Tag Archives: Ecotherapy

Counseling Connoisseur: Nature therapy and brain science in children

By Cheryl Fisher April 20, 2022

Alfred Adler purported that all behaviors have a purpose. Behaviors are often the way the body responds to life’s stressors, especially for children. Yet, many therapeutic treatments for children focus on the modification, remediation and even elimination of a behavior without addressing the underlying cause. This approach suggests that once a behavior is corrected, the child will experience general wellness.

Brain science, however, indicates that the physiological state of children must be attended to before one addresses behavioral change. In Beyond Behaviors: Using Brain Science and Comparison to Understand and Solve Children’s Behavioral Challenges, Mona Delahooke, a licensed clinical psychologist, argues, “When we see a behavior that is problematic or confusing, the first question we should ask isn’t ‘How do we get rid of it?’ but rather ‘What is this telling us about the child?’”

Therefore, behavior is adaptive and a response to the internal and external experience of the child.

Autonomic response refresher

The human body responds to perception of threats to safety by creating a biochemical and physiological state prepared to move the body to fight, flight or freeze. In this state, the body increases the production of adrenaline, norepinephrine and cortisol. The amygdala and the limbic system become activated and temporarily lead brain functioning over the prefrontal cortex, which is responsible for higher order thinking and executive functions. The child is now functioning in survival mode, and the child’s behaviors may manifest in a variety of ways, including distraction, withdrawal, irritability or fidgeting, fearfulness, regression, and aggression.

Rather than blindly rewarding or punishing the child’s behaviors, neuroscience suggests that we seek out the cause of the behaviors before addressing them. It begs us to answer the questions, “Why is the child acting this way? Is the child perceiving a threat to safety?”

As I have addressed in my book Mindfulness and Nature-Based Therapeutic Techniques for Children, counselors must consider if the child is functioning from an underdeveloped kinesthetic system (our sense of our body in space) or vestibular system (associated with the inner ear and balance) resulting from lack of free-form movement. So much of children’s time is spent sitting at their desks or in front of devices, or in structured activities. They lack nondirected, unstructured play and movement. What is the underlying cause? How is the behavior serving to protect the child? Most important, how can we, as counselors, help the child resume a sense of safety and balance and experience a calm and alert state?

Brain science

Several models have emerged over the past few years that emphasize the role of the physiological state of children when treating their behaviors. All these models assume that the behaviors are an attempt to cope with internal or external stressors.

Stephen Porges, the founder of polyvagal theory, proposes that mammals have two neural pathways. The first, the social engagement state, is accessible when the child feels safe and can trust the environment, promoting a calm state accompanied by prosocial behavior. The second pathway is engaged when the child feels unsafe.

Porges introduced the term neuroception to describe the body’s way of scanning the environment for threats to safety. At times, the body miscalculates the risk of safety. According to Porges, the symptoms of faulty neuroception are translated to psychiatric labels and disorders. In other words, a child who has experienced trauma may have a vulnerable nervous system that detects threats that do not exist. Resulting behaviors may include hypervigilance, insomnia, paranoia, bedwetting or a host of other regressive or safety-seeking responses. On the other end of the spectrum, the child may ignore actual risks in the environment, resulting in greater threat to self and psyche.

Therefore, based on neuroscience, Porges recommends providing children with individualized cues of safety that allow social engagement behaviors to emerge spontaneously. According to Porges, three situations must be present to feel safe. First, the autonomic system must not be in a defensive state (fight, flight or freeze). Second, the social engagement system must be activated, which results in the downregulation of the sympathetic nervous system and promotes prosocial behavior. Finally, there must be cues for safety (vocalizations, gestures and positive facial expressions) detected via neuroception. The assumption is that cues for safety can only be exhibited and detected in human-human interaction. However, research continues to support that human and more-than-human interactions also afford meaningful connection.

Brain science and nature

Engaging in the natural world has long been known to have a calming effect on the body. A biochemical exchange occurs in the natural world that results in by-products that, when inhaled or absorbed by the human body, produce a calm and alert state. The earth’s core is like a battery that emits negative ions. Blue spaces (oceans and waterways) offer ionic by-products. Additionally, green spaces (forests and parks) produce phytoncides and terpenes.

Fifteen to twenty minutes of being in a natural setting affects the body by decreasing cortisol, norepinephrine and adrenaline (hormones released when the body perceives threat); increasing serotonin; and reducing blood pressure and respiratory rate. The body responds to the natural space by engaging the relaxation response. Additionally, the immune system is enhanced by both an increase in number and activity of natural killer cells. These effects are sustained for up to a week following single exposure to forests and as long as a month following two days of engagement in green space.

David Clode/Unsplash.com

The earth communicates through the production of these chemicals, and the human body responds to many of the messages (safety cues) by reducing the body’s defensive state, activating the social engagement system and promoting homeostasis (i.e., a calm and alert state).

Research is conclusive that children who engage in natural settings experience greater well-being, are calmer and demonstrate more prosocial behavior. For example:

  • In their article “The role of urban neighbourhood green space in children’s emotional and behavioural resilience,” Eirini Flour and colleagues found that children impacted by poverty and living in urban settings experience improved emotional well-being when exposed to neighborhood green space.
  • Diana Younan and colleagues noted in their article “Environmental determinants of aggression in adolescents: Role of urban neighborhood greenspace” that exposure to greenspace within 1,000 meters surrounding residences is associated with reduced aggressive behaviors in youth.
  • Andrea Faber Taylor and Frances Kuo discovered that, in general, children who play regularly in green play settings are calmer and more alert than children who play in concrete outdoor and indoor settings. Their study, “Children with attention deficits concentrate better after walk in the park,” also found that children with attention deficit/hyperactivity disorder who play in green open areas versus areas with trees and green grass show milder symptoms.

Although it is becoming increasingly important to integrate outdoor activities into clinical practice, routine access to green and blue spaces may be hindered by many factors. In this case, we turn to indoor alternatives.

Nature therapy indoors

Ecotherapists are capitalizing on the research by integrating nature-informed practices and activities into their work. My own research examines the use of nature-informed sensory “time-out/time-away” stations in the emotional and behavioral regulation of school-age children. Historically, time-out has been used to remediate unwanted behaviors in children. This often involves using a corner of a room without windows or distractions. Once the child has calmed down, they may return to the group setting.

However, if (as Adler suggests) all behaviors have a purpose, then the child has learned only that the presenting behavior is unacceptable and to suppress their natural response to whatever triggered it. They have not learned to self-regulate and address the underlying emotional or physical state.

A nature-based sensory time-away station, however, is imbued with items such as plants and herbs that emit terpenes. The station may have a tabletop sand garden that provides tactile exposure and promotes mindfulness. Additionally, nature soundtracks may play in a headset to allow the brain to register these soothing frequencies.

The preliminary data continue to demonstrate that children are able to use this time-away station as a self-regulating tool to allow for the relaxation response, calming of the amygdala and engagement of the prefrontal cortex. Children engage with the natural material, feel more grounded and (depending on developmental stage) are better able to articulate their underlying state verbally or through expressive arts. They return to their previous activity feeling calm and alert.

Here’s some advice on how to create and introduce a nature-based sensory time-away station:

  • Create the station. A nature-based sensory station may be created indoors or outdoors. It includes physical elements that engage the senses. Items may include edible plants and herbs to promote exposure to terpenes. Cotton balls soaked in essential oils also can provide exposure to terpenes through smell. Small containers of rocks, sea glass, pinecones, feathers and shells can provide the child with different tactile experiences. A small tabletop sand garden with miniature rakes can be purchased or created for a tactile and mindful activity. A betta fish or small fish tank may also add biodiversity to the space. Nature sounds can be streamed through headphones. Additionally, paper and tools to write, color or paint may aid in the communication of triggers once the child begins to enter a calmer state. And items can be rotated to capture seasonal changes to your nature-based sensory station.
  • Introduce the station. Because this is a novelty, everyone in a group setting such as a classroom will want to play at the station. It is important to allow each child a chance to explore the space. Using a timer, have children take turns engaging in the station. When the time is up, they may return to the classroom activity. If introduced as a tool, children will soon learn that this space can be accessed to help regulate emotions and behavior in a productive manner. In essence, the children will learn that they feel better after spending time interacting with the space.

In the home setting, the child can help create the space and be taught that it is a place to go to reboot. Show the child how to engage with the multisensory space and then leave them to their own processes.

