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By Jennifer L.W. Fink

July 2026

Malia* wanted help with her persistent sadness and lack of motivation. So the young mother of two children scheduled a meeting with Heidi Schreiber-Pan, PhD, LCPC. Malia knew Schreiber-Pan was the executive director of the Center for Nature Informed Therapy but told her early on, “This nature thing is not for me.”

Schreiber-Pan didn’t push. She met Malia in her office and, a few sessions into their relationship, introduced sensory-based grounding techniques. She asked Malia if any natural elements brought her a sense of calm. Malia hesitated before recalling a long-forgotten memory: early morning fishing trips with her father, who’d died 10 years before.

Over their next few sessions — including one at the reservoir where Malia had once fished with her dad — the two women realized unresolved grief was at the root of Malia’s sadness and lack of motivation. Because Malia felt a sense of peace and connection to her father at the reservoir, she and Schreiber-Pan continued to meet there, near the water and trees but within sight of the parking lot, to accommodate Malia’s preferences.

Malia began bringing her children to the water independently, and eventually, with Schreiber-Pan’s support, she wrote her father a letter, read it aloud at the river’s edge, and released it into the water. Despite her initial resistance, the self-proclaimed “indoors person” found healing, in part, through nature.

Interest in incorporating nature into counseling has grown since the 1990s, when the field of ecopsychology began to explore the therapeutic value of our relationship with the more-than-human world.

“As the acceptance of the reality of our changing climate has come about, we’re seeing more and more severe weather events — and more people showing up in our offices with trauma from flooding, wildfires and hurricanes,” says Patricia Hasbach, PhD, author of Prescribing Nature: A Clinician’s Guide to Ecotherapy and a pioneer in the field.

Modern humans’ increased immersion in digital worlds has also contributed to counselors’ (and clients’) desire to include nature in mental health interventions. Yet many counselors aren’t sure how to effectively integrate nature into their work. Experienced clinicians advise others to think of nature not as a place but as a relationship that can be addressed during counseling.

Redefining What ‘Nature’ Means in Counseling

Nature isn’t “out there” — a place outside the windows, walls and doors of our offices and homes. “A lot of people talk about the need to ‘reconnect with nature,’ but we’re never disconnected because we are nature,” says Nevin Harper, PhD, co-author of Nature-Based Therapy: A Practitioner’s Guide to Working Outdoors with Children, Youth, and Families.

Nature is present all around (and in) us, and as inhabitants of Earth, each of us is affected by and has a relationship with nature, whether we consciously acknowledge it or not.

“Every human has a thread that connects them to nature,” Schreiber-Pan says. “Nature is not a place or an experience but a relationship.” And just as counselors consider their clients’ relationships with family members, coworkers, and the culture and community at large, it is appropriate for counselors to assess and address their clients’ relationship with nature. In fact, it is critical to ask clients about their definition, understanding and experience of nature.

“We have to make sure that we don’t assume that everyone has the same thread [connecting them to nature] that we do,” Schreiber-Pan says, because while some people feel comfort and solace in the woods or near the water, others have experienced pain, fear or terror in those same places.

That’s why counselors who specialize in nature-based counseling recommend asking clients about their relationship with nature as part of the intake process.

Ryan Reese, PhD, LPC, author of Natural Approaches to Optimal Wellness: Integrating EcoWellness into Counseling, broaches the conversation by saying, “One thing I like to address is your connection with the more-than-human world, or with what some people call ‘nature.’”

He then asks clients to describe their relationship with nature, using questions such as:

• Can you tell me about how you define nature for yourself?
• What role or roles does nature play in your life relative to wellness?
• Have you had any positive experiences with nature you’d like to share or feel relevant? Any negative experiences? 

“We’re inviting clients to have a mindful lens on their own experience of what nature is,” Reese explains. Counselors can use the information they share to co-create — with the client — a care plan that meets the client’s needs, respects their experiences, and integrates nature in a clinically and culturally appropriate way.

Integrating into Everyday Practice

Nature-based counseling doesn’t have to happen outside. Counselors and clients living and working anywhere — even in dense urban areas — can include nature in counseling sessions. It can even be added to teletherapy.

