Our understanding of mental health is changing. As many work to end stigma, advocate for awareness, and change outdated language around mental health and recovery, modes of care are incorporating new pathways to health.

In conjunction with this evolution, the fields of mental health care and addiction treatment are evolving as we learn more about overall well-being and healing through holistic, integrative, somatic-based perspectives. The human experience, once compartmentalized in our understanding as a dichotomy of mind and body, is deepening. In addition, as our discourse and capacity expand, we explore new ways to approach health.

Mental Health is Health

The incorporation of awareness of our physical lives into the life of the mind is relatively new when it comes to mental health. Our understanding of psychotherapy is, even today, of two or a group sitting and talking. Media reiterates this trope time and again. On a basic socioeconomic level, the traditional 28-day model of rehabilitation is how many still contemplate treatment, but this approach is under scrutiny today, as clinicians and insurance companies debate efficacy and outcomes, and whether services are covered—or not.

But the field is expanding as clients experience powerful transformation off the couch. Nature, in particular, offers many opportunities to expand one’s field of consciousness, incorporate movement and exploration, cultivate situational awareness, and experience many other positive psychological benefits. The data show reflects these benefits, and studies show significant improvement in quality of life for individuals who participate in experiential therapy. The full spectrum of human experience is incorporated in the optimal functioning of healthier living.

Bottom line, there’s no one-size-fits-all approach. Furthermore, not everyone thrives in traditional modalities. Talk therapy can be tough for some. Additionally, there is an area of evolving study in experiential practices that can be highly beneficial for those seeking a different approach. These modalities include nature therapy, adventure therapy, art-based therapy, music therapy, horticultural therapy, somatic therapy, equine therapy, and many other non-traditional methods. Movement-based, sensory-integrated approaches can stimulate growth and initiate new neural pathways, release years of maladaptive coping mechanisms and trauma, stimulate new behavioral patterns, and dissolve self-destructive modes. This can be powerful work for the client.

Alternatives to Traditional Talk Therapy

Traditional talk therapy is often thought of as a seated dialogue. This approach may not be the easiest for everyone. Group sessions can be challenging as well. These reasons, among others, are part of why experiential approaches have grown in popularity over the last few decades. Studies show that experiential modalities in mental health treatment

Time in nature is a powerful intervention that not only ameliorates unhealthy patterns, but also creates lifelong, sustainable integration of healing behaviors, rituals, and patterns. Research demonstrates that adventure outdoors can be transformative and cathartic, extending far beyond our basic understanding of risk and exertion, reinstating a vital, organic connection to the contextual human experience, one that is in and of the natural world. For many, it’s the medicine.

Nature Therapy, Outside

“Personal transformation can be as subtle as the beauty we see in nature. When we experience the shift— together, in community—the capacity for growth expands exponentially. We share successes, “failures”, doubts, and excitement. What’s more, we start to understand that all of this is life, ups and downs. How beautiful is it that we get to color it with all of our experience? This is the canvas; this is the landscape for change. Outside.”—Nathan Bennick, National Field Director for Adventure Recovery

In the outdoors, we engage in active participation—we build self-esteem, unplug from daily stressors, and expand the therapeutic toolbox. Excursions provide open space and time to explore ideas, behaviors, and activities. We often thrive when we step away, remove ourselves from our daily patterns, and gain perspective. Many of us have struggled with how to do this “at home,” especially following inpatient care. The growing need for individuals and groups to learn and engage in dynamic experiences and habits requires holistic, transformative modalities. Nature-based practices foster lasting, real-time shifts.

“Time away from stressors and off the beaten path quiets the over-analytical mind and allows us to land in the moment. This situational awareness and expansion of capacity are simple yet life-altering, and we see it time and again in our clients. At first, they may be hesitant or afraid, saying they are not athletic or don’t like nature. But once they ease through the fear and take the first step, they begin to see their own capability in a much broader context. This is where an empowering process begins. It’s a healing experience to take people outside, especially the hesitant, because once the transformation starts to happen, there’s no turning back.”—Tim Walsh, founder and CEO of AR.

Immersive experiences in the outdoors give clinical approaches an edge, as clients are removed from potential stressors such as access to substances, smartphones, computers, and specific people, places, and things. Consequently, the complementary nature of nature yields significant rewards and can enable a client to learn, integrate, and adopt new patterns more quickly and holistically.

