As with any human service endeavor, ethics are of the upmost importance. To us, an ethical practice is vital to maintain safety for our clients and integrity for our profession. This chapter explores how ethics are considered relative to nature-based therapy practice and frameworks, as others before us have already explored.1 Ultimately, we are dealing with the reality of a therapeutic practice “out of the office.”
The word ethics originates from the ancient Greek ethos, meaning character, or moral nature. An expression of one’s ethics shows up in their behaviors, attitudes, and beliefs. These manifestations then demonstrate one’s character or customs. It is how you are seen and judged societally in your context. We can adopt an ethical stance (i.e., principles), and we can be guided by ethical rules (i.e., codes), to deal with ethical issues.
First, our ethical stance is comprised of values we hold dearly. These values would supersede decisions or actions taken in practice if they were compromised. An example for us is how we uphold an ethical stance on relational-centering in serving our clients. We place the value of relationships, in building and maintaining them, as central to our work regardless of circumstances, expressed best by activist, therapist, and counselor educator Vicki Reynolds:
I have worked alongside diverse therapists and community workers who use a wide range of therapeutic and community work approaches. There are many paths to liberation and no theory or practice is harm-free. The quest is not to find the perfect intervention, but to examine our ethical positioning and hold our practice to enacting these ethics. This requires that clients are centered and that we are effective in creating relationships of dignity and respect across the chasms of difference and privilege that divide us.2
Reynolds speaks to the efforts necessary to achieve this ethical stance, which include socially locating oneself, developing a collective ethic among co-workers, establishing structures to support a safe-enough space, holding clients at the heart of supervision, maintaining accountability for one’s own transgressions, and supporting a culture of critique. She reminds us that ethics are a fluid process, not static entities, and that we need to be attuned to the immediate needs and circumstances of our clients versus getting hung up on deciding whether things are right and wrong. In this regard, your ethical stance may come up against a “do not” ethical rule. The following example may help illustrate this.
A 15-year-old male living in government care was struggling with relationships with the adults in his life as they claimed he was not trustworthy or willing to follow the rules of his current group home. The idea that he would get to go outdoor rock climbing as part of counseling piqued this young adventure seeker’s interest. After completing a couple of climbs, he asked if I (Dave) wanted to climb. Because there was no one else present to manage the rope, the options were to either decline his offer or teach him how and place my trust in him. Traditional codes of ethics may see this situation in a black-and-white manner. The relationship was not adequately established to discern if there was any potential risk for harm should the experience not go well—say, if he didn’t follow the rules and therefore had to be given consequences so early on in the therapeutic process. At the same time, there was an intuitive understanding that he really wanted to be given authentic responsibility and be trusted in a meaningful way. A quick assessment of the situation confirmed that I was able to ensure my own safety (the route was well within my skill level, and I could grab the belay rope to prevent a fall if necessary), and I accepted the invitation to climb. The youth rose to the challenge, received positive feedback regarding his technique, and the situation ended up being a major contributing factor in developing our therapeutic relationship.
Other examples of our collective ethical stance in nature-based therapy are inclusion and acceptance of diverse ways of being and knowing in the world; decentering the counselor and instead acknowledging clients as experts of their own lives and problems; recognition that children and nature have value in their own right, not for what they will become or their potential future use; and the importance of authenticity and creating an open culture of feedback.
Now, what about ethical dilemmas? When do you know you are in one? And what can you do to address the dilemmas you find yourself in? How can codes help? In general, your ethical stance is much broader than any set of rules. Ethical rules, as set out by professions in a code, are generally aimed at protecting clients from unethical practitioner behavior. They provide guidance to practitioners, can enhance a professional status (in that a code is being adhered to), and can provide the professional association with the ability to hold practitioners to account for inappropriate behaviors or actions. So, you have training and qualification as a practitioner, and you have a professional association with practice guidelines and a code of ethics. Human service work can be messy and complicated and will eventually produce scenarios in which you will be forced to make decisions when you are unsure which course of action is correct. That is the litmus test right there, to know if you are actually in an ethical dilemma. If you have more than one option to resolve a situation and no option fits nicely into ethical practice, you have a dilemma. If any one option is acceptable within your code of practice ethics, you do not have a dilemma. The notion of ethical dilemmas is actually quite often overused and misused. One simple example of an ethical dilemma in nature-based therapy involves the practice of gift giving. It is common to make things from natural materials when engaged in outdoor practice, and at some point, you will find your client’s hand stretching over toward you holding something they just made (e.g., a natural cordage bracelet, a woven basket, or a carved stick). In this case, it may be their first time or something they have done numerous times, and they want to gift it away. The dilemma is that you want to honor your relationship, and declining the gift may be taken as a personal rejection and weaken the relationship. However, being in a professional relationship also means maintaining and role-modeling healthy boundaries, so the decision as to what to do is not clear and involves careful consideration.
Of course, context is critical in this regard, since it can vary. In the realm of therapy, specifically in North America, ethics have been moved from being individual expressions into administered and enforced rules set by professional associations, colleges, and regulatory bodies. They manifest in codes of conduct and standards of practice, and most of you reading this book will likely be able to identify by which “ethics” you are held responsible. It is important, however, to not confuse ethical practice—and codes of practice—for ethics, in the manner which we describe our ethical stance above. For the purposes of this chapter, we will be sharing examples and perspectives closely aligned with two specific bodies of oversight: the British Columbia Association of Clinical Counselors (BCACC) for registered clinical counselors and the Council of Canadian Child and Youth Care Associations (CCCYCA) for our child and family support workers. You and your organizations will have titles and professions in alignment relative to your context. Associations set and maintain codes of ethics upon which practice is guided. Our practice includes counselors and child and family support workers, and while often working in collaboration, both roles carry some distinct responsibilities as defined by the scope of practice set out by the respective associations. While these associations are aligned with our work, it is incumbent upon you as practitioners to ensure ethical practice relative to your specific organization, scope, mandate, and client needs.
