The Pros & Cons of Outdoor Therapy: An Honest Review
Photography by Jordan Davidson Photography.
After nearly 5 years of incorporating nature therapy* as a cornerstone of my business model at Wildernew® Outdoor Therapy, here’s an honest review of the pros and cons (as compared to traditional office settings). You’ll notice several things repeat on each list.
As I write this, my audience is both potential clients for outdoor therapy as well as other clinicians interested in bringing their practice outdoors. The setting in which I work is Dallas, Texas at a public nature preserve. Sessions are typically for individuals or families, and last anywhere from 50-90 minutes depending on what has been agreed upon. I also offer virtual or telehealth sessions, and typically offer office sessions, though at the present moment (April 2024) I do not. Edited to add: I am not here to make the case that outdoor therapy is best. It is highly dependent on the individual and the therapeutic relationship.
*For the sake of this writing, I may use the terms “outdoor therapy” and “nature therapy” interchangeably. Some people refer to it as “walk and talk” therapy. For more information or clarification on terms, see here.
Cons of Outdoor Therapy
- Distractions: It is impossible to control the distractions outdoors compared to an office setting. The nature of being outside offers more distractions; being in a public park adds another layer of distractions.
- Weather - Dallas weather offers some extremes: heat, cold, bugs, humidity, wind, and storms. One of the top questions I get from others: “what do you do about the weather?” If you have this question, ask me.
- Privacy – I practice in a local nature preserve, which can be busy at times, offering less privacy. Sometimes this may hinder someone from going deeper into sensitive topics.
- Unpredictability – Neither of us knows what the conditions of the session will be – will the park be crowded? Will it be raining? Can we find a private spot? (For the record, we always can, it just may require using trails.)
- Gear - Special gear may be beneficial; for example a rain coat, water proof shoes, or an umbrella, comfortable walking shoes, a hat, sunglasses and sunscreen may help you be more comfortable in different circumstances. While sessions don’t require special gear, having the right gear can improve your outdoor experience.
- Risk- Potential for injury, exposure to environmental allergens (though you also have such exposure in an office, it’s just different).
- Vulnerability – Simply said, some may feel more vulnerable when sharing private thoughts and emotions in a public space.
- A Note Specifically for Clinicians: Some cons you may experience include increased liability and costs associated with liability insurance, energy demands/stamina, weather—which can impact your comfort and schedule—distractions, and some express personal safety concerns.
For clients or potential clients having any of the above concerns, I encourage you to bring it up with me! We can usually problem solve a solution together.
Pros of Outdoor Therapy
- Distractions – Sometimes our thoughts need interruption because our line of thinking wasn’t helpful (rumination); being outdoors offers natural interruptions and perspective. It also gives us the opportunity to navigate distractions, which are inevitable in today’s world, and improve attention and memory. (Studies show being in nature does both!)
- Movement - Involving body and mind together helps us process and think as well as helping with movement of emotional energy. Through movement, we are also able to explore your relationship to your body and exercise. (I work a lot with eating disorders and am certified in a program to help people heal from compulsive exercise. You can find out more about that here .)
- Skills Practice – Much of therapy is about learning new or more effective ways of navigating challenging circumstances so we have an improved ability to weather the storms that come our way. Nature allows for in vivo grounding, mindfulness, and other skills practice.
- Real World - Being in a public space mimics the real world, which may help provide clarity of the problem as well as the potential for uncomfortable circumstances allow for real life experiences to practice distress tolerance. For example, running into someone you know, observing something strange or unsettling, less than pleasant weather, and so on.
- Possibility and Options - Outdoor therapy offers a variety of options for the setting of the session: sitting on a picnic bench, in camp chairs, on rocks in the creek, or on a blanket in the woods; hiking in the woods, creek walking, walking on the sidewalk, to name a few. Likewise, we have a variety of options for experiential techniques, such as throwing rocks, practicing decision making, engaging with symbolism and metaphor as it pertains to your situation and our experience in nature.
- Perspective - We gain perspective on ourselves and our problems as we witness the connection among living beings and experience wonder and awe. Similarly, we see very real ways that change is the only constant as we observe seasonal and environmental changes. This can foster creativity and curiosity.
