Atlas›Domain XV · Nature, philosophy, social & rites of passage›Guide 016
Guide XV-016

Green gyms and conservation volunteering

William Bird, The Conservation Volunteers1997Sonning Common
A 30 · L 60 · M 1024 interventions in the Trinity explorer
Client cardCompare
[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: The Conservation Volunteers (TCV) Green Gym model as set out in the TCV Green Gym Field Guide (TCV, 2021) and TCV's public session FAQ, with conservation volunteering more broadly as described in Natural England's review of nature-based interventions (Bragg and Atkins, NECR204, 2016) and the University of Essex evaluation of Wildlife Trusts volunteering (Rogerson, Barton, Bragg and Pretty). Where these differ (for example on session length), the Field Guide is followed and the difference is noted.

Green Gym is not a psychotherapy. It is a community programme in which groups of volunteers do practical environmental work outdoors (conservation tasks, park management, food growing) in sessions that also include a safety talk, a warm-up, a refreshment break and a cool-down. TCV and Dr William Bird developed the concept; TCV's national evaluation reports a first pilot in 1997 with Sonning Common Health Centre and a second in 1999 with East Sussex Brighton and Hove Health Authority, while the Field Guide says it was first offered in 1998 [source: TCV 2016 national evaluation; TCV Field Guide 2021] [uncertain: start date differs between TCV documents]. The Field Guide calls it a "health by stealth model": people join for the work and the place, and health benefits follow [source: TCV Field Guide 2021]. Conservation volunteering with other bodies (for example The Wildlife Trusts, the National Trust, RSPB, Groundwork) works on the same lines; when commissioned for people with a defined need, Natural England treats it as a form of green care, sharing three components with ecotherapy, social and therapeutic horticulture and care farming: the natural environment, meaningful activity and a social context [source: Bragg and Atkins 2016, NECR204].

How change is understood to happen, as these sources describe it: purposeful, visible work in nature gives structure, a sense of achievement and a role in a team; regular contact with a non-judgemental group reduces isolation; physical activity rises without being the stated goal; and some participants move on to leadership roles, training or work [source: TCV 2016 national evaluation; Rogerson et al. Wildlife Trusts evaluation; Husk et al. 2016 Cochrane review, qualitative synthesis]. Evidence status in one line: the Cochrane review (Husk et al. 2016) found that most quantitative studies showed no effect on health and well-being and called the research "not very robust", while participants consistently reported feeling better and valuing social contact, achievement, nature and structure [source: Cochrane Public Health news item on Husk et al. 2016]; programme evaluations are uncontrolled pre-post designs [source: Rogerson et al.; TCV 2016].

The psychotherapist's role is mostly not to run the session. It is to assess fit, prepare and refer the client (directly, via a GP, or via a social prescribing link worker), work with the client's participation as behavioural activation and social reconnection inside therapy, debrief what happens, liaise with leaders with consent, and help the client make meaning of the work. A therapist who also leads a group is in a dual role (see section 3). Related guides: 015 green social prescribing; 077 volunteering and the helper-therapy principle; II 040 behavioural activation; 122 exercise.

2. Framework

Green Gym is a rolling, open programme rather than a course with fixed phases. The phases below combine the session pathway TCV publishes, the group life-cycle TCV describes, and the therapist-side work around referral [source: TCV Field Guide 2021; TCV 2016 national evaluation; therapist phases are synthesis].

Format. Groups meet outdoors at least weekly, usually on weekday daytimes at local community sites such as parks or nature reserves [source: TCV FAQ; TCV 2016]. Session length varies between TCV documents and between groups; check with the local group rather than assuming [source: TCV FAQ; TCV Field Guide 2021]. Groups may have many registered volunteers with a smaller weekly turnout; attendance is flexible and not compulsory [source: TCV 2016]. There is no fixed number of sessions; evaluations measured change at baseline, and after several weeks and three months, but that is a research schedule, not a course length [source: Yerrell 2008; Rogerson et al.].

The session pathway (TCV). Every session follows the same sequence: meet and greet (welcome, team ethos); safety talk explaining the tasks and tools; warm-up, starting light and building gradually (a guided warm-up is optional); a first activity block offering tasks from low to high intensity; a mid-session refreshment break used for conversation and planning; a second activity block with intensity adjusted; a cool-down in which leaders check how people feel, finish tasks slowly and thank volunteers; and refreshments. The Field Guide treats the tea kit as essential [source: TCV Field Guide 2021].

