Lawrence Rubin: I’m here today with Courtney Glickman, a licensed mental health counselor, registered play therapist supervisor, certified nature informed therapist, and owner of The Collective Healing Center. Hi Courtney.
Courtney Glickman: Hi Lawrence. Thanks for having me here today.
Nature Deficit Disorder
LR: Richard Louv coined the term “nature deficit disorder” to convey some of the challenges children face in our society. Have you found the concept useful in your work with teens and adults as well
CG: Absolutely! I think that there is a disconnection from our natural world across all ages, and that we as a society spend the vast majority of our time indoors, often on screens, whether that’s children on screens for schoolwork or video games, or adults on screens for work. So much of our life is based around technology, and we’re really limited in our access to these sensory rich and self-directed outdoor times. I also think that there has been a growing disconnection of the human species from the natural world that’s significant. This seems to be related to eco-separation and eco-boredom, as well as attentional fatigue.
LR: Clinical researchers try to establish causal links between lived experiences and psychological symptoms and syndromes, so would you go as far as to say that exclusion or isolation from nature might actually contribute to specific symptomatology? I know Louv talks about ADHD in this context.
CG: I think that ADHD is definitely one of them, but there are also elements of anxiety and sensory regulation difficulties that I see when people are out in nature. I believe that this is related to a lack of being able to practice and scaffold sensory integration that is available in a natural outdoor environment, which actually creates more of a positive influence on their nervous system regulation.
Between the artificial light, excessive use of screens, and physical containment, people are taught to tune out or dull their natural senses while they hyper-focus on the task at hand. This may contribute to a sense of eco-boredom that comes with restlessness, physical discomfort, and the feeling of “having nothing” to do. For example, when I take a client outside who is unfamiliar with unstructured space and time, they may ask, “Now, what do we do?
In that moment, I might suggest to them something like, “Well, let’s use our imagination. Let’s use our creativity. Let’s just be for a while.” Kids will often come back with something like, “this is s boring,” or, “I don’t know what to do.” I see it in adults as well, who may say something like, “Well, I have deadlines and things that I need to get done.” For them, it’s very much go, go, go with no time to rest, no time to pause. So many of us have forgotten how to slow down and just be. I think that it’s this loss of imagination and exploration and stillness rather than true boredom, so I try to tap back into how to help them to be more present.
Mindfulness is this buzzword that people use all the time, but what does this truly mean? How can we practice it without allowing ourselves to be in that outside, natural world, surrounded by the sensory rich experiences, and really begin to scaffold that? If we don’t practice, we can’t simply turn it on during a crisis.
Nature Informed Therapy
LR: So, what exactly is nature informed therapy.
CG: Eco therapy is the umbrella term that centers on ecological identity and explicitly healing the human-nature relationship. Nature informed therapy focuses on integrating nature into already established therapeutic modalities. It’s about maintaining the clinical rigor of those modalities such as play therapy, expressive arts, somatic trauma work, and attachment-based therapy, while integrating nature into them. Nature is not a resource to be used, but more of a relational partner.
Something that I always like to recognize when I’m providing training or when I’m taking my clients outside is that we’re not taking from nature, we’re in relationship with it. We leave no trace and do not harm the natural world. I’m not going to pull a flower from the natural world or take a stone and just think, okay, now it’s my stone. I wouldn’t go to someone’s home and take something without a mutual exchange.
This notion of reciprocity sets the foundation for what the work is going to entail. Kids learn to respect nature. Sometimes, I do therapy at a little beach by our office where there is sea glass. For every sea glass piece that a child wants to take home, I ask them to pick up trash. As they hold it and look out to the ocean, they ask, “do you want to come home with me or do you want to stay here?” I might ask them what the sea glass is saying so the moment becomes a special exchange.
LR: What’s going running through my mind are the lyrics of Colors of the Wind—“You think you own whatever land you land on, the earth is just a dead thing you can claim,” which conjures notions of spiritism and spirituality and the importance to indigenous cultures of respecting the natural world.
CG: Something I find really beautiful in many indigenous languages is that there’s no word for living things. So, you wouldn’t refer to a plant or an animal as entities separate from the natural world. There’s an equality among humans and other aspects of our natural world.