We must also remind our readers that ethical codes generally are protecting those we serve from harm due to unethical practice. So, in turn, ethical codes are not indicative or expressive of best practices but tend rather to include scripts of ideal practice philosophies and the necessary list of “do nots.” United Kingdom sociology and social policy lecturer Sarah Banks3 reminds us to not take codes of ethics too literally; she points out that some have gone so far as to call them rhetorical and regulatory devices, rather than guides to help us deal with our ethical dilemmas. This chapter is framed by four central principles found in the ethical codes of practice set by many counseling and psychological service colleges and associations, in this case, the BCACC:
• Principle I: Respect for the Dignity of All Persons and Peoples
• Principle II: Responsible Caring
• Principle III: Integrity in Relationships
• Principle IV: Responsibility to Society
Each of these principles will be explored relative to nature-based therapy practice, yet not all codes will be addressed. We will include examples where we can to accentuate our practice interpretations of the ethical codes, as they may differ from conventional indoor practices. It is recognized that each reader may be governed by a particular professional code of ethics, operating standards of practice set out by your organization’s policy, and/or other qualification practice guidelines. The exercise of really thinking through your practices relative to your professional association or college principles is critical. In short, if your qualifications do not connect you to an ethical framework, then you should consider finding one to guide your decision-making and practice.
Free and informed consent is truly at the heart of any therapeutic practice. We are very clear about working with those who choose freely to “walk” with us. Even this small narrative shift from working with clients to walking with them suggests an “alongside” approach in their journey to well-being. So, what about when parents force their children to attend? Not an uncommon reality, especially with families in crisis and parents seeing few to no options as to where their child may engage. If you have not picked up on this already, nature-based therapy tends to attract children and youth who typically are not interested in conventional talk therapy.
We acknowledge and accept that parental coercion exists and is a common factor influencing client engagement. Ideally, therapeutic relationships are between a client and counselor who both are choosing to engage in service. Is that the norm with children, youth, and families? No, not always. In our experience, most young people experiencing challenges would rather avoid the perceived discomfort of addressing what is going on than confront it head on, especially with someone they do not know. Distraction via screens, spending time with friends, or playing sports helps them to get a break from having to think about their problems and makes sense as a coping strategy. Furthermore, being told by their parents that they need to see someone can contribute to stories of themselves as “the bad kid” or suggest that something is wrong with them. For many, it’s hard enough having a parent constantly upset with their choices, and to now be told they must go see someone can feel like further punishment. A strategy we often take is to inform clients that problems neither arise, nor are they located, inside individuals but rather are relational in nature and therefore need to be addressed in such an ecological manner. We ask questions that help to conceptualize the current challenge relationally, such as, How has your relationship been with your family members lately? and If the problems arising in your family were to shift, how would this impact your relationships with one another?
Another consideration regarding informed consent is the reality that distinctions between formal therapeutic conversations and social time can become highly blurred in outdoor settings and may contribute to counselors feeling less bound by ethical and legal aspects of ongoing informed consent, confidentiality, and boundaries. It has been recommended that therapists take appropriate measures to ensure clarity with clients regarding what the outdoor experience entails, including the therapeutic elements.4 Often, a whole session may be dedicated to discussing the outdoor excursion, followed by the creation of an informed consent contract. Furthermore, Stephen Becker,5 a pediatric psychologist based in Cincinnati, Ohio, stresses the critical importance of discussing boundaries with clients and co-facilitators prior to any wilderness excursion, as the context is so different from traditional settings, and notes that while on expeditions, being continually mindful of both professional and personal boundaries is vital to ensure preventing harm to individuals and groups.
Counselors have a responsibility to honor clients’ autonomy and provide sufficient information such that a competent client can freely decide if they wish to comply with the therapists’ recommendations for counseling. Recognizing that nature-based counseling is not your standard therapeutic fare, achieving informed consent requires thoroughness, creativity, and a tenacious spirit to prevent subtly coercing clients to sign up for activities they are not entirely comfortable with. Remember that informed consent is not an event but a process that will encourage continued dialogue with clients as they navigate the novel terrain of an outdoor counseling experience (Shultz, et al., 2007).6
Taking informed consent one step further, and following suggestions from Michael Cohen in his book Reconnecting with Nature,7 we encourage asking permission of nature for our presence and activities. We may seek permission or guidance for harvesting materials, and we express gratitude, thankfulness, and love for supporting us and our clients. To animate nature as co-therapist can be a powerful project between client, counselor, and nature, and one in which bonds are made and commitments of care can be established.
