Nature and park prescriptions

Domain XV · Nature, philosophy, social & rites of passage · Robert Zarr, Melissa Lem · 2013 · Washington DC, USA

What it is

A nature or park prescription is not a psychotherapy. It is a brief, written, personalised recommendation by a health professional that a person spend time in a named natural place doing an activity they choose, with a plan for when and a follow-up. Park Rx America describes itself as a non-profit…

Format

• No source gives a session count or session length for a nature prescription; it is delivered inside an ordinary appointment and reviewed at the next one. The phases below follow the DC Park Rx workflow and the PaRx five steps; phase labels are this guide's own.
• Link and support. Goal: reduce barriers; connect to a PaRx Connector, a social prescribing link worker or a community provider if wanted; the GSP evaluation found that link workers accompanying people to a first session helped engagement.

Who practises it, and how they are trained or regulated

• What the psychotherapist does: (a) where their licence and the programme allow, writes the prescription themselves; (b) more often, uses the same steps inside therapy (assessment of nature contact, personalising, scheduling, follow-up), coordinates with the client's physician, who prescribes and handles any medical or exercise questions, or with a social prescribing link worker; (c) prepares and debriefs the client;…

Evidence status, as the guide reports it

• Core idea of change, as the programmes state it: a specific, written health recommendation from a trusted professional makes it more likely that a person actually goes outdoors, and regular contact with nature is linked with better mood, lower stress and fewer chronic-disease risks. Zarr frames…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• the client feeling they must match your enthusiasm. Working when the plan stays theirs.
• vague slots ("sometime at the weekend"). Working when the entry exists before the client leaves.
• choosing something aspirational rather than likely. Working when the client says "I could actually do that".
• the plan becoming another chore; perfectionism. Working when ratings show a lift the client notices themselves.
• plans that quietly lapse after discharge; build in a self-review date. Working when the client continues unprompted.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.