Taking counselling and psychotherapy outside: Destruction or enrichment of the therapeutic frame?

Abstract

This paper will explore emerging issues in the practice of counselling and psychotherapy in the outdoors, which the authors encountered when they took their clients outside of the traditional therapy room. The outdoors is defined as natural areas and spaces, such as woods and parks which have been termed 'nearby nature' (Kaplan & Kaplan, 1989) and also more remote areas such as mountains and moors which are more isolated from civilisation, what some have termed wilderness (Mcfarlane, 2007). Particular emphasis will be given to the 'frame' of psychotherapy and how aspects of this are affected by moving outdoors, in particular contracting in relation to confidentiality and timing. The relationship in psychotherapy will be explored in relation to issues of mutuality and asymmetry alongside the role of nature in the therapeutic process. Lastly the challenges and therapeutic potential of psychotherapy in nature will be explored.

Moving beyond counselling and psychotherapy as it currently is – taking therapy outside

“…This movement seeks to enlist the context and processes of the natural world in order to promote physical and psychological well-being, as well as recovery from physical and mental-ill health. Jordan and Marshall (2010) have explored how the bound aries of the therapeutic encounter shift and need to be rethought in an outdoor natural space, particularly in relation to issues such as confidentiality and the therapeutic relationship. Cognitive behavioural therapists have for a long time taken their clients outdoors in order to deal with exposure to specific phobias (Maxfield & Segal, 2008).…”

Significance of nature in a clinical setting and its perceived therapeutic value from patients’ perspective

“…Nature is sometimes utilized with specific therapeutic purposes in mental health settings, such as being a new therapeutic space different from indoor psychotherapy (Berger & Mcleod, 2006;Jordan, 2014;Jordan & Marshall, 2010, Revell & Mcleod, 2016Revell & Mcleod, 2017), or to engage patients in specific activities or experiences (Berman et al, 2012;Corazon, Schilhab, & Stigsdotter, 2011;Corazon, Stigsdotter, Moeller, & Rasmussen, 2012). The therapeutic use of nature can have various connotations and grounding theories (Stigsdotter et al, 2011).…”

Minding the Ecological Body: Neuropsychoanalysis and Ecopsychoanalysis

“…This has lead a number of therapists, including those coming from traditional psychoanalytic backgrounds, to explore the possibility of “ecotherapy,” which covers a wide variety of approaches, including taking psychotherapy outside the traditional consulting room into the outdoors (Buzzell, 2009). Jodran and Marshall (2010, 345) explore the various complex clinical factors involved in such a shift, in particular focusing on its impact on boundaries and the therapeutic frame (as both emotional and geographical space) from a relational perspective. Here, the “relational encounter within the dynamic nature of the natural world can provide rich opportunities for a new experiencing with immediacy for both therapist and client, all of which can be fed in to the therapeutic process” (Jodran and Marshall, 2010, 349).…”

“…Jodran and Marshall (2010, 345) explore the various complex clinical factors involved in such a shift, in particular focusing on its impact on boundaries and the therapeutic frame (as both emotional and geographical space) from a relational perspective. Here, the “relational encounter within the dynamic nature of the natural world can provide rich opportunities for a new experiencing with immediacy for both therapist and client, all of which can be fed in to the therapeutic process” (Jodran and Marshall, 2010, 349). Moving outdoors may also enhance mutuality (not identical with equality), given that the space within which therapy occurs is not owned by the therapist, and the process of choosing different terrain can become more a co-created ongoing experience within the therapeutic relationship.…”

“…Moving outdoors may also enhance mutuality (not identical with equality), given that the space within which therapy occurs is not owned by the therapist, and the process of choosing different terrain can become more a co-created ongoing experience within the therapeutic relationship. Placing therapy outdoors results in the normal static “backdrop” of therapy becoming “a living presence…(where) therapist and client are constantly aware of (both consciously and unconsciously), and responding to, the presence of this vibrant living third in the dynamic” (Jodran and Marshall, 2010, 353–354).…”