In addition to the many ecotherapeutic homework assignments and interventions available, counselors utilizing this space as a co-therapist in the field can introduce the benefits of nature-based multisensory engagement and help their clients learn to self-regulate outside of the therapy session.

In conclusion, behavior is a response to interpretation of internal and external stimuli. A child who feels unsafe may experience physiological arousal and respond in a defensive manner. As counselors, we can help educators and parents learn to address a child’s physiological state by creating safety cues for the child. By introducing a nature-based multisensory space, children can learn ways to reduce defensive states, increase homeostasis and activate their social engagement system.



Cheryl Fisher is a licensed clinical professional counselor in private practice in Annapolis, Maryland. She is director and assistant professor for Alliant International University California School of Professional Psychology’s online master’s in clinical counseling. Her research interests include examining sexuality and spirituality in young women with advanced breast cancer, nature-informed therapy and geek therapy. Contact her at cyfisherphd@gmail.com.



Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Climate in crisis: Counselors needed

By Laurie Meyers August 25, 2020

On a warming planet, some of the most rapid increases in temperature are being experienced in the Circumpolar North — the area within and, in some cases, just below the Arctic Circle. Overall, the average global temperature has increased by 1 degree Celsius (1.8 degrees Fahrenheit) since 1880.  Two-thirds of that rise has occurred since 1975.

Since the 1990s, warming in the Arctic, in particular, has been accelerating. Researchers say the region is warming two to three times more quickly than the rest of the planet. In some areas such as Canada’s Labrador coast, the annual average temperature has increased as much as 3 degrees Celsius (5.4 degrees Fahrenheit), causing drastic changes in the weather, terrain and wildlife.

This coastal region is home to the Labrador Inuit people, who live in Nunatsiavut, a self-governing Indigenous territory with five communities — Nain, Hopedale, Postville, Makkovik and Rigolet — accessible only by airplane. The communities are not connected by roads. Instead, navigation is via paths over increasingly unstable ice, which is now prone to sudden thaws and pitted with holes. Unpredictable seasons and severe storms have also made it more difficult for the Inuit to get out on the land that has sustained them physically and spiritually for generations. Like other Indigenous peoples, the Labrador Inuit have faced displacement and forced assimilation. Traditional activities such as fishing, trapping, hunting and foraging are not just for subsistence; they are essential practices that undergird the Inuits’ culture and identity. Climate change has disrupted all of this, not only through changes in the ice, but through changes in the wildlife and plants.

But it goes even beyond that. Climate change is affecting the mental health of this region’s residents.

In 2012, the leaders of the communities of Nunatsiavut asked Inuit and non-Inuit researchers to conduct a regional study of the effects of climate change on mental health. More than 100 residents were interviewed as part of a multiyear study. The resulting report shed light on the strong emotions and reactions of the interviewees, who expressed fear, sadness, anger, anxiety, distress, depression, grief and a profound sense of loss.

One of the interviewees attempted to convey what the land represents to the Inuit: “For us, going out on the land is a form of spirituality, and if you can’t get there, then you almost feel like your spirit is dying.”

A community leader expressed an existential fear: “Inuit are people of the sea ice. If there is no more sea ice, how can we be people of the sea ice?”

Ashlee Cunsolo, a public health and environmental expert who was one of the lead non-Inuit researchers, believes that grief — ecological grief, as she and other researchers have dubbed it — is inextricably linked with climate change. She defines it as “the grief felt in relation to experienced or anticipated ecological losses, including the loss of species, ecosystems and meaningful landscapes due to acute or chronic environmental change.”

A clear and present concern

The story of the Labrador Inuit is undeniably heart-rending. Even so, most people probably feel that scenario is pretty far removed from their own lives and losses. After all, as global citizens of the 21st century, our lives are increasingly virtual, and even if we enjoy the great outdoors, the idea of everything we are being bound to a particular land or place may seem alien.

Think about it a little more though. Whether our settings are urban, suburban or rural, most of us have geographic preferences, be they coastal, mountain, bayou, prairie, desert, forest or canyon. It might be where you live now or where you grew up, but it calls to you. And it has changed. That pond where you spent your childhood winters ice-skating no longer freezes hard enough to handle your gliding blades. Your favorite beach keeps losing feet of sand to the ocean. Ski season is now short on both time and fresh powder. Fire is prohibited at your favorite campsite. The city where you live has endured a summer string of 90-plus-degree days, leaving you longing for fall, but that season of cool, crisp air is increasingly elusive. The heat lasts well into September and October, as trees in your neighborhood stubbornly stay green — until they turn brown.

Austrian environmental philosopher Glenn Albrecht calls that feeling — a sense of missing a place that you never left because it has been altered by climate change — solastalgia.

“I think place can be really underestimated, but place attachment is such a part of who we are,” says Debbie Sturm, an American Counseling Association member who serves on the organization’s Climate Change Task Force. “If there’s harm in a place or threat to a place or loss of place, it is a significant loss.”

As an example, the diaspora caused by Hurricane Katrina in 2005 was extremely traumatic, says ACA member Lennis Echterling, a disaster, trauma and resilience expert who provided mental health support in New Orleans in the wake of the storm. In some cases, people desperately fleeing the floodwaters and destruction were barely aware of where they were headed. Many of those who evacuated have never returned.

“There is still a population who have been separated from their homes — their sacred ground,” says Echterling, a professor at James Madison University in Harrisonburg, Virginia. Although that phrase, sacred ground, is most often associated with tribal populations, Echterling believes it is true for all of us — that we all have an intrinsic attachment to place. And climate change will continue to separate people from their homes, he says, citing researchers who forecast that by the year 2050, an estimated 1 billion people worldwide will be climate refugees.

Even those who haven’t been displaced or experienced climate catastrophe may find it hard to avoid a creeping sense of existential dread — or ecoanxiety — as they witness or hear about extreme weather event after extreme weather event. On June 20, the temperature in the Siberian town of Verkhoyansk reached 100 degrees Fahrenheit, the hottest temperature ever recorded north of the Arctic Circle. Researchers say such an occurrence would be almost impossible (a once-in-80,000-years happening) without climate change caused by human activity. In recent years, wildfires have reduced entire California communities to ash, with citizens up and down the coast donning masks to protect themselves from a lingering pall of smoke. In 2018, Hurricane Florence turned Interstate 40 in North Carolina into a river. Hurricane Harvey struck Houston repeatedly over six days in 2017, leaving one-third of the city underwater at its peak. Approximately 40,000 Houston residents had settled in the city permanently after evacuating from Katrina more than a decade earlier.

Every year, the signs of a climate crisis grow more alarming, and the psychic toll can be traumatic. Psychiatrist Lise Van Susteren, an expert on the mental health effects of climate change, coined the phrase “pretraumatic stress disorder” to describe the fear that many individuals are experiencing about disasters yet to come.

Since 2008, the Yale Program on Climate Change Communication and the Center for Climate Change Communication at George Mason University have been conducting national surveys biannually to track public understanding of climate change. The latest survey results, from November 2019, indicated that 2 in 3 Americans were at least “somewhat worried” about global warming, whereas 3 in 10 were “very worried” about it. A majority of those surveyed were worried about the potential for harm from extreme events in their local areas. 

The mental health effects related to climate change extend beyond disasters such as hurricanes and wildfires. Research has indicated a link between rising temperatures and the increased use of emergency mental health services, not just in places that regularly experience hot weather, but in relatively cool areas as well. Higher temperatures have also been tied to increased levels of suicide.

As the ACA Climate Change Task Force reports in its fact sheet (currently under review), experts predict a sharp rise in mental health issues such as depression and anxiety, posttraumatic stress disorder, substance abuse and suicide, in addition to outbreaks of violence, resulting from coming climate crises. The task force views the counseling profession’s strengths-based approach and focus on resilience as essential to responding to those affected by climate crisis.

However, as part of a study that has not yet gone to press, Sturm, fellow ACA and task force member Ryan Reese, and ACA member Jacqueline Swank surveyed a group of counselors, social workers and psychologists about their personal and professional perceptions of climate change. Although Sturm, Reese and Swank found that these helping professionals were more likely than the average person to believe that climate change is real, very few felt the issue was relevant to their professional lives. Many respondents also said that they didn’t feel confident addressing issues related to climate change in their practice.

