Theoretical and Empirical Foundations for Ecotherapy

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ECOTHERAPY
THEORY, RESEARCH AND PRACTICE
EDITED BY MARTIN JORDAN
AND JOE HINDS
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1
THEORETICAL AND EMPIRICAL
FOUNDATIONS FOR ECOTHERAPY
Thomas J. Doherty
Introduction
This chapter explores some of the theoretical and empirical foundations for
ecotherapy, which are not meant to be de nitive, but rather to assist readers in
re ecting on their own practice and to better appreciate and critique the eco-
therapy approaches detailed in this volume. The goal is to create a conceptual
ground for ecotherapy and to identify some overarching theory, assumptions
and  ndings that act as a shared commons.
Hundreds of established psychotherapy and mental health counselling
approaches (Prochaska and Norcross, 2009) promote differing visions of mental
health and well-being. They use different tools to treat or prevent what, in their
view, constitutes life problems or psychopathology; and they intervene at levels
of scale from individual neurophysiology, thoughts and emotions to the struc-
ture of daily life, to the level of intimate and family relationships and on to
group, community and population levels (Burns and Burns-Lundgren, 2015;
Roth and Fonagy, 1996). So, once one becomes educated in this domain, it
becomes clear that simply saying that a person does ‘counselling’ or ‘psycho-
therapy’ is not an adequate description because it begs the questions: What
kind of psychotherapy and for whom? How is human psyche and agency con-
ceived? On what standard of health and well-being is it based? What are its
methods? How are outcomes measured?
So too with ecotherapy: the potential is great for approaches that apply
existing therapeutic models in a natural ecological context and for the creation
of others that constitute distinct innovations to therapy ‘business as usual’. In
addition to the questions posed above, an ecotherapist might ask: How does
the therapy involve the interplay of social systems and natural systems? What is
the role of the physical context (the built space of the consulting room or the
local natural environment) in the therapy? In what way does the therapy address
the ‘client’ or ‘patient’ as a human animal, a social primate of the species homo
sapiens? How are other species recognized and involved in the therapy? How is
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THEORETICAL AND EMPIRICAL FOUNDATIONS FOR ECOTHERAPY 13
relationship to community, bioregion or planet recognized? What is the role of
environmental ethics in the therapy, and how are issues like global climate
change or environmental justice addressed? How do these factors  gure into
the conception of health outcomes and the methods of the therapy, or not?
These profound questions draw attention to basic assumptions people share
about psychotherapy. There is a strong element of consciousness-raising inher-
ent in surfacing them. To assert that nature or environmental issues do not  gure
into therapy can be perfectly reasonable and ethical given the issue addressed–
and need not imply that these issues are not important to health. But for our
purposes, physical place, more-than-human nature and global environmental
issues do  gure into therapy and counselling, and for good reason. And although
ecotherapy is still evolving in terms of variety and specialization, we can sketch
out its theoretical and empirical underpinnings. This will allow for a more
nuanced discussion of ecotherapy and set the stage for answering the question:
What kind of ecotherapy do you do?
The Psychological Territory of Ecotherapy
To get a feel for the content of ecotherapy, consider the following questions,
drawn from research questionnaires used in environmental psychology and
sociology. Along with your intellectual responses, note the extent to which the
questions elicit an emotional charge or a reaction. Also, notice how responding
implicitly requires you to consider yourself in relation to others in your social
group as well as others in society:
!‘We are approaching the limit of the number of people the earth can sup-
port.’ Agree or disagree?
!‘Like a tree can be part of a forest, I feel embedded within the broader natu-
ral world.’ Strongly disagree, neutral or strongly agree?
!‘I have done this: walked barefoot in a wild area; hunted,  shed, trapped, raised
and butchered my own meat; navigated by the sun or the stars…’ Yes or no?
!Global warming is (a) caused mostly by human activities, (b) caused mostly
by natural changes in the environment, (c) caused by some other means or
(d) not actually happening.
!‘I am worried about risks to human health from nearby environmental pollu-
tion.’ Agree or disagree?
!Please indicate how often you have done each of the following in the last
year (i.e. never, rarely, sometimes, often, very often, non-applicable): com-
posted food scraps, conserved gasoline by walking or bicycling, voted for a
candidate who supported environmental issues and so on.
