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There is a strong association between nature engagement and stress reduction, restoration, and increased well-being. Recently, practitioners and researchers are integrating nature into psychotherapeutic interventions in clinical settings to address individuals' mental health and wellness. The purpose of this systematic review is to (a) identify nature interventions that are currently integrated within counseling, (b) summarize the outcomes of research studies that integrate nature interventions, and (c) review the quality of research studies to date. We found that most nature interventions include forms of adventure and wilderness therapy. Counseling intervention protocol varies among nature interventions. Overall, we found preliminary evidence that nature engagement in the counseling process contributes to positive client outcomes. However, the methodology in the available studies makes it challenging to delineate the contribution of nature versus the counseling intervention in client outcomes, or what aspects of the nature intervention are helpful for clients.
Nature has been studied across concentrations and conceptualized as a fundamental need for human existence (Searles, 1960). As part of his theory of biophilia, Wilson (1984) suggested that humans have a genetic basis that requires a connection with nature to improve cognitive functioning, enhance mood and creativity, and increase resiliency. Although the definition of nature is personal to each individual, nature encompasses products of the earth and nonhuman living organisms (Reese, 2018). Nature is largely considered a subjective experience due to the fact that an individual can experience nature in their own way. For example, caring for potted plants inside a home, walking in a park, a close connection with an animal, or full immersion into the wilderness are all forms of nature engagement. Broadly defined, nature engagement is how an individual interacts with the natural world physically and emotionally (Reese, 2018), and nature exposure is being in the presence of an outdoor or natural setting (Repke et al., 2018). With rising reliance on technology for completing daily tasks (Edwards & Larson, 2020; Fan et al., 2017; Mark et al., 2018), nature engagement has drastically decreased, despite the well-documented mental health benefits of nature exposure (Gatersleben, 2008; Guite et al., 2006; Herzog et al., 2003). A positive association has been identified between nature interventions and positive mental health outcomes (Dobud & Harper, 2018; Maller et al., 2006; Shanahan et...