Privacy and confidentiality are considered another cornerstone for creating safe and trusting counseling relationships, and as such, it is recommended to discuss this before establishing the counseling relationship. British ecotherapists Martin Jordan and Hayley Marshall8 provided essential considerations for ethically taking therapy outdoors. They reminded their readers of the historically important role the therapeutic frame has played in establishing the ground rules that govern the therapeutic process. They suggest that conducting therapy outside of the contained and predictable four walls of an office may be considered a transgression of traditional boundaries, bringing up issues regarding confidentiality, timing of therapeutic work, weather, containment, and power dynamics, and it therefore requires additional considerations. They suggest that “the frame represents a way of understanding the relationships and spaces that become therapeutic, and in this sense, can be reconstructed in a more fluid and dynamic way in the outdoors.”9 As mentioned above, their paper supports the importance of adequately contracting with clients before heading outside, as much as possible, so there are agreements about possible scenarios, such as what will happen if they run into people, when the therapeutic work will commence (right from the parking lot or at a destination), what weather factors would warrant a change of plans, and how the sessions will unfold (who leads the way and how to navigate moving in and out of therapeutic conversations). Moving from the counselor-controlled office to outdoor environments where the space is not owned or controlled by either party creates a flattening of power relations as well as an increased sense of mutuality, which can lead naturally to feelings of informality, friendship, and increased sense of involvement in the client’s life. Knowing that there will always be an element of unpredictability inherent in outdoor work, they optimistically suggest that “the therapist, through use of an attentive, inquiring, contracting process can help to hold the client at the edge of their experience in a way that may be uncomfortable but will not become overwhelming.”10
Nature-based therapy includes the natural environment as an active participant in the therapeutic process. For this reason, we extend our practice of respecting the dignity of all persons and peoples to also include all places. In communicating with clients, we include language that shows respect for the traditional unceded Indigenous lands where we have the great honor and privilege to be working. Further, we recognize the limitations of tokenized land acknowledgements and instead endeavor to first build authentic and generous relationships with both the land and the First Peoples ourselves. We visit, listen, and learn about the nearby nature forests, beaches, mountains, and established parks. We learn the history of the Indigenous communities who either once met or continue to meet in these places for harvesting and ceremony, or how original names have been anglicized or ignored, and we try our best to assist in reclaiming first names of places. We strive to educate ourselves on the impacts of settler colonialism for the local nations as well as their ongoing historical resistance.
Regarding original place names, one local example in Victoria, British Columbia, is the Anglo-settler name of a local height of land called Mount Douglas (by our sea-level standards at an oxygen-depleting altitude of 738 feet). This summit is called Pkols by the First Nations of the local region, the WSÁNEĆ and Lekwungen, and holds significant cultural, spiritual, and historical meaning. Included in the history of this peak is the colonial legacy of Captain James Douglas whom the peak was named after. Accessing these storied landscapes allows for conversations about how people treat each other and the land. The legitimacy of land “ownership” in our region is tenuous, and litigation continues to this day. This example highlights our efforts to bring stories of the land, and of its First Peoples, into our visitation of these places. The lived embodied experience of nature-based therapy is here met with a cognitive understanding of place, which further develops our own and our clients’ ecological stories.
In light of the considerations raised by ecopsychology and the growing body of research examining the health benefits of contact with nature, the position that therapists take regarding human–nature relations and its application can be considered important variables influencing therapeutic outcomes. Thus, counselors who ignore human–nature relations and the potential therapeutic benefits of nature could be failing to tap into a valuable healing relationship and perhaps may even be colluding with the problems their clients are seeking solace from. Could it be that therapists working with people struggling with ADHD and not considering the informative research regarding the restorative effects of time in nature are neglecting a potent treatment option? Or what about work with inner-city youth that fails to acknowledge the repercussions of a complete lack of contact with nature, despite compelling research linking time in nature as a critical factor in healthy emotional, cognitive, and spiritual development of young people? Finally, what about those clients who are struggling with depression, anxiety, and/or substance use, yet to whom no acknowledgment or mention is made of the potential contribution that destructive human–nature relations may be having in the manifestation of their symptoms? The point is not to insist that ecotherapies should be mandatory for every client. Rather, it is to raise the question: What are the consequences if counselors fail to acknowledge the insights from ecopsychology and assess for its appropriate application?
In order to honor the moral principles of beneficence and nonmaleficence, nature-based counselors are obligated to ensure that the treatment options they present are relatively safe and that a sense of their effectiveness can be communicated. Thus, how one determines the efficacy of their approaches is an important ethical issue.
Clinicians working within government or managed-care settings are well aware of the importance placed on empirically (or evidence-) based treatments (EBT). Due to a lack of randomized controlled studies, nature-based modalities do not fall within these treatment options, nor are they likely to any time soon. Some argue that this needs to occur if the field is to be taken seriously by professional organizations, whereas others fear that doing so would threaten the very foundations of the field. However, nature-based therapy approaches can be considered evidence-informed practices as most variations draw on a large body of existing research.11
Practice-informed evidence is another perspective that has emerged and has promising potential with regard to answering the previous question. The work of American psychologist Scott Miller and his colleagues12 has contributed enormously to an understanding of the factors accounting for successful outcomes during therapy. Their research on the factors influencing therapeutic change indicates that models and techniques only account for 15 percent, whereas client–therapist relationship (30 percent), client/extratherapeutic (40 percent), and placebo/hope/expectancy (15 percent) account for the remainder. These findings shift attention away from models and techniques (typically the independent variables in EBT) and toward the remaining factors. Of particular importance to this discussion is the client–therapist relationship, or alliance, as this is a factor of great importance for nature-based counseling. Research repeatedly suggests that the client–therapist alliance is enhanced in outdoor contexts and, as discussed earlier, brings with it added ethical challenges. However, if the therapeutic relationship accounts for 30 percent of change outcomes, it certainly is an important factor.
