What is Nature Based Therapy?
Nature Based Therapy (NBT) is a broad category of therapeutic interventions that utilize outdoor environments and natural settings to address mental health conditions, behavioral issues, and promote overall well-being. The practice encompasses diverse modalities—from Japanese shinrin-yoku (forest bathing) to multi-week wilderness expeditions—all grounded in the premise that purposeful engagement with natural environments produces measurable health benefits. Unlike casual outdoor recreation, NBT involves structured activities facilitated by trained therapists or guides, with specific clinical or developmental goals. The approach integrates elements from ecopsychology, evidence-based psychotherapy, and experiential education.
Origins & Lineage
The modern practice of Nature Based Therapy emerged from three distinct historical streams. In 1901, when Manhattan State Hospital faced overcrowding, psychiatric patients were relocated to tents on the hospital lawn—an early inadvertent experiment in outdoor therapeutic environments. The 20th century camping movement followed, with Camp Ahmek opening in 1921 in Algonquin Park, Ontario, as the first documented therapeutic camp for boys. By 1945, fully established therapeutic camps were operational across North America.
The second stream developed through German educator Kurt Hahn, who founded Outward Bound in the 1940s. Hahn’s philosophy emphasized character development through physical challenges and wilderness exposure. By the 1960s and 1970s, these principles evolved into structured wilderness therapy programs in the United States, particularly for at-risk youth and adolescents with substance abuse disorders.
The third stream arose from ecopsychology in the 1980s and 1990s. In 1982, Japan’s Ministry of Agriculture, Forestry, and Fisheries coined the term “shinrin-yoku” (forest bathing) as a public health initiative. Howard Clinebell published Ecotherapy: Healing Ourselves, Healing the Earth in 1996, providing the first comprehensive framework for nature-based therapeutic practice grounded in ecological consciousness. The field has since expanded to include horticultural therapy, adventure therapy, nature-informed psychotherapy, and walk-and-talk therapy.
How It’s Practiced
Nature Based Therapy manifests in multiple formats, ranging from passive to highly active interventions. Forest bathing involves slow, mindful walks through natural environments, engaging all five senses without destination or physical exertion. Participants may spend 2-3 hours in a forest setting, guided through sensory invitations by a certified forest therapy guide.
Wilderness therapy programs operate on a different scale: participants spend days or weeks living outdoors, often combining hiking, camping, and survival skills with individual and group psychotherapy sessions. These intensive programs typically serve adolescents and young adults with mental health conditions, behavioral issues, or substance abuse disorders.
Horticultural therapy uses gardening and plant-based activities as therapeutic tools, often in structured programs lasting weeks or months. Walk-and-talk therapy integrates traditional psychotherapy with outdoor walking, conducted by licensed mental health professionals. Adventure therapy incorporates challenge activities—rock climbing, ropes courses, cooperative games—with therapeutic processing.
All legitimate NBT modalities share three elements: structured facilitation by trained professionals, specific therapeutic or developmental goals, and intentional engagement with natural environments. Sessions may occur in forests, gardens, mountains, beaches, or urban parks, depending on the modality and accessibility.
Nature Based Therapy Today
Contemporary seekers encounter Nature Based Therapy through multiple channels. Certification programs train forest therapy guides (Association of Nature and Forest Therapy), wilderness therapists, and ecotherapists through institutions like Prescott College’s Graduate Certificate in Adventure-Based Ecotherapy. Insurance-covered wilderness therapy programs operate across North America, typically requiring referrals from mental health providers.
Medical systems in Japan, South Korea, and parts of Europe now integrate forest therapy into preventive care. The UK’s National Health Service has committed to implementing nature-based interventions in social prescription programs. Research institutions worldwide study NBT’s effects on depression, anxiety, immune function, and cardiovascular health, producing a growing evidence base.
Retreats, day programs, and drop-in forest bathing walks serve the wellness market. Organizations like the Association of Nature and Forest Therapy maintain directories of certified guides. Mental health professionals increasingly incorporate nature connection into existing therapeutic modalities like Cognitive Behavioral Therapy and Emotionally Focused Therapy.
Common Misconceptions
Nature Based Therapy is not simply “going outside” or casual hiking. It requires structured facilitation, therapeutic framing, and specific techniques. It is not a replacement for emergency psychiatric care or medication management for severe mental illness, though it may serve as complementary treatment.
The field is not homogeneous—wilderness therapy for court-mandated adolescents differs fundamentally from gentle forest bathing for stress reduction. Not all practitioners are licensed mental health professionals; forest therapy guides and adventure therapists often hold different credentials than clinical psychologists or social workers.
NBT is not universally accessible. Geographic, financial, and mobility barriers exclude many populations. Urban nature access is unequally distributed, raising environmental justice concerns. Research remains methodologically challenging, with heterogeneous populations, varied interventions, and difficulty isolating nature’s specific effects from social connection, physical activity, and therapeutic relationship factors.
The field does not claim nature “cures” all conditions. Evidence supports benefits for stress reduction, mild-to-moderate anxiety and depression, and improved well-being, but robust clinical trials targeting specific diagnoses remain limited.
How to Begin
For gentle introduction, seek certified forest therapy guides through the Association of Nature and Forest Therapy (ANFT) directory or similar organizations. Many offer public walks requiring no prior experience. Mental health professionals seeking to incorporate nature can explore training through Applied Ecopsychology programs or nature-informed therapy certifications.
Individuals interested in wilderness therapy should work with licensed therapists to identify reputable programs accredited by the Outdoor Behavioral Healthcare Center. For self-directed practice, Qing Li’s Forest Bathing: How Trees Can Help You Find Health and Happiness (2018) provides accessible guidance. M. Amos Clifford’s Your Guide to Forest Bathing (2018) offers practical techniques.
Beginners can start with 20-minute sessions in local parks, practicing sensory awareness without phones or agenda. Notice textures, sounds, smells, and microclimates. The practice is simple but not passive—it requires slowing down and sustained attention to immediate surroundings.