University of Leicester
2021CooleySPHD.pdf (1.98 MB)

Beyond The Consulting Room: An Exploration Of Outdoor Talking Therapy

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posted on 2022-02-17, 22:29 authored by Sam J. Cooley
There is growing support for the outdoors as an alternative environment for talking therapy. Practitioners and clients venture outside to incorporate nature connectedness, bodily movement, and to improve access for clients whom conventional indoor therapy is less accessible. This thesis began with a review of existing literature on outdoor talking therapy (Chapter 1). A meta-synthesis of 38 articles collated the experiences of 322 practitioners (e.g., clinical psychologists, counsellors, and psychotherapists) and 163 clients. Outdoor activities ranged from sitting or walking in urban parks and woodland to more immersive outdoor pursuits and wilderness expeditions. These environments provided either a passive backdrop or were more actively incorporated into the talking therapy. Steps were taken to support safety and containment in the outdoors, such as informed consent, process contracting, and introducing predictability. Therapy was subsequently enriched through improved engagement, mutuality, freedom of expression, mind-body holism, interconnectedness with the natural world, and practitioner well-being. Despite these benefits, organisational barriers were identified, including a lack of orientation, support and guidance on outdoor talking therapy, particularly within clinical psychology and in public health services. Subsequently, the organisational culture in clinical psychology was further explored in an empirical study (Chapter 2). Using informed grounded theory, 15 experts and leaders in clinical psychology were interviewed (e.g., heads of services, training programme directors, and developers of therapy models). The themes comprised organisational factors that either support a practitioner to maintain a position of curiosity and flexibility towards the environment where therapy is located (‘environmental safe uncertainty’), or push them towards adopting a more fixed position (‘environmental certainty’). Themes included influences from therapy traditions, accessibility of alternative environments, internalised risk, workplace subcultures, business models, biomedical approaches, and the Covid-19 pandemic. The question of whether outdoor talking therapy should become a more mainstream option is discussed and a position of environmental safe uncertainty is encouraged.



Noelle Robertson; Ceri Jones

Date of award


Author affiliation

Department of Neuroscience, Psychology and Behaviour

Awarding institution

University of Leicester

Qualification level

  • Doctoral

Qualification name

  • DClinPsy



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