Another intriguing aspect regarding therapeutic alliances for nature-based counseling is the introduction of another player, nature. As detailed throughout this book, nature is not just a backdrop but instead a central player in the change process of nature-based counseling; consideration for this point raises further questions regarding how the therapeutic relationship is regarded during a nature-based counseling experience. Clearly client–therapist dualisms fall from the wayside. Consider a quote from the Therapeutic Adventure Professional Group’s (TAPG) best practices website: “Attention to the physical space is imperative—a client who is hot, cold, or wet may struggle to engage effectively” (np.).13 Addressing this point from an ecopsychological perspective would be to state that not only would the client be uncomfortable but their relationship with a crucial co-facilitator could be in jeopardy.
Recognizing the importance and uniqueness of client–therapist–nature relationships brings forth numerous questions regarding their influence on therapeutic results. In the interest of respecting the integrity of clients and promoting their welfare, are counselors responsible for ensuring that positive relational bonds are made with nature during therapy? How exactly would this be done? How would therapists intervene if necessary? These questions raise issues pertaining to the competency of the therapist.
Due to the number of outdoor therapy variations, issues pertaining to competence are especially relevant as, in addition to traditional training, practitioners may be required to have training in other areas. Calls for dual-trained practitioners, where clinicians are required to possess outdoor skills, experience in nature-connection practices, in addition to their counseling training, have been suggested as preferable methods for addressing competency in outdoor therapy programs.
There is little doubt that, in order to practice ethically, nature-based therapists must ensure they are adequately educated on ecotherapy and ecopsychology theory and techniques for facilitating experiential nature-based activities prior to leaving the comfortable confines of their offices. Conversely, seeking out partnerships with other service providers who have the desired skill sets and resources may be another appropriate action, despite the additional ethical concerns it raises (e.g., confidentiality).
There are very few accredited degree programs at the master’s or doctoral level in North America that directly train counselors in nature-based therapy approaches. Nature-based therapists wishing to meet ethical standards for boundaries to competence need to receive formal training in counseling, or an allied helping profession, and then supplement that with training in their desired ecotherapy specialty—including continuing education certificates, specialized workshops and intensives offered by mentors, and personal reading and inquiry. John Scull,14 a retired psychologist living on Vancouver Island, BC, recommends that therapists wishing to move their practice outdoors ensure they have done some of their own work with experienced ecopsychologists before commencing their client work. The TAPG code of ethics states that “in those areas where generally recognized standards for preparatory training do not yet exist, professionals take reasonable steps to ensure the competence of their work and to promote the welfare of participants.”15 Training specifically in ecotherapy is challenging as, without any representing professional associations, there really is no cohesiveness or agreement regarding what exactly ecotherapy encompasses. This is a matter of professional identity, which is known to be an important aspect for any successful movement toward public protection, public recognition, and licensure.16
Finally, with no national or international established set of competencies and few clear routes for training, the possibility for adequate supervision and consultation becomes an important ethical concern. Recognizing that many ethical dilemmas arise when practitioners work in isolation, it is imperative that nature-based counselors seek out allied professionals who have a reasonable level of knowledge and skill in their area and arrange for supervision or consultations when doubts or uncertainties arise during their work. A key question remains: By what standards does someone qualify as a competent professional? If there is no consensus regarding training and best practices within the field, then what standards should determine suitable candidates for supervisors? These questions will continue to raise concerns due to the complexity involved in establishing a professional identity.
Aspire to the highest integrity possible and accept responsibility for the consequences of our actions. Leaving the confines of the office clearly adds elements of risk, compared with standard indoor therapeutic exchanges. The unpredictability and wildness of nature is considered by many to be a core aspect of ecotherapy.17 Expanding on this topic, the founder of the Nature-Therapy Center in Israel, Ronen Berger, states, “[Nature therapy] takes place outdoors, in nature, in a place that does not necessarily have human-made boundaries, is open to the world’s influences, and is not owned by the therapist.”18 He recommends that clinicians assess for populations who “have a need for clear boundaries, hierarchy, and a high level of control”19 and make the necessary adjustments to their activities and location to ensure client safety.
Although most nature-based therapies do not focus on the facilitation of risk and challenges in the same way that adventure therapy does, potential for physical, psychological, and emotional harm still exits. For example, many outdoor therapists utilize fire, a source of life and sustenance. Robert Greenway, one of the first contributing authors to the field of ecopsychology, coined the term the wilderness effect to describe the psycho-spiritual shifts that occur when engaged in wilderness travel and activities. He explains that “a group sitting around a fire often prompts someone to remark, ‘we’ve been here before.’ The archetypal setting links us to earlier cultures, earlier times, and the very essence of life.”20 Although sitting around a fire is mesmerizing and full of healing potential, the fact remains that fire can be extremely dangerous and must be interacted with respectfully.
Using fire, encounters with wild animals, and walking within forested trails are examples of nearby nature-based activities that inherently contain elements of risk. Clinicians are caught in a balancing act, where promoting client beneficence comes into conflict with responsibilities to do no harm. Managing these risks becomes an important responsibility for nature-based therapists, and steps must be taken to become aware of potential risks and adequately prepare for them. One effective strategy in dealing with risk associated with nature-based therapies involves establishing risk management plans, although it has been pointed out that much of this debate may be about managing liability versus promoting safety.21 In evaluating risk in wilderness therapy, Russell and Harper encouraged programs to “examine and identify what risks they are managing, implement the policies and procedures needed to reduce risks, then write and implement risk management plans.”22 These same strategies can be employed by therapists to effectively deal with risk in planned and efficient ways and may be guided through the process of accreditation or adhering to standards set out by recognized professional associations. Client agency and the notion of “choice,” especially related to the element of “challenge by choice” in practice, should be further explored by those interested in nature-based therapy.23 Reading critically on this topic is worth the investment for practitioners who want to better understand what it means to work experientially, and ethically, with clients in meaningfully balancing challenge and support.
