The original research submitted to the University of Worcester included five themes. This paper presents one theme: ‘Transitional landscapes—transitional thinking’. This theme was chosen as it best demonstrates the application of interpersonal process recall in gaining an in-depth and nuanced understanding of the environment within the session. The theme is broken into subthemes including; the embodied experience, parallel processing, and watching for drift.
3.1. Transitional Landscapes; Transitional Thinking
Outdoor therapy can be direct (working outdoors from the start), planned (starting indoors with a plan to move outside), combined (using indoor and outdoor spaces on alternate or particular sessions), or emergent (finding opportunity for the work to progress to an outside space). Emergent opportunities arise where the client learns and becomes interested in an outdoor approach or where the practitioner gets a sense that working outside might be safe and beneficial to the client. As with traditional counselling, the initial sessions are important for establishing the therapeutic relationship, ensuring there are clear and contracted boundaries of practice and establishing the focus of the work and whether the practitioner’s modality will suit the client.
Compared to indoor counselling that is often assisted with a clear transition from the waiting room to the contained counselling room, in a direct approach, where the client and practitioner meet and start working outside from the beginning, there is a less clearly defined transition. Participant C describes one approach using the environment and assisting the client to make a transition between landscapes and beginning the therapy session.
“We’d get to the bridge at the head of the lake … that’s like a passage and I’d say to people… when we come off the tarmac road I’d invite them to think about their leaving one kind of environment and going into somewhere else”.
This approach uses a land feature to symbolize the transition into the therapeutic session. It indicates that for participant C, the session offers an escape from everyday life and a passage into an alternative space. The journey becomes metaphoric as well as physical as the participant transitions from one space to another. Conversely, participant B describes a combined approach whereby the outdoors is used as an experiential space to explore the therapeutic work.
“He chose a route through some paths, woodland paths and ended up going off track and over walls… it was almost quite playful, and quite a sense of lostness and re-emerging and all that kind of stuff he was experiencing which mirrored some of our indoor sessions, literally as opposed to metaphorically”.
In this example, the client is able to actively experience some of the metaphoric content of an indoor session, the metaphors of being lost and finding themselves are given a literal meaning as the client navigates through the forest. A combined approach allows for the client and practitioner to work with the presenting issue through rational, reflective and abstract forms.
As the sessions progress, the client may become more confident to work with the practitioner and the outdoor approach. The sessions transition from beginnings (getting comfortable with the approach) to middles (utilizing the approach to explore the presenting issue). Participant B describes a client’s integration of the natural environment within the session. The client starts to experience an embodied agency within the outdoor environment.
“He was moving along, like in the same way that his emotions were moving… feeling very lost, very confused… what mirrored that process was walking along in the light, a light airy space for a little bit and then going through the woods as per his direction, and getting very lost and weaving our way through these little paths”.
Here, the therapeutic process emerges with, and is guided by the natural environment; as the client and practitioner talk, the client is able to move into spaces of shade or light, clear pathways, or trickier terrain. The terrain affects the conversation as the natural environment stimulates the therapeutic process, providing dynamic material within the session. Equally, the client can affect the terrain by changing the path they choose; thus, enabling an embodied expression to emerge. The practitioner observes the client shifting between affecting and being affected by the environment. The practitioner’s role shifts, allowing room for the natural world to interact within the therapeutic relationship.
“Just at the point where we were more tangled was when we could actually start to see the sky through the trees again…and then saw the hope, the light through the trees and that seemed to help facilitate him getting back to himself, answering his question about the here-and-now”.
Whilst the client can dictate the path, they are also in a dynamic and emergent terrain. After leading the way into a thick mass of trees, the environment offers a natural window and sense of perspective. The light through the trees offered a symbol of hope and provided light to the situation that shifts the client’s thinking process. This is experienced physically, emotionally, and cognitively as the client finds patches of clarity within an enclosed forest. The client is able to discern the figure from the ground and return to the present moment.
“That for me is like the holy grail, when the experience of the session and the experiencing of it feels as real as what’s going on internally, we hit those moments throughout that journey because the client is picking the route in tune with the content of their session”.