Climate change in the counseling office

Reese, a licensed professional counselor practicing in Bend, Oregon, believes that not knowing how to define — and, thus, recognize — climate concerns is part of counselors’ discomfort.

“What is climate change?” he asks. “Is it when you live in California and no longer have a home? … Is it a climate issue when a client is just talking about the general state of affairs and worrying about the world for their kids?”

Of course, there is also the matter of climate change being a polarizing topic, says Reese, an assistant professor of counseling and director of the EcoWellness Lab at Oregon State University-Cascades. When he is talking with clients about broader health and wellness and the topic of climate change comes up, sometimes they will tell him they think it is fake news. “What am I going to do?” Reese asks. “Am I going to impose my view? How do we find ways to introduce our wellness perspective without imposing?”

Reese’s practice is based on ecowellness, a model he co-developed with Jane Myers that revolves around a neurobiological relationship with nature. “The bridge here is, ‘Tell me about your relationship with nature,’” he says.

Reese says he does see a significant amount of ecoanxiety and fear of the unknown, especially among his adolescent clients. But they typically come in talking about depression.

Reese’s intake process includes questions about spirituality and life’s meaning and purpose. He asks clients about their outlook on the future, which is where their anxiety sometimes emerges. Questions about their relationship with nature often reveal the connection between that anxiety and their concerns about the climate.

If clients mention any angst about the environment, Reese asks whether they can unpack that a little more. He’ll follow up by asking questions about how a client spends their time outdoors, what their everyday access is to nature, where and how they feel most effective in nature, and whether they have any hobbies involving nature. He also encourages them to think about what role they can take on: “You mentioned being fearful about what your future is going to hold. What, if anything, can you do right now to address your concern about environmental crisis? … What is within your immediate grasp and control that you can do?”

Reese’s approach involves seeing what the individual’s broader landscape looks like and what their interests, passions and resources are. He urges his clients to get creative and often suggests that his adolescent clients take some kind of action at school, such as starting a recycling program. One of his adult clients took the action step of buying an electric bike and not driving his car as frequently to lessen his impact on the environment.

Reese also helps clients connect their hobbies with environmental action. For instance, if they like skateboarding, he’ll ask them what kind of impact they think that has on the environment. That may lead them to taking the action step of picking up trash around the skate park.

“It’s looking at what is the way we can increase self-efficacy in response to the environment so that it’s not abstract,” he says. “This is something I can engage in and learn and sustain this particular activity for myself and other people.”

Reese also asks clients to educate him about their activities. “For example, mountain biking is huge in Bend, but I don’t know anything about it. … What is the environmental impact? Oh, you don’t know either? Where can we find out?”

Climate change as social justice

ACA’s Climate Change Task Force notes that the resulting trauma from climate change has been and will continue to be experienced disproportionately. Black, Indigenous and people of color (and their communities), children, pregnant women, older adults, immigrants, individuals with limited English proficiency, those with disabilities, and those with preexisting and chronic medical conditions are all more likely to be affected by climate crisis and to have fewer resources to cope with its impact.

In September, the Gulf Coast will mark the 15th anniversary of Hurricane Katrina, one of the most powerful Atlantic storms on record. It wrought widespread devastation and flooding, including the overflow and eventual break of the levee system around New Orleans. As a result, 80 percent of the city was submerged underwater.

New Orleans and Katrina are important to the discussion of climate change as a social justice issue for a number of reasons, says Cirecie West-Olatunji, a past president of ACA who now lives and works in New Orleans. “Katrina was our first uber-disaster related to climate change,” she says. “It informed the world and was a global example of what was to come.”

West-Olatunji provided disaster mental health assistance in the aftermath of Katrina. “I could see the gaps,” she says. “The normal [disaster] response was not going to be sufficient.” Specifically, she recognized that the recovery period would be lengthy, the trauma and mental health challenges extensive, and the reconstruction resources unequally distributed.

Foreshadowing the 2017 tragedy of Hurricane Maria in Puerto Rico, the federal government’s response to Katrina was inadequate. It highlighted an essential barrier to recovery, namely that “whatever disparities exist prior to a disaster will be exacerbated post-disaster,” says West-Olatunji, an associate professor and director of the Center for Traumatic Stress Research at Xavier University of Louisiana.

Racial injustice, economic instability, and government funding for economic development that was distributed to certain communities and not to others were among the factors that magnified the physical and mental damage left behind by Katrina. And those factors continue to hinder recovery today. “Fifteen years later, and New Orleans is still in trauma mode,” West-Olatunji asserts.

There were multiple levee breaches, but only one adjacent neighborhood — the historically Black Lower Ninth Ward — was all but written off from the beginning of the recovery period, West-Olatunji says. Many of the residents owned their homes but faced multiple barriers to rebuilding. One of the most significant factors was discrimination in the distribution of Louisiana’s “Road Home” rebuilding funds. According to the Greater New Orleans Fair Housing Action Center (one of multiple plaintiffs in a lawsuit against the U.S. Department of Housing and Urban Development and the state of Louisiana), the program’s own data showed that Black residents were more likely than White residents to have their grants based on the much lower prestorm market value of their homes rather than on the actual cost of repair. Other displaced residents were unable to return and now cannot afford to pay their homeowners taxes, West-Olatunji says.

In the Lower Ninth, what’s left is an economic and food desert, with virtually no stores beyond a few mom and pops and only one school, she says. Developers have bought up properties, and instead of properly renovating them by gutting and bleaching the houses, in many cases they have simply repainted, leaving renters exposed to toxic mold.

In addition, much of what has been done to “rebuild” New Orleans has rendered it unlivable for those with low and modest incomes, West-Olatunji says. The city bulldozed public housing, and rent has skyrocketed. All of the city’s schools are now charter schools, which essentially makes them private schools that don’t answer to anyone other than their shareholders, she explains. “Kids are bussed all over the place … having to come out —unaccompanied — before daylight to find their way to school.”

New Orleans’ primary industry of tourism afforded a modest living to a significant number of residents for many years, West-Olatunji says. Pre-Katrina, that income could purchase a moderately priced house and even allow families to send children to state schools for higher education. Today, she says, the city is “assailed by outsiders and carpetbaggers who buy up properties. … We went from majority home ownership to rentals and Airbnbs.”

New Orleans is also a much whiter city now. Although most of the White residents who fled the city due to Katrina have returned, approximately 100,000 fewer Black people currently live in New Orleans than did before late August 2005.

West-Olatunji says there is a frequent refrain from the Black citizens who remained or returned: “I survived Katrina only to deal with the coronavirus and with the latest police brutality.”

“The trauma of Katrina was an overlay to existing and continuing stress and racial events,” she says. “It makes it really difficult to recover. … People are emotionally exhausted.”

Climate change should be of great importance to counselor practitioners, West-Olatunji says. “It’s influencing people’s behaviors and their possibility of choices. It narrows choices and creates barriers for living. Our job is to assist people in living abundantly. Climate change isn’t making that easy,” she says.

ACA member Edil Torres Rivera, a professor of Latinx studies and counseling at Wichita State University in Kansas, believes that climate change is still too frequently dismissed as a hoax. “Climate change is something that is real and … has implications for mental health,” he says, “particularly for populations like poor people, Indigenous people and people of color.”

Anyone who doubts that need only visit Rivera’s home island of Puerto Rico, where, three years after Hurricane Maria, people are still trying to recover. He says the urgent nature of the climate crisis is a primary reason that he joined ACA’s Climate Change Task Force.

In line with what happened in New Orleans after Hurricane Katrina, Hurricane Maria drove many people out of Puerto Rico, and those who remained faced multiple challenges, particularly around securing federal relief assistance and dealing with severe infrastructure deficits. Most critically, the island’s electrical grid was decimated, and it took approximately 11 months for power to be restored to everyone who lost it. But even now, Rivera says, it is still common for people to lose power for several hours whenever it rains. And this past January, a major earthquake left most of the island without power again for several days.

The trauma of Maria was compounded by the stress of the earthquake, which has been magnified even further by the coronavirus pandemic. “People are desperate,” Rivera says.

Many children in Puerto Rico are still terrified when it rains heavily and the wind rises, he continues. And since the earthquake, people are often hesitant about sleeping in their houses, so they stay in tents. This scenario will pose a major problem when a hurricane comes, Rivera says.

