The impact of working outdoors on the therapeutic relationship

Ideas around nature improving wellbeing are strengthening, and an increasing number of therapists are choosing to work outdoors. There is a paucity of research focused on the impact of working therapeutically outdoors. The present study aims to contribute to an emerging theory: How does working outdoors impact the therapeutic relationship? A constructivist grounded theory methodology (Charmaz, 2006) was adopted for this study and 9 semi-structured interviews were conducted with therapists who work outdoors around the UK. The data was analysed in accordance with this methodology. A core research category ‘Constructing the Therapeutic Relationship’ was generated and comprised four categories: Using Nature as a Therapeutic Opportunity, Allowing the Outdoors to Effect Change, Constructing the Therapist Role, and Power dynamics in the Therapeutic Relationship: Outdoors vs indoors. The findings indicate that the therapists use the varied therapeutic opportunities afforded by working in a dynamic environment to enhance the therapeutic relationship. The outdoor environment alters the internal states of the therapists and their clients, and becomes part of the therapeutic relationship by blurring the boundaries between the therapeutic space and the relationship. The outdoors also alters the therapeutic roles and therapists actively reconstruct therapeutic roles to maintain the relationship. Finally working outdoors highlights and begins to balance power dynamics within the relationship. These findings are contextualised with existing research and theories drawn from different disciplines