LR: On one of the paths I walk, there’s a tree that creeks in the wind. If you were walking with me, how would you capture that in a therapeutic moment?
CG: I might have offered an invitation to sit with the tree and listen and become curious as to what it might be saying.
LR: If a client walking with you was seeking treatment for anxiety or depression, how would that moment with the tree take shape?
CG: I wouldn’t want to rush that process, so I wouldn’t necessarily offer an invitation to sit with the tree in that moment. If, on the other hand, we were working in the sand tray and that person seemed to gravitate to a tree, I would assume that the tree served a purpose for that person, and we would explore that purpose together.
I did this with a client who was mourning the loss of her mother. We sat with flowers that were transported from her mom’s garden to her own, and I would do something similar with the tree example. I like integrating expressive arts into my work as well as writing narrative prompts. I also like bilateral stimulation, and do EMDR, so I would offer the invitation to have a conversation with the tree.
I might ask, “I want you to write with your left hand and ask the tree a question, and have the tree answer with the right hand.” I would have them do that all the way down the page as the tree. Then, I might offer another invitation to “go through all the answers and circle one word or a phrase from each answer that stands out to you.”
That would create a lyrical poem around what the tree is trying to communicate. I might ask how that relates to them and their experience? And what does the tree want them to know? Maybe it’s about what the tree is representing. If they get stuck on a prompt, I might say ask the tree how it’s feeling. Ask the tree what it wants you to know, and then they kind of flow from there. Their own form of communication and reciprocity with the tree’s experience is often related to their own.
LR: What’s the difference between bringing therapy into nature and bringing nature into therapy?
CG: That distinction is important because accessibility is an issue. We’ve trained clinicians across the U.S., and recently had a cohort from Ukraine visit us to get certified in nature informed work. It is important to understand the natural landscapes, what’s happening in their environments, and how their work is being impacted. Some live in a community where there aren’t a lot of natural spaces or in a war zone where it’s not safe to go outside, or in an area that has heavy air pollution.
Accessibility and equity within natural spaces can be a problem. For these reasons, finding ways to bridge nature and indoor work is essential. Bringing nature indoors would involve the use of nature-related “loose parts” within my practice for clients to engage with. [Editor’s note: Nature loose parts are natural objects and materials that can be used creatively in education and therapy.]
I do expressive artwork and make my own paint using natural materials and paint brushes out of the chicken feathers that are in my backyard or the snake plants that are in my office. So, we get creative with how to integrate those elements into our indoor work including sound—just think of all the sounds and sensory experiences found in nature. I might play nature background music when clients are artmaking or creating a sand tray, or if we’re doing some meditation that is related to the natural world.
There’s also considerations whether someone is able bodied enough to be able to be outside. There’s a ton of studies about virtual reality experiences for people that are in hospital settings, that show similar positive physiological and neurological responses to those experienced in the natural world. There are also studies showing that being by a window within a hospital setting is related to faster recovery compared to being in a windowless room.
LR: Have you worked with dying clients in hospital or hospice settings?
CG: I haven’t personally, but one of my colleagues at Chesapeake Hospice Center runs a nature-based group for the families of loved ones in hospice care. In terms of providing nature-based care in a hospital setting, I would say that the majority of what I’ve seen centers around the use of virtual reality and more of a sound experience because of not being able to bring some nature inside.
Integrating-based Care and Traditional Therapy
LR: Are there any particular models of traditional therapy that better lend themselves to a nature informed approach?
CG: Clinicians are only limited by their own creativity, but I am drawn to indigenous ways of knowing. I’ve been inspired by the “two eyed seeing” concept that was coined by Albert Marshall, and elder in a Canadian indigenous community. It means that we are doing ourselves a disservice if we’re not seeing things from the two-eye lens, one being the indigenous way of knowing and the other being the Western scientific way of understanding our world.
If we’re only looking at things from the Western scientific perspective, we’re missing all of these other elements that are so essential to our well-being; as you know, humans and the well-being of this planet. And if we’re only seeing things from the indigenous side, we’re losing the ability to utilize the evidence based scientific the research to back it up. Through the two-eyed lens, we move forward as a community that includes our human species and the natural world.