Another aspect warranting attention is the experiential nature of ecotherapy. Clients may find themselves moving too quickly or encountering experiences in the environment that are psychologically or emotionally harmful. Ronen Berger24 commented on this topic by recounting a situation where a client heard the unexpected sounds of a military training drill while working outside the hospital she had been admitted to for PTSD symptoms. The unexpected noise began to trigger memories from her own war experiences, igniting a vicious downward spiral. This story brings attention to the dangers of not being aware of the different ways the environment can adversely influence clients. In addition, simply participating in experiential activities can cause some clients to venture into uncomfortable and potentially harmful psychological and emotional places. Considering psychological depth, adventure therapy theorist and practitioner Michael Gass explains how “[experiential] activities can be too powerful a therapeutic intervention for some [clients] since activities may raise certain issues too quickly in therapy.”25
In response, Ringer and Gillis26 suggest that psychological goals should be established prior to ecotherapeutic activities and that staying on track with these goals is the therapist’s responsibility. Further, they explain that honoring clients’ rights for autonomy include “maintaining the psychological depth above or at the level of contracted agreement (explicit or implied).”27 This may involve consistently checking in with clients and ensuring that options for stepping back and watching or withdrawing from any activities are established beforehand. Similarly, the TAPG considers “challenge by choice” a critical element of best practice, which involves promoting the client’s right of always having a choice to participate in any aspect of the therapeutic process.28
Committing to truthfulness and accuracy in communications is an essential component of professional therapeutic practice. Most one-to-one nature-based counseling occurs in isolation from other practitioners (trees, birds, and squirrels do not count in this case), therefore the need for personal integrity and a culture of openness regarding reporting to supervision and owning mistakes is critical for ethical practice. When working with vulnerable children and youth, the risk of allegations becomes a real possibility, and thus practitioners must be highly aware of client needs, practice ethically, and make sure to not put oneself in a position where a false accusation may be made and cannot be defended. A way to navigate this risk is to start sessions either in the office or at more public locations and, even better, to include the parent in sessions, especially at the beginning. As a general rule, we encourage working in teams, at the least in pairs, when possible. Consideration and care must be taken into account for biological needs because a sudden call to the washroom when it is just two of you in the forest is not an ideal situation. Additionally, experiential activities and challenges requiring maintaining physical safety (scrambling up some rocks, crossing a fallen tree, etc.) may necessitate more physical contact than office-based sessions; again, avoiding the element of surprise is key, and instead, discussing these scenarios prior to their occurrence is recommended.
Avoiding dual relationships. Nature-based therapy occurs, as we have described, in settings and through activities that may cloud the lines between when therapy is occurring and when it is not. In this reality, a client may be in a social setting with the counselor—say, while setting up an activity for a group of youth to take part in or playing a game while waiting for a parent to pick them up—and not consider this part of the therapy. In this case, is the counselor something other than therapist? As emphasized above, continually reminding oneself of the responsibility to maintain high levels of professionalism needs to be adhered to despite the informal feel of some aspects of the work. It is recommended that “information that is irrelevant to either the client or group’s treatment goals, progress, or safety should not be shared, and relevant information should be discussed in a professional manner at all times.”29
Another potential dilemma regarding dual relationships is that there is currently a limited number of nature-based counselors available to offer these services, resulting in situations where clients who would normally be referred to another practitioner may have nowhere else to go. Examples in our practice have included siblings or another family member deciding to also seek out services after seeing the positive impacts firsthand or a personal friend wanting to refer their child for nature-based services. Deciding on a course of action requires addressing each situation as it arises and also remembering to revisit one’s ethical stances in making such decisions.
Challenging self and others to be personally accountable to the values and ethical principles of the profession and a commitment to continuous improvement. Therapists, on average, get worse over time. This was the conclusion of a recent and quite robust study of 170 therapists and their combined 6,500 clients.30 How can this be the case? These researchers suggest it may be due to a lack of integrated learning and development from ongoing evaluation. While not groundbreaking news, investing in deliberate practice, including seeking and working with feedback, was the key element linked to improvement in therapeutic practice.31 Some therapists adopt the principle of continuous improvement more than others. An American colleague, Will Dobud, who runs an adventure and wilderness therapy practice in Australia, provides some insight into his efforts to improve his practice.
In 2012 I moved to Australia and opened a small private practice in Adelaide, South Australia, and began offering regular counseling sessions and 14-day expeditions for at-risk youth. I was rigorous in how I evaluated our programs and each of our treatment effectiveness. As we gathered data, we started to uncover a trend. Some of us were more effective outside the office than in, and some vice versa. The data indicated I’m a better therapist in the outdoors and that I needed to become a better “couch therapist.” By routinely monitoring my outcomes, I found that clients I worked with in the canoe, on a climbing wall, or mountain bike were more engaged, reported greater improvement of well-being, and actually began booking their own sessions. We also found that some of our other therapists were the opposite; their outcomes were better in the office. We have used this data to focus our training and supervision in an effort to improve in areas we need to improve in.32
Dobud suggests that implementing solution-focused assumptions and following outcome and alliance data can drastically change programming and improve outcomes in therapeutic settings, as privilege is placed on the client’s voice and choice. He provides a model of practice demonstrating a strong ethical commitment to continuous improvement for himself and his staff team. His work highlights the importance of creating rigorous self- and program evaluations and not making assumptions about the effectiveness of our work. Further, by collecting practice-based feedback and bringing it to group supervision, nature-based counselors can learn about elements of practice that are working and identify areas for continued growth.