This past summer in Puerto Rico has been particularly hot, with some days reaching 103 degrees Fahrenheit. Rivera says this is higher than the norm when he was growing up and asserts that it again points to the effects of climate change. Typically, on hot days, people go to the beach to cool off. But the need to physically distance because of the pandemic has largely eliminated that option. Still, there are thos who, given the oppressive heat, would rather take their chances with possibly being exposed to the coronavirus. Another way that people cool off when it is hot is by having a beer, Rivera points out. He says that climate change has had a hand in sending both drinking and domestic violence rates through the roof for several years. The forced proximity of the pandemic is only exacerbating those trends, he adds.

Building resilience

Professional counselors “need to be involved and aware,” West-Olatunji says. “We can’t sit back and say that [climate change] has nothing to do with counseling.”

In fact, the counseling profession uses a holistic, ecosystemic perspective that looks at all the factors that influence behavior, she emphasizes. To take on climate change, counselors must broaden that model and consider structural interventions that target groups of people and focus on prevention. “Our discipline has always thought that prevention was at the core of wellness,” she points out.

West-Olatunji sees a great need for climate change literacy, noting that the people who most need knowledge about the climate crisis — because it is most likely to affect them either directly or indirectly — are also the least likely to have it. Vulnerable communities need to be given more information about how they can mitigate their risk and protect the health and safety of their citizens, she says.

Counselors can assist communities in building climate resilience by using their skills as facilitators to bring people together and help them work effectively as a group, says Mark Stauffer, a member of the ACA Climate Change Task Force. These groups don’t necessarily have to be focused specifically on climate change, he says. They could be formed to advocate for community needs, such as the right to clean water, or something more fun, such as establishing neighborhood gardens.

The essential aspect is to do the group work and to keep bringing people together, he says. “People coming together in times of need — we need to start practicing that now,” emphasizes Stauffer, the immediate past president of the Association for Humanistic Counseling, a division of ACA.

If counselors are personally concerned because their communities are not focused on climate change, Stauffer suggests they host a meeting of people who are interested in the topic. “See what people are thinking and where they want to go,” says Stauffer, a member of the core faculty in Walden University’s mental health counseling program. “It’s a process, but that’s the good part — connecting and building ongoing relationships. … People in the community need to get used to working together. The dialogue is just as important, if not more important, than the work.”

Stauffer thinks that counselors can play a key role in facilitating a new way of being in communities together. He believes that Western society has been living in a kind of empire culture, focused on what can be extracted. The mindset that started with Rome extracting treasures for itself from Europe and then Europe extracting treasures from its colonies has evolved into this sense that survival is about grasping and eking out a living by oneself, he says.

Stauffer says that our collective disaster survivor visual seems to be someone holding an AR-15 rifle in the air, surrounded by their supplies. “That’s not where we find joy,” he says. “Other cultures have found that surviving and being sustainable is something that we can do together.”

We need to find a way to be a part of the Earth in a generative way, Stauffer emphasizes. “The wild is not something to dominate and be afraid of,” he says.

Sturm, an associate professor and the director of counseling programs at James Madison University, urges counselors to get involved by finding out if their communities have climate resilience groups. Counselors who are unsure of where to start can bring themselves up to speed by using the U.S. Climate Resilience Toolkit (toolkit.climate.gov), a comprehensive resource that explores community vulnerabilities and climate resilience efforts.

Mental Health and Our Changing Climate: Impacts, Implications and Guidance, a 2017 report published by the American Psychological Association, Climate for Health and ecoAmerica, suggests several strategies for mental health professionals interested in promoting community well-being and helping to mitigate climate-related mental health distress. Among the strategies recommended:

  • Assess and expand community mental health infrastructure.
  • Reduce disparities, and pay attention to populations of concern.
  • Engage and train community members on how to respond.
  • Ensure distribution of resources, and augment with external supplies.
  • Have clear and frequent climate-mental health communication.

“Find out who is doing this in your area. Our voice has to be at the table to talk about trauma,” stresses Sturm, who is also currently earning her master’s degree in environmental advocacy. “Counselors think this is important, but they’re not doing it. … We’re not reaching out in our communities as a profession to be part of the discussion.”



ACA members: ACA’s free CE of the month for September is a video session titled “Climate Change and Mental Health: The Role of the Counselor.” See more here: https://imis.counseling.org/store/catalog.aspx#


Additional resources

To learn more about the topics discussed in this article, take advantage of the following select resources offered by the American Counseling Association:

Counseling Today (ct.counseling.org)

Books (counseling.org/publications/bookstore)

  • Coping Skills for a Stressful World: A Workbook for Counselors and Clients by Michelle Muratori and Robert Haynes 
  • Disaster Mental Health Counseling: A Guide to Preparing and Responding, Fourth Edition, edited by Jane M. Webber and J. Barry Mascari
  • Introduction to Crisis and Trauma Counseling, edited by Thelma Duffey and Shane Haberstroh

Continuing Professional Development: Multicultural Products (https://imis.counseling.org/store/catalog.aspx#category=multiculturalism-diversity)

  • “Counseling Refugees: Addressing Trauma, Stress and Resilience” with Rachael D. Goodman
  • “Addressing Clients’ Experiences of Racism: A Model for Clinical Practice” with Scott Schaefle and Krista M. Malott

ACA Mental Health Resources (counseling.org/knowledge-center/mental-health-resources/)

  • Trauma and disaster
  • Family separation
  • Grief and loss


Laurie Meyers is a senior writer for Counseling Today. Contact her at lmeyers@counseling.org.


Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

The Counseling Connoisseur: Picnicking as a therapeutic tool

By Cheryl Fisher August 29, 2019

“A picnic is a state of mind and can be made anywhere.” — Author Unknown


A few years ago, I purchased a beautiful, fully furnished wicker picnic basket from Ireland. It is lined in moss green fabric with leather straps that hinge the basket lid and latch the top closed. The lid lifts to expose beautiful porcelain plates with huge sunflowers painted on the creamy surfaces. Moss and golden linen napkins are folded neatly to the side, and crystal wine glasses are nestled against the fabric basket wall. Silver salt and pepper shakers hang in leather straps alongside the carefully arranged silverware and wine opener. A dark green corduroy container is perfect for holding a chilled wine bottle and a larger, insulated, corduroy covered cooler holds containers of varied sizes — perfect for holding nibbles and tapas to enjoy with the beverage du jour. A matching moss green blanket is neatly rolled and strapped against the side of the basket with leather ties. It is just lovely and evokes the promise of fun family gatherings, evenings under the stars, romantic dinners and quiet solo outings with an enticing book.

This is what I love about picnics. They can be as casual as a peanut butter sandwich devoured while lying on a blanket in your backyard or as adventurous as the promise of a chilled shrimp cocktail thawing in the warmth of the hot boulders that hold kayaks after a rapid run down a stream. Or as elegant as lobster rolls and blueberry lemonade consumed while overlooking the Bay of Fundy. What picnics all possess is the promise of a satisfying sensory experience with good food, great company, and a setting that soothes the mind, body and spirit.

The history of picnicking

Picnicking has evolved over time. Although early picnics consisted of medieval hunting feasts of the wealthy, over the centuries they have become more egalitarian. The location of picnics has also evolved. Early European picnics took place indoors and in the city where the elite would promenade fancy foods and fine dining. However, picnicking eventually shifted to outdoor pastoral settings and became a custom common to people of all classes and socioeconomic levels. Picnics have been captured in art and literature, epitomizing leisure and social gathering.

Some picnics occur in seemingly strange places. For example, during the 19th century, Americans regularly picnicked in cemeteries. Although this is no longer a common custom in the United States, other cultures continue to picnic among the dead. Picnicking in a graveyard can provide an opportunity to honor deceased loved ones while enjoying a peaceful green space.

In many countries, specific holidays, events and forms of attire are celebrated with picnics. For example, Japan’s Cherry Blossom Festival is often accompanied by a hanami (cherry blossom viewing) picnic. In Argentina, after their official celebration on Christmas Eve, Argentines often spend Christmas picnicking outdoors—in some cases on the beach. Australia’s Northern Territory has an official Picnic Day celebrated on the first Monday in August. Picnic Day was first observed by railway workers, and the town of Adelaide River honors this history by celebrating with a Railway Heritage Picnic Day event. In Finland, a traditional May Day celebration includes a “herring picnic” in which pickled herring and other salty foods play a starring role, and Greece ushers in the beginning of Lent with kite flying and family picnics.