I’m very drawn to the creative modes of healing like play and being able to understand how that happens with our bodies and sensory systems. So, I take more of a bottom-up approach, but also understand that people are different and have to be meet where they are. Some people want more of a cognitive, top-down model. I think that you can blend both within nature-based work by bridging what you know to be true with this framework.
The evidence base just accentuates what you’re already doing and because I’m rooted in attachment theory, I think about nature as a secure base, a predictable and nonjudgmental presence, and a place that we can explore and return to for safety. I believe that nature-based therapy mirrors these healthy attachment dynamics because clients can experience, wonder while taking risks, from which they can retreat and then reengage. They can feel really supported by both the therapist and the therapeutic elements of the natural world. That’s a nice way for people to experience attachment, especially if they’ve had more inconsistent or unsafe experiences in other relationships.
Somatic regulation is another big element of my approach because I gravitate towards embodied practices. Nature-based work offers a natural rhythm and movement, bilateral engagement, and grounding. Walking, climbing, breathing fresh air, and responding to natural rhythms help to stabilize the autonomic nervous system and allows clients for more flexibility between activation and rest. I might ask a client what kind of animal they’re showing up at us today.
A client might say, “today, I feel like a tiger,” to which I might respond, “well, what does that tiger look like, and can we practice bringing our nervous system back down to more of a calm state.” After they express their feeling like a tiger, I express that I’m feeling like a fish swimming in the water, but floating, and then I’m going to have them mirror that with me. This is the process of co-regulation that we teach families, and that parents and children can practice at home.
Existentialism and Nature-Informed Therapy
LR: I notice when I walk in the preserve, my mind sometimes goes to very existential issues like connection, meaning, death, and re-birth. Have you worked with adult clients around existential issues?
CG: Earlier, I had mentioned the woman I had worked with who lost her mother. We did most of our work outside, walking on trails. We had a bilateral conversation that centered around a hibiscus flower that reminded her of her mother. She worried that it wouldn’t survive the transfer from her mother’s garden to her own. It was the only thing that she wanted from her mom’s home after she passed.
We had so many conversations with the hibiscus around what it was experiencing in that transfer from one garden to the next. That was just very beautiful. She talked about it feeling wounded and what it would experience in the transition, and the life stages and trying to survive in the grief.
We also did some other work with clay because it’s a natural material that you can offer to leave out in the earth, or use and then discuss its own phases as it returns to the land. I like being able to offer that to clients, especially those with whom I’m working indoors where we can make a clay sculpture or vessel or something that is showing up for them. It’s so somatic and tactile, and there’s just so much that can be brought up within clay. And then we offer it to the natural world as a symbol of impermanence and notice its shifts and changes as it returns to the land. And maybe we revisit it each week to see how the vessel or the sculpture is changing and how maybe the rain has fallen this week and has shifted the way that the vessel is looking.
Maybe we’re in Fall when the trees are changing, and the leaves have fallen, and it’s shifting the way that the vessel is appearing. The impermanence piece is a really beautiful metaphor. It’s similar to going for a walk and making what I call “nature art pieces.” We might gather loose parts on our walk and create an offering in a particular space that represents what it is that the client is processing or going through, and how the wind is going to come by and shift it, and how it will look different today than it looks tomorrow.
LR: If a client came to you who wasn’t seeking nature-based work, would you, or how would you introduce it?
CG: Not everyone comes to me for that work. I might think, “oh, they would be such a good candidate to take this outside,” or “maybe they’re in their head too much, or “maybe they need to slow down, or “maybe I want them to be inspired by this perspective.”
I might invite them to go outside into the woods and say, “let’s go slow and just take some time and look up. We’ve been walking. We’ve been focused on our feet but we haven’t taken that perspective of what’s up, what’s over of this direction. We have to pause for some wonder, for some humility, some perspective taking.” So, for some clients, I might want to engage in that kind of experience.
I would sit down with them, talk to them about the offering, see if they might be interested in the experience. It’s important to always take, an eco-identity assessment because some people don’t like the natural world. They don’t want to be outside. They don’t like the cold. It’s getting out of their comfort zone that can actually nudge them through a stuck point within the therapeutic process. So I gently encourage, if they really don’t want to, they don’t have to, obviously. But I would take an eco identity assessment and ask them about their experiences in the natural world.