Group life-cycle (TCV). TCV staff lead a new group at first, train and mentor participants to run it, and the group may then become an independently constituted community group, with some participants moving into roles such as Volunteer Officer [source: TCV 2016]. The Field Guide lists volunteer roles such as coordinator, treasurer, tool keeper and refreshments organiser [source: TCV Field Guide 2021].

Therapist-side phases [synthesis]:

  1. Assessment and fit. Goal: decide whether practical outdoor group work fits the client's goals, health, and current state. Move on when the client wants to try it, medical questions have been routed to their clinician, and practical barriers have a plan.
  2. Preparation and referral. Goal: a warm, informed first contact. The client (or you, with consent) contacts the group leader before the first visit; TCV asks newcomers to get in touch a few days ahead rather than just turning up, and to tell the group in confidence about any condition that might affect taking part [source: TCV FAQ]. Move on when a first session is booked.
  3. Engagement. Goal: regular attendance at the client's own pace. Therapy sessions track attendance, mood, social contact and meaning. Move on when attendance is steady or the client has decided it is not for them.
  4. Consolidation and growth. Goal: the client uses the group for routine, belonging and possibly responsibility (a role in the group, training, a route back to work, which TCV reports for some volunteers) [source: TCV 2016]. Move on when gains are part of the client's life outside therapy.
  5. Ending therapy, keeping the group. Goal: the group continues as a community resource after therapy ends; Natural England notes that people can move back along the green care continuum toward everyday nature contact as wellbeing improves [source: Bragg and Atkins 2016].

3. Guiding principles

  • Health by stealth [source: TCV Field Guide 2021]. Practical meaning: present the group as real conservation work with people, not as treatment; the client's identity there is volunteer, not patient.
  • Leaders are not health experts [source: TCV Field Guide 2021]. The Field Guide says "The responsibility for a participant's health lies firmly with that participant and their clinician." Practical meaning: medical screening questions belong to the client's GP or physician; do not expect leaders to manage clinical risk.
  • Readiness questions before activity [source: TCV Field Guide 2021]. Participants answer screening questions about heart and chest symptoms, balance or loss of consciousness, bones and joints, medication and other reasons to avoid activity, and any "yes" is discussed before they start. Practical meaning: help the client answer honestly and see their doctor first where advised.
  • Work at your own pace [source: TCV FAQ]. Tasks suit different fitness levels and newcomers can start light. Practical meaning: you do not set targets for effort or attendance; you support the client in choosing tasks that fit their body and mood. No exercise prescription is given in this guide; physical-activity guidelines exist (WHO 2020) and individual advice comes from the client's physician or a qualified exercise professional [source: WHO 2020 guidelines, BJSM].
  • Meaningful activity, nature and social context together [source: Bragg and Atkins 2016]. Practical meaning: in therapy, attend to all three: what the work means, how the place feels, and who the client is with.
  • Non-judgemental culture [source: TCV 2016]. Volunteers described not being defined by their past or diagnosis. Practical meaning: protect this; the client decides what, if anything, to share with the group.
  • Indirect supervision [source: TCV Field Guide 2021]. The leader's "prime responsibility is to supervise the task"; carers or partner organisations supervise individuals who need support. Practical meaning: a client who needs one-to-one support needs a supporter who comes with them; arrange this before referral.
  • Safety first, every session [source: TCV FAQ; TCV Field Guide 2021]. Sites are risk-assessed, tool training happens at the start of each session, a first aider is present. Practical meaning: route all safety questions to the group's published guidance; do not improvise outdoor safety advice.
  • Clinical referral and self-referral both work [source: Rogerson et al.; TCV 2016]. Practical meaning: the client can go alone; your referral is a support, not a gate.
  • Those starting lowest may gain most [source: Yerrell 2008; Rogerson et al.]. Practical meaning: low wellbeing is not a reason to delay referral, but extra support at entry may be needed.
  • Confidentiality outdoors [synthesis]. Practical meaning: you share nothing with a group without the client's written consent, agree in advance what the client wants said if you are ever seen together, and keep clinical conversation out of the group.
  • Dual roles [synthesis; APA Ethics Code Standard 3.05]. Practical meaning: if you lead or volunteer in a group, avoid referring your own therapy clients into it, or contract explicitly about the overlap, because a multiple relationship can impair objectivity or risk exploitation (APA Standard 3.05).
  • Competence and insurance [source: TCV Field Guide 2021; synthesis]. At least one leader per session must have completed TCV's "Essentials of Green Gym" training, one must hold at least an emergency first aid certificate, and sessions must be adequately insured. Practical meaning: a therapist who wants to lead needs that training, first aid and insurance cover for outdoor practical work; professional indemnity for therapy may not cover it [synthesis].