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ECOTHERAPY14
These survey items are meant to determine (i) whether respondents believe
human activities are subject to or exempt from the natural order (NEP Scale:
Dunlap, 2008); (ii) the extent to which someone perceives they are connected
with nature (Connectedness To Nature Scale: Mayer and Franz, 2004);
(iii)immersion and hands-on self-suf ciency in the outdoors, as in a hunter-
gather context (Participation in Nature Scale: Scott, Amel and Manning,
2014); (iv) beliefs about human responsibility for global climate change
(Global Warming’s Six Americas Screening: Maibach et al., 2011); (v) emo-
tions regarding felt impact of environmental changes (Environmental Distress
Scale: Higginbotham et al., 2007); and (vi) the frequency of various conserva-
tion behaviours (Proenvironmental Behavior Scale: Schultz and Zelezny, 1998).
Your responding, both emotional and intellectual, gives a  avour of the mental
activity associated with environmental perception and how this is linked with
identity, self-image, moral judgements about self and others, and expectations
for responsible behaviour. It is in this realm of ecological self in relation – to
one’s own ideals, to other humans as they utilize natural resources for survival,
to other species and habitats and to the planet Earth as a whole – that eco-
therapy takes place.
De ning Ecotherapy
For the sake of our work, ecotherapy will be de ned as ‘psychotherapeutic activi-
ties (counselling, psychotherapy, social work, self-help, prevention, public
health activities) undertaken with an ecological consciousness or intent’. These
activities are considered ecological as they partake of natural ecology such as the
local environment or the planetary biosphere, and not only the social ecology
of human relationships and culture (Bronfenbrenner, 2005; Cook, 2012). Put in
the language of conservation science, they concern coupled natural and human
systems. Although the human sociocultural sphere, including the information
technologies through which we can perceive global issues, is embedded in eco-
therapy work, it is important to realize that the human need not be the basis or
starting point of ecotherapeutic activities. In fact, a goal of many ecotherapies
would be to bracket human culture and technologies, and look to the ‘more-
than-human’ world (Abram, 1996) for a holistic and fundamental experience of
identity, mental health and well-being.
Put another way, ecotherapy, in terms of its orientation and moral compass,
can be seen as ‘ecocentric’ (i.e. focused on systems, wholes and interdepend-
ence, with humans being one part of the natural order). This is in comparison
to the more normative and unacknowledged anthropocentric-biased nature of
psychotherapy and counselling (i.e. human-centred and seeing all nature in
terms of human ideas, uses and bene ts). And as noted above, just as there is a
great diversity in the form, content and scope of anthropocentric psychotherapy
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THEORETICAL AND EMPIRICAL FOUNDATIONS FOR ECOTHERAPY 15
approaches, a similar potential for diversity exists in the ecopsychotherapeutic
enterprise, both in theory and based on a survey of extant approaches.
De ning Ecotherapy
Psychotherapeutic activities (counselling, psychotherapy, social work, self-help, preven-
tion, public health activities):
!Undertaken with an ecological consciousness or intent
!Often utilizing natural settings, activities or processes as an integral part of the thera-
peutic process
!Focusing on ecological aspects of self, identity and behaviour
!At various scales, from personal to planetary
Ecotherapy Activities and Scope
Ecotherapy often, but not necessarily, utilizes natural settings, activities, meta-
phors and processes as an ingredient of therapy. These can include conducting
therapeutic conversations outdoors or using walking, gardening, or structured
challenge and adventure. Ecotherapy may also involve bringing sense of place
and other species into the therapeutic process (e.g. having a daily outdoor
retreat space, engaging in animal-assisted therapy or simply considering the
rights and well-being of other species and natural systems as a part of therapeu-
tic goals). At its most basic, ecotherapy welcomes ecological aspects of self,
identity and behaviour into the psychotherapeutic arena. Depending on the
recipient(s) of the therapy, this ecological self may include direct or vicarious
experience of natural or technological disasters, concerns about environmental
toxins or degradation, or considerations of personal responsibility for larger
global issues like climate change.
Most ecotherapy remains private and concerns the private sphere, just like
traditional anthropocentric psychotherapies. However, like some anthropocen-
tric therapies that are explicitly political in nature (e.g. feminist or liberation-
based therapies), some ecotherapy approaches operate as a form of social and
environmental activism – a sort of environmentalist therapy – and utilize indi-
vidual therapeutic experiences to resolve a cultural-level split from wild nature
in developed societies that is seen to impact health and identity and to drive
ecologically destructive behaviours.
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ECOTHERAPY16
Cultural Competence and Ecotherapy
Before moving forward, a caveat is important. Despite intuition and evidence
that adding a natural ecological dimension to psychotherapy and counselling
is a healthy progression, would-be ecotherapists need to be prepared for
scepticism and resistance, both from other mental health providers and from
the public. Some scepticism is to be expected of any new intervention and
can be addressed by presenting clear rationale, evidence and outcomes for
ecotherapy. However, the consciousness-raising aspect of ecotherapy can also
activate cultural stereotypes about environmentalism and draw the discussion
into often-polarized environmental debates. Whether someone may intellec-
tually and functionally link the concepts of psychology, psychotherapy and
nature has much to do with their environmental world view, which in turn is
informed by their cultural background, education and personal experience.
