1
|
Neil AL, Pryor A, Kneebone J, Flies EJ. Outdoor mental healthcare: What, who, why and where to? Australas Psychiatry 2023; 31:798-805. [PMID: 37970826 DOI: 10.1177/10398562231211110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Objective: Outdoor mental healthcare can increase the breadth of multidisciplinary interventions available to people with a therapeutic need. The aim of this article is to educate readers about the field of outdoor mental healthcare through the exploration of a series of basic questions.Conclusions: Outdoor mental healthcare spans a range of therapies that apply a variety of theoretical approaches and treatments across a multiplicity of settings, patient groups and desired outcomes unified by key evidence-informed practice elements. Through use of a predominantly non-mainstream workforce working in non-conventional clinical settings outdoor mental healthcare may contribute to treatment accessibility and acceptability.
Collapse
Affiliation(s)
- Amanda L Neil
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
- The ALIVE National Centre for Mental Health Research Translation, University of Tasmania, Hobart, TAS, Australia
| | - Anita Pryor
- Adventure Works Australia, Hobart, TAS, Australia
- Outdoor Health Policy Unit, Australian Association for Bush Adventure Therapy, Templestowe, VIC, Australia; and
- Australian Association of Family Therapy Inc., Tasmanian Branch
| | - Jessica Kneebone
- Tasmanian Aboriginal Corporation, Hobart, TAS, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Emily J Flies
- School of Natural Sciences, University of Tasmania, Hobart, TAS, Australia
- School of Geography, Planning and Spatial Sciences, University of Tasmania, Hobart, TAS, Australia; and
- Healthy Landscapes Research Group, University of Tasmania, Hobart, TAS, Australia
| |
Collapse
|
2
|
White MP, Hartig T, Martin L, Pahl S, van den Berg AE, Wells NM, Costongs C, Dzhambov AM, Elliott LR, Godfrey A, Hartl A, Konijnendijk C, Litt JS, Lovell R, Lymeus F, O'Driscoll C, Pichler C, Pouso S, Razani N, Secco L, Steininger MO, Stigsdotter UK, Uyarra M, van den Bosch M. Nature-based biopsychosocial resilience: An integrative theoretical framework for research on nature and health. ENVIRONMENT INTERNATIONAL 2023; 181:108234. [PMID: 37832260 DOI: 10.1016/j.envint.2023.108234] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/09/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023]
Abstract
Nature-based solutions including urban forests and wetlands can help communities cope better with climate change and other environmental stressors by enhancing social-ecological resilience. Natural ecosystems, settings, elements and affordances can also help individuals become more personally resilient to a variety of stressors, although the mechanisms underpinning individual-level nature-based resilience, and their relations to social-ecological resilience, are not well articulated. We propose 'nature-based biopsychosocial resilience theory' (NBRT) to address these gaps. Our framework begins by suggesting that individual-level resilience can refer to both: a) a person's set of adaptive resources; and b) the processes by which these resources are deployed. Drawing on existing nature-health perspectives, we argue that nature contact can support individuals build and maintain biological, psychological, and social (i.e. biopsychosocial) resilience-related resources. Together with nature-based social-ecological resilience, these biopsychosocial resilience resources can: i) reduce the risk of various stressors (preventive resilience); ii) enhance adaptive reactions to stressful circumstances (response resilience), and/or iii) facilitate more rapid and/or complete recovery from stress (recovery resilience). Reference to these three resilience processes supports integration across more familiar pathways involving harm reduction, capacity building, and restoration. Evidence in support of the theory, potential interventions to promote nature-based biopsychosocial resilience, and issues that require further consideration are discussed.
Collapse
Affiliation(s)
- Mathew P White
- Cognitive Science HUB, University of Vienna, Austria; European Centre for Environment & Human Health, University of Exeter, UK.
| | - Terry Hartig
- Institute for Housing and Urban Research, Uppsala University, Sweden; Department of Psychology, Uppsala University, Sweden
| | - Leanne Martin
- European Centre for Environment & Human Health, University of Exeter, UK
| | - Sabine Pahl
- Urban and Environmental Psychology Group, University of Vienna, Austria
| | | | - Nancy M Wells
- Department of Human Centered Design, College of Human Ecology, Cornell University, Ithaca, NY, United States
| | | | - Angel M Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Lewis R Elliott
- European Centre for Environment & Human Health, University of Exeter, UK
| | | | - Arnulf Hartl
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria
| | | | - Jill S Litt
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Rebecca Lovell
- European Centre for Environment & Human Health, University of Exeter, UK
| | - Freddie Lymeus
- Institute for Housing and Urban Research, Uppsala University, Sweden; Department of Psychology, Uppsala University, Sweden
| | | | - Christina Pichler
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria
| | - Sarai Pouso
- AZTI, Marine Research, Basque Research and Technology Alliance (BRTA), Herrera Kaia, Portualdea z/g, 20110 Pasaia, Gipuzkoa, Spain
| | - Nooshin Razani
- University of California San Francisco, San Francisco, CA, United States
| | - Laura Secco
- Department of Territorio e Sistemi Agro-Forestali (TESAF), University of Padua, Padua, Italy
| | | | - Ulrika K Stigsdotter
- Department of Geosciences and Natural Resource Management, University of Copenhagen, Denmark
| | - Maria Uyarra
- AZTI, Marine Research, Basque Research and Technology Alliance (BRTA), Herrera Kaia, Portualdea z/g, 20110 Pasaia, Gipuzkoa, Spain
| | - Matilda van den Bosch
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| |
Collapse
|
3
|
Rodríguez-Redondo Y, Denche-Zamorano A, Muñoz-Bermejo L, Rojo-Ramos J, Adsuar JC, Castillo-Paredes A, Vega-Muñoz A, Barrios-Fernandez S. Bibliometric Analysis of Nature-Based Therapy Research. Healthcare (Basel) 2023; 11:healthcare11091249. [PMID: 37174792 PMCID: PMC10178870 DOI: 10.3390/healthcare11091249] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/05/2023] [Accepted: 04/15/2023] [Indexed: 05/15/2023] Open
Abstract
Unrestrained urbanisation and natural space loss are reducing contact with nature in today's society, producing negative consequences for people's mental and physical health and wellbeing. Nature-based therapies, such as physical activity in natural settings, forest bathing, therapeutic hiking, or experiential learning, reduce anxiety and depressive symptoms and improve the quality of life in both general and specific populations. A bibliometric analysis of research on nature-based therapies was performed by applying the traditional laws of bibliometrics (exponential growth law, Bradford's concentration law, Lotka's law, Zipf's law, etc.) to documents published in journals indexed in the Core Collection of the Web of Science (WoS). Graphical visualisation was performed using the VOSviewer software. Annual publications between 2006 and 2021 presented an exponential growth trend (R2 = 91%). The International Journal of Environmental Research and Public Health (MDPI) and Urban Forestry & Urban Greening (Elsevier) were the most productive and cited journals. Ikei, Miyazaki, and Song are the most cited prolific authors. The USA and South Korea were the countries with the highest scientific production. In recent years, there has been a growing interest in adventure, nature, and forest therapies among researchers. Nature-based therapies have experienced a growing interest in recent years. Positive effects on mental, physical, and emotional health have been found in different populations and research lines, although more studies with different designs and populations are needed.
