Therapeutic Factors in Nature-Based Therapies: Unraveling the Therapeutic Benefits of Integrating Nature in Psychotherapy

The psychological benefits of human connection to nature have instigated the development of nature-based therapies (NBTs). This article focuses on the distinct therapeutic factors that characterize NBTs, from the perspective of practitioners from various NBTs, shedding light on the therapeutic value of psychotherapy conducted in the natural environment. To gain a general understanding of the distinct therapeutic factors, currently lacking in the broad field of NBTs, grounded theory methodology was applied. Data included in-depth interviews conducted with 26 nature-based practitioners from five countries, with various professional backgrounds, and six field observations of multiday nature-based group interventions. The findings of this study illuminate four distinct and common therapeutic factors enhanced by the natural environment and linked to the beneficial effect of NBTs: (a) the natural environment, delineated as a unique growth-oriented setting fostering health and wholeness; (b) challenge, described as a therapeutic means by which limiting perceptions of self may expand; (c) the role of nature, perceived as actively influencing the therapeutic process; and (d) expansiveness and interconnectedness experienced through nature eliciting a broad perspective on life and sense of belonging. New perspectives are revealed regarding the first two therapeutic factors that have been discussed previously in the literature, and two factors that are new to the broad field of NBTs are revealed providing us with new understandings regarding the therapeutic value of integrating nature in psychotherapy. All four factors are discussed in the context of examples of practice in the field and their practical implications for mental health professionals. Clinical Impact Statement Question: This study asked what the distinct therapeutic factors or mechanisms of change are that practitioners of diverse types of nature-based therapy (NBT) describe as key in their work and which specific therapeutic effects the practitioners perceived to be associated with these factors. Findings: The understandings and examples presented explain how the natural environment is integrated in NBTs as a growth-oriented setting, reflecting healthy qualities in external form that evoke an internal attunement to change, vitality, and wholeness. Meaning: The boundless landscape and novel situations involved in nature provide clients in NBTs with various possibilities to gain a more expanded and interc