So, in much the same way that cultural competency is essential to any psy-
chotherapy (Sue, Zane, Hall and Berger, 2009), ecotherapists need to be cul-
turally competent about the environmental world views of those they serve,
their colleagues and their communities. This is one rationale for including
 ndings on environmental beliefs and attitudes drawn from environmental
and conservation psychology as a theoretical and empirical touchstone for
ecotherapy.
To give a personal example, writing as an able-bodied, heterosexual white
male in the Paci c Northwest of the United States, my ecotherapeutic work
more easily partakes of regional values and a commonly held, self-actualizing
‘Go West’ narrative in US culture (Nash, 1992). Your region may be more or less
receptive in terms or programmes, community uptake and institutional sup-
port, and have different cultural in uences such as northern European countries
versus Asian countries (Kellert, 1993). Given your diverse personhood, and your
social and cultural milieu, you may be able to be more or less ‘out’ with your
ecotherapy philosophy. But you can be con dent there are resources available
to ground your practice in a coherent theoretical and empirical structure.
The Evolution of Ecotherapy
Ecotherapy as a discrete endeavour, in the form of explicit environmental or
ecological initiatives in counselling and psychotherapy, coalesced in the last
decades of the twentieth century (Burns, 1998; Clinebell, 1996; Conn, 1998;
Howard, 1993; Macy and Young-Brown, 1998; Roszak, Gomes and Gomes,
1995; Swanson, 1995). These advances, in turn, drew from many contempo-
rary and historic sources, notably the nineteenth- and twentieth-century conser-
vation and environmental movements (Adelson, Engell, Ranalli and Van Anglen,
2008; Gottlieb, 2005) and associated work in the peace, nuclear disarmament
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THEORETICAL AND EMPIRICAL FOUNDATIONS FOR ECOTHERAPY 17
and environmental justice movements (Bullard, Johnson, King and Torres, 2014;
Macy, 1983). Ecotherapy is also in uenced by environmental spirituality of vari-
ous kinds (Badiner, 1990; Berry, 1988), ecofeminism (Mies and Shiva, 1993;
Plumwood, 1993), deep ecology (Drengson, Devall and Schroll, 2011), early
ecopsychology theorizing (Roszak, 1978; Shepard, 1982), and work on environ-
mental literacy (Orr, 1991; Thomashow, 1995).
In recent years, there’s been a  owering of ecotherapy initiatives of increas-
ing sophistication and specialization. Theoretical innovations at the turn of the
millennium (Fisher, 2002, 2012; Kidner, 2001; Weber-Nicholsen, 2001) set
the stage for broad-based surveys of ecotherapy practice and subculture (Buz-
zell and Chalquist, 2009). More recently, unique integrations by scholars and
practitioners (Hasbach, 2012; Jordan, 2015; Totton, 2011) and development
of targeted therapies have continued this trend, for example, coping with
climate change (Randall, 2009); addressing trauma in military veterans (Vella,
Milligan and Bennett, 2013); providing outdoor therapies for adolescents
(Gass, Gillis and Russell, 2012); and observing modern-day rites of passage
(Plotkin, 2003). In the evolution of ecotherapy, one can discern a creative
tension between grassroots innovations and institutional, research-based ini-
tiatives and integration of additional therapy perspectives (e.g. psychody-
namic, cognitive-behavioural, mindfulness-based) into the gestalt, humanistic
and transpersonal frameworks that were prominent in earlier waves of
ecotherapy.
There are a number of parallel initiatives in mental and physical healthcare
and social services that can be considered ecotherapeutic. These include envi-
ronmental social work, horticultural therapy, animal-assisted therapies, and
disaster relief (Blazina, Boyraz and Shen-Miller, 2011; Gray, Coates and Hether-
ington, 2012; Haller and Kramer, 2006; Jungerson et al., 2013). Differences
between ecotherapy and these parallel initiatives are more often an artefact of
the disciplinary silo in which they have developed than in the goals, practices or
outcomes. Ecotherapists will  nd common ground in terms of actual practices
by aligning with professionals in these areas.