Unusual attire—or the lack thereof—accompany picnics in some countries. Nude picnicking may not be an official activity in Germany, but nudity is more widely accepted there and is common in some popular locations for picnics such as parks and the beach. While Germans may not have established nude picnicking as a tradition, in France, nudists hope to do just that. In June of 2018 and 2019, naturists held a public nude picnic in a park in Paris.

However, picnics are not just a pleasurable leisure activity—they can also be therapeutic.


Five ways in which picnicking can be therapeutic

  1. It is a form of nature therapy

Most picnics are accompanied by an outdoor setting. In a lush field, by a babbling brook, on a sandy shoreline, at a park table, or at the peak of a mountain top, picnics encourage outdoor dining.

As I have discussed in previous columns, research suggests that natural settings can help decrease cortisol levels and blood pressure while increasing serotonin levels. Spending time in the outdoors also exposes people to more sunlight. Light therapy can be an effective treatment for certain types of depression—particularly cases caused by seasonal affective disorder.

Simply being in nature is healing.


  1. It can cultivate positive social experiences

Rather than the isolating experience of eating in front of a digital device (TV, computer, smartphone), picnicking promotes personal interaction and engagement that can result in a satisfying social experience as well as a meal. Communication is enhanced as friends and family enjoy a meal amidst the slower pace of natural settings.


  1. It provides an opportunity to practice acceptance and commitment (ants and bugs cohabitating)

Picnics offer an excellent opportunity to lean into the reality of outdoor dining — which includes those creatures who may not have been invited. Bugs join the party, and unless you are going to spend the time swatting them away, it is an opportunity to learn patience and tolerance while enjoying the many other aspects of outdoor dining that are less of a nuisance.


  1. It encourages reflection

The naturally slower pace of outdoor dining promotes a more mindful experience. It is one that creates the space for quiet and reflection. I love to begin my mornings by eating breakfast on my patio. It’s a mini-picnic just beyond my back door that embraces an appreciation of the morning sun and is enhanced by the fragrant herbs from my garden and the morning activity of the birds and small animals. As I sip my tea, my mind clears, and I have the mental bandwidth for reflection of gratitude–for the beautiful day, my health or the fullness of my life (translation: busy schedule). My practice is just one example of how picnics can offer opportunities for reflection.


  1. It can promote healthier eating

Recently, I packed up my beautiful picnic basket with a variety of foods. As I nibbled on the fresh vegetables that I had harvested from my home garden that morning — dipped in warm lemon-infused hummus — I honestly could not imagine anything tasting as splendid. The fresh air, green space and gorgeous food made for an exquisite sensory experience. While it is true that a quick visit to a fast-food drive-through could fill a picnic container (basket, backpack, bucket), people often select foods that promote healthier eating.



So, the next time you are faced with clients who could benefit from a mini-break that would include a therapeutic experience that will encourage positive interactions and reflection, suggest they pack their favorite goodies and head for an outdoor space. Inviting clients to participate in a picnic promotes their connection with self, others and natural settings. Picnicking can help enhance engagement, interaction, and reflection. It also encourages the development of more tolerance and may even lead to healthier eating. As the summer wanes, prescribing a picnic is a traditional, creative and therapeutic way to ease the stressors found in a skim, scan and scroll world.





Cheryl Fisher

Cheryl Fisher is a licensed clinical professional counselor in private practice in Annapolis, Maryland. She is director and assistant professor for Alliant International University California School of Professional Psychology’s online MA in Clinical Counseling.  Her research interests include examining sexuality and spirituality in young women with advanced breast cancer; nature-informed therapy; and geek therapy. She may be contacted at cyfisherphd@gmail.com.




Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.


Using nature as a therapeutic partner

By Lindsey Phillips April 26, 2018

In 2013, officials in Melbourne, Australia, assigned the city’s trees ID numbers and email addresses to make it easier for citizens to report problems such as fallen limbs and unwieldy branches. However, Melburnians used the email-a-tree-service for another purpose: to talk directly to the trees. They sent emails to the trees expressing their love and appreciation, and they also treated the trees as friends, discussing topics such as school tests, tree biology, construction work and politics.

This unexpected exchange underscores the human desire to reconnect with nature, yet urbanization and technology often distance people from the natural world. “Nowadays, we’re spending close to 90 percent of our time indoors,” says Megan Delaney, an assistant professor in the Department of Professional Counseling at Monmouth University in New Jersey. “This is a major shift in how we utilize our time. And some of that has to do with how we live. We are in our cars. We are in our offices. … We don’t walk anywhere anymore.”

This disconnect comes at a cost because nature plays a role in our mental health. In fact, a prescription of nature may be just what the counselor ordered. Research suggests a possible link between increases in obesity, diabetes and attention-deficit/hyperactivity disorder (ADHD) symptoms and a lack of outside time, says Patricia Hasbach, a licensed professional counselor and clinical psychotherapist with a private practice in Oregon.

Delaney, who has a small private practice in New Jersey and recorded a podcast on ecotherapy this past year for The Thoughtful Counselor (thethoughtfulcounselor.com), says research also suggests a connection between the increase in anxiety and depression in children and their disconnection from nature. “There’s been a loss of this free play,” Delaney argues. “If [children] go outside at all, it’s controlled.”

Nature isn’t a panacea, but even going outside for as little as five minutes a day will provide a boost to well-being, Delaney contends. In addition, exposure to nature can help improve relationship skills, reduce stress and aggression, help with the ability to focus, reduce symptoms of ADHD, improve impulse control and even improve fetal growth and birth rate, she says.

Unwilding ecotherapy

Despite the positive benefits, the idea of incorporating nature into counseling often overwhelms clinicians and clients because they assume it means wholeheartedly embracing the “wild” — packing up their belongings and taking a solo hike on the Pacific Crest Trail (à la Cheryl Strayed) to “find themselves.” For others, the very thought of “wilderness” or “nature” raises fears of the possible dangers, ranging from bug bites and sunburn to life-threatening injuries and encounters with dangerous animals.

The word ecotherapy often evokes a common myth of being fully immersed in the natural world, living and sleeping on the ground, says Delaney, an American Counseling Association member whose book Nature Is Nurture: Counseling and the Natural World is under contract. “That’s not what [ecotherapy] is about,” she argues. “It’s about our reconnection to our relationship with nature in whatever form that feels right for you. It could be a window box with your tomato plants. … I think that dispelling that myth is important.”

Ryan Reese, an assistant professor of counseling at Oregon State University-Cascades, agrees that a misconception often surrounds the idea of integrating nature into therapy. “[Clinicians] don’t have to take clients out into a wilderness setting in order for it to be EcoWellness or ecotherapy,” he says. “It can be at a park or walking on a trail that’s flat.”

Thus, expanding counselors’ and clients’ definition of nature becomes key, Reese argues. “We all are going to define nature in our own sociocultural, political context. How I define nature is probably going to be different than [for] somebody who grew up in downtown Manhattan.”

Reese, who has a private practice in Oregon, finds that broadly defining nature is beneficial, especially for clients who lack access to more traditional natural settings such as rivers, woods and mountains. To achieve this, he says, counselors might work with clients to expand their assumptions about nature by asking if it could include a local park, their backyards or even a view of trees from an office window.

When Delaney presented at the ACA 2017 Conference & Expo in San Francisco on wellness and nature, she was shocked that approximately 150 people attended. At the end of the presentation, several clinicians approached Delaney and stated they were already conducting nature-based counseling but wondered if they were doing it correctly. To which she responded, “If it feels good, you are probably doing it right.”

“People are doing [ecotherapy] intuitively and don’t know the theory behind it,” she continues. “They probably are taking their clients outside. They probably are prescribing nature. They’re probably doing things with kids in natural spaces. Maybe they bring their dogs into the office. … When they read the science and research behind it and the theory … [they] get it.”

There is growing interest in ecotherapy among counselors and, thus, more options for training, says Hasbach, an ACA member who teaches ecotherapy at Lewis & Clark College in Oregon. Her continuing education course, “Prescribing Nature: Incorporating Ecotherapy Methods Into Your Clinical Practice,” quickly fills up with professional counselors and therapists from all over the country.