Collapse
Affiliation(s)
- Yeray Rodríguez-Redondo
- Social Impact and Innovation in Health (InHEALTH) Research Group, University Centre of Mérida, University of Extremadura, 06800 Mérida, Spain
| | - Angel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Laura Muñoz-Bermejo
- Social Impact and Innovation in Health (InHEALTH) Research Group, University Centre of Mérida, University of Extremadura, 06800 Mérida, Spain
| | - Jorge Rojo-Ramos
- Physical Activity for Education, Performance and Health, Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Jose Carmelo Adsuar
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Antonio Castillo-Paredes
- Grupo AFySE, Investigación en Actividad Física y Salud Escolar, Escuela de Pedagogía en Educación Física, Facultad de Educación, Universidad de Las Américas, Santiago 8370040, Chile
| | - Alejandro Vega-Muñoz
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330507, Chile
- Public Policy Observatory, Universidad Autónoma de Chile, Santiago 7500912, Chile
| | - Sabina Barrios-Fernandez
- Occupation, Participation, Sustainability and Quality of Life (Ability Research Group), Nursing and Occupational Therapy College, University of Extremadura, 10003 Cáceres, Spain
| |
Collapse
|
4
|
Hauge ÅL, Lindheim MØ, Røtting K, Johnsen SÅK. The Meaning of the Physical Environment in Child and Adolescent Therapy: A Qualitative Study of the Outdoor Care Retreat. ECOPSYCHOLOGY 2023. [DOI: 10.1089/eco.2022.0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Affiliation(s)
- Åshild Lappegard Hauge
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Maren Østvold Lindheim
- Department of Child and Adolescent Mental Health in Hospital (S-BUP), Oslo University Hospital University, Oslo, Norway
| | | | - Svein Åge Kjøs Johnsen
- Department of psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| |
Collapse
|
5
|
Delaney ME, Rian SW, Owenburg N. The Experiences of Counselors-in-Training in A Semester-Long Ecotherapy Course: A Qualitative Study. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2022. [DOI: 10.1080/15401383.2022.2129894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Affiliation(s)
- Megan E. Delaney
- Department of Professional Counseling, Monmouth University, West Long Branch, New Jersey, USA
| | - Sage W. Rian
- Department of Counseling Psychology, University of Denver, Denver, Colorado, USA
| | - Nicole Owenburg
- Department of Professional Counseling, Monmouth University, West Long Branch, New Jersey, USA
| |
Collapse
|
6
|
Hunt DF, Morgan M, Connors M, Mellor C. Bringing nature into CAMHS inpatient services: reflections for the implementation and integration of training into practice. Int Rev Psychiatry 2022; 34:546-552. [PMID: 36165746 DOI: 10.1080/09540261.2022.2080530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Poor mental health is a global concern and is exacerbated by recent challenges concerning COVID-19 and the climate emergency, with significant consequences to individuals and to society. Increasing evidence demonstrates that nature-based approaches (NBAs) have numerous benefits to mental health services and the people they support with mental health needs. Despite these benefits, understanding how to integrate these approaches into practice is challenging. In this paper, we report our findings from a recent qualitative study with staff from a CAMHS inpatient unit who had recently undergone NatureWell Facilitator training. This is a particular approach to working with people in nature developed by The Natural Academy. Participants identified the importance of implementation of discreet, novel NBAs, as well as integrating nature into current practice, the benefits when fostering psychologically safe and therapeutic relationships with staff, and the clinical and operational factors when carrying out NBAs in these settings.
Collapse
Affiliation(s)
- David Francis Hunt
- Oxford Health NHS Foundation Trust, Littlemore Mental Health Centre, Oxford, UK.,Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Mia Morgan
- Oxford Health NHS Foundation Trust, Littlemore Mental Health Centre, Oxford, UK.,Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | | | - Catriona Mellor
- Oxford Health NHS Foundation Trust, Littlemore Mental Health Centre, Oxford, UK
| |
Collapse
|
7
|
Nature-Based Meditation, Rumination and Mental Wellbeing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159118. [PMID: 35897493 PMCID: PMC9332585 DOI: 10.3390/ijerph19159118] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 02/04/2023]
Abstract
Novel approaches for children and young people (CYP) in the prevention and intervention of mental illness are needed and nature-based interventions (NBI) may be clinically useful. This proof-of-principle study tested the effects of a novel brief nature-based meditation on rumination, depressive symptoms and wellbeing in young people. Sixty-eight university students were randomised to one of three conditions: active control (n = 23), indoor meditation (n = 22) or nature-based meditation (n = 23). Participants completed self-report measures on state and trait rumination post intervention and depression and wellbeing at a 2-week follow-up. Depressive rumination significantly decreased post intervention in the nature condition and depressive symptoms improved for both intervention groups. Wellbeing only significantly improved at follow-up in the nature condition. Nature condition participants demonstrated one minimal clinically important difference (MCID) for wellbeing at follow-up. Depressive symptoms for this condition were below the clinically significant threshold for depression. The number needed to treat (NNT) analysis suggested that two to five young people would need to complete the intervention. Preliminary evidence suggests NBIs, such as the one in the present study, can reduce depressive rumination and symptoms and improve wellbeing. Replication with larger clinical samples is required to substantiate findings.