As a counter to the apparent newness and novelty of ecotherapy, it’s impor-
tant to note that outdoor therapeutic activities, for example in the form of
therapeutic camps, have been present in the United States and in other coun-
tries since the 1860s (White, 2012), and therapeutic conversations while walk-
ing outdoors were a common practice in early days of the psychoanalytic
movement (Reik, 1948). From the perspective of Western cultural history and
environmental philosophies, the impulse towards holistic and therapeutic
approaches to human’s relationship with nature and wilderness are perennial
(Oelschlaeger, 1991). Most of today’s modern ecotherapies can be meaning-
fully understood as responses to changes in Western culture (e.g. a desacralized
nature, urbanization, increased use of machines and technology) that date to
the Enlightenment and the Industrial Revolution (Merchant, 1980).
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ECOTHERAPY18
Empirical and Theoretical Basis in Environmentally
Focused Psychology
While ecotherapy as a  eld is rather new and relatively untested in many
domains, there are a number of long standing environmental initiatives in psy-
chology that provide theoretical constructs and empirical  ndings useful to the
practicing ecotherapist. At times, locating these requires some effort and schol-
arly investigation. While original studies may not have been explicitly designed
with psychotherapy in mind,  ndings on environmental topics that impact on
human health and well-being, crowding, noise, the effects of information tech-
nology, impacts of natural disasters (Bechtel and Churchman, 2002), will have
obvious bearing on the creation of therapeutic contexts. Other studies, such as
on the effective design of wildlife conservation programmes or ways to reduce
barriers to pro-environment behaviour (Clayton and Myers, 2009), provide
guidance on how to support environmental engagement on the part of indi-
viduals and communities. On a deeper level, environmental psychology research
provides insights on basic perceptions of nature and the natural environment
and the development of environmental world views.
There is great diversity among psychology-environment approaches in terms
of epistemology, methodology and goals. The categories below (e.g. environ-
mental psychology and ecopsychology) while useful in terms of conducting a
literature review, are also somewhat arbitrary as these areas overlap and indi-
vidual researchers and practitioners do not always hew to these labels. Various
theoretical and practical debates among environmental psychology and eco-
therapy scholars will broaden the personal and professional perspectives of
would-be ecotherapists: certainly Thomas Doherty’s interviews with Robert
Greenway, Sherri Weber-Nicholsen, Joseph Reser (2009), Michael Cohen (2010),
Andy Fisher, Riley Dunlap (2011) Peter Kahn and Patricia Hasbach (2012), have
aided this process.
There is a rich history of study of the dynamic interchange between humans
and their environmental milieu, both built and natural, and how this relates to
both basic psychological processes and the amelioration of social problems.
This area coalesced into the sub eld of ‘environmental psychology’ in the late
1960s and early 1970s (Ittelson, Proshansky, Rivlin and Winkel, 1974). More
recently, environmental psychology of the spatial and built environment has
continued to grow and evolve in terms of focus and research methods (Gifford,
2007) and interweave a more explicit conservation mission (Clayton, 2012).
Some areas of environmental psychology that are of particular interest to
ecotherapists are Stokols et al.’s (2009) theory and  ndings regarding contem-
porary polyfunctional environments (i.e. spaces that combine home, work and
social settings and are linked through instantaneous global information tech-
nologies) and how these in uence global environmental consciousness and
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THEORETICAL AND EMPIRICAL FOUNDATIONS FOR ECOTHERAPY 19
mood and well-being. Also, research on links between clinical and environmen-
tal psychology, for example in terms of aetiology and treatment of anxiety dis-
orders (Anthony and Watkins, 2002) and on the effective design of healthcare
settings and psychotherapists’ of ces (Devlin, 2014), has practical signi cance.
Finally, environmental psychology has much to offer in terms of understanding
the various aspects of global climate change as an existential reality, and in
terms of disaster impacts and mitigation and adaptation responses (Doherty,
2015; Reser and Swim, 2011).
Ecotherapy is probably most associated with taking therapy ‘outdoors’ (Jor-
dan and Marshall, 2010). Indeed,  ndings on the bene ts of greenery and natu-
ral settings for psychological health and well-being through stress reduction,
improved cognitive and emotional functioning, and the development of iden-
tity, ef cacy and meaning, are some of the strongest in the social sciences
(Kaplan and Kaplan, 1989). This knowledge has been applied in the design of
buildings and workspaces, healing gardens in hospitals, and in community-wide
greening programmes (Frumkin, 2012; Hartig and Marcus, 2006; Ulrich et al.,
2008). As I have argued, knowledge of the therapeutic effects of nearby and
wild nature can be seen as a form of basic ‘mental health literacy’ in terms of
self-help strategies and potential for psychological treatments (see Jorm, 2012,
cited in Doherty and Chen, 2016.