4. Intervention inventory

Items 4.1 to 4.12 are the programme components that TCV and the Wildlife Trusts evaluation publish. Understand them in order to prepare a client, or deliver them if you are trained as a leader. Items 4.13 to 4.24 are therapist-side procedures. The sources describe only a few of them, so those are marked [synthesis]. Example wording throughout is illustrative.

4.1 Meet and greet and team ethos

  • Purpose: to welcome people, set the tone of the group and help newcomers belong. Used at the start of every session [source: TCV Field Guide 2021].
  • Steps: (1) The leader greets each person by name and introduces newcomers to one or two regulars. (2) They say what the group is for: the site, the work, the team. (3) They name the ground rules on respect and pace. (4) If you are preparing a client, tell them this is what will happen so the first minutes are predictable [synthesis].
  • Example language (illustrative): "Welcome. Today is mostly about getting to know the site. Nobody expects you to know anything yet."
  • Watch for: a newcomer left standing on the edge. If the client says after the session that someone talked to them early on, the welcome worked.

4.2 Safety and tool talk

  • Purpose: to explain the tasks and how to use each tool safely, given that participants may be new to the setting. Done at the start of every session [source: TCV Field Guide 2021; TCV FAQ].
  • Steps: (1) The leader explains the day's tasks and why they help the site. (2) They demonstrate each tool and how to carry it, store it and pass it. (3) They point out site hazards from that day's risk assessment. (4) They check that people understood and invite questions. You do not give tool advice yourself; the client follows the leader [synthesis].
  • Example language (illustrative), therapist preparing a client: "There'll be a short safety talk at the start. It's fine to ask them to show you again."
  • Watch for: clients with attention, memory or hearing difficulties who miss the talk. Ask, with consent, whether instructions can be repeated one-to-one [synthesis].

4.3 Readiness and welfare questions

  • Purpose: to find out before activity whether someone has a health reason to adapt or avoid tasks [source: TCV Field Guide 2021].
  • Steps: (1) The participant answers TCV's readiness questions. These cover heart and chest symptoms, balance or loss of consciousness, bones and joints, medication, and any other reason to avoid activity. (2) Any "yes" is discussed before they start, and they may be advised to see a health professional first. (3) A walk-in participant completes the welfare form and takes part at their own risk. (4) The leader does not give health advice [source: TCV Field Guide 2021; TCV FAQ]. (5) Therapist side: before referral, go through the kinds of questions the client will be asked, encourage honest answers, and route any medical question to the client's GP or physician [synthesis]. Never advise a client to start, stop or change a medicine.
  • Example language (illustrative): "They'll ask a few health questions. If any of them apply to you, a quick word with your GP first is the safe route."
  • Watch for: under-reporting out of shame or eagerness. The Field Guide also lists stop signs during activity, such as chest or upper-body pain, uncontrollable breathlessness, dizziness, fainting and palpitations. Make sure the client knows to stop and tell the leader if any occur [source: TCV Field Guide 2021].

4.4 Warm-up

  • Purpose: to prepare the body for practical work [source: TCV FAQ; TCV Field Guide 2021].
  • Steps (outline only): the warm-up starts light with pulse-raising and mobility movements, adds gentle stretches only once people are warm, and allows adaptations for injury or disability. The Field Guide notes that cold conditions need a longer warm-up. A guided warm-up is optional [source: TCV Field Guide 2021]. This guide gives no durations, repetitions or intensities. A client who wants individual guidance should ask their physician or a qualified exercise professional.
  • Example language (illustrative): "Do only the movements that feel right for your body. Skipping one is fine."
  • Watch for: pain, or self-consciousness about moving in front of others. Clients with a history of compulsive exercise may push past the group's pace (see 4.13).

