The Eco-Friendly Therapist: 
An Interpretive Literature Review 
of Obstacles and Solutions to Practicing Ecotherapy
By Selina Clare

Chapter One: Introduction

Introduction 

Psychotherapy conventionally occurs indoors in a range of spaces, from austere hospital rooms with plain chairs, a simple table, and a view of buildings; to luxuriously appointed rooms with plants, comfortable armchairs, and views of nature.  Where we choose to hold therapy sessions is important as spaces can be detrimental (Evans, 2003) or beneficial (Wolsko & Hoyt, 2012) to our mental and physical health, as well as our behaviour.  Based on their extensive review of the literature, Christopher Wolsko and Kathy Hoyt (2012) have presented a substantial list of health benefits derived from exposure to natural environments. 

·      Improved surgery recovery (Park & Mattson, 2009).

·      Physiological stress reduction (Hartig, Evans, Jamner, Davis, & Gärling, 2003).

·      Increased positive affect (Fuller, Irvine, Devine-Wright, Warren, & Gaston, 2007).

·      Better self-reported health (Vries, Verheij, Groenewegen, & Spreeuwenberg, 2003).

·      Lower disease morbidity (Maas et al., 2009).

·      Lower mortality related to income deprivation (Mitchell & Popham, 2008).

·      Reduced anxiety and depression (Antonioli & Reveley, 2005).

·      Reduced stress (Gidlöf-Gunnarsson & Öhrström, 2007).

·      Reduced aggression (Kuo & Sullivan, 2001). 

As therapists we could offer these benefits to ourselves and our clients, by adapting our therapy space to increase our exposure to natural environments, by leaving the office or through bringing nature indoors.

Ecotherapy offers psychotherapists and counsellors (and other mental health professionals) an opportunity to combine the natural world and therapy, this creates an opening for clients and therapists to explore their relationship with nature, and for this to be incorporated into treatment.  A client’s relationship with the natural world is often unexplored in mental health (Buzzell & Chalquist, 2009a), as, depending on the theoretical orientation of the therapist, the intrapsychic and interpersonal, is generally considered to be the central focus of the therapy.  However, use of the natural world in ecotherapy is wide-ranging, from week long wilderness excursions, walking in a park during a therapy session, to bringing nature indoors using plants or photos of nature. 

One of the questions this dissertation seeks to answer is whether psychotherapists and counsellors without specialised training in ecotherapy can take advantage of the benefits of incorporating nature in therapy.  The article which provided the spark for this dissertation topic was, “Employing the Restorative Capacity of Nature: Pathways to Practicing Ecotherapy Among Mental Health Professionals” by Wolsko and Hoyt (2012).  They (Wolsko & Hoyt, 2012) surveyed 231 mental health professionals (mental health counsellors, psychotherapists, counselling services, and psychologists) who worked throughout the United States.  This voluntary survey was “to investigate the personal attitudes and demographic characteristics of those who practice ecotherapy, by incorporating the natural environment into their processes of assessment, diagnosis, and treatment” (Wolsko & Hoyt, 2012, p. 10).  One area of their survey asked participants for personal examples of factors that may “inhibit you from the use of nature in your therapy practice” (Wolsko & Hoyt, 2012, p. 18).  This question was quite broad, and although ecotherapy was not mentioned directly, it is evident from this article that the authors were focused specifically on ecotherapy practice. From these answers, that were coded and analysed, Wolsko and Hoyt (2012) found five categories of perceived obstacles to participants use or practice of ecotherapy, these were: (1) lack of time and money; (2) boundary, confidentiality, and legal concerns; (3) poor location; (4) ecotherapy was considered irrelevant to treatment goals; and (5) a lack of awareness or confidence in implementing ecotherapy. 

The core of the dissertation provides a hermeneutic literature review of ecotherapy, focusing specifically on the aforementioned perceived obstacles to practicing ecotherapy and potential solutions to those obstacles.  The five categories of obstacles to ecotherapy practice, based on the work of Wolsko and Hoyt (2012) will provide the framework for this aspect of the dissertation.  It is anticipated that the literature review will deepen the understanding of each category, and potentially contribute to new categories emerging.