Respect for peoples revisited: Demonstrate respect for the diversity of persons, peoples, and cultures. Historically, nature-based recreation and nature appreciation activities have been criticized in North America for serving primarily a privileged homogenous white population. Much of our suggested “nearby nature” equates to managed natural areas, including municipal through to national parks. While the critique often relates to the design and development of parks, and a particular academic research paradigm of leisure and recreation describing the use of said parks, the picture remains fairly consistent today: those accessing outdoor spaces and outdoor activities are less diverse than the populations living in the region around the park. That said, the human service field we work in is often not representative of the local population by any measures of diversity either. So, is nature-based therapy falling into the same pattern as parks use? And if so, why? And what can we do to responsibly address questions of diversity in our practice?
The etymology of the word park, from Old English, is that of a paddock or enclosed space, much like a forest isn’t! That enclosure traditionally denoted inclusion and exclusion from use of the space. In this regard, and in our Western Eurocentric realities in North America, parks were in fact developed from a protectionist standpoint, and while not explicitly exclusionary in their promotion, many have become so. Park planners and many leisure researchers have argued that parks hold deterministic values, in that if properly attended, parks can improve lives, uplift spirits, and make for a healthier, happier society. How do these ideals sit if parks are accessed by only certain portions of the population? How do we adopt an ecologically sound relationship with park spaces that bear little resemblance to the previous natural habitat of the area? Wetlands were filled in, streams were dammed, and many species and people have been displaced. This places parks in that realm of indirect nature in that it has been manufactured. Does this matter? Do our clients know or recognize the differences? Maybe. Either way, we need to be aware of it because it is an ideal metaphor for the daily struggles of many people in terms of power and autonomy, often due to their social location and society’s response to it.33
So, what do we mean when we say we need to promote diversity in nature-based therapy? Consider this activity with our clients in which we start by inviting them to look inward and get a sense of how they are doing in that particular moment. We then request they share a movement that captures the essence of their inner landscape. What they express is unique to them and different each time. After acknowledging their expression, a moment is taken to look around at the surrounding outer landscape and notice all the different ways nature is expressing herself: the various shapes of trees, stages of living and dying, and abundance of diverse organisms. The presence of rich biodiversity teaches how each organism is distinct yet important and reinforces an embodied knowing that we too are all different yet can be accepted just the way we are. A healthy ecosystem teaches about sacred balance, a vision for a world where humans are in right relation with the rest of the living world, recognizing their deep reliance and embeddedness with the air, water, and soil.
An environment where one species is dominating or has an advantage that sets it apart from the others teaches about the harmful impacts of unchecked domination. If you have ever walked in a Pacific Northwest Douglas fir forest that has been introduced to English ivy, you likely have seen the devastation from the vine carpeting the forest floor and suffocating the trees and understory. Or similarly, the introduction of Scotch broom (which can grow prolifically in this region) in a Garry oak meadow and how the landscape turns from a multiplicity of species to a dense monocrop of broom. The point is not to dig into the debate surrounding invasive species and the management of ecosystems but rather to highlight the detrimental impacts of colonizing forces on diversity and how, when these factors go unchecked, they drastically alter physical environments, closing spaces for alternates, in much the same way as the dominant societal structures operate to marginalize certain groups while bolstering others.
With this metaphor in mind, it is useful to name and contemplate some of the dominant forces that are restricting the diversity of nature-based therapy. A thorough investigation of each of these forces is a considerable and important task. For the purpose of this conversation regarding raising awareness of ethical issues for nature-based practitioners, what will be offered is a small window into some of the important considerations. We recognize that much more work needs to be done on each of these topics (plus there are many more to be named than what we have selected) for the field of nature-based therapy to develop its potential as a truly diverse and socially just field. We hope that this chapter can act as a catalyst for the necessary conversations across related outdoor therapy practices.