Collapse
|
8
|
Newman E, Gabriel L. Investigating clients' experiences of walk and talk counselling. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
9
|
Reese RF, DeMeyer M, Hoag A, Glass L, Madigan C, Avent Harris J. A CQR Study of the Fishing for Wellness Nature-Based Group Intervention for Adults Facing Adversity. JOURNAL FOR SPECIALISTS IN GROUP WORK 2022. [DOI: 10.1080/01933922.2022.2058663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | | | - Amy Hoag
- Oregon State University Cascades
| | | | | | | |
Collapse
|
10
|
Mixing Job Training with Nature-Based Therapy Shows Promise for Increasing Labor Market Affiliation among Newly Arrived Refugees: Results from a Danish Case Series Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084850. [PMID: 35457716 PMCID: PMC9031245 DOI: 10.3390/ijerph19084850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/01/2022] [Accepted: 04/13/2022] [Indexed: 01/27/2023]
Abstract
The unemployment rate among newly arrived refugees in European countries is high and many experience mental health problems. This has negative consequences on integration and mental well-being. In this case series study we investigated the effect of a 30-week program that included horticulture activities, nature-based therapy, and traditional job training on job market affiliation and mental well-being. Fifty-two refugees met initial screening criteria and twenty-eight met all inclusion criteria and were enrolled. The program took place in a small community and consisted of informal therapeutic conversations, exercises aimed at reducing psychological stress, increasing mental awareness and physical wellbeing. At the end of the program traditional job market activities were led by social workers. Provisionary psychiatric interviews showed that at baseline 79% met criteria for either an anxiety, depression, or PTSD diagnosis. After the program, statistical analyses revealed an increase in the one-year incidence of job market affiliation (n = 28) and an increase in mental health according to two of four questionnaire measures (nrange = 15–16). The results strengthen the hypothesis that horticulture and nature-based therapy can help refugees enter the job market. However, the small sample size emphasizes the need for methodologically stronger studies to corroborate these preliminary findings.
Collapse
|
11
|
Lane D, Reed P. The nature space. A reflexive thematic analysis of therapists' experiences of 1:1 nature‐based counselling and psychotherapy with children and young people: Exploring perspectives on the influence of nature within the therapeutic process. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Deborah Lane
- School of Psychology University of Roehampton London UK
| | - Paula Reed
- School of Psychology University of Roehampton London UK
| |
Collapse
|
12
|
Owens M, Bunce HLI. The Potential for Outdoor Nature-Based Interventions in the Treatment and Prevention of Depression. Front Psychol 2022; 13:740210. [PMID: 35401311 PMCID: PMC8984301 DOI: 10.3389/fpsyg.2022.740210] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 02/15/2022] [Indexed: 01/05/2023] Open
Abstract
There is growing interest in nature-based interventions (NBI) to improve human health and wellbeing. An important nascent area is exploring the potential of outdoor therapies to treat and prevent common mental health problems like depression. In this conceptual analysis on the nature-depression nexus, we distil some of the main issues for consideration when NBIs for depression are being developed. We argue that understanding the mechanisms, or 'active ingredients' in NBIs is crucial to understand what works and for whom. Successfully identifying modifiable mediating intervention targets will pave the way for interventions with increased efficacy. We highlight a non-exhaustive list of five clinically relevant putative, candidate mechanisms which may underly the beneficial effects of NBIs on depression: stress, rumination, mindfulness, sleep and exercise. We also make the case that when developing NBIs it is important to not neglect young people, explore personalised approaches and focus on both treatment and prevention approaches. To achieve these aims methodologically rigorous programmes of clinical research are needed that include well-powered and controlled experimental designs including randomised controlled trials, qualitative research, longitudinal studies and large prospective cohorts.
Collapse
Affiliation(s)
- Matthew Owens
- Department of Psychology, The Mood Disorders Centre, University of Exeter, Exeter, United Kingdom
| | - Hannah L. I. Bunce
- CEDAR, University of Exeter and Somerset Foundation Trust NHS, Taunton, United Kingdom
| |
Collapse
|
13
|
Gandy S. Predictors and potentiators of psychedelic-occasioned mystical experiences. JOURNAL OF PSYCHEDELIC STUDIES 2022. [DOI: 10.1556/2054.2022.00198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract
Mystical experiences are often described as being among the most profound and meaningful events of a person’s life. Their occurrence, while a normal but uncommon phenomenon, is reliably occasioned by psychedelic substances under the appropriate conditions, although care is needed around the context of usage to help ensure safe and beneficial experiences. The occurrence of mystical experiences in psychedelic sessions is a key mediator of the sustained psychological benefits reported in both healthy and clinical populations. Certain factors including set and setting, drug dosage, trait absorption, drug type, intention and states of surrender and acceptance all predict or influence the occurrence of mystical experiences. Various additional factors may further contribute to the occurrence and intensity of mystical experiences and enhance their long-term benefits, including music, meditation and spiritual practices and nature-based settings. This review examines these factors and considers how they might be optimised to increase the chances of a mystical experience occurring, while also considering factors that are negatively associated with mystical experiences with suggestions on how these might be mitigated where applicable. Finally, potential future research avenues for furthering our knowledge of psychedelic mystical experiences and how their benefits might be enhanced is suggested. Maximising the potential for the occurrence of mystical experiences is an important aspect of the beneficial application of psychedelics.