Firstly, I provide a brief overview of ecotherapy to introduce ecotherapy and the diverse forms it takes; this also includes a historical background to ecotherapy.  Chapter 5 is based on the five key findings from Wolsko and Hoyt’s (2012) survey.  This chapter covers the five obstacles to ecotherapy practice in separate sections, and offers potential solutions to overcoming these obstacles.  The different obstacles had varying amounts of literature available; hence, some categories were covered more comprehensively than others were.  Chapter 6 covers several straightforward practice examples of ecotherapy, along with explanations for therapists to understand the purpose behind the interventions.  This chapter is also to illustrate simple ecotherapy interventions that can be integrated into a therapist’s current practice.  Chapter 7, the discussion, summarises four key points that were covered.  They are explained by discussing them in conjunction with an aspect of my personal process that occurred during this project, this is completed by a few personal, concluding remarks. 

Research Aims The objective of this dissertation is to clarify and explore the presented obstacles and solutions in order to provide recommendations on how ecotherapy can be practiced.  It is hoped that this research will contribute to the field of ecotherapy by providing information that will help therapists to consider the ecological context in their practice, including practical information on how to practice and integrate ecotherapy.    

It has been important for me to write a dissertation that assists practitioners to take up ecotherapy without needing to overhaul their current practice.  My aspiration is for practitioners to begin to work with environmental or ecological ideas with clients, and I hope this dissertation assists in bringing ecotherapy into the mainstream.  For this reason, I developed inclusion/exclusion criteria in order to find the modalities of ecotherapy that I believed therapists could integrate into their current modality, such as psychodynamic psychotherapy.  In other words, the modalities of ecotherapy that I included in this dissertation had to be similar enough to psychotherapy and counselling practices to be included.

Terminology As my training has been in psychotherapy I, at times, refer specifically to this field.  When I use the more generic term therapy, I am including both psychotherapy and counselling.  However, it is my intention for this dissertation to be useful specifically for both psychotherapists and counsellors as these professions are quite similar to each other.  Other professions (such as psychology and social work) have not been included as it is my understanding that they diverge significantly from psychotherapy and counselling. Nevertheless, I consider that a range of mental health professionals would be able to utilise some of the practices of ecotherapy described in this dissertation.

Ecopsychology is centrally about “bridg[ing] our culture's longstanding historical gulf between the psychological and the ecological” (Roszak, 1992, p. 14) by reminding us that we (humans) are living within an ecosystem. Ecopsychology is not a mainstream psychological paradigm; rather it is radical in its aim to explore ethically, practically, and psychologically how humans are a part of our current climate crisis (Fisher, 2013; Roszak, 1992).

The term ecotherapy is applied ecopsychology – “ecopsychology provides a solid theoretical, cultural, and critical foundation for ecotherapeutic practice” (Buzzell & Chalquist, 2009c, para. 1).  

Nature tends to refer to the natural environment, ecological environment, the great outdoors, etc., that is not man-made (Oxford University Press, 2014).  The scale varies, for example, a national park, a community park, or a large backyard with lots of plants.

The term environment refers to someone’s surroundings, particularly the physical conditions (Oxford University Press, 2014).  Depending on the context this word is used in, it could refer to the space where therapy occurs, the local environment of a neighbourhood, or our planet earth.

Green space is an area in an urban environment which is reserved for nature, such as parks, woods, cemeteries, green belts, gardens, community gardens, bodies of water, and other natural areas (United States Environmental Protection Agency, 2014).

The human-nature relationship refers to the relationships between humans and nature.  This represents both to the subjective experience of an individual’s relationship to nature, as well as the more tangible, physical relationship (Apàthy, 2010).  There is a tension in this term, as often the discourse on humans’ relationships with nature sets us outside of nature.  The human-nature relationship acknowledges both that humans are physically inextricable from nature (Fisher, 2013) and that this might not be our subjective experience.

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