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Outdoor Walking Therapy (Wilderness Therapy)

Nature-Based Therapy in Alaska

Outdoor therapy goes by several names: wilderness therapy, ecotherapy, nature-based therapy, or walking therapy. 

These terms describe the same experience: a mental health professional providing therapeutic services involving nature.

I typically use the terms walking therapy, outdoor therapy, wilderness therapy, and nature-based therapy interchangeably.

When a mental health professional incorporates psychotherapy treatment in an outdoor setting: we get nature-based therapy. 

My anecdotal experience as a clinician who provides nature-based therapy: it’s awesome

Anecdotal experiences can be insightful, but do keep reading to see what researchers say.

Perhaps this is your first time learning about wilderness therapy or you are curious how I incorporate the outdoors into my clinical work as a therapist. 

While many folks enjoy and prefer virtual therapy, others would rather meet for therapy in-person. Some folks may have no preference, or opt for a secret third option: a hybrid of both.

picture a lush green trail lined with birch trees and dappling sunlight. Stellar Insight CounselingLush birch tree lined trail 

How I Use Nature-Based Walking Therapy

After my first walking therapy session with a client (and subsequent training courses specific to outdoor/nature-based therapy), I was hooked.

Outdoor therapy exists along a spectrum; one therapist may use nature-based therapy with a client in a garden outside of their office for 10-20-minutes. Another therapist may lead a multi-week long backcountry wilderness therapy expedition. 

In my work with clients, I have used nature-based interventions along that spectrum. 

Some nature-based therapy sessions may have lasted as short as 5 minutes; and I have provided wilderness therapy on overnight camping trips. It depends on the client, and outdoor therapy is not appealing to everyone 

(which is perfectly fine!)

abundant crowberry plant and other plants with leaves changing colors for fallImage Caption: Abundant crowberry plant 

I like to use outdoor therapy for individual and group therapy sessions. 

The immediate positive experiences that come out of group wilderness therapy warrant a future post, so check back for that. 

50-minute individual outdoor walking therapy sessions are, in my opinion, one of the more practical ways to use wilderness therapy by replacing an office + couch with a trail and trees. 

I ask this question to people who are contemplating wilderness therapy: if you have to drive across town in the middle of the day from your office to an appointment, would you prefer to go sit in another office, or instead go for a walk outside?

If you prefer to go for a walk or jaunt outside, consider a therapist who offers nature-based therapy. 

Nature-Based Therapy & Accessibility

boardwalk path through wilderness and views of snow capped mountainsImage Caption: boardwalk path over uneven hiking trail

The only requirement for outdoor therapy compared to the typical therapist + couch + office setting is an interest in being outside.

People of any mobility level can benefit from outdoor therapy whether they are walking, rolling, or strolling. Folks of any age or those who use mobility aids can still benefit from and enjoy nature-based therapy.

I follow the lead and pace of each client, and all body types and sizes are welcome in my walking therapy sessions.

Some sessions we may walk the entire time while other sessions we may meander, stand, sit, roll, or move at an inconsistent pace. 

All movement options are valid! One pace is not superior over another. Each session may look different, and that is great.

Common Questions:

Is outdoor therapy ... a thing?” or, Is wilderness therapy evidence-based?” 

Here are the main points:

#sorrynotsorry for the visually unappealing citations in this section, but they are important!

First, let’s recall the benefits nature has on mental health and well-being:

Benefits of spending time in outdoor green spaces include: Decreasing stress, improving cognitive functioning, and promoting well-being (Bratman, Olvera-Alvarez, & Gross, 2021; Choe, Jorgensen, & Sheffield, 2020). Those benefits are achieved when a person simply spends time in nature, no therapy interventions.

The integration of nature, movement, processing thoughts and emotions with a mental health professional, leads to greater insight around one’s problems, and feeling less stressed (thanks, nature).

Studies have explored several benefits of outdoor therapy; whether through a decrease in symptoms of mood disorders such as depression (Joschko, Pálsdóttir, Grahn, & Hinse, 2023), increasing participants mental health and well-being (Cervinka Röder, & Hefler, 2012; Maller, Townsend, Pryor, Brown, & St Leger, 2006), and reducing stress as a health promotion intervention (Djernis, Lerstrup, Poulsen, Stigsdotter, Dahlgaard, & O’Toole 2019; Song, Ikei, & Miuazaki, 2016).

There is a well-studied phenomena in which people who feel more connected to nature are happier (Cervinka et al., 2012; Song et al., 2016).

Nature-based therapy can be used for people who wish to begin developing their sense of connection to nature, or can be used for people who wish to strengthen that connection.

Most data on wilderness therapy (also called “ecotherapy”, “nature-based therapy”, or “outdoor walking therapy”) consist of (mostly) white people in their twenties; while there are demonstrated benefits of nature-based therapy for middle-aged women and other populations (Lee, Son, Kim, & Lee, 2019; Song et al., 2016), most research on this type of therapy lacks representation of middle-aged adults and people of color.

Adults who are not in their twenties and who are not white can still benefit from and enjoy this type of therapy (Song et al., 2016)! If you wish to become a client for nature-based therapy, please continue reading about how to get started.