Conservation psychology coalesced as an interdisciplinary, ‘crisis discipline’
modelled after conservation biology, in which social scientists partnered with
natural resource and wildlife conservation colleagues (Saunders, 2003). Conser-
vation psychology theory and research is particularly useful to ecotherapy given
its explicit focus and research  ndings on environmental identity (Clayton,
2003) and the effects urban ‘nearby’ nature, human-wildlife interactions and
the psychological basis for care of other species, for instance in terms of foster-
ing the public education and conservation efforts of zoos and aquariums and in
terms of managing wild lands (Clayton and Myers, 2009).
Conservation psychology also provides examples of effective conservation
behaviour change programmes and detailed studies of barriers and incentives
to pro-environmental behaviours in complex, real-world contexts (McKenzie-
Mohr, Lee, Schultz and Kottler, 2011). This includes the role of attention and
mindfulness in making pro-environmental behavioural choices (Amel, Manning
and Scott, 2009). Given that the factors that promote successful conservation
or sustainability programmes are often dif cult to determine and counterintui-
tive (Nolan et al., 2008), the empirical studies of successful conservation pro-
grammes are very important for ecotherapists who seek to in uence behaviour
change or to promote programmes that have a higher likelihood of success.
In contrast to the more conventional disciplinary approaches associated with
environmental and conservation psychology, ecopsychology can be seen as a
transdisciplinary area that critiques normative, anthropocentric psychology in
general where more-than-human nature remains effectively absent. This
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ECOTHERAPY20
includes a critique of other environmental psychology approaches that operate
on a reductive, experimental basis and downplay experiential and therapeutic
aspects of nature connection and lack a critical focus on systems of power and
issues of social and environmental justice. In contrast, ecopsychology theorists
seek to promote a more embodied, ethical interdependence with the natural
world (Roszak, 1992). While again quite diverse in terms of perspectives and
approaches, most ecopsychology work can be characterized as holistic, depart-
ing from the basic Cartesian split associated with Western science and envision-
ing the human psyche and psychological processes as more fundamentally
embedded in natural and wild systems (Kahn and Hasbach, 2012; and Bragg’s
1996 concept of ‘ecological self’). Ecopsychology theorizing tends to be explic-
itly political, drawing from critical social theory and feminism to address issues
of power, ideology and economic processes that drive humans’ exploitation of
other peoples, species and planetary resources (Fisher, 2012). Ecopsychologists
also tend to adopt a more explicit stance as therapeutic environmental activists,
often working in grassroots settings (Macy and Young Brown, 1998).
With its validation of the emotional impacts of environmental issues and
normalization of environmental fears and anxieties, ecopsychology can be seen
as helping to create ecotherapy as an endeavour. These areas are highly over-
lapped and for some practitioners, ecotherapy would be seen as an applied
form of ecopsychology (Buzzell and Chalquist, 2009). However, given the
potential variety of ecotherapy settings and activities, philosophically diverse
approaches to the theoretical and empirical basis of ecotherapy, and multicul-
turally diverse practitioners, it’s more useful to see ecopsychology as a key theo-
retical and practical contributor to ecotherapy but to keep some conceptual
openness between these areas.
Theoretical Synthesis: Identity, Self, Consciousness
and Setting
The environmentally focused schools of psychology described above provide
measurable theoretical constructs that help us to understand the synergy of
physical-environmental, social-behavioural and embodied-experiential phe-
nomena that come into play in ecotherapy. From a non-reductive perspective,
the cognitive and intellectual realm of beliefs, attitudes and attributions about
the self and world (Clayton, 2003) is continually in uenced by actual experi-
ence of being in the world (Bragg, 1996). Embodied experiences of ecological
self are intimately in uenced by the quality of one’s moment-to-moment con-
sciousness and focus of attention such as mindfulness, sense of  ow, attention
to patterns in nearby nature, or alternatively, immersion in communications
technology or other human-centric stimuli (Amel, Manning and Scott, 2009;
Stokols et al., 2009). Identity, self and consciousness cannot be meaningfully
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THEORETICAL AND EMPIRICAL FOUNDATIONS FOR ECOTHERAPY 21
separated from the design of the physical setting, whether built or natural, and
whether restorative or stressful (Kaplan, Kaplan and Ryan, 1998).
For example, a relaxing walk in a safe, forested park setting will provide
opportunities to attend to natural views and stimuli (soft fascination) and facili-
tate an experience of ecologically embedded self that will in uence one’s cogni-
tive appraisal of their identity and mood, and thoughts about the world at large.
Conversely, a high-intensity behavioural setting exhibiting hard fascination (e.g.
driving in rush-hour traf c), particularly a poly-functional setting with continu-
ous access to global information technology, will provide a different set of
stimuli to attend to and a different quality of consciousness and physiological
arousal. This in turn is likely to be experienced as a different sense of self and to
give rise to different thoughts about one’s identity and one’s sense of the world
and their place in it. All of these factors – cognitive appraisals of identity, sense
of embodied self, focused awareness and attention, and qualities of setting –
can be utilized in the creation of ecotherapy interventions (see Figure 1.1).
