Quick answer: Nature therapy, also called ecotherapy, uses time in natural settings as part of mental health care. Common types include forest bathing, therapeutic gardening, walk-and-talk therapy, mindfulness outdoors, adventure-based activities and farm-based therapy. Research links regular time in nature to better wellbeing, and nature therapy works best alongside clinical care, not instead of it.
How we put this guide together
Trillium Wellness is a residential mental health program in the quiet, rural landscape outside Knoxville, Tennessee, where nature and experiential therapy are core parts of treatment. This guide explains the main types of nature therapy, what the research does and doesn’t show, and how these approaches fit into residential care.
Types of nature therapy at a glance
| Type | What it involves | What it can help with |
| Forest bathing | Slow, mindful time among trees, engaging the senses | Stress, relaxation |
| Therapeutic gardening | Planting, tending and harvesting with guidance | Purpose, routine, patience |
| Walk-and-talk therapy | Therapy sessions held while walking outdoors | Opening up, reducing pressure |
| Mindfulness outdoors | Breathing and awareness practices in nature | Anxiety, staying present |
| Adventure-based activities | Hiking and outdoor challenges with debriefing | Confidence, trust, coping |
| Farm and animal-based therapy | Caring for land and animals | Responsibility, connection |
What does the research say?
A large study of nearly 20,000 people in England, published in Scientific Reports in 2019, found that people who spent at least 120 minutes a week in nature were significantly more likely to report good health and high psychological wellbeing than those who spent no time in nature. It didn’t matter whether the time came in one long visit or several shorter ones.
Much of the research on nature and mental health is observational, so it shows associations rather than proof of cause. The fair conclusion is that nature therapy is a promising complement to evidence-based treatment such as therapy and medication, not a replacement for them.
1. Forest bathing
Forest bathing, from the Japanese practice of shinrin-yoku, isn’t about hiking or exercise. It’s slow, intentional time among trees, noticing sounds, smells, textures and light. Many people find it calming, and it can be a gentle way to practice being present.
2. Therapeutic gardening
Planting, watering and harvesting give structure to the day and a sense of purpose. Watching something grow can be a quiet, powerful reminder that change takes time. Gardening also offers a low-pressure way to work alongside others.
3. Walk-and-talk therapy
Some people find it easier to open up side by side, walking, than sitting face to face in an office. Walk-and-talk sessions bring therapy outdoors, combining conversation with gentle movement and fresh air.
4. Mindfulness in nature
Breathing practices, body awareness and sensory exercises take on a different quality outdoors. Focusing on birdsong, wind or the feel of the ground can help anchor attention when anxious or racing thoughts take over.
5. Adventure and experiential activities
Hiking, outdoor challenges and team activities, followed by guided reflection with a therapist, can build confidence and trust and help people practice new coping skills in real moments. The reflection afterward is what turns an activity into therapy.
6. Farm and animal-based therapy
Caring for land and animals builds routine, responsibility and connection. Farm- and nature-based approaches are an area of focus for the University of Tennessee’s social work program, which partners with Trillium.
How nature therapy fits into residential care
At Trillium, nature isn’t an amenity. It’s part of treatment. Residents take part in hands-on, outdoor healing experiences led by an experiential therapist, alongside individual and group therapy and medication management. Our rural setting gives residents space to walk, breathe and reconnect with the natural world as part of their recovery.
Learn more about nature therapy at Trillium or all of our therapies, or call 865-459-2096.
Questions to ask about a program’s nature therapy
- Who leads nature-based activities, and what training do they have?
- How often do residents take part?
- Is there therapeutic reflection after activities?
- How does nature therapy connect to each person’s treatment plan?
- How are activities adapted for different physical abilities or symptoms?
FAQ
What is nature therapy?
Nature therapy, also called ecotherapy, is an approach that uses time in natural settings as part of mental health care. It can include forest bathing, gardening, outdoor mindfulness, walk-and-talk therapy and adventure-based activities, often guided by a trained therapist.
Does nature therapy work for depression and anxiety?
Research links time in nature to better wellbeing, including a large 2019 study that found benefits with at least two hours a week. Most studies are observational, so nature therapy is best used alongside evidence-based treatments like therapy and medication, not as a substitute.
What is the difference between nature therapy and spending time outside?
Nature therapy has a therapeutic purpose and is guided by a trained professional who helps connect the experience to treatment goals. Simply spending time outdoors can be helpful too, but therapy adds structure, reflection and clinical support.
Can nature therapy help with serious mental illness?
Nature-based activities can support people with serious mental illness as part of a broader treatment plan that includes therapy and medication. They can reduce stress, build routine and offer meaningful ways to connect, while clinical care addresses core symptoms.
Do I need to be fit or outdoorsy for nature therapy?
No. Nature therapy can be as gentle as sitting quietly outdoors or tending a garden. Good programs adapt activities to each person’s abilities, comfort and treatment needs.