuse and neglect. The effectiveness of the adventure therapy intervention was measured by a reduction in child trauma symptoms and improved family functioning, as reported via the Trauma Symptom Checklist for Children (TSCC), the Family Assessment Device (FAD), as well as qualitative data gathered via family focus groups. Findings showed that trauma-informed adventure therapy with youth and families affected by abuse reduces trauma symptomology in youth and improves family functioning, particularly in the areas of communication, closeness and problem-solving skills.

Ecotherapy - A Forgotten Ecosystem Service: A Review

Natural ecosystems provide important services upon which humans depend. Unfortunately, some people tend to believe that these services are provided by nature for free; therefore, the services have little or no value. One nearly forgotten ecosystem service is ecotherapy – the ability of interaction with nature to enhance healing and growth. While we do not pay for this service, its loss can result in a cost to humans resulting in slower recovery times, greater distress and reduced well-being. Losses in these images of nature can diminish our basic happiness. Little is understood or, at least, appreciated concerning the potential ecotherapy benefits of the natural environment and its ecosystem services. The complex and interactive relationship of ecosystems, their services and human well-being is poorly acknowledged in the broad social, philosophical, psychological and economic well-being literature. In this article, we examine the role of nature and its ecosystem services in ecotherapy and its associated enhancement of recovery from physical and mental illness through a review of studies evaluating this ecosystem service-recovery connection.

Mental health benefits of interactions with nature in children and teenagers: a systematic review

Background

It is commonly believed that nature has positive impacts on children’s health, including physical, mental and social dimensions. This review focuses on how accessibility to, exposure to and engagement with nature affects the mental health of children and teenagers.

Methods

Ten academic databases were used to systematically search and identify primary research papers in English or French from 1990 to 1 March 2017. Papers were included for review based on their incorporation of nature, children and teenagers (0–18 years), quantitative results and focus on mental health.

Results

Of the 35 papers included in the review, the majority focused on emotional well-being and attention deficit disorder/hyperactivity disorder. Other outcome measures included overall mental health, self-esteem, stress, resilience, depression and health-related quality of life. About half of all reported findings revealed statistically significant positive relationships between nature and mental health outcomes and almost half reported no statistical significance.

Conclusions

Findings support the contention that nature positively influences mental health; however, in most cases, additional research with more rigorous study designs and objective measures of both nature and mental health outcomes are needed to confirm statistically significant relationships. Existing evidence is limited by the cross-sectional nature of most papers.

Nature-based interventions in institutional and organisational settings: a scoping review

The objective of this review was to scope the literature on nature-based interventions that could be conducted in institutional settings where people reside full-time for care or rehabilitation purposes. Systematic searches were conducted across CINAHL, Medline, Criminal Justice Abstracts, PsycINFO, Scopus, Social Care Online and Cochrane CENTRAL. A total of 85 studies (reported in 86 articles) were included. Four intervention modalities were identified: Gardening/therapeutic horticulture; animal-assisted therapies; care farming and virtual reality-based simulations of natural environments. The interventions were conducted across a range of settings, including inpatient wards, care homes, prisons and women's shelters. Generally, favourable impacts were seen across intervention types, although the reported effects varied widely. There is a growing body of literature on nature-based interventions that could be applied to a variety of institutional settings. Within most intervention types, there is sufficient research data available to perform full systematic reviews. Recommendations for future systematic reviews are offered.

Exploring salutogenic mechanisms of an outdoor experiential learning programme on youth care farms in the Netherlands: untapped potential?

This study explored how (learning) experiences offered through outdoor experiential programmes, particularly the youth care farm approach, may (or may not) enhance young peoples’ ability to recognise and then utilise available resources for personal growth, protection and health promotion. A total of 11 youngsters were asked to look back on their half-year stay on a care farm in the Netherlands, by using semi-structured interviews to elicit their experiences from a salutogenic perspective. Analysis revealed that several resources (and the interaction of these resources) on the youth care farm worked well for the youngsters; contributed to their personal development and to their sense of coherence: the feeling that the world is or can be meaningful, comprehensible and manageable, associated with positive outcome in endeavours linked to improving health and well-being. In general, the attitude of the farmer, working with animals, the informal atmosphere and being temporarily cut-off from the former environment were elements most positively highlighted by the youngsters. The farm environment was mentioned as calming, however, as structuring as well. The strength of the programme as an experiential learning opportunity appears to be the diversity and richness of resources (and stressors!) available to the participants. This creates various opportunities for learning: making sense, interpreting and giving meaning to resources and stressors. Further research into the impact of this kind of programmes, compared to more ‘traditional’ programmes, especially on the ability of youngsters to use resources to finish school, find employment and develop better relationships with their parents is recommended.

An Examination of the Feasibility of Adventure-Based Therapy in Outpatient Care for Individuals With Psychosis

Adventure-based therapy (ABT) involves experiential learning, outdoor education, group counselling, and intrapersonal education. While it has shown benefits in a number of populations including at-risk youth, little research has focused on individuals with psychosis. The objective of this study was to employ a mixed-methods pre-post design to examine the feasibility of a 6-week ABT intervention in an outpatient care setting among 15 adults with psychosis. The intervention proved feasible with significant improvements found in engagement in the recovery process, emotional well-being, and energy level. No changes in self-esteem or global health were observed.

Nature-assisted therapy: Systematic review of controlled and observational studies

Background: Nature’s potentially positive effect on human health may serve as an important public health intervention. While several scientific studies have been performed on the subject, no systematic review of existing evidence has until date been established. Methods: This article is a systematic evaluation of available scientific evidence for nature-assisted therapy (NAT). With the design of a systematic review relevant data sources were scrutinised to retrieve studies meeting predefined inclusion criteria. The methodological quality of studies and abstracted data were assessed for intervention studies on NAT for a defined disease. The final inclusion of a study was decided by the authors together. Results: The included studies were heterogeneous for participant characteristics, intervention type, and methodological quality. Three meta-analyses, six studies of high evidence grade (four reporting significant improvement), and 29 studies of low to moderate evidence grade (26 reporting health improvements) were included. For the studies with high evidence grade, the results were generally positive, though somewhat ambiguous. Among the studies of moderate to low evidence grade, health improvements were reported in 26 cases out of 29. Conclusions: This review gives at hand that a rather small but reliable evidence base supports the effectiveness and appropriateness of NAT as a relevant resource for public health. Significant improvements were found for varied outcomes in diverse diagnoses, spanning from obesity to schizophrenia. Recommendations for specific areas of future research of the subject are provided.