We have already named the profound and ongoing impacts of settler colonialism on the relation between Indigenous people and non-Indigenous settler people and on relations to land and sovereignty. Specifically, how the unjust phenomenon of settler colonialism continues to maintain the dispossession of land, disconnection from culture, and erasure of Indigenous people from the history of the colonized space. Alysha Jones and David Segal’s article on unsettling ecopsychology takes a strong position on this topic regarding the field.34
On the whole, ecopsychology as a field of study and practice does not acknowledge and engage with settler colonialism, its intense impacts on people and land, and its relevance for the field. In many cases, ecopsychologists practice on land that settlers have dispossessed from Indigenous peoples. The logical extension of this critique is to all land-based, nature-based, wilderness, and outdoor programs and practitioners; we are all implicated. According to Jones and Segal, “Addressing settler colonialism as a significant gap in ecopsychology represents an opportunity and invitation for the field to enter into the awkward and challenging task of discussing the unearned advantage (or privilege) to practice ecopsychology on Indigenous lands, as well as challenge the colonial context in which practice occurs.”35
One of the first steps in the unsettling process is to acknowledge and investigate how nature-based therapy’s “culturally situated narratives and knowledge practices may unintentionally reproduce settler colonialism and erase Indigenous histories and voices.”36 Jones and Segal suggest unsettling practices such as questioning whose traditional territory nature-based practice occurs on, what the specific protocols are in that territory, and how is it that they themselves have gained access to the land, in this way and at this time. Further, they recommend asking questions about one’s own heritage, as they identify the desire to create an authentic place-based identity among settlers as one of the factors that may be driving the continued harmful dispossession of land and appropriation of Indigenous practices. Finally, serious contemplation regarding how to support the protection and return of traditional lands for Indigenous people is a core component of an unsettling practice. Their article references a personal conversation with Canadian political theorist James Tully regarding the importance of such actions and his comments on the topic:
By learning about Indigenous resurgence projects and seeking to ensure Indigenous peoples have access to their territories to carry out their traditional cultural practices, settler ecopsychologists would be “joining in on a long history of Indigenous people who have been able to survive genocide, regenerate their life-ways and earthways, and influence at least some settlers to join in and stand beside them.”37
These are only a few of the unsettling practices that may be helpful in raising awareness and transforming relations regarding the ongoing impacts of settler colonialism operating out of awareness in the field of nature-based therapy. It is recommended that practitioners make efforts to educate themselves on the particular history of relations between Indigenous peoples and settlers in their own countries, inform themselves of the lived realities of Indigenous peoples by seeking out their voices through scholarship and building genuine relationships, and finally investigate how they may be able to support local Indigenous-led initiatives regarding addressing the ongoing injustices and reconnection with land.
Questions of ethical practice have been asked in the related fields of adventure and wilderness therapy. Denise Mitten, professor and longtime outdoor adventure educator and leader, has written compellingly on ethical considerations in adventure therapy specifically for female clients and other marginalized populations.38 Aligning herself with ecofeminism, she describes the projects as an effort to “change the subordination of nature, poor people, children, indigenous people, and women. The goal of ecofeminism is to increase the health and welfare of humans and nature.” In her 1994 article, she shared a historical reality of patriarchal design and leadership on the adventure education and therapy fields, from stories of “founding fathers” through program aims based on building “boys to men.” These themes, stemming from militaristic roots, have diminished little in the intervening decades, and Mitten’s critique is equally valid today. The major issue lies in the nature of the programs developed primarily by men and for males in that their use or application to females, transgender, or other populations, may not be appropriate, or as Mitten clearly points out, ethical. It appears to us that the strength of the patriarchal narratives was, and remains today, strong, and this early critique did not receive the attention it deserved.
So, what comprised Mitten’s critique of adventure therapy? We have to recall that an adventure therapy approach, compared to a nature-based approach, often includes risk and challenging activities and/or longer trips of multiple days to weeks and involves technical knowledge and skills. The two major issues identified with this approach for women were (1) a leader/therapist and client power imbalance and (2) the role of nature in healing. The first was highlighted by the use of technical skill and knowledge, the group influence on individual behavior, and the possible belief that everyone needs to be compliant for the group’s success. Each of these variables has the potential to override an individual client’s capacity to speak for themselves and to their needs. Client insecurity entering the adventure arena, coupled with the disempowerment of possibly not having the technical knowledge or skills that, in this Western culture, that boys have grown up learning, and then adding the group influence over personal decision-making can all add up to the potential for further trauma or harm. These place a significant amount of responsibility on the leader/therapist to ensure that client care is at the forefront of their practice.
In 1994, Mitten questioned whether enough had been done to address concerns of power imbalance in outdoor therapies. To consider that the leader/therapist may be providing the technical knowledge of route finding, rope handling, or the management of other technical or safety equipment; choosing the activities of the day; leading the conversations; holding expert status; and having the professional obligation for the group, it is not hard to see how this power differential may be an area of great concern for practitioners. Let us not forget, in the case of female clients, that the leaders may also be male and older, and an all-too-common perception of adventure leaders is that of the hero-guide. Not more than a generalization, but in our minds, this is not far off the norm for outdoor leadership even today; it is a male-dominated field, and stereotypical gender roles still play out in leadership teams.
The second issue raised by Mitten is that of the role that nature can play in therapuetic healing processes. This, of course, is contrasted with the traditional risk, challenge, and physicality of the adventure model. Since this 1994 paper, we have seen considerable developments of more ecopsychological and nature-based approaches, along with advances in understandings of adventure and wilderness therapy (as we have shared in this book). Mitten offered an early challenge to the conversation about whether risk, perceived or real, was justified as a therapeutic practice, and whether the folk pedagogy of “You will overcome your fear” or “You will feel like a hero” held water or would even be useful to clients when they returned home. She questioned directly whether the means justified the ends, again, specifically thinking of the female clinical client who may have been manipulated with untruths in her life. Mitten’s recommendations seem simple and effective: allow the client to learn about the activity, its real, and perceived risks, and then provide the opportunity for her to choose to complete the activity or not. As Mitten explained, a woman who may have experienced abuse cannot be told to trust (e.g., as in a trust fall where other clients will catch you); rather she learns to trust through the process of building relationships, and equally, she should be allowed to simply say no to an activity without the leader or the group pushing her to participate and having her capitulate due to peer pressure or fear of upsetting the ones with power.