Ecotherapy Research
The study of ecotherapy can be approached in a number of ways, ranging from
positivist/biomedical approaches that focus on symptom reduction, to more
systems-focused biopsychosocial approaches; to humanistic, meaning-making
approaches; to constructivist/critical approaches that recognize the role of cul-
tural discourses and power in the social construction of ecopsychological prob-
lems (Marks and Yardley, 2004). Ecotherapy programmes will have differing
Ecotherapy Constructs: Identity, Self, Consciousness & Setting
Environmental
Identity & Beliefs
about the World
Moment-to-moment
Consciousness
& Mindful Attention
Qualitative Experience
of Embodied,
Ecological Self
Behavioural Setting:
Restorative Quality,
Access to Information
Technology, etc.
Figure 1.1 Key ecotherapy constructs.
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ECOTHERAPY22
standards of evidence depending on their rationale and target goals. For exam-
ple, expressive ‘despair and empowerment’ approaches (Macy and Young-
Brown, 1998) will have more qualitative and subjective outcomes than
interventions designed to address symptoms (Faber-Taylor and Kuo, 2009) that
lend themselves to more quantitative methods.
Evidence-based Ecotherapy Programmes. As interest, funding and system-
atic study have increased, the evidence base for ecotherapy has become more
substantial. Practitioners are now fortunate to have some well-developed mod-
els to learn from (Doherty and Chen, 2016). Academic research programmes
that combine theory building, controlled study and intervention (see Landscape
and Human Health Laboratory: http://lhhl.illinois.edu/) provide robust tem-
plates to build on, and have spurred their own interventions, such as outdoor-
based treatment for children experiencing attention de cit disorder symptoms,
(Faber-Taylor and Kuo, 2009). Private and public sector programmes have
spawned ongoing research programmes as well. These include longitudinal
outcome studies completed by the Outdoor Behavioral Healthcare Industry
Research Cooperative http://obhic.com/research.html) sponsored by a consor-
tium of residential wilderness therapy programmes in the United States and
Canada. Forestry Scotland’s Branching Out programme, a community mental
health programme that utilizes outdoor experiences, bushcraft and nature
awareness, is also an exemplar. On the individual level, the construct of eco-
wellness – the subjective experience of wellness through one’s perceived con-
nection with nature – has found empirical support in counselling settings. A
perception of eco-wellness is mediated by factors such as access to restorative
Eco Wellness
Physical
Access
Sensory
Access
Spirituality Community
Connectedness
ProtectionConnection Preservation
Figure 1.2 Ecowellness.
Source: Adapted from R. F. Myers, J. E. Lewis and J. T. White (2015) ‘Construction and Initial
Validation of the Reese Ecowellness Inventory’, International Journal for the Advancement of
Counselling, 37, 124–42.
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THEORETICAL AND EMPIRICAL FOUNDATIONS FOR ECOTHERAPY 23
settings, and sense of safety, ef cacy, spirituality and community connectedness
(Reese and Myers, 2012; Reese, Myers, Lewis and Willse, 2015).
Theoretical and Empirical Issues Unique to
Ecotherapy
Competency in ecotherapy requires a nuanced understanding of commonly
used terms such as ‘nature’ or ‘natural’. While these terms can provide a useful
shorthand for the out-of-doors or for objects or processes with minimal in uence
of humans (or explicitly valued for non-human attributes), this distinction can
also present a false dualism that obscures the inherent naturalness of all human
cultures and endeavours. From a perspective of environmental and conservation
psychology (Clayton and Myers, 2009), it is helpful to think of a spectrum from
domestic nature such as plants in the home, to nearby nature such as parks and
gardens, to managed nature such as tree farms and agricultural areas, to wild
nature – nat ive plants and animal s, wilderness areas t hat are remote, chall enging,
or purposely left undeveloped; and ‘wild’ processes in the human body (Cryan
and Dinan, 2012). From the perspective of environmental philosophy and his-
tory, ideas of ‘nature’, ‘wilderness’ and ‘the environment’ are also social and
cultural constructions whose meanings vary greatly based on the social context
(Cronon, 1995; Soule and Lease, 1995). Conceptualizing nature has practical
implications. When hypothesizing about ecotherapy outcomes, it is important to
be clear about what aspects of ‘nature’ you intend to access and utilize, how
these are to be operationalized, and in service of what therapeutic goal. Consider
for example, doing so-called wilderness therapy. A place may be subjectively
experienced as ‘wild’ given its remoteness, level of challenge or visible presence
of other species. This can be assessed through a qualitative interview. A setting
may also be considered wild based on its legal designation, or quantitative
assessments of its size, number of visitors, or diversity of its ecosystem.