The practitioner’s likening of an embodied session (synchronicity between mind and body) to the holy grail indicates a sense of actualization, flow, or epiphany that is deep and powerful. To the practitioner, the client’s ability to work in this way and encounter such a state of mind indicated that the session was meaningful. The practitioner’s role is to dynamically facilitate this engagement with the natural environment and work with the client to offer awareness.
Being with the client outside allows other-than-spoken processes to emerge. Participant A explains that silently walking with the client was equally as useful. The session takes a different pace and allows the process of walking to hold the space between conversations.
“I think walking gave us an opportunity to share times of stillness and silence which were sometimes necessary for my client to be able to process what was going on and to find the words to say what he wanted to say”.
Transitions in outdoor therapy take many forms. These transitions include the intentional shift from an indoor to outdoor space, the client’s attunement and integration of the approach, and the shift of the practitioner to provide space for the natural environment to interact and be an active component of the work.
3.2. The Embodied Process
Outdoor therapy reframes the therapeutic relationship and offers both the client and therapist a different experience of one another. This reframe symbolically alters the perception of the role and context of the professional. The therapeutic work becomes defined, negotiated, and maintained within the context of the outdoor environment. The therapeutic process takes on additional dimensions as the client and therapist move through and engage with the environment. Participants noticed that working outdoors impacted their experience of the client:
“You feel kind of more what they’re feeling and their kind of anger can become perhaps more understandable or certainly experienced anyway!”.
Outdoor therapy offers a holistic approach. Whilst indoor counselling works mainly with the cognitive and emotional, outdoor therapy involves an active element that invites clients to be present with their emotions, thoughts, and actions. The immersive experience can impact the practitioner’s ability to experience the client authentically.
“In a therapy room… they can see the clock… but in nature when they’ve been walking around in the woods and they don’t really know where they are, old worries and anxieties and things may well resurface but they may be reflecting the real person rather than the person they try to be”.
Participant C explains that outdoor therapy allows clients to become immersed in the moment, and in doing so, they might forget about how they are trying to portray themselves and start being authentic. Participant C suggests this process may lead to worries and anxieties resurfacing, which offer a more genuine experience of the client. Working with the client in an experiential way enables the therapist to observe and experience the client’s way of being in real situations rather than through the client’s self-reflection. This allows the therapist to engage with the client’s authentic self and provides an opportunity to experiment with coping-mechanisms.
“If they don’t look after themselves physically in that environment, then what does that say about them emotionally? Are they able to take care themselves?”.
Outdoor therapy alters what it is to engage in therapy and for participant A, reframes the purpose of therapeutic encounters from clinical to organic.
“Stillness’s and silences can seem a very natural part of the process of walking, whereas in a counselling room, sometimes those dark silences can seem very, yeah unbearable almost”.
In this example, the participant reflects upon the meaning implied by stillness and silence. He suggests the tone of silence is altered when walking to resemble a natural pause, whereas within a counselling room, the tone can feel imposing and stifled. Equally, participant A reports an ability to experience their client’s disconnect, their discomfort and vulnerability, and the impact of this on their work.
“One particular client… it was very obvious there was not psychological contact between him and his surroundings… within about ten-fifteen minutes I had this most enormous headache… it was really frustrating because I was really feeling that sense of complete disconnection with where I was… I was in his world, I’d kind of lost a sense of me as a counsellor… I was as disembodied as he was”.
Participant A details a disconnect between the client and their surroundings, which in turn affects the practitioner’s ability to connect with their environment. This disembodiment affects the practitioner’s sense of self. Whilst the practitioner uses the natural environment to remain grounded and focused on the client, here, the practitioner is unable to make psychological contact between nature–practitioner–client.
When removed from the traditional context of counselling and engaging experientially in outdoor therapy, the practitioner must be cautious to remain focused, rational, and professional and avoid getting lost in the experience:
“The risk is you have a genuine relationship with somebody… then you actually feel their pain and their sorrow and their sadness”.
Participant A considers the risk of intimacy on professionalism. He suggests practitioners working outdoors might have an altered perception of the role of intimacy in the therapeutic relationship and be more inclined to experience their clients authentically. This suggests that for participant A, the risk of intimacy is not that professional boundaries will be compromised, but that the practitioner may begin to feel their client’s emotions.