4.5 Graded task choice

  • Purpose: to match work to each person's ability and let effort build over time. Newcomers might start with light work, such as potting seedlings, and move on to heavier jobs, such as wheelbarrowing [source: TCV 2016; TCV FAQ].
  • Steps: (1) The leader offers a range of tasks from low to high intensity. (2) Participants choose, or are allocated, tasks to suit them. (3) Intensity is adjusted in the second activity block. (4) The leader monitors people throughout and may ask someone not to take part [source: TCV Field Guide 2021]. (5) Therapist side: help the client choose a first task that fits their energy and mood. The aim is a finished, visible piece of work, not maximum effort [synthesis].
  • Example language (illustrative): "What would let you leave feeling you'd done something, without wiping you out for the rest of the week?"
  • Watch for: all-or-nothing patterns, such as overdoing the first session and then missing the next. It is working when the client describes choosing tasks by fit rather than by proving themselves.

4.6 Manual handling and task rotation

  • Purpose: to prevent strain and injury during physical tasks [source: TCV Field Guide 2021].
  • Steps (qualitative): loads are kept manageable and lifted with bent knees. Kneeling on cushioned support is preferred to bending forward. Twisting while raking is avoided. People rotate between tasks and take regular breaks during sawing. Heavy fencing tools are used briefly and only by capable participants. Straining tasks, such as heavy lifting, pulling brambles or tightening wire, can sharply raise blood pressure, so anyone with high blood pressure or heart trouble should avoid them [source: TCV Field Guide 2021].
  • Example language (illustrative): "If your doctor has mentioned your blood pressure or heart, tell the leader. They'll find you something that doesn't involve straining."
  • Watch for: clients who cannot say no to heavy jobs. Rehearse a sentence for declining a task (see 4.19).

4.7 Mid-session refreshment break

  • Purpose: rest, social contact and group cohesion. Leaders encourage conversation and planning during the break, and the Field Guide describes the tea kit as possibly "THE most important thing" [source: TCV Field Guide 2021].
  • Steps: (1) Work stops for refreshments. (2) The leader opens conversation and asks the group about plans for the site. (3) Newcomers are drawn in without being pushed. (4) Therapist side: for socially anxious clients, the break is often the hardest part, so plan for it (see 4.19) [synthesis].
  • Example language (illustrative): "At the tea break you could ask someone how long they've been coming. Most people like that question."
  • Watch for: the client hiding in a task during the break. One short exchange counts as progress.

4.8 Cool-down and check-in

  • Purpose: to wind down physically, check how people feel and close with thanks [source: TCV Field Guide 2021].
  • Steps: gentle movement and optional stretches adapted to each person. The leader asks how participants feel, finishes tasks slowly and thanks volunteers. No durations are given in this guide [source: TCV Field Guide 2021].
  • Example language (illustrative), in therapy: "When they thanked everyone at the end, what did you notice in yourself?"
  • Watch for: discounting thanks. A client who begins to accept it is internalising the achievement.

4.9 Shared roles and leadership progression

  • Purpose: to sustain the group and give members responsibility. TCV staff train and mentor participants to run the group, and some take on roles [source: TCV 2016; TCV Field Guide 2021].
  • Steps: (1) Roles such as tool keeper, refreshments organiser, publicity or practical work organiser are shared out. (2) Interested volunteers are mentored toward leading. (3) Leaders complete the required training (see section 3). (4) Therapist side: explore whether a role fits the client's goals and capacity, and plan how they would step back if it became too much [synthesis].
  • Example language (illustrative): "Looking after the tools is a real job. How would it feel to be the person they rely on for that?"
  • Watch for: taking on roles to please others, or helper burnout (cross-refer 077). A role the client chose and enjoys is a good sign.