Collapse
Affiliation(s)
- Sam Gandy
- Synthesis Institute, Zandvoort, Netherlands
| |
Collapse
|
14
|
Pijpker R, Veen EJ, Vaandrager L, Koelen M, Bauer GF. Developing an Intervention and Evaluation Model of Outdoor Therapy for Employee Burnout: Unraveling the Interplay Between Context, Processes, and Outcomes. Front Psychol 2022; 13:785697. [PMID: 35310237 PMCID: PMC8929413 DOI: 10.3389/fpsyg.2022.785697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Burnout is a major societal issue adversely affecting employees’ health and performance, which over time results in high sick leave costs for organizations. Traditional rehabilitation therapies show suboptimal effects on reducing burnout and the return-to-work process. Based on the health-promoting effects of nature, taking clients outdoors into nature is increasingly being used as a complementary approach to traditional therapies, and evidence of their effectiveness is growing. Theories explaining how the combination of general psychological support and outdoor-specific elements can trigger the rehabilitation process in outdoor therapy are often lacking, however, impeding its systematic research. Aim The study aims to develop an intervention and evaluation model for outdoor therapy to understand and empirically evaluate whether and how such an outdoor intervention may work for rehabilitation after burnout. Methodological Approach We build on the exemplary case of an outdoor intervention for rehabilitation after burnout, developed by outdoor clinical psychologists in Netherlands. We combined the generic context, process, and outcome evaluation model and the burnout recovery model as an overarching deductive frame. We then inductively specified the intervention and evaluation model of outdoor therapy, building on the following qualitative data: semi-structured interviews with outdoor clinical psychologists and former clients; a content analysis of the intervention protocol; and reflective meetings with the intervention developers and health promotion experts. Results We identified six key outdoor intervention elements: (1) physical activity; (2) reconnecting body and mind; (3) nature metaphors; (4) creating relationships; (5) observing natural interactions; and (6) experiential learning. The results further showed that the implementation of these elements may facilitate the rehabilitation process after burnout in which proximal, intermediate, and distal outcomes emerge. Finally, the results suggested that this implementation process depends on the context of the therapist (e.g., number of clients per day), therapy (e.g., privacy issues), and of the clients (e.g., affinity to nature). Conclusion The intervention and evaluation model for outdoor therapy shows how key outdoor intervention elements may contribute to the rehabilitation process after burnout. However, our model needs to be further tested among a larger group of clients to empirically evaluate whether and how outdoor therapy can support rehabilitation.
Collapse
Affiliation(s)
- Roald Pijpker
- Health and Society, Social Sciences Group, Wageningen University, Wageningen, Netherlands
| | - Esther J Veen
- Urban Food Issues, Aeres University of Applied Sciences, Almere, Netherlands
| | - Lenneke Vaandrager
- Health and Society, Social Sciences Group, Wageningen University, Wageningen, Netherlands
| | - Maria Koelen
- Health and Society, Social Sciences Group, Wageningen University, Wageningen, Netherlands
| | - Georg F Bauer
- Center of Salutogenesis, Division of Public and Organizational Health, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| |
Collapse
|
15
|
Mattsson M, Fernee CR, Pärnänen K, Lyytinen P. Restoring Connectedness in and to Nature: Three Nordic Examples of Recontextualizing Family Therapy to the Outdoors. Front Psychol 2022; 13:768614. [PMID: 35360556 PMCID: PMC8964260 DOI: 10.3389/fpsyg.2022.768614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
Mentalization-based family therapy and family rehabilitation represent a rich variety of approaches for assisting families with difficult interaction patterns. On the other hand, adventure therapy methods have been successfully used with families to offer them empowering experiences of succeeding together against difficult odds and to improve communication between family members. Further, the health promoting qualities of spending time outdoors are now well established and recognized. The Nordic approach to mentalization-based family rehabilitation combines adventure, outdoor, and systemic therapy. We provide three examples of nature-based family rehabilitation practices that are delivered as brief, multi-family psychological interventions taking place in nearby nature and aiming to support sustainable, systemic change. The current contribution is a description of clinical practice, not a systematic review or a formal evaluation. We propose that recontextualizing mentalization-based family rehabilitation to the outdoors can not only provide added health benefits, but also strengthen intra-familial attuned interaction and emotional connectedness. The outdoor adventure provides the families with embodied, multisensory experiences of verbal and, especially, non-verbal interaction that can be usefully examined through the lens of theory of mentalization. The concreteness of adventure experiences is particularly beneficial for families that have difficulties in verbal communication and/or utilizing executive functions, perhaps due to neuropsychiatric traits, intellectual disabilities, or learning difficulties. Furthermore, outdoor adventure can support the participants’ connectedness to nature.
Collapse
Affiliation(s)
- Markus Mattsson
- The Foundation for the Rehabilitation of Children and Young People, The Mannerheim League for Child Welfare, Turku, Finland
| | - Carina Ribe Fernee
- Department of Child and Adolescent Mental Health, Sørlandet Hospital HE, Kristiansand, Norway
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- *Correspondence: Carina Ribe Fernee,
| | - Kanerva Pärnänen
- The Foundation for the Rehabilitation of Children and Young People, The Mannerheim League for Child Welfare, Turku, Finland
- Department of Education, Faculty of Education, University of Turku, Turku, Finland
| | - Pekka Lyytinen
- The Foundation for the Rehabilitation of Children and Young People, The Mannerheim League for Child Welfare, Turku, Finland
| |
Collapse
|
16
|
Harper NJ, Fernee CR. Unpacking Relational Dignity: In Pursuit of an Ethic of Care for Outdoor Therapies. Front Psychol 2022; 13:766283. [PMID: 35222181 PMCID: PMC8866185 DOI: 10.3389/fpsyg.2022.766283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 01/07/2022] [Indexed: 12/03/2022] Open
Abstract
Dignity is a universal principle that requires us to treat every person as having worth beyond who a particular person is or what they do. Dignity is a complex and sometimes contested idea, that at times can be compromised in health care and allegedly also within the practice of outdoor therapy. Outdoor therapies comprise a range of therapeutic approaches including nature-based therapy, adventure therapy, animal-assisted therapy, forest therapy, wilderness therapy, surf therapy, and more. Within the literature of outdoor therapies there has been limited research on ethics related to common understandings of care concepts such as relational dignity and human rights. The aim of this paper is therefore to unravel briefly whether dignity in general, and relational qualities of dignified care more particularly, might be a useful concept to apply in order to support an ethical practice in outdoor therapies.