“I think that’s one of the reasons why counsellors are very reluctant to work outdoors because… strangely… it seems paradoxical because what you want is intimacy, I think often counsellors are actually very scared of true intimacy”.
Participant A identifies a paradox whereby on the one hand the work between the client and practitioner fosters intimacy within the working relationship and on the other, professional boundaries imply that true intimacy is to be un-boundried or step over the professional boundary of practice. For participant A, professional boundaries do not restrict intimacy, nor does intimacy restrict professionalism. There is an indication that counsellors may be restricting their work through limiting the intimacy within the working relationship and that by situating work too squarely within professional boundaries, the innate human connection is lost. Despite this, participant A acknowledges that intimacy must be managed with care.
“I think trusting relationships can develop very quickly, that can also be a problem too in the sense that sometimes people might be working quicker than they actually feel comfortable with”.
Here, the participant explains that intimacy takes time to develop between the client and practitioner. The pace, intimacy, and depth of the work are managed in the altered context. The practitioner must consider the duty of care to the client and decide what is appropriate and best for the client within the scope of the approach.
3.3. Parallel Processing
The outdoor environment provides a dynamic element affecting both the client and practitioner. The participants expressed a motivation and passion for outdoor environments as a place of self-care. These places become a working environment offering a symbiotic relationship and providing restorative conditions for both the therapist and client and a sense of rejuvenation to the therapeutic work:
“I notice that when I’m outside I can be more immediate with what is going on in the moment, I can be more focused, perhaps more available for the client… that has an impact in terms of holding from a person-centered point of view… holding of the necessary and sufficient conditions”.
Participant A describes a sense of attunement to the client within the natural environment. The participant describes a sense of seeing more within the moment and being grounded in the present here-and-now in which the client is the center of attention. Here, the person-centered core conditions (empathy, congruence, and unconditional positive regard) flow naturally between nature–practitioner and practitioner–client to provide the conditions for therapeutic change. Not only is the client held, nurtured, and contained, but the practitioner too. However, the therapist must be aware of their own processes and motives within the session, putting aside their ‘stuff’ to be present with the client.
“My feeling is joy, I’m finally in a new place, there’s a new lostness; I love exploring so for me there’s an adventurous side, I love that feeling. But I love it so much that I’ve had to learn how to not let that get in the way of how the client is feeling… this has taken a long time… to both feel that excitement that I’m having in the moment… but to be with the client and how they’re experiencing that moment”.
Participant B describes his emotional response to the sense of lostness within the session. He acknowledges his inner-reaction and sense of adventure which is parked to remain present and attuned to the client’s experience. Participant B indicates a journey of realization and training that he has taken to remain present with the client and to sustain focus during the session.
Equally, the process of joining with the client and remaining responsive to the terrain and safety elements requires the therapist to dynamically examine their anxieties and intrinsic response to the land in relation to the context of the work and their code of practice;
“I keep feeling naughty about that… like little school boys playing… we were in this deep process literally a moment ago, but it got really steep and really windy, I had this feeling like ‘we shouldn’t be here’… and I just have to let it go because I’m looking at the client just carrying on talking but he’s weaving through”.
Participant B’s use of the words ‘naughty’ and ‘school boys’ indicates a more playful dynamic between the client and practitioner. The participant uses ‘we’, suggesting that the moment was a shared experience and state of being. The practitioner notes the change in the terrain and its impact on their movement. Here, the practitioner takes a moment to check-in and acknowledge his sense of discomfort with the situation before considering its impact on the client’s safety and process. The practitioner is able to focus on the client and reserves his doubts to allow the client’s process to continue. As a person-centered counsellor attuned to following the client, participant B explains the practitioner must recognize and hold their own agentic response to nature. Dissonance can emerge between the client’s and the practitioner’s experience.
“For me it was divine, it was heavenly, but for my client it who was feeling very suicidal at the time, he just had this deep feeling of foreboding because it was just too much”.