4.10 Outcome monitoring

  • Purpose: to show outcomes to funders and referrers and to improve the programme [source: TCV Field Guide 2021].
  • Steps: (1) Evaluations have used the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) or its short form, the ONS personal wellbeing questions, a physical-activity questionnaire (IPAQ), the SF-12v2 and nature-relatedness items. Measures were taken at joining and at follow-up points [source: TCV 2016; Yerrell 2008; Rogerson et al.]. (2) Data must be stored safely under data protection rules, and participants must be told who can access it [source: TCV Field Guide 2021]. (3) Therapist side: if you track change, use your usual licensed measures under their own terms. The items are not reproduced here. Agree with the client which measures, if any, are shared with the group [synthesis].
  • Example language (illustrative): "The group may ask you to fill in a wellbeing form. That's for their funding, and it's your choice what you share with me."
  • Watch for: clients feeling they are being assessed as patients. Restate that taking part is voluntary.

4.11 Referral follow-up call

  • Purpose: to check suitability and needs before a referred person starts. The Wildlife Trusts' Wellbeing Through Nature programme did this, and the evaluation recommended it [source: Rogerson et al.]. TCV describes a referrer phoning a Project Officer or Volunteer Coordinator, who arranges a visit with the client [source: TCV 2016].
  • Steps: (1) With written consent, give the group the minimum information it needs: support needs and access requirements, not diagnosis detail. (2) The coordinator calls the client. (3) A first visit is arranged, sometimes with the referrer or a link worker present. A West Leeds GP-linked service supported patients at their first session [source: TCV 2016].
  • Example language (illustrative): "Would you like me to let the coordinator know you'd prefer a quieter task to start with? I won't say anything else."
  • Watch for: oversharing by referrers. A good sign is that the client feels expected, not labelled.

4.12 Tailored activity and one-to-one check-ins

  • Purpose: to support people with mental health problems within the group. The Wildlife Trusts evaluation recommended tailoring activities, offering one-to-one check-ins, providing a welcoming setting and helping with transport [source: Rogerson et al.]. TCV runs specialist Green Gyms for people with learning disabilities and mental health problems [source: TCV 2016].
  • Steps: (1) Identify with the client whether a general group or a specialist group fits better. (2) Ask whether the group offers check-ins or a named contact. (3) Where a client needs one-to-one support, arrange a supporter, because under TCV's indirect supervision leaders supervise the task, not the individual [source: TCV Field Guide 2021].
  • Example language (illustrative): "There's a group designed for people who are finding things hard at the moment. Would that feel easier as a first step?"
  • Watch for: a mismatch between need and support. The leader may stop a session if supervising adults are not provided for identified needs [source: TCV Field Guide 2021].

4.13 Fit assessment

  • Purpose: to decide whether practical outdoor group work suits the client now [synthesis, informed by Bragg and Atkins 2016 on the three shared components].
  • Steps: (1) Ask about the client's interest in outdoor or practical work, past experiences of groups, and what they hope for: structure, company, skills, a route to work. (2) Review current risk, including suicidality, using your standard risk-assessment practice; a group is not a crisis service. (3) Screen for compulsive exercise and disordered eating. If either is present, discuss whether physical work fits, and refer to a registered dietitian or an eating-disorder service. In the US, the National Alliance for Eating Disorders offers support. (4) Note access needs, such as mobility, sensory needs, energy limits and learning disability. (5) Decide with the client between a general group, a specialist group or another green care option (cross-refer 015 green social prescribing).
  • Example language (illustrative): "Some people love getting muddy with a group. Others find it too much at first. What sounds closer to you?"
  • Watch for: interest driven only by wanting to burn energy or control weight. It is working when the client can name a reason that is about connection, purpose or place.

4.14 Medical routing and outdoor-safety preparation

  • Purpose: to make sure physical risks are handled by the right people and the client arrives prepared [source: TCV FAQ; TCV Field Guide 2021; UKHSA 2025].
  • Steps: (1) Ask the client to check with their GP or physician if they have heart, chest, balance, joint or blood-pressure concerns, are pregnant, or take medication that affects activity or heat tolerance. (2) Clothing, as TCV advises: sturdy boots with a good grip, clothes that can get dirty, a waterproof, and suncream and water in summer. The group can help with kit [source: TCV FAQ]. (3) Weather: rain usually does not cancel a session, and unsafe conditions may. Volunteers are contacted in advance [source: TCV FAQ]. (4) Ticks, following UKHSA advice: keep to paths, cover skin, use repellent, check the body and clothing afterwards, remove attached ticks promptly with a tick tool or fine tweezers without squashing them, and contact a GP or NHS 111 if a spreading rash or flu-like symptoms follow a bite [source: UKHSA 2025]. (5) Allergies, such as hay fever, insect stings or plant sap, and hydration are handled by the client's own clinician and the group's guidance [synthesis].
  • Example language (illustrative): "Before you go, could you check with your GP that physical work is fine with your heart condition? Then we can focus on the rest."
  • Watch for: health anxiety that becomes a reason never to start. Help the client move from reassurance-seeking to a single check with the doctor.

