Outdoor complementary therapies

Domain XV · Nature, philosophy, social & rites of passage

What it is

This is not a single therapy. It is a family of practices that community providers run outdoors, and that health professionals and social prescribing link workers may connect people to. Green social prescribing is defined by NASP as helping people take part in nature-based activities to improve…

Format

• Before referral: the provider gives link workers a service description; referral forms carry contact details, health and social information, identified risks, an agreed limit on contact attempts, and other professionals involved.
• Participant information: an accessible welcome pack, with optional taster visits, videos or a short phone call.

Evidence status, as the guide reports it

• Evidence status in one line each: nature-based mindfulness showed a medium pre-post effect across 25 studies, but the authors stress "the generally low quality of the studies" and call the field "in its infancy". Structured outdoor nature-based interventions reduced depressive mood and anxiety in…

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 any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• 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?
• 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 practice becoming another chore. Working when the client reports spontaneous moments of noticing.
• grief at losing the group, dropping all activity at the end. Working when the client has a concrete, self-chosen plan.
• drowsiness, dissociation, cold or discomfort, insects. Working when the client describes attention resting with less effort.
• improvement attributed only to the class while other problems go unaddressed. Working when change shows in the client's own markers.
• over-sharing that stigmatises the client; consent given under pressure. Working when the client has read or heard what is being sent.

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.