Participant B offers another example, whereby their passion and motivation for the outdoors was not reflected by the client. In this case, the practitioner was forced to consider the intention behind the approach and who was benefiting from the approach.
“I was expecting them to have the same relationship to nature as I did. Which was enthusiastic, love, joy, it was amazing the best thing in the world and the first person I took outside hated it… I was really disappointed”.
Participant B reflects upon how he has attempted to narrow the gap between his personal experience and the client’s experience using a process of intentional disorientation, within a safe and confined boundary, to become more equal, avoid complacency, and better understand the here-and-now experience.
“I didn’t realize until I did this on reflecting on this… I’m aiming for this ideal kind of equality with the client and the session… to mirror what I’m actually doing indoors… I wanted to actually go somewhere I hadn’t been before, so that it did feel more like it does in a normal session which is new territory, new ground”.
Taking therapy outside requires the practitioner to be comfortable and aware of their own relationship with outdoor and natural spaces. Their competence and comfort in these environments allow them to be present with their client’s experience. Staying in tune with their own response, the practitioners internally supervise the session, considering the client’s wellbeing and the therapeutic work aside the landscape and terrain.
3.4. Watching for Drift
Working with the client’s response to nature requires and invites the therapist to experience additional roles and blurs the boundaries of the traditional therapeutic hour. This offers multiple elements for the practitioner to balance and manage simultaneously. Participant A describes the importance of finding safe conditions for the session to emerge. Where the conditions are not suitable, the practitioner adapts accordingly until conditions are met.
“Walking to the park, we would have general sort of chit-chat but we wouldn’t be doing sort of deep work because I’d end up walking into a car”.
Once safe conditions are found, the practitioner can settle into the session. Whilst the practitioner continues to dynamically assess safety, participant B describes an experience of becoming immersed in the session with the client, presenting a risk of drift from the presenting issue to the experience itself.
“I’m almost giggling here actually because I remember… there was a part where the alliance was as if we were being a bit naughty like here we are doing a counselling session, talking about all these things and then we find ourselves weaving up, weaving up quite a steep track, not even a track, a steep wall with no track”.
This can alter the therapeutic alliance, whereby the client and practitioner experience each other differently.
“That pretense goes, you just lose yourself… we shared in those moments so that our eye contact was more and we were having fun”.
The therapist shifts focus with the terrain of the session. Whilst managing safety, the therapeutic work, the client’s experience, and the environment, the outdoor therapist must also follow their navigational location. Participant B describes a moment where he did not know their exact location and considers the impact of this on the client.
“I didn’t know that was the way out, he did actually find it… he thought I was pretending… that I did really know where I was… and I didn’t. And that was really levelling”.
This can alter, shake or destabilize the client’s view of the therapist and the perceived competence, safety, and professionalism bestowed upon the practitioner.
Watching for drift requires the practitioner to juggle the different hats that they must wear to work as competent lone-practitioners. Whilst working in line with their ethical framework and seeking supervision to review their work, practitioners must be mindful of the heightened duty of care they have for clients whilst outdoors.
This study adopted an interpretative phenomenological analysis to explore the participants’ lived-experiences of outdoor therapy sessions. The theme presented reflects upon the use of an environment which is intrinsically therapeutic and which can lead to transitional thinking [54
], and the multiphasic nature in which cognitive and psychological states ebb and flow throughout the encounter [55
]. This research supports links between internal and external landscapes [56
], symbolism between nature and the therapeutic alliance [12
], the other-than-human-world and the reflective process within the session [25
], and the impact of sharing external landscapes upon the therapeutic relationship [26
]. There is also support that the mechanism of change depends on the therapeutic modality of the therapist [23
This research builds upon Revell and McLeod’s [1
] account that the altered physicality and embodied relating between the client–practitioner/client–nature/mind–body can create opportunities for synchronicity, metaphors, and transitional experiences to emerge. There becomes a balance, whereby the practitioner must step back to let the client lead whilst containing the safety, focus, and depth of the session. The practitioner holds the process, noticing the client’s physical and verbal expression, transition between states, and interaction with surroundings. Further, the practitioner notes whether the client is affecting or affected by the environment and helps to explore the links between the internal and external, delicately managing the figure and ground. The figure and ground present “ambivalent and nuanced spaces [with] many shades of meanings… perceived as healthy and unhealthy at the same time” [57
] (p. 261). The natural world provides texture, context, and stimuli to explore the figure and ground through physical, cognitive, and emotional modes.