Collapse
Affiliation(s)
- Nevin J. Harper
- Faculty of Human and Social Development, University of Victoria, Victoria, BC, Canada
| | - Carina Ribe Fernee
- Department of Child and Adolescent Mental Health, Sørlandet Hospital HE, Kristiansand, Norway
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| |
Collapse
|
17
|
Langman-Levy A, Johns L, Palmier-Claus J, Sacadura C, Steele A, Larkin A, Murphy E, Bowe S, Morrison A. Adapting cognitive behavioural therapy for adolescents with psychosis: insights from the Managing Adolescent first episode in psychosis study (MAPS). PSYCHOSIS 2022; 15:28-43. [PMID: 36866165 PMCID: PMC9970186 DOI: 10.1080/17522439.2021.2001561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background Onset of psychosis commonly occurs in adolescence, and long-term prognosis can be poor. There is growing evidence, largely from adult cohorts, that Cognitive Behavioural Therapy for Psychosis (CBTp) and Family Interventions (FI) can play a role in managing symptoms and difficulties associated with psychosis. However, adolescents have distinct developmental needs that likely impact their engagement and response to talking therapy. There is limited guidance on adapting CBTp to meet the clinical needs of under-eighteens experiencing psychosis. Method This educational clinical practice article details learnings from therapists and supervisors working with young people (aged 14-18 years) with psychosis during the Managing Adolescent first-episode Psychosis: a feasibility Study (MAPS) randomised clinical treatment trial, supplemented by findings from nested qualitative interviews with young people receiving CBTp. Results Suggested are given for tailoring CBTp assessment, formulation and interventions to meet the developmental and clinical needs of adolescents with psychosis. Developmentally appropriate techniques and resources described. Conclusions Early indications from MAPS study indicate this developmentally tailored approach is an acceptable, safe and helpful treatment for young people with psychosis. Further research is needed to develop empirically grounded and evaluated CBTp for adolescents.
Collapse
Affiliation(s)
- Amy Langman-Levy
- Early Intervention in Psychosis Service, Warneford Hospital, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Louise Johns
- Early Intervention in Psychosis Service, Warneford Hospital, Oxford Health NHS Foundation Trust, Oxford, UK,Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK,CONTACT Louise Johns Warneford Hospital, Oxford Health NHS Foundation Trust, Oxford OX3 7JX, UK
| | - Jasper Palmier-Claus
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, UK,Research and Development Department, Lancashire and South Cumbria NHS Foundation Trust, Preston, UK
| | - Catarina Sacadura
- Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex, UK
| | - Ann Steele
- Research and Development Department, Sussex Partnership NHS Foundation Trust, Sussex, UK
| | - Amanda Larkin
- Psychosis Research Unit, Greater Manchester Health NHS Foundation Trust, Manchester, UK
| | - Elizabeth Murphy
- Psychosis Research Unit, Greater Manchester Health NHS Foundation Trust, Manchester, UK
| | - Samantha Bowe
- Psychosis Research Unit, Greater Manchester Health NHS Foundation Trust, Manchester, UK
| | - Anthony Morrison
- Psychosis Research Unit, Greater Manchester Health NHS Foundation Trust, Manchester, UK,Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| |
Collapse
|
18
|
Ross T, Bulla J, Fontao MI. Space and Well-Being in High Security Environments. Front Psychiatry 2022; 13:894520. [PMID: 35711591 PMCID: PMC9195501 DOI: 10.3389/fpsyt.2022.894520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Abstract
Research into the spatial dimensions of deprivation of liberty and psychiatric hospitalization has a long and complex tradition. In this context, the increasing numbers of prisoners and patients in forensic hospitals have impressively shown how difficult it is to ensure security, therapy and rehabilitation when space is scarce or not well-suited. In this narrative review, we present the main findings of recent lines of research on spaces in prisons and forensic psychiatric wards, with particular attention to the links between overcrowding in prisons and secure forensic psychiatric hospitals and violence, the foundations of prison and hospital architecture, and on how the design of spaces in prisons and hospitals can influence well-being. We assess and discuss these findings in the context of the current debate on how well-being in secure spaces can support the achievement of rehabilitation goals even in overcrowded institutions.
Collapse
Affiliation(s)
- Thomas Ross
- Forensic Psychiatry and Psychotherapy, Reichenau Psychiatric Center, Reichenau, Germany
| | - Jan Bulla
- Forensic Psychiatry and Psychotherapy, Reichenau Psychiatric Center, Reichenau, Germany
| | | |
Collapse
|
19
|
James G, Kidd K, Cooley SJ, Fenton K. The Feasibility of Outdoor Psychology Sessions in an Adult Mental Health Inpatient Rehabilitation Unit: Service User and Psychologist Perspectives. Front Psychol 2021; 12:769590. [PMID: 35002861 PMCID: PMC8734031 DOI: 10.3389/fpsyg.2021.769590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
Few studies have explored outdoor therapy when facilitated by clinical psychologists within an inpatient mental health service. In the present study, outdoor psychology sessions were introduced after service users (SUs) expressed a desire to return to face-to-face working during the COVID-19 pandemic. This study aimed to explore SUs’ and clinical psychologists’ perspectives on the feasibility of conducting outdoor therapy within the service. A mixed-method approach was underpinned by critical realist philosophy. Three psychologists maintained reflective diaries following outdoor therapy sessions with 16 SUs. A subsample of 14 SUs completed scales measuring therapeutic alliance and comfort during outdoor sessions. A subsample of eight SUs participated in semi-structured interviews. Data was analysed using descriptive statistics and thematic analysis. Quantitative and qualitative data demonstrated high SU satisfaction with therapeutic alliance and comfort outdoors. Six themes were identified: utilising a person-centred approach; the value of multi-disciplinary team support; enhancing therapeutic engagement; the benefits of time away from the ward; managing confidentiality; physical health and safety. This feasibility study demonstrated the introduction of outdoor psychology sessions within an inpatient mental health service to be a viable response to COVID-19. The findings suggest outdoor therapy can be an effective and safe mode of therapy, and can offset the challenges of indoor working, providing certain risk factors are considered and managed. The limitations of this study and implications for clinical practice are discussed. Further research is now required to support future integration into clinical practice.
Collapse
Affiliation(s)
- Gail James
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, United Kingdom
| | - Katherine Kidd
- Department of Clinical Psychology, Leicestershire Partnership NHS Trust, Leicester, United Kingdom
| | - Sam J. Cooley
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, United Kingdom
| | - Kelly Fenton
- Department of Clinical Psychology, Leicestershire Partnership NHS Trust, Leicester, United Kingdom
- *Correspondence: Kelly Fenton,
| |
Collapse
|
20
|
Meuwese D, van der Voort N, Dijkstra K, Krabbendam L, Maas J. The Value of Nature During Psychotherapy: A Qualitative Study of Client Experiences. Front Psychol 2021; 12:765177. [PMID: 34858291 PMCID: PMC8631326 DOI: 10.3389/fpsyg.2021.765177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/19/2021] [Indexed: 11/23/2022] Open
Abstract
Nature is considered to have restorative qualities that can potentially improve psychotherapy success. However, little is known about how clients experience nature during psychotherapy. The research aim of this phenomenological qualitative study was to study how clients experience nature during individual outpatient psychotherapy that took place while walking in nature. More specifically we were interested in clients’ inner world experiences. All participants (N = 12) received treatment through licensed therapists for a DSM-5 classified disorder. Semi-structured interviews were conducted. To uncover true lived experiences during these interviews, participants were asked to close their eyes and envision themselves during a psychotherapy session in nature. The verbatim transcripts were coded by means of inductive thematic analysis and the results were member checked. Results showed that nature brings clients closer to their inner worlds. How nature brings this about is unfolded in a conceptual model of lived experience. We argue that psychotherapy can be enriched by considering nature as a supportive environment because bringing clients closer to their inner worlds is of essential value in facilitating successful treatment interventions.