Everyone has had a thread that connects them with nature, whether it’s a memory from childhood or it’s a natural landscape. Personally, there’s something about sunsets and the ocean that just immediately sends me to a certain place within my body. It creates calm and almost makes my heart squeeze in the most beautiful and loving way, because of the memories that I have of growing up in Florida.
On the other hand, some people might have negative threads as well because of a traumatic experience or one that happened while they were in nature. As much as I love Florida, there are hurricanes that have brought lots of evacuations and destruction. So, for some, nature can be related to fear and anxiety.
Clinical Examples of Nature-informed Work
Working With Children
LR: We first met when I invited you to speak in my play therapy class about your nature work with kids. Can you share an example with our readers where nature played a significant role or healing role?
CG: I run a nature based group therapy for kids; it’s a six-week program that I do in the Fall and Spring terms. I also run a nature based therapeutic summer camp. It’s incredibly rewarding and beautiful to see these kids connect with themselves, with each other, and with the natural world. It’s such a privilege and a gift to create this curriculum and offer it to our community.
It’s hard to select one case example, but one of the things that comes to mind happened this past summer. I always have some form of container within the summer camp, something that is consistent each day that they can go back to and participate in that may symbolizes their journey across their time with each other and within themselves and their connection to the land. This summer I created a human sized bird’s nest for the kids. It was so much fun because the kids participated in adding to the nest each day by foraging for different items. They would climb in the nest and pretend like they were baby birds that were hatching from their eggs. This was particularly significant for some of the kids that had attachment trauma.
It was incredible to watch them be able to kind of be reborn in this egg, within this coziness that they helped create with their peers and with the staff, where they were adding little felt items or chicken feathers to weave into it. Then we created clay pieces around the nest from our last day, so that they could leave little elements that were going to stay with the nest. Then they created their own little nests to take home that captured the elements of a secure base and how that helped them to experience that safety which was now embodied within themselves. That was really special.
Working with Teens
LR: Incredible! Can you share an example of your work with a teen that, given their excessive use of screens, social media, and indoor activities?
CG: I was seeing a high school senior as she transitioned to college and who was experiencing profound loneliness. She was the oldest of six kids, very connected with her family, and the first one to go off to college which was only a few hours away but resulted in reliance upon online connection which just wasn’t doing it for her. We talked about befriending a big tree on campus and started having lunch every day with it. It made for a really powerful grounding ritual for her, one that was steady and predictable. Eventually, as she began feeling the attachment, she invited someone to sit with her and the tree after class. It blossomed from there, as the tree was holding this first meeting with her and a potential friend, and providing a place that was familiar, and an attachment figure who said, “you can do this!” She graduated and is doing phenomenally well. She has revisited that place as a very meaningful part of her journey.
Working with Families
LR: Can you share an example of your work with a family where nature played a significant, if not healing, role?
CG: I’ve done family work that has involved nature-based genograms which is a therapeutic and reflective tool that’s adapted from traditional family genograms that explore individual or the family’s relationships with one another. They might also include their relationship with nature. We select nature-based loose parts that reflect those relationships and experiences with one another including their thoughts or feelings about the relationships, and any sort of meaning or pattern or losses that might emerge that are related to that family’s system.
The one family that comes to mind had a boy that had some anxiety and some sensory processing difficulties. I had the parents come in because a lot of his sensory sensitivities were to sound, and when he was outside, he couldn’t differentiate certain sounds from thunder or storms and would get really anxious and start crying. We worked a lot on co-regulation and often were in the open natural world where some of his anxiety would manifest. The parents were participating in the session to be able to offer their own co-regulation, but to also learn how nature itself could also be a source for it.
As it happened one day, there was some construction nearby, and the boy was worried that a storm was coming. We were practicing perspective taking and noticing that the skies were clear, that the sun was out, and that there were no dark clouds. We were kind of challenging some of those nervous feelings that were coming up for him through the recognition of what was happening and through practicing the integration of his sensory system. I asked him to feel his feet on the ground by taking off his (our) shoes.
