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Review
. 2023 Feb;86(2):101-115.
doi: 10.1177/03080226221126893. Epub 2022 Oct 13.

Engaging with nature and the outdoors: A scoping review of therapeutic applications in contemporary occupational therapy

Heather Firby  1   2 , Rosi Raine  3
Affiliations
Review

Engaging with nature and the outdoors: A scoping review of therapeutic applications in contemporary occupational therapy

Heather Firby et al. Br J Occup Ther. 2023 Feb.

Abstract

Introduction: Engagement with the natural outdoors is recommended for public health and wellbeing. Occupational therapists are well-placed to promote these therapeutic benefits, yet limited evidence exists of the scope of such applications.

Methods: A scoping review was conducted informed by the Joanna Briggs Institute framework. A systematic search was undertaken across five databases, and 64 sources were included following screening. Data were extracted using deductive content analysis, and themes identified through thematic analysis.

Findings: Three themes were identified: occupation-based applications; occupation-focused applications; and occupational therapy's contribution. Whilst current applications were evident, most literature explored potential or emerging practice. Outdoor engagement was found to be a complex, therapeutic occupation with the potential to promote mental health and restoration; quality of life and wellbeing; and healthy lifestyles through connection to nature; others; and self.

Conclusion: Occupational therapists enable outdoor engagement through occupation-focused and occupation-based interventions across a range of practice contexts. Occupational science may offer a valuable contribution to the evidence base, through considering being in nature as a meaningful occupation and outdoor accessibility as a matter of occupational justice. However, evidence of current practice is limited. Further research is recommended to strengthen the evidence-base and inform routine consideration within practice.

Keywords: Occupational therapy; eco; green; nature; outdoor.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Preferred reporting items for systematic reviews and meta-analyses flow diagram. Source: Moher et al. (2009).
See this image and copyright information in PMC

References

    1. Algado SS, Townsend AE. (2015) Eco-social occupational therapy. British Journal of Occupational Therapy 78: 182–186.
    1. Alty B, Langfield C. (2015) Creating a caring garden: The added value of occupational therapy. British Journal of Occupational Therapy 78: 112–113.
    1. Aoyama M. (2014) Occupational therapy and environmental sustainability. Australian Occupational Therapy Journal 61: 458–461. - PubMed
    1. Baum CM, Christiansen CH, Bass JD. (2015) The Person-Environment-Occupation-Performance (PEOP) Model. In: Christiansen CH, Baum CM, Bass JD. (eds) Occupational Therapy Performance, Participation, and Well-Being, 4th edn. Thorofare, NJ: SLACK Incorporated, pp.49–56.
    1. Birkby EE, Booth HB, Henderson MH, et al. (2012) Occupational therapy and the use of therapeutic gardening. British Journal of Occupational Therapy 75: 145.

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