What A Typical Outdoor Walking Therapy Looks Like

Walking therapists will typically meet clients at local park, often a trail. You greet and start walking (or rolling) around, and continue until you want or need to pause.

Walking therapy sessions often look different each week

One day a walking therapy session may be focused on walking and processing, while another session may involve practicing mindfulness with the natural environment. 

Wilderness therapy strengthens appreciation for the way wilderness can soothe stressed brains. Outdoor therapy is often a mix or spectrum between processing and communicating, or practicing being in the "here and now."

Perhaps you stumble upon a metaphor for your struggle in the form of a woodpecker flying to a new tree; or by means of stepping in mud, or recognizing the shared ways you and the environment have been harmed, unprotected, or hurt.

Perhaps you develop a new insight into your challenges while walking up a steep hill, or you find no metaphor and avoid a moose instead.

silly -ish picture of a moose bellowingImage Caption: Silly-ish picture of a moose bellowing (Which we will avoid)

About halfway through the session, your therapist will acknowledge when to start heading back to your initial starting point (or area).

Before parting ways you schedule your next session, ending similar to how you end a typical therapy + office appointment.

What to Bring to Your Walking Therapy Appointment

  • Sturdy shoes. You will know ahead of time which park or trail we will use (paved or unpaved).

  • Appropriate clothes: dress comfortably, or as you prefer.

  • Bring a rain jacket (or keep one in your car). Walking therapy works in rain, sunshine, or cloudy days

  • Water bottle. Hydration!

  • Bug deterrent (if you prefer)

  • Tissues (it is still therapy)

narrow trail going up a mountain AlaskaImage Caption: Calming trail to a mountain

In Summary

Those are the main themes and questions associated with outdoor nature-based walking therapy. I hope this post answered your questions and perhaps piqued your interest in outdoor therapy as an alternative option to the standard therapist + couch + office setting.

Wilderness therapy is an evidence-based treatment for issues including PTSD, depression, anxiety, and stress reduction (Choe et al., 2020; Djernis et al., 2019). 

If you are interested in becoming a client with Stellar Insight Counseling, I’d be delighted to hear from you: 

Give me a call for a free 15-minute initial consultation.

Land Acknowledgement: I  live, work, and play on land traditionally cared for by the Dena’ina Ełena Indigenous peoples. 

I acknowledge and appreciate this cultural group’s stewardship and contributions on these restorative lands.

Picture of partial sundog overlooking Anchorage, Cook Inlet, Mount Susitna; the sky fades from blue to goldPartial sundog from Glen Alps Trailhead overlooking Anchorage, Cook Inlet, and Mount Susitna.


Bratman, G., Olvera-Alvarez, J., Gross, J. (2021). The affective benefits of nature exposure. Social and Personality Psychology Compass 15(8).

Choe, E. Y., Jorgensen, A., Sheffield, D. (2020). Does a natural environment enhance the effectiveness of mindfulness-based stress reduction (MBSR)? Examining the mental health and wellbeing, and nature connectedness benefits. Landscape and Urban Planning. V 202.

Cervinka, R., Röderer, K., & Hefler, E. (2012). Are nature lovers happy? On various indicators of well-being and connectedness with nature. Journal of Health Psychology. 17(3):379-388, doi:10.1177/1359105311416873

Djernis, D., Lerstrup, I., Poulsen, D., Stigsdotter, U., Dahlgaard, J., O’Toole, M. (2019). A systematic review and meta-analysis of nature-based mindfulness: Effects of moving mindfulness training into an outdoor natural setting. International Journal of Environmental Research and Public Health. 16(17):3202.

Joschko, L., Pálsdóttir, A. M., Grahn, P., & Hinse, M. (2023). Nature-based therapy in individuals with mental health disorders, with a focus on mental well-being and connectedness to nature-A pilot study. International journal of environmental research and public health, 20(3), 2167.

Lee, H., Son, Y., Kim, S., Lee, D., (2019). Healing experiences of middle-aged women through an urban forest therapy program, Urban Forestry & Urban Greening,V 38, pg. 383-391.

Maller, C., Townsend, M., Pryor, A., Brown, P., & St Leger, L. (2006). Healthy nature healthy people: 'contact with nature' as an upstream health promotion intervention for populations. Health Promotion International, 21(1), 45–54.

Song, C., Ikei, H., & Miyazaki, Y. (2016). Physiological effects of nature therapy: A Review of the research in Japan. International Journal of Environmental Research and Public Health, 13(8), 781.

Meet Nicole Zegiestowsky, M.S.

My name is Nicole (she/her), and I'm a pre-licensed therapist in Alaska under supervision of psychologist and LPC board approved supervisor Dr. Ekstrom (#125200, 196093).

Prior to private practice, I’ve provided outpatient and residential psychotherapy services to individuals across the lifespan through community mental health, interdisciplinary family medicine, and tribal health agencies.

I actively incorporate our relationship, the “therapeutic alliance,” into sessions which may look like: 

  • • checking in on how a moment felt to you, 
  • • asking questions, “Do you feel I am understanding what you’re going through?”

I use telehealth and outdoor walking therapy in my weekly sessions with clients to help them heal from PTSD, trauma, depression, and relationship issues.