4.15 Practical barrier planning

  • Purpose: to remove obstacles that stop people attending. The evaluations name transport, staffing for people who need one-to-one support, weekday-only sessions for people in work, and web-only registration excluding people without internet access [source: TCV 2016; Rogerson et al.].
  • Steps: (1) List the barriers with the client: travel, money, kit, timing, caring duties, digital access. (2) Problem-solve each one. Some groups run minibus pick-ups, and most people walk, cycle or take the bus [source: TCV FAQ]. (3) Use a link worker for local options. (4) Under-16s attend only with an adult, and 16 to 18 year olds need signed parental consent [source: TCV FAQ]. When working with young people, follow your safeguarding duties and obtain both consent and assent.
  • Example language (illustrative): "Let's work out the journey together. Which part feels most likely to stop you on the day?"
  • Watch for: barriers that are really avoidance. Name this gently and see 5.2.

4.16 Warm referral and handover

  • Purpose: to make first contact as easy as possible [source: TCV FAQ; TCV 2016; Rogerson et al.].
  • Steps: (1) Get the client's consent, specifying what will be shared and with whom. (2) Either the client contacts the leader a few days before a first visit, as TCV asks [source: TCV FAQ], or you, the GP or a link worker do it with them. (3) Agree whether you will hear back from the group, and what you would hear. (4) Plan the first visit: arrival, who to ask for, what to say about themselves [synthesis].
  • Example language (illustrative): "Shall we write the message to the coordinator together now, while we're here?"
  • Watch for: contact delayed week after week. If so, offer to make the call in session.

4.17 Integrating attendance as behavioural activation

  • Purpose: to use the group as a values-linked, scheduled activity within behavioural activation (cross-refer II 040) [synthesis].
  • Steps: (1) Link attendance to the client's values, such as usefulness, belonging or caring for a place. (2) Schedule it like any activity, with a plan for low-mood days. (3) Ask the client to note mood and sense of achievement and pleasure before and after. (4) Review in session what helped and what got in the way. Set no exercise targets: physical activity is a by-product. Questions about activity levels go to a physician or a qualified exercise professional.
  • Example language (illustrative): "You said you want to feel useful again. How does Thursday's group fit with that?"
  • Watch for: attendance becoming a test the client fails. Count partial attendance as data, not failure.

4.18 Debriefing after sessions

  • Purpose: to consolidate what participants report as valuable: achievement, social contact, time in nature and daily structure [source: Husk et al. 2016, qualitative synthesis, as reported by Cochrane Public Health]. Use it after early sessions and periodically after that [synthesis].
  • Steps: (1) Ask what the client did and what changed on the site. (2) Ask about contact with others. (3) Ask what they noticed in their body and mood, and about the place itself. (4) Ask what was hard. (5) Link all this to therapy goals and plan the next week.
  • Example language (illustrative): "Tell me about the hedge you laid. What does it look like now compared with when you started?"
  • Watch for: reports of mental fatigue or anxiety. The Cochrane review notes that a subset of studies found these increased [source: Cochrane Public Health on Husk et al. 2016]. Adjust the pace, or reconsider the fit.

4.19 Graded approach to the social side

  • Purpose: to help socially anxious or isolated clients join the group step by step. Participants in the Wildlife Trusts evaluation described growing social confidence and peer support [source: Rogerson et al.; procedure is synthesis].
  • Steps: (1) Build a ladder with the client. It might run from working near others, to one exchange at the tea break, to asking a question, to joining planning. (2) Rehearse key sentences, such as introducing themselves, declining a task and saying how much they want to share. (3) Agree what the client will say if asked why they are there, for example "I wanted to get outdoors." (4) Review after each session. Get the client's consent for each step, and they can stop at any point.
  • Example language (illustrative): "If someone asks what brings you, what answer would feel true but private enough?"
  • Watch for: safety behaviours, such as staying permanently busy in a task. It is working when the client reports a conversation they did not plan.