Working with Systems and Scale
An important ecological skill for ecotherapists is ‘thinking at scale’ the ability to
track interdependent issues and phenomenon at different levels of local and
global context, and to recognize the emotional and ethical rami cations. This
can include understanding how ‘distant suffering’ (Boltanski, 1999) associated
with events at great physical remove can be personally experienced (Stokols
etal., 2009). In the short term, this awareness can be disorienting and over-
whelming. However, with patience and perseverance, simultaneously cultivating
connections with local place and planetary awareness can also be comforting, a
positive synergy of consciousness and dedication to daily efforts and local action.
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ECOTHERAPY24
Assessing Psychopathology in an Ecotherapy
Context
Expertise in assessment and diagnosis of psychopathology and psychiatric dis-
orders and use of diagnostic criteria is beyond the scope of this chapter. But this
constitutes a necessary practical and ethical component of doing ecotherapy
work. Some individuals seeking ecotherapy may be experiencing signi cant
distress or impairment or suffering from psychiatric disorders. Others may be
quite ‘well’ in terms of their general life functioning. Making a functional dis-
tinction between the concerns of someone who would be seen as normatively
healthy by their cultural group but who is also suffering distress or concern
regarding environmental issues, and another person who is impacted by a pre-
existing interpersonal trauma, psychiatric disorder, or psychosocial adjustment
process that in turn makes them susceptible to environmental distress, requires
some clinical sophistication. In practice, these situations are rarely clear-cut.
Would-be ecotherapists are encouraged to make use of their existing training
regarding psychopathology and psychodiagnosis. In fact, no special diagnostic
criteria are needed to treat ecotherapeutic issues. For example, existing criteria
for adjustment, anxiety and depression disorders can be applied to problems
associated with the natural environment – both acute and secondary.
In terms of natural disasters or climate change, causal pathways for psycho-
pathology or psychiatric impairment are relatively clear-cut. Geophysical effects
such as  ooding, heat waves, droughts, and extreme weather events increase
the likelihood of injury, trauma and anxiety-related responses in individuals and
communities, and over time, the prevalence of chronic and severe psychologi-
cal problems (see Doherty, 2015). Indirect or vicarious mental health impacts of
environmental issues are more dif cult to assess and diagnose compared to
acute disaster impacts. These tend to be gradual, diffuse, and contingent on
other aspects of a person’s life functioning such as their exposure to media and
information technology (see the discussion of the information-saturated poly-
functional environments in the environmental psychology section above) and
their general level of environmental literacy.
In their treatment, ecotherapists are forced to make a dif cult philosophical
distinction between normal and expected worry about ecological threats and
pathological worry that impacts their client’s or patient’s life functioning. Eco-
logical worrying in and of itself does not correlate with pathology but rather
with proenvironmental attitudes and positive personality traits such as altruism
(Verplanken and Roy, 2013). Anecdotes of ‘eco-anxiety’ symptoms in the popu-
lar press (Nobel, 2007) including anxiety or panic, irritability, sleeplessness and
malaise, signal the presence of diagnosable or sub-threshold disorders of various
kinds. Only a comprehensive diagnostic history and interview can sort these
issues out with speci c individuals.
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THEORETICAL AND EMPIRICAL FOUNDATIONS FOR ECOTHERAPY 25
Creative Tensions in Ecotherapy
The practice of ecotherapy becomes a radical endeavour when it calls into ques-
tion assumptions of what philosophers might call the ‘world in force’, the nor-
mative anthropocentric-technological world of so-called developed human
societies. In particular, ecotherapy questions seemingly obvious dichotomies in
psychotherapy (and in general culture) between built and natural, inner and
outer, global and local, wild and domesticated, backcountry and front country.
Ecotherapy not only blurs distinctions between these concepts but also upends
their assumed hierarchies and therapeutic values. This has philosophical and
practical implications. For example:
A major insight of ecotherapy is that what are commonly seen as mental pro-
cesses located ‘in the head’ (thoughts, emotions, behavioural impulses) are actu-
ally ecological products of environmental interactions. There is no psyche and no
therapy without the physical setting. Ecological psychology in its physical-spatial
framing (rather than its social and anthropocentric variations) has long conceived
of human psychological processes as transactional, based on a systemic embed-
dedness in the physical environment, and taking form as patterns of action that
continually attune people to that environment as an integrated behaviour-setting
(Heft, 2012). From the perspective of ecological psychology, certain settings pro-
vide affordances – physical properties of the environment that shape conscious-
ness and behaviour. These spatial-systemic properties can also be understood
from a phenomenological perspective and approached in the language of ecopsy-
chology as ‘turning the psyche inside out’ (Fisher, 2012). This spatial-ecological
thinking can also take on an evolutionary turn. When climbing a tree,  nding a
convenient branch that neatly  ts one’s hand is no accident. The human hand has
been evolved to climb and has been shaped by such branches over millennia.
