Different approaches to nature-based therapy include engagement with plants, animals, wilderness settings, nature-focused arts and crafts, and play in natural environments and/or with natural materials. While nature-based therapy can be practiced indoors as well as outdoors, the focus always includes nature engagement in some form for the purpose of achieving therapeutic goals. Positive outcomes include improved socio-emotional functioning and increased connectedness to nature. 

Caring for hens at school helped children make social-emotional gains and develop awareness and respect for nature

Feedback from teachers and students involved in the care of hens at a Dublin elementary school indicated that the animal-care experience helped children–who were from an area of high socio-economic marginalization and who experienced a range of socio-emotional and educational needs–make gains in responsibility, empathy, respect for the natural world, cooperation, relaxation, improvement in motivation and peer-assisted learning processes.
Gilligan & Downes, 2021. Reconfiguring relational space: A qualitative study of the benefits of caring for hens for the socio-emotional development of 5 – 9-year-old children in an urban junior school context of high socioeconomic exclusion.
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Nature’s role in outdoor therapeutic interventions remains unclear 

A “review of reviews” found that the populations served, issues addressed, and types of interventions provided in outdoor therapies vary considerably. Most of the reviews reported positive findings. Studies referenced intricate links between human health and environmental health, but lacked a clear articulation of the role of nature in specific therapies. While the researchers were hoping to use the findings of this review to develop a theoretical framework for practice, they concluded that it would be premature to formulate specific recommendations at this time.
Harper, Fernee & Gabrielsen, 2021. Nature’s role in outdoor therapies: An umbrella review.
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Forest healing programs can positively improve the interpersonal relationship skills of adolescents in foster care 

A forest healing program in South Korea engages children in foster care in forest-related activities over a period of three days and two nights. Results of self-report surveys completed by close to 4000 children (middle-school aged or older) before and after the program showed a statistically significant overall increase in interpersonal relationship skills such as friendliness, sensitivity, understandability, credibility, openness, and communication.
Hong, Park & An, 2021. Are forest healing programs useful in promoting children’s emotional welfare? The interpersonal relationships of children in foster care.
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Nature prescription programs are growing faster than the evidence base to support and guide such programs

This review of the literature examined the evidence base of nature prescription programs offered in out-patient settings. The included studies evaluated a wide variety of health-related behaviors and outcomes, often focusing on at-risk children and families. Results indicate that the research is still too limited to draw conclusions about health-related outcomes. This review highlights the need for more research and evaluation to support and guide nature prescription programs, which are rapidly increasing.
Kondo et al. 2020. Nature prescriptions for health: A review of evidence and research opportunities.
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Nature-based therapy practitioners describe nature as an active agent in the therapeutic process

Twenty-six nature-based practitioners with different professional backgrounds participated in individual interviews focused on how they experience, perceive, and work with nature to address therapeutic goals. Overall findings indicate that nature-based therapists are intentional in using specific methods of intervention so that nature’s input is acknowledged and interpreted to the client as significant to the therapeutic process.
Naor & Mayseless, 2020. The art of working with nature in nature-based therapies.
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Nature engagement during an indoor counseling session may range from being present to nature to actively interacting with natural materials 

When practiced indoors, nature-based counseling sometimes involves the use of natural sounds, guided imagery involving nature, and technological nature. Positive results for the clients as noted by the practitioners include greater focus, new insights, and feeling more creative and relaxed. Results for young children participating in a nature-based play session included progress in self-efficacy and interest in connecting with a friend.
Swank, Walker & Shin, 2020. Indoor nature-based play therapy: Taking the natural world inside the playroom.
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Nature-based art activities can support children’s mental health and well-being

Artist pedagogues in the UK shared their ideas about how their nature-based practices impacted children’s well-being. Discussion themes suggest that nature-related art activities have the potential to promote children’s agency and confidence, while providing inspiration to support creativity. Although these results are based on a small-scale qualitative study, they do support the idea that nature-based art activities might play an important role in the prevention and treatment of such mental health concerns as depression and anxiety.
Walshe, Lee & Smith, 2020. Supporting children’s well-being with art in nature: Artist pedagogue perceptions.
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The use of nature to achieve therapeutic goals can be effective with different populations, including children with adverse childhood experiences (ACEs) and individuals dealing with COVID-related mental health concerns. The research suggests that a range of approaches might be effective, and, that there is no one nature-based therapeutic approach for use with all populations. 