4.20 Meaning-making with the work and place

  • Purpose: to explore what caring for land means to the client, including purpose, legacy, seasons and belonging. Natural England's framework puts meaningful activity at the centre [source: Bragg and Atkins 2016; procedure is synthesis].
  • Steps: (1) Invite reflection on the long-term results of the work, such as trees planted or paths restored. (2) Notice links to the client's story: loss, repair, patience, being part of something larger. (3) If climate or ecological distress comes up, explore it, and consider eco-distress groups as their organisers describe them [uncertain: not verified]. (4) Concepts such as nature connection or biophilia belong to their authors. Explore what they mean for the client without stating them as fact or dismissing them.
  • Example language (illustrative): "You won't see that oak grown. What is it like to work on something that will outlast you?"
  • Watch for: the work becoming a vehicle for despair about environmental loss. Hold this, and see 5.6.

4.21 Liaison with leaders

  • Purpose: to coordinate support without turning the group into a clinical setting. The Yerrell evaluation recommended clearer professional relationships and referral expectations with health and social care [source: Yerrell 2008].
  • Steps: (1) Liaise only with written consent and within its limits. (2) Agree whether you will be contacted, and how, about attendance, concerns or incidents. (3) Remember that leaders are not health or social care workers [source: Yerrell 2008]. Do not ask them to monitor symptoms. (4) Agree a plan in case the client discloses distress or risk to a leader.
  • Example language (illustrative), to a leader: "With her permission: she may need a quieter task some weeks. If you're ever worried, the number she's agreed you can use is her GP's."
  • Watch for: role creep, where leaders start to act as informal clinicians. Clear agreements protect everyone.

4.22 Route to roles, training or work

  • Purpose: to support progression. Some volunteers use Green Gym as a route back to work, citing structure, routine and new skills [source: TCV 2016].
  • Steps: (1) Identify the skills the client is gaining. (2) Explore roles in the group (4.9) or training. (3) Link to employment support if the client wants it. (4) Pace the steps so that gains are not lost to overload [synthesis].
  • Example language (illustrative): "You've been there every week since spring and you know the tools. Is that something you'd want on a CV?"
  • Watch for: progression pushed by others before the client is ready.

4.23 Ending and maintenance planning

  • Purpose: to keep the group as part of the client's life after therapy ends. Natural England describes people moving back along the green care continuum as wellbeing improves [source: Bragg and Atkins 2016].
  • Steps: (1) Review what the group has given the client. (2) Name early warning signs, such as stopping attending, and plan what the client will do if they appear. (3) Decide whether the client continues, changes group, or moves to everyday nature contact. (4) Close any liaison arrangements with leaders [synthesis].
  • Example language (illustrative): "If you noticed you'd missed three Thursdays in a row, what would that tell you?"
  • Watch for: the group ending or changing, for example funding loss or a move to self-run status. Plan for this, because TCV-led groups may become community-run [source: TCV 2016].

4.24 Therapist as leader: contracting the dual role

  • Purpose: to manage competence and boundaries when a therapist also leads or volunteers in a group [source: TCV Field Guide 2021 for training, first aid and insurance; APA Ethics Code Standard 3.05; rest is synthesis].
  • Steps: (1) Complete the required leader training, emergency first aid and insurance before leading. (2) Do not run therapy within the group, and keep notes and records separate. (3) Avoid recruiting your own clients. If a client joins, contract explicitly about confidentiality, how you will relate to each other there, and what happens if difficulties arise. (4) Touch, for example passing tools or helping someone up a bank, needs consent before and during, the person can stop it at any time, and it is never sexual. (5) Have weather, travel and emergency plans in place.
  • Example language (illustrative): "Here I'm one of the leaders, not your therapist. If something comes up that you'd like to talk through, let's keep it for Tuesday."
  • Watch for: blurred roles, favouritism, or the client feeling watched. If there is a multiple relationship that could impair your objectivity or harm the client, Standard 3.05 says to avoid it [source: APA Ethics Code].