Ecotherapy involves practitioners who work in urban settings and those who
act as guides or expedition leaders in more (un)managed or wild settings. Hav-
ing done both types of work, I would encourage practitioners not draw too
strict a line between the backcountry and the front-country. Approached from
the perspective of physical challenge and risk management, a backcountry set-
ting may be seen as more dif cult than an urban setting. In some senses this is
true. However, working out of doors and away from more mainstream settings
offers greater space and freedom for doing ecologically focused and nature-
based techniques without perceived stigma. Conversely, while front country
activities may offer more infrastructure and convenience, they can also highlight
the novel, political nature of ecotherapy with practices that question the thera-
peutic status quo. For example, trying to institute even the most benign eco-
therapeutic initiative (e.g. a healthy plant or a window in every consulting
of ce) in an urban, anthropocentric practice location can require laborious
efforts to overcome scepticism; justify and seek support for the activity; and deal
with the resources of the facility.
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ECOTHERAPY26
The Development of the Ecotherapist: Inside Out
and Outside In
Rather than resolve these creative tensions in any essentialism about ecotherapy,
I recommend that practitioners be mindful how their practice constitutes a syn-
thesis of these dialectics and how this evolves during their career. I have observed
in my own practice, and in the activities of others, a developmental trajectory in
terms of ecotherapeutic practice that contains a tension between the indoors
and outdoors and the level of risk and exposure in the activities (i.e. between
sedentary, low-risk activities in nearby nature, such as doing walking sessions
with clients, versus more physically active, challenging adventure activities
requiring technical skills, specialized gear and explicit risk-management think-
ing, such as overnight outdoor retreats). Curiously, this trajectory can go in
either direction: one can begin with of ce-style activities and then venture out-
wards into more complex and challenging scenarios as they become empow-
ered; or one can transition into an of ce-based practice from a career of doing
high adventure activities (due to lifestyle changes). For a complementary per-
spective, see Kempton and Holland (2003) for an interesting study of the life
development of environmental advocates.
Putting It All Together
I have respect for inside and outside realms. My evolution as an ecotherapist, up
until now, has gone more in an ‘outside-in’ direction. My conceptual baseline for
ecotherapy was established during multi-week ‘wilderness therapy’ backcountry
expeditioning in the western United States, in the late 1980s and early 1990s, and
witnessing the standardization of grass roots backcountry out tter and therapy
programmes into the outdoor recreation and ‘outdoor behavioural healthcare’
industries. The bene ts of this shift included shared knowledge and resources,
quality control and improved risk management. The losses included the passing
of idiosyncratic regional programmes and homogenization of wildness therapy
models. My growing edge has included the urban delivery of ecotherapy, teach-
ing the science and craft of ecotherapy and  guring out how to make a living
doing this work in a personally and environmentally sustainable manner.
In my own work as an ecotherapist, I use a constructivist-developmental
approach that fosters consciousness-raising and exploration of one’s life history
vis-à-vis nature (broadly, in the client’s own cultural understanding) and sense
of physical and regional place, and how these in uence environmental identity
and diversity. I  nd that this tends to organically segue into a discovery of per-
sonal agency and curiosity about experimenting with new behaviours. This
creates a need for a more precise assessment of readiness for change and
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THEORETICAL AND EMPIRICAL FOUNDATIONS FOR ECOTHERAPY 27
deployment of conservation behaviour change strategies. Immersion in the
world of action creates experience (i.e. new knowledge, setbacks and successes)
that then can be re ected on, in an ongoing cycle of growth (Kempton and
Holland, 2003). I particularly enjoy doing this ecotherapy work in groups where
the added complexity and synergy of different environmental identities and
world views comes into play. (I imagine a similar enjoyment on the part of thera-
pists who specialize in work with other species.) Finally, I enjoy the challenge of
risk management – risk in the sense of emotional risk as well as physical or
practical risks. Rather than perceiving this as a burden, I see this as a signal that
the therapeutic work I’m doing is truly real and adventurous and not simply
abstract or removed from the joys and dangers of the physical and natural
world. I wish you well on your own ecotherapy journey.
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