The Outdoor Outpatient Experience

Outdoor outpatient through nature therapy consists of skillful, life-affirming, intentional activities outdoors, facilitated by seasoned, credentialed experts. This is not just about joining some folks in recovery for a hike. A greater context is created through pre-activity discussion, mid-adventure awareness, and debriefs that speak specifically to the individual or group. Furthermore, the relationship occurs in a continuum so experiences can be referenced and on, which is powerful for those seeking a shift. It is not about simply learning to kayak, surf, or snowboard. The work of outdoor outpatient is a mental health informed approach, accessing cathartic teachings to reach deeper self-actualization. It takes professionals, with training and real-time experience to know how to access, utilize, and leverage natural settings for personal development and achievement.

What is Outdoor Outpatient?

We know that environment and habit impact us greatly. Where we spend our time, who we spend it with, and how we fill our days can determine our mental and physical well-being. There are some basic elements that go into a healthy lifestyle. Exercise, rest, connection, self-care, challenging ourselves, asking for help—all these areas are part of our well-being. We know that exercise is vital for our health, both physical and mental. In addition, relationships play a significant role and research shows that when we feel a sense of community and purpose, we tend to bounce back from setbacks, with deeper resilience and emotional stability overall.

Traditionally, outpatient is defined as healthcare services provided on an outpatient basis, receiving structured support while still engaging in your day-to-day life. This type of care can be appealing because one is able to heal in the context of daily living, in one’s natural habitat. Not everyone wants to admit to inpatient treatment and this style of care allows us to harmonize more in day-to-day connection.

Why Nature Therapy?

*An AR Guide sharing a moment with a client, outside*

Nature therapy can be defined quite simply as therapy performed outdoors, but there are nuances to the different ways clinicians and organizations engage in this work. Time in nature has many positive benefits and serves as a perfect backdrop to learn, adapt, and apply new behaviors. The research shows that the outdoors has a favorable impact on mood and disposition, brain function and cognition, and boosts our immunity. In addition, there are multiple evidence-based reasons cited in scientific studies as to why nature and adventure serve mental health. Adventure in nature can be utilized as a prevention tool for dangerous high-risk behaviors, and studies show greenspaces can positively affect substance use disorder. Some factors contribute to the outcomes including diminished stress, greater capacity for healthy relationship building and self-awareness. These factors are significant when it comes to addiction and mental health care.

When we move our bodies intentionally in natural settings, we initiate multiple avenues of well-being. Exercise invigorates and releases happy hormones, which benefit physiology and psychology. What’s more, the immune system is influenced, as recent studies show. The evidence is clear that when regularly immersed in activities outside, immunity is strengthened, mood is improved, and our general disposition is uplifted. We feel better, period. Furthermore, the results for mental health support increase with coaching and peer support. Together, we learn new tools, challenge ourselves and one another, and develop healthy capacity and self-efficacy. We build confidence and community simultaneously. This is powerful and appealing for many since learning adventure skills ensures consistent and sustainable results that one can apply daily in their own lives. To reap the benefits, we must develop new habits and skills and exploring outdoors is the perfect way to cultivate a healthy body and a healthy mind. Adventure is a mindset—a way of life. And, the bottom line is, it works. We see it time and again. Movement, connection, growth.

Adventure as a Way of Life

Outdoor therapy can have a powerful effect on mental health and substance use disorder clients. There are challenges to being removed from daily life for treatment to consider, especially upon re-entry. When we are trying to learn new, healthful habits it can feel easy to apply when we’re in a new place. But, applying the positive patterns in the same environment where we developed toxic, destructive behaviors is a whole other story. What happens when we return home from a residential treatment program, and we’re faced with the same stressors that existed before we went into treatment? And how do we maintain the positive habits we acquired while in the treatment environment? These are the important questions we set out to answer.

Many of us have experienced this firsthand. We went away to treatment and upon returning home, we lose momentum, fall into old patterns, or fall off the path. Perhaps we’re triggered or we are influenced by unhealthy peers or family members. We may end up back in an abusive situation or feel unable to change. Or we may not feel confident to face the world or engage in activities outside. So, what do we need? Support, guidance, connection—these are all key. And, for many of us, sitting in a group setting helps, but we need more—we need to move our bodies, breathe fresh air, create new patterns.

