Nature Informed Therapy in Substance Use Recovery
Something to move toward
After his brother Max died from fentanyl poisoning in 2023, Grant Morris found Max’s fishing rods in his room. Fly fishing became part of the recovery story behind his documentary project, The Wake. [1]
In public conversations about the film, Morris describes finding his way through grief while in recovery himself. His account gives clinicians a concrete place to begin a conversation about what a person wants to return to. A river, in his case. An activity that asks for attention and offers something to practice. [1, 2]
The question extends beyond fishing. Alongside reducing harm from substance use, what might someone want more of in their week?
Nature-informed therapy makes room for that question within clinical care. A familiar place outdoors can become part of a plan developed with a client, with attention to what they enjoy and what they can actually reach. Research gives reasons to explore this work. It also leaves substantial questions about its effects on substance use recovery.
Start with what the person wants to return to
A clinician might ask, “Was there a place outdoors you used to enjoy, or one you’re curious about now?” The answer could be a garden behind an apartment building. It could also be no.
That answer matters. Someone who associates wooded spaces with danger should not have to accept the clinician’s idea of what feels restorative. A client who dislikes walking might prefer tending a plant. Another may want company before considering any outdoor activity.
At the Center for Nature Informed Therapy, the work connects engagement with the natural world to established therapeutic approaches. CNIT’s model pays attention to relationships with oneself and other people, as well as with the places where life happens. The setting becomes part of the clinical work. [3]
Consider an illustrative example. A client misses growing vegetables with a relative and wants something to do during an otherwise empty Saturday morning. The therapist and client might explore whether a nearby community garden has an accessible visiting time. Before agreeing on a plan, they would discuss transport and whether the client wants someone to go with them.
The next session would return to what happened. Perhaps the visit was enjoyable. Perhaps the gate was locked. Either answer tells the clinician more than a general instruction to spend time in nature.
Enjoyment is a reason to investigate
Meredith Berry and colleagues make a related argument in their 2021 conceptual review in Behavioural Processes. They propose nature exposure as an addition to medication and behavioral treatment for opioid and other substance use disorders. One possible contribution is access to enjoyable activities that do not center on substance use. [4]
The review also considers stress and decision-making. Some studies suggest that nature exposure can affect “delay discounting,” the tendency to favor an immediate reward over a larger benefit later. Whether those findings translate into lasting changes in substance use remains uncertain.
This is a research proposal, not a recovery trial. Much of the evidence came from people outside diagnosed substance use populations. The paper does not show that a walk prevents a return to use, or that fishing caused Morris’s recovery.
For clinicians, the useful question is specific: what might this activity contribute to this person’s care? A garden visit could provide an appointment with a supportive friend. Learning to identify neighborhood birds could offer an absorbing interest. These are possible applications to discuss and evaluate with a client.
A brief visit is not a prescribed dose
Broader mental health research helps explain the interest. Joanna Bettmann and colleagues’ 2024 meta-analysis in Ecopsychology examined 45 studies involving 1,492 adults with diagnosed mental illness. Nature exposure was associated with improvements across the outcomes studied. Effects were smaller in studies that included comparison groups. [5]
Some experiences were brief and some took place in urban green spaces. The findings suggest short-term benefits can occur without a wilderness trip. They do not establish 10 minutes as a dose that works for everyone, and they do not demonstrate lasting addiction recovery.
A 2018 trial by Ulrika Stigsdotter and colleagues in the British Journal of Psychiatry adds another distinction. Eighty-four adults with stress-related illnesses were assigned to a 10-week nature-based program or a specialized cognitive behavioral therapy program. Both groups improved in well-being and burnout, with gains maintained at 12 months. No statistically significant difference between treatments was found. [6]
The nature program included therapeutic conversations based on cognitive behavioral therapy, alongside activities in a garden. Treatment hours and formats differed. People with drug or alcohol problems were excluded. This trial cannot tell us whether nature-informed therapy improves substance use outcomes.
Make the plan small enough to examine
For a client who wants to try it, an outdoor practice can have a modest, agreed purpose. During a session in a suitable setting, a clinician might offer, “Would you like to pause and notice a sound around us, or would you prefer to keep talking?” Afterward: “What did you notice, if anything?”
There is no required feeling.
If attending to the surroundings increases distress, the clinician can stop the exercise and return to an agreed source of support. A quieter indoor setting or a view through a window may fit better. Client preference should guide the choice, including the choice to decline.
Practical details belong in the plan. A public garden may have nowhere private to speak. A route that looks short on a map may have no seating. Weather can change what is possible. Discuss these conditions beforehand and agree on an alternative.
Nature-based activities sit alongside individualized substance use treatment, including medication when indicated. Prescribed medication is compatible with recovery. An outdoor practice does not replace medical care for withdrawal or other urgent needs. [7]
Where CNIT brings this into clinical training
CNIT’s collaboration with BriteLife Recovery brings these questions into an addiction-treatment setting. Its published account describes clinician training with Heidi Schreiber-Pan and Zoe Jack, alongside observations about staff well-being. Those observations concern staff. They do not establish improved patient recovery outcomes. [8]
Schreiber-Pan describes her interest in helping people find experiences that “make life feel worth participating in.” That aim leaves room for a client’s own definition of what is worth returning to.
CNIT also emphasizes reciprocity, or caring for the places that support people. In practice, someone who enjoys a garden might choose to help water it. Such care should remain voluntary and suited to the person’s capacity. [3]
For clinical teams considering this work, CNIT offers customized nature-informed therapy training adapted to their setting. A useful starting point is the place clients can reach after they leave the program.
References
1. Robidoux, C. (2026, May 11). A brother lost, a story told: ‘The Wake’ examines addiction through a personal lens. Nashua Ink Link. Source for the fishing rods and Morris’s public account. See also the filmmaker’s official project page for The Wake.
2. Riverstone Mental Health Collective. (2026). Documenting sobriety: Grant Morris on fly fishing and healing in nature. The Nature of Mental Health. Interview with Morris.
3. Center for Nature Informed Therapy. (n.d.). Nature Informed Therapy. Organizational description of the approach and reciprocity.
4. Berry, M. S., et al. (2021). Using greenspace and nature exposure as an adjunctive treatment for opioid and substance use disorders: Preliminary evidence and potential mechanisms. Behavioural Processes, 186, 104344. https://doi.org/10.1016/j.beproc.2021.104344.
5. Bettmann, J. E., Speelman, E., Blumenthal, E., Couch, S., & Schmalz, D. L. (2024). Nature exposure, even as little as 10 minutes, is likely to yield short-term benefits for adults with mental illness: A meta analysis. Ecopsychology, 16(3), 174–190. https://doi.org/10.1089/eco.2023.0063.
6. Stigsdotter, U. K., Corazon, S. S., Sidenius, U., Nyed, P. K., Larsen, H. B., & Fjorback, L. O. (2018). Efficacy of nature-based therapy for individuals with stress-related illnesses: Randomised controlled trial. The British Journal of Psychiatry, 213(1), 404–411. https://doi.org/10.1192/bjp.2018.2.
7. Substance Abuse and Mental Health Services Administration. (n.d.). Treatment options for substance use disorder. Source for medication as an evidence-based treatment option.
8. Center for Nature Informed Therapy. (n.d.). The impact of Nature Informed Therapy for recovery center clinical staff. Organizational account of the BriteLife collaboration.
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