Department of Neuroscience, Psychology and Behaviour, Centre for Medicine, University of Leicester, UK.
Department of Neuroscience, Psychology and Behaviour, Centre for Medicine, University of Leicester, UK.
Clin Psychol Rev. 2020 Apr;77:101841. doi: 10.1016/j.cpr.2020.101841. Epub 2020 Mar 4.
Time spent in natural outdoor spaces has physiological and psychological benefits, such as reduced stress responses and improved mood. Mental health practitioners have begun to harness nature's restorative capacity by challenging convention and taking talking therapies outdoors. This review synthesises the experiences of these practitioners and their clients, with the aim of establishing a framework for best practice. A thematic synthesis was used to provide a systematic and integrative exploration of multiple therapy professions. Articles (N = 38, published from 1994 to 2019) comprised 322 practitioners and 163 clients. A mixed-method meta-synthesis resulted in a framework of higher and lower level themes. The outdoor context for therapy ranged in intensity from sitting or walking in urban parks and woodland to remote wilderness expeditions. The outdoors provided either a passive backdrop to therapy or was more actively incorporated through behavioural analysis, relationship building, metaphor, narrative therapy, role play, modelling, and stabilisation. Practical, therapeutic, and organisational issues were mitigated through assessment and formulation, informed consent, process contracting, enhancing predictability where possible, and awareness of professional competency. Therapy was subsequently enriched by added mutuality, freedom of expression, mind-body holism, interconnectedness with the natural world, and practitioner well-being. The question of whether therapy in natural spaces should become a more mainstream option for clients and practitioners is discussed.
在自然户外空间中度过的时间对身心都有好处，例如减少应激反应和改善情绪。心理健康从业者开始利用大自然的恢复能力，挑战传统，将谈话疗法带到户外。本综述综合了这些从业者及其客户的经验，旨在为最佳实践建立一个框架。使用主题综合法对多个治疗专业进行了系统和综合的探索。文章（N=38，发表于 1994 年至 2019 年）包括 322 名从业者和 163 名客户。混合方法元综合产生了一个具有较高和较低主题的框架。治疗的户外环境从在城市公园和林地中坐或散步到偏远的荒野探险，强度各不相同。户外环境要么为治疗提供被动背景，要么通过行为分析、建立关系、隐喻、叙事疗法、角色扮演、建模和稳定化等方式更积极地融入治疗。通过评估和制定、知情同意、过程契约、尽可能提高可预测性以及了解专业能力，可以减轻实际、治疗和组织方面的问题。随后，治疗因增加了相互性、表达自由、身心整体性、与自然世界的相互联系以及从业者的幸福感而更加丰富。讨论了在自然空间中进行治疗是否应该成为客户和从业者的更主流选择。