In a process of multi-sensory involvement, the therapist becomes part of the experience, moving between witness and companion within the client’s process. The therapist watches for drift from the presenting issue, aware of experiences which might become un-boundried or destabilize the process. As Baer and Gesler [58
] advocate, the therapeutic potential of environments changes over time and therapists must assess the validity of the landscape on the healing process. This was confirmed as participants explained the selection, evolution, and therapeutic use of sites.
This theme builds upon previous literature, which identified the positive effect on therapists’ personal psyche and ability to prevent burnout [1
]. The altered therapeutic relationship is examined in relation to the impact of experiencing the client; Revell and McLeod [1
] identify a process of bodily empathy, whereby therapists experience their clients more holistically. Whilst Revell and McLeod [1
] note a freer and less inhibited relationship that emerges, altering the dynamic as the client and therapist move from face-to-face to side-by-side, the findings suggest the therapist is not completely uninhibited and care-free and works alongside a complex process of providing an appropriate therapeutic relationship, maintaining flexible boundaries, and being able to separate and hold their own ‘stuff’ apart from the client.
Like Jordan and Marshal [24
], the study found the neutral space allows the therapist to be more real within a natural setting and provides deepened intimacy, although they caution that intimacy must be handled carefully. This offers an opportunity to experience the client in real time and witness the client’s disconnect, discomfort, and vulnerability. This can widen the gap between the client and therapist’s experience, allowing the therapist to work with the client through the issue or alter the therapeutic experience as necessary. Jordan and Marshall [24
] note the ability for the experience to provide immediacy for both the client and therapist. The findings support an altered therapeutic alliance and therapeutic role in terms of bringing more of themselves into the relationship and loosening their professional role [1
]. Berger and McLeod [12
] (pp. 87–88) identify the role of the therapist as “witness, container, and mediator” shifting in relation to the client’s engagement with nature. In this case, it appears the therapist can also become a ‘partner’ with the client, experiencing together. In many cases, participants detail processes which are adapted from indoor counselling. This appears to align with McMullan’s [27
] considerations that the alliance is removed from traditional rules of therapy, instead locating and obliging nature’s rules. However, as Harris [23
] warns, participants equally detail the ability for the alliance to become destabilized based on the client’s expectations of the therapist not being met or due to lacking boundaries.
4.1. Limitations and Reflexivity
The sample inclusion and exclusion parameters had specific demands of the research participants. Whilst these were upheld, an unexpected element was the scope of participants’ work and range of sessions, which presented within the post-session-reflective-recordings. Such diversity is echoed in Harris’s [23
] research, which underestimated the range and complexity of cases presented. The diversity of cases proved difficult to hold amongst one another. For example, holding group work amongst one-to-one therapy or overnight sessions amongst 50-minute sessions. An implication for future IPR research is to specify both participant and post-session-reflective-recording parameters.
In accordance with a phenomenological approach, this research explored the thing itself, applying IPR research methodology providing a reflective stance for the participant and researcher and generating practitioner knowledge. Each stage in the IPR procedure allowed a different layer of depth to be explored and highlighted different aspects of the lived-experience. Whilst it might be argued that the findings lack generalizability, this research questions the extent to which generalized findings would benefit the field of outdoor therapy and considers it critical to know more about specific practices.
An alternative view of the therapeutic alliance was encountered whereby the practitioner and client become partners and can reveal their authentic selves. The therapist is both a participant in the experience and holds responsibility for the therapeutic encounter. The relational dynamic appears complex and needs to be considered from the client’s perspective.
In addition to the many positive accounts of outdoor therapy, investigation needs to explore the experiences which drift from the therapeutic aim, distract from the goal, or destabilize the therapeutic process and the implications of such occurrences. In view of physical and emotional risk, and the reporting culture of the counselling and outdoor industries, further research might investigate the provision of support extended to lone-practitioners.