Reese, an ACA member who occasionally offers a one-day workshop on interventions and ethics for integrating the natural world into therapy, recommends that counselors take training courses to help them consider things they might not think about otherwise. For example, he has noticed that his boundaries can change when he is outdoors with a client. Because he feels calm and relaxed, he is more susceptible to getting lost in the beauty of nature and being less focused on what is going on with the client. He advises clinicians to be aware of how the counselor-client interaction might differ in an outdoor setting versus an indoor setting.

“It’s not that you don’t allow yourself to engage in the experience too. It’s just making sure that the client is ultimately who you’re there for and not yourself,” Reese says. “Sometimes, I just get the vibe [from people who want to] do this outdoor work … that it’s more about the clinician than it is about the client.” Thus, counselors need to be mindful of their own reasons and motivations for incorporating nature into their practice.

More than a ‘beautiful backdrop’

“Ecotherapy is one of those techniques that therapists and counselors can have in their toolbox, but they also need to know how to use it effectively,” Hasbach asserts. Ecotherapy goes beyond simply walking in nature or playing with a dog, she points out. Instead, she explains that it involves a triadic relationship between the client, the counselor and nature.

Thus, nature operates as a therapeutic partner. “[Nature] is an active agent in the work that we’re doing with our clients. It’s not just a beautiful backdrop,” Hasbach says.

Hasbach, a pioneer in the practice of ecotherapy, has co-edited two books on the subject — Ecopsychology: Science, Totems and the Technological Species and The Rediscovery of the Wild. She stresses the importance of incorporating a “nature language,” which is a way of speaking about patterns that represent how humans interact with nature in meaningful ways, such as sleeping under the night sky. “These interactive patterns can be really powerful if [clinicians] use them skillfully and intentionally in asking clients to incorporate them into some of their homework,” she says.

Hasbach had one client who was struggling with the end of an important relationship. Hasbach knew the client was a good photographer, so she asked her to take photographs of the sunset while contemplating the end of this relationship. The client’s journal of the experience reflected the similarity between the ending of the light and her relationship. Without being asked, the client also brought in a portfolio of sunrise pictures to discuss how this was also a new beginning for her — which was going to be Hasbach’s next assignment.

Nature can also operate as a metaphor in therapy. “There [are] metaphors in nature every day about things that we’re going through in our lives that can be powerful,” Delaney points out.

For example, Reese asked a client who had severe anxiety to identify with a section of the path they would walk. The client picked a picnic table with a view of a river. “We would go there each time, and we would talk about his view of that experience and his view of himself in that experience and how it continued to change. … Over time, he would go there on his own, and to me, that was the real special part,” Reese says.

Hasbach keeps a basket of 20-25 nature objects such as stones, feathers, shells and pieces of bark in her office. When clients are struggling for words, she asks them to see if any of the objects depict what they are feeling. Hasbach once had a client who was depressed about a breakup, but the client initially had a hard time talking about it. Hasbach asked the client if anything in the basket resonated with her in that moment, and the client picked out a naturally woven ball of vines. She said she felt like her life was a tangle and empty inside, just like the ball of vines. “It was just a prop that allowed her to be able to begin to talk about what she was feeling,” Hasbach says.

Nature can also be a metaphor for resiliency, Delaney points out. “After a … forest fire, the forest regrows. It starts over. It regenerates. It heals. Those are things we can talk about with our clients — being able to see how nature is reborn from even that horrific experience. … [The client’s] natural tendency as a natural being or animal being is to be resilient and to finds ways of growing and rebuilding.”

Connecting through nature

Reese also finds that engaging nature as a co-facilitator helps with building trust between the counselor and client. “Whether we are out in [nature] or we’re talking about it inside, that’s what we’re connecting through. We’re talking about [the clients’] nature connection,” meaning what they like doing outdoors. “We go for a walk. We just talk about other kinds of things, not their issues, and then, inevitably, what comes up are their issues,” he explains.

“[Nature] doesn’t explicitly judge you,” Reese continues, “[so] that offers … a pathway for people presenting with trust challenges, which [are] oftentimes based in relational trauma.” The fact that clients can talk and process in a space where no one is critiquing or yelling at them can be restorative and healing, he adds.

Reese has been piloting the Fishing for Wellness project with an alternative treatment community for people presenting with adverse life experiences. He explains that for clients dealing with complex trauma, building trust and engaging in conversation directly can be difficult. So, Reese integrates fishing as a means of creating a nonjudgmental space that bolsters wellness and mindfulness.

While teaching clients the mechanics of fly-casting and the general principles of fishing, Reese talks about being open to experiences and accepting of one’s self in the casting process. If clients get frustrated, Reese checks in with them and often slows the process down. Once, when a client was upset that he wasn’t catching any fish, Reese asked him to put down the fishing rod and pay attention to what was happening for him in that moment. Next, he invited the client to notice one thing he found beautiful or appreciated around him. Later, he processed what this experience was like for the client and what it brought up. Together, they identified patterns around the client’s frustration tolerance and behaviors in his life.

“The nature piece is a window into people’s challenges [and] presenting problems, and it’s also this amazing coping resource, especially when people can develop an effective connection with it,” Reese says. “The goal is that [clients] begin accessing some of these outdoor resources on their own without [the counselor].”

Some nature-based techniques work well with certain mental health issues. For example, Hasbach has found that walk-and-talk therapy is often effective with teenagers and people who are dealing with anxiety and social skills deficits. These clients typically find it more comfortable to walk side by side with the counselor rather than sitting and looking at each other face-to-face, she says.

Hasbach also believes that nature-based interventions are effective for clients with posttraumatic stress disorder. “It’s a way of helping [clients] recognize this calming effect that nature can have and this sense of belonging because many times, they feel very disassociated. So, this sense of belonging to something bigger than [themselves] can be very helpful,” she explains.

Integrating nature into holistic wellness

Even after dispelling the myth that ecotherapy must involve complete immersion into a natural setting, counselors still might find it difficult to think of nature-based techniques that work well in office settings. After realizing there wasn’t a clear guide on how to intentionally incorporate nature into a traditional counseling setting, Reese, along with the late Jane Myers, who was a leading proponent of wellness in the counseling profession, developed the EcoWellness model. It explores the extent to which one’s connection to nature affects wellness. The model includes seven domains — physical access, sensory access, connection, protection, preservation, spirituality and community connectedness — that are correlates of wellness.

The EcoWellness model “is not necessarily a specific intervention. … It’s more of a way of thinking or conceptualizing how to be effective in integrating this human-nature connection into counseling,” Reese says. Other wellness models do not explicitly mention the nature connection, but nature is another part of wellness and a way to aid in the healing process, he adds.

Because research clearly shows the wellness effects of nature contact, Reese encourages all counselors to include nature-based questions (for example, how much time clients spend outdoors, what clients enjoy outdoors) in their intake process, even if they simply ask clients about their experience outdoors in the context of exercise or physical wellness. He argues that if a client’s relationship with nature isn’t included in the intake process, then counselors are missing out on a vitally important part of holistic wellness.

Reese addresses the seven domains of EcoWellness with all of his clients by having a conversation with them about their experiences with nature. “My goal is to develop a pretty contextualized understanding of what that person’s connection with nature is like, how they benefit from it [and] how they don’t benefit from it,” he says.

Hasbach also weaves in a few questions in the intake session to gain a better understanding of clients’ histories and current interactions with nature. Sometimes the answers to these questions also reveal details about clients’ family life, she adds, such as hunting with their grandfather or hiding in the woods to escape violence in the home. Her questions include asking what recollections clients have about being outside in nature as a child, what their family members’ views were of the natural world, what clients like to do outdoors now and how often they engage in that.

Too often, clients’ connections to nature are left out of the conversation. These initial nature-based questions demonstrate that it is an appropriate topic and invite clients to discuss it in a therapeutic setting, Hasbach explains. In addition, the questions help counselors determine the best approach for integrating nature into therapy based on the client’s personal experiences.

Hasbach also finds eco-genograms to be a helpful technique for discovering clients’ connections to nature. Counselors often use genograms to encourage clients to think and talk about their family histories in more depth, but, traditionally, only people are included in genograms, Hasbach says. With eco-genograms, clients can include pets or even natural elements such as mountains or rivers that were important to them. They can also include facts such as living near a farm, having a garden or hunting their own food, Hasbach explains.