“You want to be mindful of what the client is looking at when they’re looking at you,” Hasbach says. “I typically do teletherapy in my home office, so when a client is looking at me, in the background is a window with a lot of trees.” Counselors who don’t have an office with a view can put a plant or vase of flowers behind them.

Counselors can also deliberately integrate natural elements into their office décor. A basket that contains a collection of natural items, such as rocks, seashells, pinecones, twigs and feathers, brings the outside in and can inspire reflection.

“If a client is having hard time finding words for what they’re feeling, sometimes I’ll just hand the basket to them and say, ‘Is there anything in here that helps show me what you’re feeling?’” Hasbach says.

She also uses “nature prescriptions” — essentially, between-session homework assignments co-created with her clients — to tap into the healing power of the natural world. When a client who enjoyed photography and journaling mentioned she was going on a trip to the mountains with friends, Hasbach asked the woman, who was struggling with the break-up of a long-term relationship, if she’d be willing to take some sunset photographs in the mountains and journal about a specific question around the end of the relationship.

The woman agreed and returned to Hasbach’s office a few weeks later with photos and a new perspective.

“She said, ‘I didn’t realize how beautiful the afterglow was, after the sun had gone down,’” Hasbach says. “That was very meaningful to her. She realized that if she let the sun go down on this relationship, there was hope.”

A nature prescription doesn’t have to include an outdoor excursion; it could be as simple as asking a client to look out a window (even if they live on the 12th floor of a high-rise apartment) for two minutes a day and record their observations.

Crucially, nature prescriptions should not be imposed on clients. “It is important that the client is involved in the co-creation of the prescription,” Hasbach says. Similarly, no client should ever be forced or pressured to participate in an outdoors counseling experience.

While walk-and-talk sessions, in which a counselor and client meet at a predetermined location such as a park or nature trail, can be helpful for some individuals, particularly those who are uncomfortable with face-to-face conversation, they are also logistically complex and require careful evaluation of both the environment and client to determine whether they are appropriate.

Matching Nature-Based Approaches to Client Needs

You can use what clients share during intake and early sessions to help you determine how and whether to incorporate nature into their care. As Schreiber-Pan did, pay careful attention to client cues; watch and listen for any “threads” connecting them to nature but do not force natural interactions.

Clarifying client boundaries and expectations is particularly important if you decide to offer outdoor sessions. Think through and discuss with your client how you will maintain confidentiality and protect their physical and emotional safety.

Naomi Coleman Medina, PhD, LPC-S, an assistant professor in the psychology department at Texas State University and a counselor in private practice, emphasizes the importance of visiting and thoroughly vetting any location before using it for client interactions.

Counselors should consider accessibility, foot traffic and the availability of cellphone service and emergency support. Medina also assesses clients’ fears, phobias, insect reactions and tolerance for heat and cold. She asks clients if they are aware of any health conditions that could place them in danger should they engage in walk-and-talk sessions, or if they have ever been encouraged by their physician to take cautionary measures pertaining to physical exercise.

She encourages counselors to ask clients how they’d like to respond if they encounter someone they know during an outdoor session. Medina reminds them they are not obligated to introduce her and asks them, “If you choose to introduce me, how would you like to do it?” (She is perfectly willing to go along with “friend.”)

As an additional protection to confidentiality, Medina suggests the counselor and client also agree upon a simple verbal cue that either of them can use to signal that someone is approaching during outdoor meetings. That allows them to pause the conversation until the person passes.

Counselors should always center client needs and adjust their approach based on clients’ responses, comfort levels and cues in the moment. For example, a counselor standing at the edge of a shallow stream with a young client who has an anxiety disorder might observe aloud that it’s possible to hop across on nearby rocks, Harper says. If the child is interested but hesitates, the counselor could go first — and even offer their arm or hand as an aid. If the child is willing, they may learn they can take risks, tolerate uncertainty and move forward with support.

Ultimately, incorporating nature into counseling is less about location than intention. In today’s technological world, Reese says, “It’s more important than ever that we encourage and empower folks to connect with nature in whatever ways make sense to them.”

* Name changed to protect privacy