Nature-based creative activity

Domain XV · Nature, philosophy, social & rites of passage · Ronen Berger, Siddons Heginworth, Nash · 2006

What it is

This is not one manualised therapy. It is a family of activities: making art with natural materials, land art and sculpture, nature photography, nature writing and poetry, map-making, and ritual and enactment out of doors. It runs at three levels: community groups (nature-based health promotion…

Format

• Levels and formats
• Community nature-arts groups. These are led by artists, rangers or volunteers and reached by self-referral or a social prescribing link worker. The therapist's job is to refer, prepare the client and debrief afterwards.

Who practises it, and how they are trained or regulated

• Individual or group therapy outdoors. The therapist delivers it within their own training. Examples are the year-long Circle of Trees groups built around a different tree each month (Siddons Heginworth) and the Safe Place school programme of "12 weekly two-hour group sessions, indoors and outdoors", co-led by a programme facilitator and the class teacher (Berger 2022). Session counts outside these named programmes…
• Criteria for moving between phases are not specified in the sources. Use the client's regulation, consent and engagement as the guide, and step back a phase if the client becomes overwhelmed.

Evidence status, as the guide reports it

• Evidence status in one line each: the 2025 scoping review found "the scarce evidence base for nature-based art therapy" and concluded that "further research is necessary to establish its initial effectiveness". The national green social prescribing programme reported statistically significant…

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?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• 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

• burns and fire rules; the task becoming an activity with no therapeutic frame. It is working when trust and spontaneous talk grow during the task.
• sites that become busy, have private sightlines or carry seasonal hazards. It is working when the logistics fade and the client can attend to the work.
• clients who want to keep everything (attachment and loss), or who refuse any record (privacy). It is working when the choice itself becomes meaningful.
• losing a place as well as the therapist (a double ending). It is working when the client leaves with their own ongoing relationship to nature and making.
• imposing seasonal metaphors that do not fit, and clients from other climates or cultures. It is working when members bring their own seasonal metaphors 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.