- Health - Being outside offers the benefit of improved immunity (including the potential for reduced allergies over time) by boosting natural killer cells and vitamin D exposure. We also experience improved mood, attention, memory, and brain health including reduced risk for dementia through walking.
- Risk and Play - Both are important qualities of a healthy life as they help us learn about ourselves, including our strengths, skills, and abilities and limits. It helps foster confidence and resilience and can promote brain health by creating new neural pathways.
- Space to breathe and to explore (outer and inner landscape).
- Vulnerability has a buffer as it is absorbed by nature; the intensity of vulnerability may be reduced by having an “other” (nature) which may be beneficial in helping us discuss difficult topics.
- Fosters Connection – Time in nature helps facilitate connection to self, therapist, environment, and community.
- A Note Specifically for Clinicians- A benefit to conducting a therapy session outdoors offers you a chance to be active instead of sitting all day, helps buffer the emotional heaviness of therapeutic work, is grounding, and you may potentially reduce your overhead costs as a result of not renting office.
If you’re interested in reading more about my reflections on outdoor therapy or reading about the benefits of time in nature, check out the following:
Wildernew®: 4th Anniversary Reflections
Nature Rx: How Nature Improves Mood, Boosts Optimism and Fosters Unity
Want a life changing experience? #OptOutside
Now, let’s move on to consider office sessions. These lists may be less exhaustive and obviously each person experiences these in their own way.
Cons of Office Therapy
- Distraction - While being in an office allows for more control of the environment, there are still distractions. The session on the other side of the wall –hearing another client cry or yell, someone laughing in the hallway, a loud bang in the office next door, the fire alarm going off, your or the therapist’s phone buzzing or ringing, just to name a few. For the record, all of these have occurred while I’ve been in an office session. Also, as mentioned above, sometimes our thoughts and patterns need interruption.
- Vulnerability - You’re 1:1, usually facing each other, as you share your private thoughts and emotions. This can be very uncomfortable. There’s no where to hide (except, perhaps behind a pillow or if you exit the session).
- Less Risk - The predictability and control of meeting in an office offers less opportunity for risk.
Pros of Office Therapy
- Less distraction (though, still distractions… see above)
- Vulnerability - We have the opportunity to face fears as we are vulnerable 1:1 with the therapist with no place to hide. We see that we can handle it, that the other person doesn’t leave us when we share a piece of ourselves that we usually hide.
- Predictability and Stability – The conditions for therapy in an office are often the same: location, time/space, temperature, lighting… all of this offers a sense of continuity,
- Safety – less physical risk, potentially same level of emotional risk
As a bonus, let’s consider the pros and cons of telehealth or virtual therapy. Telehealth has become standard option as a result of Covid. Some therapists I know practice entirely online. Again, this list is not exhaustive.
Cons of Telehealth
- Unpredictability and Unknowns – The patient or therapist can be in different settings each time, including an office, home, parking lot, driving, on vacation, or at work. Depending on the setting, it can hinder the therapeutic work.
- Distractions – There are still distractions. Dogs barking, door bell ringing, your laundry signaling it’s time to switch it over, phone pinging with less chance of someone noticing if you check it (we still notice), open tabs, the little picture in picture view of yourself… the list goes on.
- Reduced Visibility - We may miss cues and important messages through body language and facial expressions being less visible (some patients choose to show the ceiling or part of their face or not have their camera on at all).
- Tech Issues – Internet connectivity, battery life, bluetooth connectivity for audio, Apple’s emoji’s flying across the screen when you do certain gestures from an apple product. Again, the list goes on.
- Relationship – Meeting online is not the same as gathering together in person. Humans need in person connection with other humans. Loneliness, and the resulting anxiety and depression, was a key consequence of taking relationships online during the pandemic.
Pros of Telehealth
- Flexibility - You can meet on your lunch break or get some fresh air in your back yard. You can fit sessions in your day more easily without factoring drive time.
- Accessibility - More people have access to quality psychotherapy.
- Health - The original benefit to offering telehealth during the pandemic was reduced exposure to illness.
Still have questions about any of the above? Clinicians or aspiring therapists, feel free to contact us to discuss outdoor therapy consultation. For potential clients, feel free to contact us to discuss options for sessions and address any concerns you may have.