Collapse
Affiliation(s)
- Daphne Meuwese
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Altrecht Institute for Mental Health Care, Utrecht, Netherlands
| | - Nienke van der Voort
- Research Group Nursing, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Karin Dijkstra
- Research Group Nursing, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Lydia Krabbendam
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jolanda Maas
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
21
|
[Looking into international journals]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2021; 67:351-353. [PMID: 34524060 DOI: 10.13109/zptm.2021.67.3.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
22
|
Meuwese D, Maas J, Krabbendam L, Dijkstra K. Viewing Nature Lets Your Mind Run Free: Three Experiments about the Influence of Viewing a Nature Video on Cognitive Coping with Psychological Distress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168842. [PMID: 34444590 PMCID: PMC8392410 DOI: 10.3390/ijerph18168842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/12/2021] [Accepted: 08/19/2021] [Indexed: 12/29/2022]
Abstract
Viewing nature has restorative qualities that might help people cope with their personal struggles. Three lab experiments (N = 506) studied whether environment (nature vs. built) influences cognitive coping with psychological distress. Psychological distress was induced with an autobiographical recall task about serious regret, whereafter participants were randomly assigned to view a nature or built video. Cognitive coping (i) Quantity, (ii) Content, and (iii) Quality were hereafter assessed as well as extent and vividness of the regretful memory during the video. Results showed a higher cognitive coping Quantity (Study 1 and 3) and a higher cognitive coping Quality (All studies) for the nature (vs. built) condition. Regarding cognitive coping Content, results varied across the studies. Additionally, participants reported to have thought about the experienced psychological distress to a greater extent while viewing the nature (vs. built) video. Yet they did rate viewing nature as more relaxing. We propose a two-step pathway as an underlying mechanism of restoration. In the first step the capacity for directed attention replenishes. Secondly, this renewed capacity is directed towards internal processes, creating the optimal setting for reflection. Hence, viewing nature allows people to truly process whatever is occupying their minds, which is ultimately relieving and beneficial for mental health.
Collapse
Affiliation(s)
- Daphne Meuwese
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands; (J.M.); (L.K.)
- Correspondence:
| | - Jolanda Maas
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands; (J.M.); (L.K.)
| | - Lydia Krabbendam
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands; (J.M.); (L.K.)
| | - Karin Dijkstra
- Research Group Nursing, Saxion University of Applied Sciences, 7513 AB Enschede, The Netherlands;
| |
Collapse
|
23
|
Cuthbert S, Sharp H, Berry C. Green care in first-episode psychosis: short report of a mixed-methods evaluation of a 'woodland group' in an early intervention service. BJPsych Bull 2021; 45:235-237. [PMID: 34315549 PMCID: PMC8499623 DOI: 10.1192/bjb.2021.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/04/2021] [Accepted: 04/21/2021] [Indexed: 11/23/2022] Open
Abstract
AIMS AND METHOD In the context of increasing recognition of the role of nature in well-being, but limited evidence for specific patient groups, we describe a mixed-methods evaluation of a 10-week green care intervention (a woodland group) for 18- to 30-year-olds who had experienced a first episode of psychosis. Data were collected using the Questionnaire on the Process of Recovery (QPR), semi-structured service evaluation questionnaires, the NHS Friends and Family Test (FFT), and focus group analysis. RESULTS All participants present at week 10 (n = 5) would recommend this group to others; 4/8 participants showed reliable improvement on QPR outcome measures. Thematic analysis identified themes of connection with nature and others, development of a sense of well-being and 'peacefulness' and new perspectives on psychotic experience. CLINICAL IMPLICATIONS This small retrospective evaluation describes patient-reported benefits, feasibility and acceptability of green care interventions within early intervention in psychosis services (EIS).
Collapse
Affiliation(s)
| | | | - Clio Berry
- Sussex Partnership NHS Foundation Trust, Hove, UK
- Brighton and Sussex Medical School, Brighton, UK
| |
Collapse
|
24
|
A Qualitative Study Comparing Mindfulness and Shinrin-Yoku (Forest Bathing): Practitioners’ Perspectives. SUSTAINABILITY 2021. [DOI: 10.3390/su13126761] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The boundary between mindfulness and forest bathing, two conceptually related therapies, is unclear. Accordingly, this study reports the strengths and challenges, similarities and differences, and barriers and facilitators for both. Semi-structured interviews were conducted with seven trained and experienced practitioners of both mindfulness and forest bathing. Reflexive thematic analysis revealed four main themes: (i) differences between the approaches; (ii) the benefits of forest bathing; (iii) biophilia through forest bathing; and (iv) inward versus outward attentional focus as a distinction between the approaches. Both practices were found to benefit well-being, but practitioners revealed key barriers to mindfulness. For vulnerable groups experiencing mental health challenges or difficulties achieving a meditative state, mindfulness may introduce well-being risks. By offering a gentler, more intuitive approach that encourages outward attentional focus, forest bathing was found to overcome this barrier. Forest bathing is suitable for all groups, but adaptations are recommended for those expressing fear or discomfort in forested environments. The findings inform how to position both approaches in practice, as a first step towards social prescribing recommendations. Wider implications concern forest bathing’s potential to impact environmental well-being. Future research must garner comparative data, involve young people, and explore the feasibility of a forest bathing social prescription.