Counselors shouldn’t assume that everyone’s early experiences with nature were positive, Hasbach warns. That is why asking about a client’s experience with nature as a child during the intake session is important. If a client discloses that he or she had a frightening experience in the woods, then the counselor shouldn’t take the client on a walk in the woods. “[Clinicians] have to understand the client’s experience of the natural world, just like [they] have to understand the client’s experience of society, family [and] interpersonal relationships,” Hasbach explains.

In fact, taking clients outdoors may not always be beneficial for them, Reese notes. One of his clients who had been assaulted by a man told Reese that she didn’t feel comfortable working with him in an outdoor space. When they went back into the office, the dynamic shifted, and she felt safer.

Bringing nature inside

There’s good news for counselors who are hesitant about taking clients outside: They can stay inside and still use ecotherapy.

“The logistics of … meeting in a park or going to a specific place for individual sessions can present a challenge for many clinicians,” Hasbach notes. Instead, counselors can assign nature-based homework for clients to extend the therapeutic hour, she advises.

Hasbach and Delaney both find that nature-based assignments encourage clients to go outdoors, unplug from technology and incorporate the healing and restorative aspects of nature outside of the session.

For example, Hasbach sometimes asks clients to sit in their backyards or to take a walk on the beach and think about a question with which they’ve been struggling. She also uses a “special place” assignment in which clients select a special place that they agree to visit several times each week — during varied weather conditions and at different times of the day — for a specific number of weeks. This exercise fosters heightened sensory perception, a reconnection with and expanded knowledge of a natural place, and a sense of belonging, Hasbach explains.

Counselors can also make their office spaces greener. Hasbach first realized the powerful influence of nature during an office session before she was intentionally incorporating ecotherapy into her practice. On this particular day, she forgot to turn on a water feature that she regularly used. During her first session, the client noticed and asked about the absence of the water sound.

This experience taught Hasbach to be mindful of the elements in her office setting. She still has a rock fountain that provides the soothing sound of trickling water, and she often brings in freshly cut flowers. She has also purposefully arranged her office so that her clients face a window overlooking a tree canopy.

Research supports this idea of greening the office space. As Delaney points out, high-quality natural light from windows has been shown to decrease employee discomfort and improve productivity. As a result, she advises counselors to let in more natural light to their offices when possible, add plants, put up pictures of natural places and play nature sounds such as gurgling streams and distant thunder. Delaney even uses her computer screen as a way of displaying various nature scenes.

Technological nature

With an increase in urbanization and technology use, people often can find themselves even more removed from the natural world and spending more time in front of screens than outside, Hasbach points out. According to a 2010 Kaiser Family Foundation report, children ages 8-18 spend more than 7.5 hours a day on average with media. Common Sense Media reported that the amount of time young children (up to age 8) spent on mobile devices tripled from 15 minutes a day in 2013 to 48 minutes a day in 2017.

“Technology is with us,” Hasbach acknowledges. “We are technological beings as well as natural beings. We have always been toolmakers, so it’s not going away.” Rather than fight that fact, counselors need to help clients achieve a better balance between their technological and natural selves. “Richard Louv [author of Last Child in the Woods: Saving Our Children From Nature-Deficit Disorder and The Nature Principle: Reconnecting With Life in a Virtual Age] … says, ‘The more high-tech we become, the more nature we need,’ and I think that speaks beautifully to the balance that we have to find,” Hasbach reflects.

It is perhaps fortunate then that technological nature — digital representations of nature, including nature music and videos — can have benefits for one’s well-being. Research suggests that technological nature has similar properties to the real thing, Reese says. Although being out in nature is most effective, technological nature is better than no nature at all, he adds.

In 2016, Reese co-authored a study published in The Journal of Humanistic Counseling that examined the use and preferences of nature media accessed through YouTube and found that people often use nature media to help them sleep, study or destress. “People are still accessing a form of nature even in digital form and saying that they are benefiting from it,” Reese says. This finding might help counselors and clients expand their concept of what nature can be, he adds, especially for people who may not have easy access to outdoor spaces or those presenting with a severe pathology such as paranoid schizophrenia or severe obsessive-compulsive disorder. Thus, for people with no access or limited access to nature, such as those in prisons, nursing homes or health care environments, technological nature can play an important role.

Hasbach was part of a study that incorporated nature imagery into a prison that used solitary confinement to determine if it would affect the inmates’ behavior and well-being. The inmates spent either 23 or 24 hours per day confined to individual cells. Four or five times each week, they were allowed to spend an hour alone in the exercise area (another cellblock) or the recreation yard (a concrete enclosure with the top open to the sky).

The prison installed a projector in the exercise cell. Half of the inmates were given the option of watching a nature video during their hour of exercise time; the other half were not. The findings revealed a 26 percent decrease in violent offenses among the inmates who watched the nature videos. When Hasbach interviewed some of the inmates, she learned that the natural scenes had a restorative value for them. Some inmates said that when they were agitated, recalling the nature scenes helped them calm down. Hasbach explains that they were using the images to self-regulate.

However, Hasbach is concerned that technological nature may become a convenient substitute, even when real nature is available, especially in schools. Instead, she stresses that counselors should incorporate technological nature only as an augmentation to authentic nature.

Ethical considerations

Hasbach identifies confidentiality, avoiding harm and competency as three ethical considerations central to ecotherapy. Reese says he has encountered negative reactions about including EcoWellness in counseling in part because some counseling professionals have concerns about how to implement it ethically. Thus, both Hasbach and Reese recommend that counselors who want to pursue nature-based work have a solid plan for what they are doing, why they are doing it, what their hopes or outcomes are and how they can incorporate nature to be most beneficial to the client.

In terms of confidentiality, counselors and clients need to discuss the differences between going outside for a session and staying inside the office, Hasbach says. Among questions to consider: What happens if you and the client are discussing a sensitive issue on a trail and someone walks up behind you? What if you encounter someone whom either you or the client know? What happens if the client gets emotional on a trail?

After having a discussion, Hasbach documents how clients say they want to handle these situations. Some clinicians might take it a step further and have clients sign a waiver, she notes. Counselors also need to ask clients about allergies or physical limitations and document those as well. Reese spends at least two sessions indoors with clients discussing these possible scenarios and clients’ concerns before he even thinks about taking them outside.

Physical safety is another big consideration when working with groups, Reese says. “[Group work] adds an element of risk. You’ve got more people that you need to manage … so having a co-facilitator, having at least another person there who can help, in my mind is really important for the physical safety [of clients].”

Counselors must be competent and prepared for the environment they are taking clients into, Hasbach emphasizes. Walking on a bike path or working in a garden outside a home office doesn’t require as much physical competency as taking clients out by a river where they could be walking on rocks and have a heightened level of wilderness, she explains. Whenever she goes outside with a client, she takes a small emergency bag with a cell phone, water and allergy medicine. She says the only time she has had to use this bag was when offering water to a client who had gotten emotional.

Finding a balance

Melbourne’s email-a-tree initiative aimed to help with city maintenance, but it also revealed people’s need to reconnect with nature and find a balance between their technological and natural selves. It also reaffirms Louv’s claim that the more high-tech we become, the more we need nature.

“We are nature. We are a part of it, not apart from it,” Hasbach says. Ecotherapy provides a healthy environment for counselors and clients, and it gives clients permission to admit that they are out of balance and need to change, she continues. Ecotherapy also provides counselors and clients with tools to help clients balance the pace and stress of life, she adds.

For Hasbach, helping humans reconnect with nature and find (or rediscover) their balance is an exciting area for the counseling profession to explore. “When we really look at what is at the heart of people’s well-being, the environment that we’re in is part of that, so I think ecopsychology and ecotherapy [have] a [role] to play.”




Lindsey Phillips is a contributing writer to Counseling Today and a UX content strategist living in Northern Virginia. She has written on topics including health, social justice and technology. Contact her at consulting@lindseynphillips.com or through her website at lindseynphillips.com.


Letters to the editor: ct@counseling.org




Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

The Counseling Connoisseur: Eco-culture: Clinical application of nature-informed therapy

By Cheryl Fisher November 27, 2017

“Each of us inherits the story of our people, communities, nations, and it is remembered through, with and in the context of the land and seas, and air, and creatures.” — Kimberly Ruffin


Anna, a small-framed 15-year-old Caucasian female, sat engulfed by the overstuffed chair in my office. She looked down, past the floor, to the day her world collapsed. She was walking home from school when three men jumped her, threw her against the huge old oak tree that lay on the outskirts of her family’s farm and proceeded to rape her. They left her against the tree, with torn clothes, battered and forever changed.

