What CNIT’s ecotherapy study found, and what it did not
Updated: Sep 15
Updated 09/15/2026
What CNIT’s ecotherapy study found, and what it did not
Four to six weeks after CNIT’s ecotherapy program ended, nine adults were interviewed about their experiences. All nine identified being present as among the experiences that most helped with stress or anxiety.
The 2025 study in The Humanistic Psychologist was authored by Paul Deal, Megan Delaney, Emma Sacco, and Heidi Schreiber-Pan, Executive Director of the Center for Nature Informed Therapy (CNIT).
The focus was participants’ experience. Its distinctive question concerned how relief from stress related to feeling part of the living world. Participants’ accounts offer a way to examine that relationship, with enough detail to inform what clinicians ask during outdoor work.
What happened during the six weeks
The group met in a large suburban park for weekly 90-minute sessions, each led by two licensed clinicians. The program combined mindfulness and relaxation with Acceptance and Commitment Therapy, an approach that includes accepting difficult experiences and acting in line with personal values. Sessions also included forest bathing, therapeutic group conversations, and education about the human relationship with nature.
The practices were concrete. In a sit spot exercise, participants chose a place to observe their surroundings. A tree-based breathing practice invited attention to the exchange of oxygen and carbon dioxide. Making a mandala from natural materials offered a way to consider cycles and belonging.
Nine adults were recruited through a private mental health practice in Maryland, with eligibility limited to people who had mild to moderate anxiety-related impairment and did not have acute or severe mental health conditions.
An anxiety questionnaire helped screen participants. It was not reported as a before-and-after outcome measure.
In interviews averaging 40 minutes, participants described what they had experienced; researchers then used consensual qualitative research, a method in which team members code those accounts and work together to agree on the main themes. The analysis examined what participants described and what those experiences meant to them.
Five themes emerged from the interviews
The researchers identified five main themes, called domains in the paper:
Stress reduction and less reactivity.
Being present.
A shift in perspective.
A deepening relationship with nature.
Transcendence, including a sense of connection beyond the individual self.
Each main theme appeared in eight or nine interviews. Those counts describe how widely a theme occurred in this sample. They are not treatment success rates.
Being present involved close attention to what participants could see, hear, and smell. Some described noticing surroundings they had previously passed through without much attention, while others spoke about finding enough of a pause in moments of stress to choose how they responded.
The shift in perspective could carry into daily routines. Several participants described making more deliberate time for nature after the program. One began traveling to a forest for walks, while another described learning to care for plants at home as part of a changing relationship with the natural world.
Awe was a subtheme within transcendence, appearing in four to seven interviews. That distinction matters. The study did not report that everyone experienced awe, and transcendence included a wider range of experiences of belonging to something beyond oneself.
A theme’s frequency tells us how often it appeared in these interviews. It does not measure the size of a clinical benefit.
Feeling calmer and feeling connected often overlapped
The paper distinguishes two orientations within ecotherapy. An anthropocentric approach centers human needs, such as relief from stress. An ecocentric approach attends to a person’s relationship with nature and recognizes the living world as valuable beyond its usefulness to people.
Participants’ accounts often crossed that boundary. Feeling present could accompany a sense of belonging, while a meaningful connection with nature could make it easier to settle.
The authors examined what participants identified as most helpful for stress or anxiety. All nine named being present, and seven named transcendence. This is a different count from how often each theme appeared anywhere in an interview.
The authors propose that these experiences may support one another. That remains a hypothesis. The study did not test whether adding an ecocentric practice produces greater symptom improvement than a program focused on stress relief alone.
Some accounts included a wish to care for nature in return, although a stronger connection could also bring distress, as one participant described when she talked about becoming more upset by environmental destruction. That experience deserves space in a clinical conversation, alongside accounts of calm or enjoyment.
For clinicians, this is a reason to listen beyond symptom language. A client may be describing a relationship with a place, a sense of responsibility, or a spiritual meaning that belongs to them. The paper cautions practitioners against imposing their own spiritual or religious values.
The client supplies the meaning.
What this study can leave open
This was a small qualitative study of a specific group. Participants ranged in age from 29 to 71, eight identified as female and one as male, and all identified as White and as having a middle to upper-middle socioeconomic status. Four worked in mental health, and five were receiving counseling.
That sample leaves substantial questions about whose experiences are represented. People with less access to green space, different cultural relationships with nature, or fewer resources may experience the same program differently. The authors also acknowledge possible selection bias toward people with more favorable experiences of nature.
The research team described its own positive relationship with nature and discussed how that could influence interpretation. Team coding and reflection addressed that concern. The paper also notes a gap of several years between interviews and coding, and that participants were not asked to review the interpretations.
Timing matters too. Because researchers spoke with participants four to six weeks after the program, these interviews offer an account of what remained meaningful beyond the final session, although recall may have shaped what people remembered. This was not a six-month follow-up, and the study does not establish sustained clinical improvement.
There was no comparison group. The design cannot separate the effects of the setting from clinician guidance, group contact, or the practices themselves. It also does not show how much anxiety changed on a symptom scale.
These interviews give clinicians detailed accounts of what participants found helpful and give researchers specific relationships to test.
Let the findings sharpen the next conversation
Begin with the client’s account. If a client mentions feeling connected with a place, invite them to describe what that connection means, while leaving room for experiences that were uncomfortable or did not feel useful.
These are editorial suggestions, not a tested protocol from the study. A client may feel no change. That is useful information too.
Outdoor work still requires informed consent and planning for privacy, weather, terrain, and access. A client should be able to decline or adapt an activity. Nature-informed therapy does not replace assessment or care for acute risk.
The authors recommend interviewing participants immediately after future programs and again six months later, alongside research with more diverse participants. Those designs could clarify what remains useful over time and for whom.
CNIT’s Foundational Training in Nature-Informed Therapy covers research, outdoor practice ethics, and clinical application through hands-on exercises. The study also appears in CNIT’s research collection.
Reference
Deal, P. J., Delaney, M. E., Sacco, E. G., & Schreiber-Pan, H. (2025). Understanding what makes a brief ecotherapy program therapeutic: A qualitative analysis of anthropocentric and ecocentric factors. The Humanistic Psychologist. Published study and DOI.
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