Ecotherapy may promote mental wellbeing and be helpful in dealing with COVID-related emotional issues

This review provides an overview of techniques, applications and challenges related to nature-related therapy (ecotherapy) in psychology as well as a discussion of the intersection of environmental and human health. Related discussion includes the idea that ecotherapy may be helpful in ameliorating the isolation and loneliness associated with the COVID-19 pandemic. Specific “green care” recommendations are offered, including more contact with plants and animals in and outside of the home environment.
Chaudhury & Banerjee, 2020. “Recovering with nature”: A review of ecotherapy and implications for the COVID-19 pandemic.
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Family nature engagement can support parents’ psychological needs while living in a shelter

This study involved 160 parents (mostly mothers) who lived with their children in a women’s shelter or homeless shelter in the Netherlands. The parents were selected from 20 shelters with newly developed natural environments (garden, natural play area, children’s farm, etc). Parental responses to psychological need and frustration scales showed higher need satisfaction and lower need frustration while experiencing nature with their child(ren) compared to an activity in the standard indoor environment of the shelter.
Peters et al. 2020. Experiencing nature to satisfy basic psychological needs in parenting: A quasi-experiment in family shelters.
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Learning how to tap into the therapeutic use of nature may enhance the competencies of professionals working with women and children exposed to domestic violence

Staff at a crisis shelter and researchers in the field of nature and health from the University of Copenhagen worked together to develop a systematic learning program focusing on the use of nature-activities as a healing factor for women and children exposed to domestic violence. The goal of the proposed educational program was to help staff members learn how to use a newly renovated garden at the shelter more purposefully and to integrate nature-based therapy (NBT) into their work at the shelter.
Poulsen et al. 2020. Nature is just around us! Development of an educational program for implementation of nature-based activities at a crisis shelter for women and children exposed to domestic violence.
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The therapeutic and protective potential of nature for children with adverse childhood experiences warrants the attention of researchers and practitioners 

Adverse Childhood Experiences (ACEs) are potentially traumatic events experienced during the childhood years. ACEs and the stress associated with such experiences have been consistently linked to chronic physical and mental health problems across the lifespan. While research supports the idea that nature engagement may provide therapeutic and protective benefits for children with ACEs, two related reviews of the literature highlight the sparsity of studies investigating this potential.
Touloumakos & Barrable, 2020. Adverse childhood experiences: The protective and therapeutic potential of nature.
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Forest healing programs can positively improve the interpersonal relationship skills of adolescents in foster care

A forest healing program in South Korea engages children in foster care in forest-related activities over a period of three days and two nights. Results of self-report surveys completed by close to 4000 children (middle-school aged or older) before and after the program showed a statistically significant overall increase in interpersonal relationship skills such as friendliness, sensitivity, understandability, credibility, openness, and communication.
Hong, Park & An, 2021. Are forest healing programs useful in promoting children’s emotional welfare? The interpersonal relationships of children in foster care.
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Some research indicates that nature engagement can potentially play an important role in promoting healthy social emotional functioning and preventing mental health concerns such as depression and anxiety. 

The frequency of contact with nature in childhood predicts adult personality, including indicators of positive mental health 

A two-part survey was used to investigate a possible relationship between childhood contact with nature and adult personality. The first part focused on the respondents’ frequency of contact with natural environments in childhood and in adulthood. The second part included an adult personality assessment. Responses from close to 800 adults from 42 different countries showed that frequency of contact with nature in childhood predicts certain aspects of adult personality, including higher Openness (Creative Imagination, Intellectual Curiosity) and lower Neuroticism (Anxiety, Depression).
Snell, Simmonds & Klein, 2020. Exploring the impact of contact with nature in childhood on adult personality.
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Nature-based art activities can support children’s mental health and well-being 

Artist pedagogues in the UK shared their ideas about how their nature-based practices impacted children’s well-being. Discussion themes suggest that nature-related art activities have the potential to promote children’s agency and confidence, while providing inspiration to support creativity. Although these results are based on a small-scale qualitative study, they do support the idea that nature-based art activities might play an important role in the prevention and treatment of such mental health concerns as depression and anxiety.
Walshe, Lee & Smith, 2020. Supporting children’s well-being with art in nature: Artist pedagogue perceptions.
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