Nature Therapy as an Intervention

Time outside is an impactful intervention, and the goal is to learn how to apply an adventure mindset to our daily lives. Immersive time outdoors is a huge part of our lives and our habit patterns. It informs our perspective. What’s more, to sustain the healing power of the tools we cultivate outside; we must be consistent. When we learn new ways to care for ourselves, develop relationships with like-minded individuals, and feel motivated each day, it is far easier to create lasting change. This is how we find healing—in the ongoing community striving towards the same goals. At the end of the day, it’s the joy we experience outside, together, that keeps us coming back.

Hence, outdoor outpatient helps others understand the work we do. Traditional outpatient offers structured time in a clinic or facility, often including one-on-one therapy and group activities to help a client feel connected and continue on the recovery path with a continuum of support. These programs tend to be primarily clinical, and often insurance driven, which can influence the modalities and length of care. Some outpatient services also use experiential therapies but to comply with the rigor of medical, insurance-based models, programming is usually with licensed clinicians, typically indoors. This can limit the opportunity for real-time integration and real-life application.

Outdoor Outpatient: The Adventure Model

Research shows that adventure complements mental health therapy and is a therapeutic path used by many. What makes adventure unique is that the therapeutic space is outdoors, in nature, offering robust opportunities to engage. One client may need an expedition for extended days, another may want to meet with a guide or mentor once a week for a few months to build on skills and develop accountability and camaraderie.

Many highly skilled therapists are trauma-informed, somatically literate, and versed in progressive approaches. Furthermore, clinical behavioral treatment can be a vital component of mental healthcare and habit modification. The rubber hitting the road is when we learn to apply what we have learned in real life, alongside peers, building connections internally and externally. This is a core component of the adventure model.

Adventure-based skill-focused activities, such as rock climbing or whitewater river sports, help clients to be in the present moment while navigating physical and emotional endeavors in real time. In addition, they learn to trust others and access vulnerable feelings that may be easy to suppress in a more traditional talk therapy model. Adventure can enhance one’s emotional access, allowing for transformational experiences that generate healing. This occurs as shifts in behavior are applied in real time. Consequently, a holistic approach boosts our overall wellness, providing therapeutic modalities the space to integrate into our consciousness in subtle ways.

Outdoor adventure brings us into our bodies, to inhabit the skin we’re in. Also, interpersonal skills development accelerates efficacy and self-actualization. For many of us, development is stunted at a younger age—typically during adolescence—due to substance use or trauma, so we need opportunities to grow and evolve on multiple levels. Healing is often found in nature, which generates space for transformation.

Outdoor Therapy and the Continuum of Care

“As a field guide, I was one of the lucky ones to witness the "a-ha" moments. Individuals would reach out to me months and, sometimes, years later to check in. I have often heard the common theme of things going really well for a while after discharge, and then similar patterns emerging. It can be a painful experience to go through such a drastic change and not be able to keep that momentum going. I always try to remind them of the same thing: Nature goes through seasons of change. Some of them are filled with immense beauty and emergence when we enjoy the beauty of the bloom. Then, we go back to periods of shedding and quiet reflection. The key is that we show up consistently to get to know all of these parts of our journey. What I love about what we do now is, the continuum is there. Instant connection to our crew ensures that individuals apply what they learn in real life and sustain the growth. This is so powerful to witness.”—Nathan Bennick, National Field Director, Adventure Recovery

Healing is a personal experience and traverses many paths. What we know for sure is that outdoor experiences are impactful and translate directly to our mental health and well-being. What we also know for sure is that one of the most important components of healthy living is developing and sustaining behavior patterns that promote positivity, connection, and wellness. We find all of this, and more, outside.

The AR team consists of licensed clinicians, advising seasoned psychotherapists, professional outdoor guides, and adventure instructors who have years of experience in clinical and experiential settings as well as working with treatment teams. The crew includes AR consulting clinical director, Peter Lazar, LCSW, and Nate Bennick, national field director at Adventure Recovery, who has direct experience in traditional wilderness therapy models, having served as milieu coordinator and field guide. Josh Flaherty, LCSW, serves as our dxecutive director and is in the process of acquiring his clinical license, offering distinctive mental health support in natural environments. Our field manager, Seth Gottlieb, serves as an expert in adolescent and young adult mental health, having worked in clinical care settings and as a guide for families navigating mental health concerns and substance use disorder. In addition, our founder, has 30+ years serving populations in need of acute and sub-acute intervention, providing experiential programming for individuals, families, and treatment centers across the US.

We are familiar with the practice of outdoor therapy, and we sought to create something distinctive and complementary, but broader in offering and targeted to those in need. If you or someone you love needs deeper support, we are here to help.