The parents were lovely. I offered a family genogram with the parents symbolizing comfort and safety. I asked him what other nature around him could help him feel safe and comfortable. I have a magnolia tree in the back with those little seed pods that look prickly, but are actually really soft which he chose to represent his father, which is pretty common for the stereotypic father figure. While moms are usually depicted with more cuddly and nurturing figures and objects, his father was incredibly loving and had a softness about him. So, that was captured with the seed pod of the magnolia, and then he found very smooth stone to represent his mother.
I had mentioned that he had some sensory processing difficulties, so asked if he could pick up the smooth stone when he felt anxious and rub it. He also loved the coldness on his face and the sensation of its texture. In a sense, the stone was offering him a cooling off of his anxiety, and reflective of how his mom was also capable of doing that. Then I asked him to choose something for himself, and he went into the chicken coop and got one of the little small eggs and because we have silky chickens, the eggs are really tiny.
He then placed the egg between the seed pod and the stone as a symbol of himself. We talked about how it was held between the two, how the egg was safe and secure, and how it was being held within the soft grass. It was a nice moment for them to be able to recognize this vulnerability and fragility, and how easily the egg could crack. But it was being contained within those two spaces on the soft ground. It was also a special moment for him to recognize that there are elements around him that can offer some of the same comfort as his parents.
LR: As we wind down, can you tell me if and how one may become certified in nature-informed therapy?
CG: The Center for Nature Informed Therapy where I train and supervise has a scholarship program. I think a lot of the missions for some of the certification programs that are out there are about increasing accessibility and equity with nature informed practices and also offer some forms of scholarships.
LR: What do you mean by equity in the context of nature informed therapy?
CG: I mean equitable access to nature and to practice. I’m thinking about how that taps into indigenous ways of knowing and to the universality of concepts and not appropriating or colonizing aspects of this work. The other element is equity not only within who is served, but who is providing the therapy. It’s important for there to be opportunities for minority populations, women, and people of color to be able to access these training resources and become providers within the community as well.
LR: Have you been invited to work with indigenous clients?
CG: I would love to do that so I can connect and learn, but I also want to respect boundaries. I want to be able to know where my own boundaries and limitations are going to be and offer myself to other people within our community that do nature-based work to have those platforms. I know that I can learn so much from them, but I also want to be respectful of what that might look like, but I would be absolutely honored to participate in shared humility.
LR: Do you have any questions, Courtney, or concluding remarks?
CG: I love this work so much, and I appreciate the opportunity to talk about it. “Possibilities” is a word that comes up for me a lot within this work. There are just so many possibilities of where someone might take this, whether it’s within their practice, indoors or outdoors, and how they might want to shape it within their own lives.
LR: Are there any graduate programs that have nature-informed courses that you know of?
CG: Not that I’m aware of now.
LR: Well, there’s a clarion call if ever I heard one. It’s been an absolute pleasure chatting with you today, Courtney. Thanks so much and take care.
CG: You too, Lawrence. Thanks for the opportunity.
References
Anderson, C. L., Monroy, M., & Keltner, D. (2018). Awe in nature heals: Evidence from military veterans, at-risk youth, and college students. Emotion, 18(8), 1195.
Arbuthnott, K. D. (2023). Nature exposure and social health: Prosocial behavior, social cohesion, and effect pathways. Journal of Environmental Psychology, 90, 102109.
Buxton, R. T., Pearson, A. L., Allou, C., Fristrup, K., & Wittemyer, G. (2021). A synthesis of health benefits of natural sounds and their distribution in national parks. Proceedings of the National Academy of Sciences, 118(14), e2013097118.
Clinebell, H. (2013). Ecotherapy: Healing ourselves, healing the earth. Routledge.
Dodd, H. F., Nesbit, R. J., & FitzGibbon, L. (2023). Child’s play: examining the association between time spent playing and child mental health. Child Psychiatry & Human Development, 54(6), 1678-1686.
Duran, E. (2006). Healing the soul wound: Counseling with American Indians and other native peoples. Teachers College Press.
Duvall, J., & Sullivan, W. C. (2016). How to get more out of the green exercise experience: Insights from attention restoration theory. In Green exercise (pp. 37-45). Routledge.