In a recent conversation with Mitten, she relayed results of her body image study, which suggest benefits in addressing patriarchal relationships in nature-based therapy in general and specifically for women:
Through time in nature, women are able to rebuff the patriarchal beliefs that contribute to the diminishing and objectifying of women and nature. This seems to illustrate that if someone doesn’t try to conquer nature, then nature’s acceptance of oneself is healing. There seems to be a correlation between women feeling accepted in natural environments and being able to become internally stronger, resulting in feeling better about their body image.39
Undoubtedly, there is a tremendous amount of work to be done in understanding and addressing the ways that patriarchal relations are showing up in nature-based therapy as well as being resisted and transformed, such as in the work by Mitten and other ecofeminists. We are grateful for the work of so many dedicated writers, activists, and changemakers and recognize that the work is really just beginning in our field.
In the groundbreaking edited anthology Ecopsychology and the De-construction of Whiteness, released in 1995, Carl Anthony, an African American social justice activist, asked an important and eye-opening question: “Why is it so easy for people to think like mountains and not to think like people of color?”40 He went on to raise concern for the field’s inherent bias toward Eurocentric and predominantly white perspectives. His critique was fundamental to the field starting to address issues of white privilege operating largely out of awareness in both academic circles and outdoor programming occurring at the time. Likewise, the social model of disability was introduced in the mid-’70s and developed by people living with disabilities in an attempt to shift perspectives on how they are seen and related to by mainstream society. The social model shifts attention away from the individual being the source of impairment and to how society is organized as the cause. For example, if a building has a step to its entrance and no ramp, the problem lies in the design of the building, not a person’s inability to walk. The model recognizes that all humans at some point in their lives will face some sort of physical or cognitive challenges, and therefore, it is the responsibility of the society to address this reality, not the individual.
This model has been taken up by the Victoria-based non-profit Power To Be Adventure Therapy Society (PTB, featured in chapter 9), and they have made it their goal since 1998 to remove barriers for people to connect with nature. They recognize that people are adapting all the time to meet their needs and have come up with some inspiring and creative ways to ensure that everyone who comes their way, irrespective of their ability, can access the healing power of nature. Finally, in Boulder, Colorado, there is a unique and much-needed program called Queer Nature run by So Sinopoulos-Lloyd and Pınar Sinopoulos-Lloyd, who are queer-identified and passionate about nature connection. On their website, they state how they “recognize that many people, including LGBTQ+ people, have for various reasons not had easy cultural access to outdoors pursuits, especially ‘survival skills’ like bushcraft, tactical skills, and (ethical) hunting.”41 Their program “envisions and implements ecological literacy and wilderness self-reliance skills as vital and often overlooked parts of the healing and wholing of populations who have been silenced, marginalized, and even represented as ‘unnatural.’”42 An article in their hometown newspaper tells the story of a young man who, as a gay teenager, did not feel safe to join the nature connection programs being offered locally. The lack of a safe space led him to disconnect from the natural world and lose his sense of belonging. He relates how finding Queer Nature has allowed him to rediscover his love for the natural world and let go of his belief that the wilderness was not a place he could access.
These three stories, specifically, Carl Anthony’s call for attention to the reality and marginalization of non-white people in the field of ecopsychology, PTB’s commitment to the removal of barriers, and the creation of Queer Nature, are examples of positive responses to the mainstream structures threatening to limit diversity in nature-based reconnection work. They are inspiring models of how the field of nature-based therapy can address some of the normative structures existing in the dominant culture that restrict access and marginalize certain groups and instead promote a diverse and vibrant ecology of people accessing nature-based services.
Numerous deaths and reports of unethical treatment of youth in residential treatment of youth, including wilderness therapy programs, surfaced in the news and popular media in the early 2000s. Action was taken at governmental levels, resulting in reports of incidents including negligence on the part of program staff, inappropriate standards of practice, and in some cases, unhealthy organizational philosophies. The broad inclusion of programs under review by forensic auditors Kutz and O’Connell in 2007 for the US Government Accountability Office (GOA) included interventions best described as boot camps or boarding schools, while others were simply referred to as residential treatment.43 The GAO report recognized the need for “last effort” services such as those provided by residential treatment options for “troubled youth” who may have already exhausted numerous interventions and resources in their family and home community, leaving this form of residential treatment as an option for difficult cases of emotional, behavioral, and substance abuse issues. In that regard, they recognize the purpose programs such as these may serve in extreme situations. They also point out, however, that in many states (although they don’t mention which ones), parents are legally entitled to send kids into treatment (1) without the child’s input, (2) against their will, (3) by hiring a “transport” service to (at times physically) remove the child from the home and place them in treatment programs, and (4) make these decisions based on discussions with program administrators and sometimes educational consultants (who are expected to be free of conflict of interest with programs they help refer youth to). Wrapped up in this short narrative are many potential ethical dilemmas.
While we are not writing a book on wilderness therapy, this approach has informed our work, and we three have work histories with longer expedition-type outdoor programs. Wilderness therapy has also been challenged for a lack of theoretical explanation for what appear to be very positive treatment outcomes, a lack of accessibility to this type of intervention due to costs, the difficulty of integrating families in treatment, and establishing meaningful transitions to home or aftercare services near home.44 What is relatable to our nature-based therapy practice is that we do occasionally use overnight and multi-day trips and, doing so, engage in practices similar to wilderness therapy. What we are not engaged in is working with involuntary clients and families; no one is forced to attend. Although we have acknowledged that parental coercion to have children attend may be present, any client may choose to end the counseling relationship at any point. For those working with involuntary clients, you will need to consider your professional code of ethics and take responsibility for your actions relative to your profession.
As ethical practitioners and researchers, we ask our colleagues to ensure your practices are guided by an ethic of care, child and family rights, and professionalism. Ultimately, in the name of client care, it is our obligation.