Collapse
|
25
|
Cooley SJ, Jones CR, Moss D, Robertson N. Organizational perspectives on outdoor talking therapy: Towards a position of 'environmental safe uncertainty'. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 61:132-156. [PMID: 34117797 PMCID: PMC9291048 DOI: 10.1111/bjc.12315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/27/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES There is growing support within the therapy professions for using talking therapy in alternative environments, such as outdoor spaces. The aim of the present study was to further understand how the organizational culture in clinical psychology may prevent or enable practitioners to step outside the conventional indoor consulting room. DESIGN Informed grounded theory methodology was used within a pragmatist philosophy. METHODS Participants (N = 15; nine male, six female) were identified using theoretical sampling. The sample consisted of experts and leaders within the profession of clinical psychology (e.g., heads of services, training programme directors, chairs of professional bodies, and developers of therapy models; M years in the profession = 34.80, SD = 9.77). One-to-one interviews and analysis ran concurrently over 9 months (April-December 2020). Mason's model of safe uncertainty was drawn upon to illuminate and organize themes. RESULTS The main themes comprised organizational factors that either support a practitioner in maintaining a position of curiosity and flexibility towards the environment where therapy is located ('environmental safe uncertainty'), or push them towards adopting a more fixed position ('environmental certainty'). Themes included influences from therapy traditions, accessibility of alternative environments, internalized risk, workplace subcultures, business models, biomedical approaches, and the COVID-19 pandemic. CONCLUSIONS Whether therapy is located in a consulting room, outdoors, clients' homes, or digitally, practitioners, clients, and services are encouraged to maintain a position of environmental safe uncertainty. PRACTITIONER POINTS The therapy process and outcomes are influenced by the physical environment in which talking therapy is situated. Practitioners have often remained fixed in their preferred therapy environment, such as the indoor consulting room, without exploring the potential benefits of alternative environments or involving the client in this decision-making (i.e., 'environmental certainty'). Outdoor environments, as well as other alternatives to the consulting room (e.g., digital, home visits, and public places), can support access to therapy, subsequent engagement, and therefore health care equity. Practitioners and clients are encouraged to adopt a position of 'environmental safe uncertainty', which is defined as having openness, critical curiosity, and collaboration regarding the therapy environment and the possibility of other environments being more conducive to therapy.
Collapse
Affiliation(s)
- Sam J Cooley
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, UK.,Leicestershire Partnership NHS Trust, Leicester, UK
| | - Ceri R Jones
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, UK
| | - Duncan Moss
- Faculty of Health, School of Psychology, University of Plymouth, UK
| | - Noelle Robertson
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, UK.,Leicestershire Partnership NHS Trust, Leicester, UK
| |
Collapse
|
26
|
Reuter L, Fenn J, Bilo TA, Schulz M, Weyland AL, Kiesel A, Thomaschke R. Leisure walks modulate the cognitive and affective representation of the corona pandemic: Employing Cognitive-Affective Maps within a randomized experimental design. Appl Psychol Health Well Being 2021; 13:952-967. [PMID: 34038624 PMCID: PMC8239580 DOI: 10.1111/aphw.12283] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 12/15/2022]
Abstract
In response to the corona pandemic, many leisure activities have been restricted while walking has been explicitly endorsed by health authorities. We investigated how leisure walking affects individuals' attitudes to the pandemic. We used Cognitive‐Affective Maps (CAMs) to measure individual's cognitive and affective attitudes toward the corona pandemic and related issues. In a controlled randomized experiment, we asked (N = 66) participants to draw a CAM before and after a walk. Participants in a control group drew CAMs before and after any self‐chosen activity at home. We found that walking led to a more negative evaluation of the pandemic itself, likely due to a more intense reflection, while in everyday routines one has already adapted to it. In further qualitative post hoc assessments of the CAMs, we observed that negative concepts other than corona disappeared after walking. We conclude that leisure walks have complex effects on individuals' cognitive and affective conceptualization of the corona pandemic. Hence, the exact mechanisms of these effects need to be examined in future research. Our study has also shown that CAMs are a promising tool for measuring experimental interventions in health psychology.
Collapse
Affiliation(s)
- Lisa Reuter
- Institute of Psychology, University of Freiburg, Freiburg, Germany.,Cluster of Excellence livMatS @ FIT Freiburg Center for Interactive Materials and Bioinspired Technologies, University of Freiburg, Freiburg, Germany
| | - Julius Fenn
- Institute of Psychology, University of Freiburg, Freiburg, Germany
| | | | - Melanie Schulz
- Institute of Psychology, University of Freiburg, Freiburg, Germany
| | | | - Andrea Kiesel
- Institute of Psychology, University of Freiburg, Freiburg, Germany.,Cluster of Excellence livMatS @ FIT Freiburg Center for Interactive Materials and Bioinspired Technologies, University of Freiburg, Freiburg, Germany
| | | |
Collapse
|
27
|
Thoma MV, Rohleder N, Rohner SL. Clinical Ecopsychology: The Mental Health Impacts and Underlying Pathways of the Climate and Environmental Crisis. Front Psychiatry 2021; 12:675936. [PMID: 34093283 PMCID: PMC8175799 DOI: 10.3389/fpsyt.2021.675936] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/26/2021] [Indexed: 01/14/2023] Open
Abstract
Humankind is confronted with progressing climate change, pollution, environmental degradation, and/or destruction of the air, soil, water, and ecosystems. The climate and environmental crisis is probably one of the greatest challenges in the history of humankind. It not only poses a serious current and continuing threat to physical health, but is also an existing and growing hazard to the mental health of millions of people worldwide. This synergy of literature provides a current summary of the adverse mental health impacts of the climate and environmental crisis from the perspective of Clinical Psychology. Furthermore, it presents potential underlying processes, including biological, emotional, cognitive, behavioral, and social pathways. The existing data suggest that the climate and environmental crisis not only acts as a direct stressor, but can also exert a detrimental impact on the various pathways, with the potential to amplify an individual's biopsychosocial vulnerability to develop mental ill-health. This is a call for an increased investigation into this emerging research field of Clinical Ecopsychology by clinical psychologists and other researchers.