After a time (how long Anna could not recall), she walked home to her beloved lakeside farm that was just a quarter-mile from the assault. She described her home as her “safe place” where she was able to “just be myself,” surrounded by her animals, which included horses, dogs, goats and chickens. After finishing her numerous chores around the farm, she would grab a book and take her kayak to the center of the lake, spending hours immersed in the narratives. This had been her haven … until now.

Anna’s mother met her at the door, and Anna collapsed in her arms. The police were called but were unable to make sense of the traumatized youth’s story and unintentionally violated her with their dismissal. She was left feeling ashamed, alone and unlovable. She began isolating herself from her siblings, her friends and even her animals.


Eco-cultural sensitivity

According to Dan McAdams, Ruthellen Josselson and Amia Lieblich in their book Identity and Story: Creating Self in Narrative, identity development is a “process of dialogue between the person and the host culture. The individual appropriates meaning from the culture in the form of important attachments to people, events, valued objects, environments and even orientations to our bodies (i.e., embodied identity).”

The history of humanity is held in the context of the ecosystems in which it takes place. Conflict leaves marks on the earth and with the people and animals who reside in that setting. Although most of us do not rely on cues from the sea or sky to determine our fate or next move, we still rely on the global eco-community to provide food, clean water, medicine and oxygen. Although we are removed, we remain interconnected, and our connection is just as important to our overall well-being as it was centuries ago.

Human development has been described as a biopsychosocialspiritual experience that is a complex interaction of genetics and internal and external environments. Among the external contributors to a person’s growth are family, community and culture (which examines customs, beliefs and values).

However, often excluded from a cultural assessment is the green space and biodiversity experienced by a child. Green space refers to open space, urban spaces such as parks or any natural setting in a person’s regular surroundings. Biodiversity is a term that describes the variety of (and interaction between) life on earth. This information provides a framework to the early interactions among natural settings that inform an individual’s concept of self within a more global context.

As clinicians, we are greatly remiss when we fail to explore a person’s eco-culture. Children learn through early interactions with their environment. According to Stephanie Linden, a special education curriculum specialist at Crofton Elementary School in Maryland, “A child’s first language is not verbal; it is sensory. Children learn to communicate through their senses. Therefore, it is imperative to have an understanding of their routine sensory climate.”

This is especially of interest when considering the variety of environments that may be experienced. A person living in an urban setting may know only of concrete playgrounds with metal benches and pigeons gathering on windowsills. This is different from a person who lives on a farm with goats and horses. Furthermore, consider individuals arriving from other countries who may experience human-animal-plant relationships differently. For example, a child from India (where cows are viewed as sacred) may find a school fieldtrip to a dairy farm to be disturbing. Therefore, assessing for eco-culture demonstrates a level of cultural sensitivity that encompasses a holistic understanding of the person’s worldview.


Eco-culture and nature therapy

Ronen Berger, researcher, author and founder of Nature Therapy in Tel Aviv, along with Mooli Lahad, medical psychologist and professor at Tel-Hai College, identified several variables that contribute to overall resiliency. In their BASIC Ph Resiliency Model, Berger and Lahad noted that it is the combination of our Beliefs, Affect, Social Functioning, Imagination, Cognition and Physiology that aid in coping with stressful and traumatic events. However, they found that most clinicians and academics focus on cognitions alone. In addition, the researchers proposed that engaging in nature promotes creativity and aids in physical, emotional, social, cognitive and moral development.

Berger and Lahad concluded, “Nature invites us to make room for the child within, those parts of us that feel, imagine and are present in the experience of playing. Connecting to the cycles of nature can help us bond with parallel processes in our lives and to relate to them in a broad universal context. An encounter with a migrating bird, a dead lizard or a blooming plant can be a stimulus for expressing a similar story within us, of which we were previously ashamed. Sharing the story can normalize it and impart hope. The direct contact with natural elements, the wind, the earth, the plants, can connect us to our body and can awaken the world of images and emotions. Something in the encounter with nature and its powers has the potential to connect us to ourselves; to our strengths and to our coping resources.”

Engaging in the natural eco-culture of the client can provide a deeper, more meaningful healing.


Anna’s recovery

Anna’s ability to discuss any aspect of her trauma was enhanced when Max, my therapy dog, joined the sessions. Initially, we would take Max for short walks around the practice neighborhood. On one of those walks, Anna proclaimed her love of kayaking and asked if we might be able to go one day. I had never taken a client kayaking before, and I was unsure of the liability and ethical ramifications. Still, Anna felt strongly that she wanted to go kayaking with me on our nearby creek.

Following consultation with several colleagues, I asked Anna’s mother about the possibility of holding a session on the kayaks. To my surprise, Anna’s mother enthusiastically agreed: “Anna is a very proficient kayaker and a very strong swimmer. I am happy to consent.”

The following week, we met at the area where I keep my kayaks. Anna had brought her own. We put the kayaks in on the sandy shore of the lazy creek and paddled around for a while. Anna had become more animated since we took our sessions outdoors, and she eagerly pressed for us to move out of the calm water to the more challenging adjoining river. I decided that this was indicative of her trust in our relationship — to venture into deeper, more challenging waters.

As we entered the mouth of the river, I remembered the bulkhead that was just around the bend. I had frequently found myself paddling too close and instantly getting sucked into the undertow, which resulted in my kayak being thrust into a head-on collision with a rock barrier. I knew how to release from the undertow, but I was curious how my eager client would view the challenge.

As we paddled into the river, the waters began to churn, splashing in the wake of passing boats. Anna stayed safely in the middle of the river, while I deliberately ventured slightly closer to shore. Sure enough, the current grabbed my kayak and forced me against the rock bed. Anna remained safely beyond the current and was surprised to see me paddling against the waves and rocks. She called out to me, “Stop paddling! Just let the waves take you in … then release.”

I acted as if I had not heard her wisdom and continued to struggle with the current. Finally, Anna yelled, “Stop fighting it, Dr. Cheryl! You have to let it take you in … to release you! You will be fine. Just let go!”

AH! YES! Don’t fight it. Just release it! So, I did …and easily paddled to my very wise (and now frowning) client.

“You knew how to do that all along, didn’t you? You were trying to show me that I need to not fight this thing so much, right?”

She lowered her head and began to cry for the first time. We adjoined our paddles and for the rest of the session sat in silence in the middle of the river.

The weeks that followed were an emotional roller coaster filled with disclosure, tears and healing. At the end of one session, Anna announced, “It is time. It is time to return to the oak tree.” She was ready to return to the place where her violation had occurred. To confront the oak tree that had stood witness. The sessions that followed were characterized by imagery and preparation for Anna’s journey to the location of the assault.

Finally, she was ready. We met at the site of the rape. We got out of the car and slowly walked to the tree — a huge ancient oak whose branches, now bare preparing for the winter rest, stretched out, welcoming Anna. I could never have been prepared for what happened next. Anna ran to the tree, wrapped her arms around its wide girth and began to cry, “Thank you!”

Anna had now slipped to the base of the tree and continued, “Thank you! During everything, you stood with me. You held me up. You never left me!”

Anna’s mother and I just looked at each other in astonishment. Anna was grateful to the oak tree for holding witness to her assault and remaining with her throughout the entire atrocity. Anna’s rape is remembered through, with and in the context of the land and seas, and air, and creatures. She wanted to honor the old oak, so she planted bulbs at its base. In the early spring, Anna returned to find the most beautiful small white flowers peeking up through the late frost … a sign that life can hold beauty even after devastation.



Nature provides us with the context of our experiences. It is not separate from, but a container for — a co-journeyer of — our lived experiences. As Berger and Lahad found, “Through the direct contact and connection with nature, people can also touch their own ‘inner’ nature. One can feel authenticity and develop components of personality and important ways of life that might have been hard to express amidst the intensity of modern life.”

As clinicians, we have the ability to facilitate this type of deep healing as we venture into the eco-cultures of our clients and invite them to reconnect with the natural settings of their lives.




Cheryl Fisher

Cheryl Fisher is a licensed clinical professional counselor in private practice in Annapolis, Maryland. She is affiliate faculty for Loyola and Fordham Universities. Her research interests include examining sexuality and spirituality in young women with advanced breast cancer, nature-informed therapy and geek therapy. Contact her at cyfisherphd@gmail.com.









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