5. Handling problems

The programme sources mainly cover safety, barriers and support needs. Most of the guidance below is therapist-side synthesis and is marked as such.

  • 5.1 The client never makes first contact [synthesis]. Make the call or write the message together in session (4.16). Offer a link worker or peer to go with them. Lower the first step to visiting the site, or to attending only the meet and greet.
  • 5.2 Avoidance presented as practical barriers [synthesis]. Solve each barrier in turn (4.15). If new barriers keep appearing, name the pattern without judging it and explore the fear underneath, which is often the group, being seen, or failing. Then use the graded approach (4.19).
  • 5.3 Stuck: the client attends but nothing changes [synthesis]. Check whether they are only working, never connecting. Use the debrief (4.18) to find what is missing: achievement, people or place. Try a different task, a role (4.9) or a specialist group (4.12). Remember the Cochrane finding that measurable effects are often absent even when people value taking part. Judge change by the client's own goals [source: Cochrane Public Health on Husk et al. 2016].
  • 5.4 Overwhelm or more anxiety [synthesis; a subset of studies reported more mental fatigue and anxiety, source: Cochrane Public Health on Husk et al. 2016]. Reduce the load: lighter tasks, part-sessions if the group allows, or a quieter or specialist group. Rehearse leaving early or taking a break. If risk rises, follow your standard risk assessment. Crisis lines: 988 in the US; Samaritans 116 123 in the UK and Ireland. The group is not a crisis service.
  • 5.5 Physical symptoms, injury or overexertion [source: TCV Field Guide 2021 stop signs; synthesis]. The client should stop and tell the leader if they get chest or upper-body pain, uncontrollable breathlessness, dizziness, fainting or palpitations, and seek medical help. Afterwards, send them back to their GP before they resume. Do not give exercise or medical advice yourself. If the client's pattern looks like compulsive exercise, or work is being used to control weight, reassess (4.13) and refer to a registered dietitian or eating-disorder service. In the US, the National Alliance for Eating Disorders offers support.
  • 5.6 Ecological grief or despair stirred by the work [synthesis]. Normalise it as a response to real loss. Work with grief and meaning (4.20). Balance it with the client's sense of agency through the work. Assess for depression if the distress becomes pervasive.
  • 5.7 Interpersonal conflict in the group [synthesis]. Help the client separate the group from the person they are in conflict with. Rehearse assertive responses. Raise the issue with the leader if the client wants that (with consent). Bullying or harassment is a matter for the organisation's procedures. Safeguarding concerns about vulnerable adults or children go through the group's safeguarding lead and your own safeguarding duties [source: TCV FAQ states leaders are trained in safeguarding; procedure is synthesis].
  • 5.8 Confidentiality breaches or being seen [synthesis]. If a leader or referrer shared more than was agreed, repair with the client, renew the consent, and correct the flow of information. If you meet a client in a public green space, follow the agreement you made in advance.
  • 5.9 Rupture with the therapist over the referral [synthesis]. The client may feel "sent away" to volunteering instead of being helped. Acknowledge this. Frame the group as an addition to therapy, not a replacement. Make clear the client can decline it.
  • 5.10 The client relies on the group for everything [synthesis]. Value the structure it gives, and also widen their supports. Plan for the group changing or ending (4.23).
  • 5.11 Helper burnout and over-responsibility [synthesis; cross-refer 077]. A client who takes on many roles may repeat a caring or self-sacrificing pattern. Review their capacity, and practise saying no.
  • 5.12 Weather, seasons and access [source: TCV FAQ; synthesis]. Low winter attendance is common [uncertain: not verified]. Plan clothing and transport, and use the group's own cancellation system. For clients with limited mobility, ask about accessible sites and seated tasks such as potting [source: TCV 2016 names light tasks such as potting seedlings].
  • 5.13 Tick bites or symptoms after outdoor work [source: UKHSA 2025]. If a spreading rash or flu-like symptoms follow a bite, the client should contact their GP or NHS 111 promptly. Health anxiety about ticks is worked with in therapy, using the UKHSA facts.
  • 5.14 The therapist's dual role goes wrong [synthesis; APA Ethics Code Standard 3.05]. If leading the group and treating the client conflict, step back from one role, discuss it in supervision, and document the decision.

Sources

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