Collapse
Affiliation(s)
- Myriam V. Thoma
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zürich, Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Aging,” University of Zürich, Zurich, Switzerland
| | - Nicolas Rohleder
- Friedrich-Alexander University Erlangen-Nürnberg, Chair of Health Psychology, Erlangen, Germany
| | - Shauna L. Rohner
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zürich, Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Aging,” University of Zürich, Zurich, Switzerland
| |
Collapse
|
28
|
Harper NJ, Fernee CR, Gabrielsen LE. Nature's Role in Outdoor Therapies: An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5117. [PMID: 34065947 PMCID: PMC8150931 DOI: 10.3390/ijerph18105117] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/07/2021] [Accepted: 05/09/2021] [Indexed: 11/22/2022]
Abstract
Objective: To report on the role of nature in outdoor therapies through review and summary of existing systematic and meta-analytic reviews in an effort to articulate a theoretical framework for practice. Materials and methods: An umbrella review was conducted following systematic protocols PRISMA guidelines. Results: Fourteen studies met the inclusion criteria and represented five self-identified approaches: nature-based therapies, forest therapy, horticultural therapy, wilderness therapy, and adventure therapy. Clear and comprehensive descriptions of theory, program structure, and activity details with causal links to outcomes were mostly absent. Conclusions: A rigorous and determined program of research is required in order to explicit in-depth theories of change in outdoor therapies. Conversely, or maybe concurrently, a holistic theory of integrated relatedness may be developed as a parallel expression of support for nature in therapy while the explanatory science catches up.
Collapse
Affiliation(s)
- Nevin J. Harper
- Faculty of Human & Social Development, University of Victoria, Victoria, BC V8W 2Y2, Canada
- Sørlandet Sykehus, 4604 Kristiansand, Norway; (C.R.F.); (L.E.G.)
| | - Carina R. Fernee
- Sørlandet Sykehus, 4604 Kristiansand, Norway; (C.R.F.); (L.E.G.)
| | | |
Collapse
|
29
|
Magnussen IL, Alteren J, Bondas T. "Human Flourishing with Dignity": A Meta-Ethnography of the Meaning of Gardens for Elderly in Nursing Homes and Residential Care Settings. Glob Qual Nurs Res 2021; 8:23333936211035743. [PMID: 34377742 PMCID: PMC8327254 DOI: 10.1177/23333936211035743] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 11/15/2022] Open
Abstract
This study aims to identify and synthesize qualitative research regarding residents' experiences of gardens while living in nursing homes and residential care facilities. To provide an optimal nursing environment inspired by nature, we need to derive knowledge from the residents' perspective. An interpretive meta-synthesis approach, a meta-ethnography, was chosen for this study. Altogether, six articles representing three continents and comprising 124 participants were included. The six articles that fulfilled the inclusion criteria were analyzed and synthesized according to Noblit & Hare's seven phases of meta-ethnography and the recent eMERGe guidelines. Four themes were identified: (1) The garden-a place to feel a connection with life, (2) the garden-a place to sense and find comfort, (3) the garden-a place to feel healthy and alive, and (4) the garden-a place to relate past and present. An overarching metaphor, "human flourishing with dignity," offers a deeper understanding of the meaning of the garden for older people in nursing homes and residential care. This meta-ethnography provides a reflective, systematic, data-driven synthesis based on literature spanning ten years. Rather than simply relying on retelling, the narration of experiences according to the primary researcher's descriptions and interpretations results in new knowledge. The significance of gardens for older people's health and well-being needs to be given greater attention and space in nursing practice, education, and health policies.
Collapse
|
30
|
Gandy S, Forstmann M, Carhart-Harris RL, Timmermann C, Luke D, Watts R. The potential synergistic effects between psychedelic administration and nature contact for the improvement of mental health. Health Psychol Open 2020; 7:2055102920978123. [PMID: 33335742 PMCID: PMC7724423 DOI: 10.1177/2055102920978123] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Therapeutic psychedelic administration and contact with nature have been
associated with the same psychological mechanisms: decreased
rumination and negative affect, enhanced psychological connectedness
and mindfulness-related capacities, and heightened states of awe and
transcendent experiences, all processes linked to improvements in
mental health amongst clinical and healthy populations. Nature-based
settings can have inherently psychologically soothing properties which
may complement all stages of psychedelic therapy (mainly preparation
and integration) whilst potentiating increases in nature relatedness,
with associated psychological benefits. Maximising enhancement of
nature relatedness through therapeutic psychedelic administration may
constitute an independent and complementary pathway towards
improvements in mental health that can be elicited by
psychedelics.
Collapse
Affiliation(s)
- Sam Gandy
- Centre for Psychedelic Research,
Imperial College London, UK
- Synthesis Institute, The
Netherlands
- Sam Gandy, Synthesis Institute B.V.,
Korte Leidsedwarsstraat 12, 1017 RC Amsterdam, The Netherlands.
| | | | | | | | - David Luke
- Centre for Psychedelic Research,
Imperial College London, UK
- University of Greenwich, UK
| | - Rosalind Watts
- Centre for Psychedelic Research,
Imperial College London, UK
- Synthesis Institute, The
Netherlands
| |
Collapse
|
31
|
Pretty J, Barton J. Nature-Based Interventions and Mind-Body Interventions: Saving Public Health Costs Whilst Increasing Life Satisfaction and Happiness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7769. [PMID: 33114167 PMCID: PMC7660642 DOI: 10.3390/ijerph17217769] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/14/2020] [Accepted: 10/20/2020] [Indexed: 12/14/2022]
Abstract
A number of countries have begun to adopt prevention pays policies and practices to reduce pressure on health and social care systems. Most affluent countries have seen substantial increases in the incidence and costs of non-communicable diseases. The interest in social models for health has led to the growth in use of social prescribing and psychological therapies. At the same time, there has been growth in application of a variety of nature-based and mind-body interventions (NBIs and MBIs) aimed at improving health and longevity. We assess four NBI/MBI programmes (woodland therapy, therapeutic horticulture, ecotherapy/green care, and tai chi) on life satisfaction/happiness and costs of use of public services. These interventions produce rises in life satisfaction/happiness of 1.00 pts to 7.29 (n = 644; p < 0.001) (for courses or participation >50 h). These increases are greater than many positive life events (e.g., marriage or a new child); few countries or cities see +1 pt increases over a decade. The net present economic benefits per person from reduced public service use are £830-£31,520 (after 1 year) and £6450-£11,980 (after 10 years). We conclude that NBIs and MBIs can play a role in helping to reduce the costs on health systems, while increasing the well-being of participants.
Collapse
Affiliation(s)
- Jules Pretty
- School of Life Sciences, University of Essex, Colchester CO4 3SQ, UK
| | - Jo Barton
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester CO4 3SQ, UK;
| |
Collapse
|