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NATURE THERAPY: A READER
Prepared for the First Nature Therapy Conference: Therapeutic-Educational Applications for Populations with Special Needs

Tel-Hai Academic College, Israel:
7th JULY, 2005

Author and Editor: Ronen Berger
The Nature Therapy Center. Israel 
© Berger 2005,  Ronen Berger – The Nature Therapy Center, Israel
ISBN: 965-90845-0-1

First published in 2005 by The Nature Therapy Center. Israel

To my children: Alon and Neta

May you always stay connected to nature, and may the wilderness and openness of nature always be there for you and your children to come…

Amen

 
Acknowledgments

I would like to acknowledge a number of people without whose ongoing support this work could not have been accomplished;

Meira Berger - My mother, for her constant spiritual and concrete support, believing in me at crucial times;

Lilach Berger-Glick - My partner in the ongoing love, companionship and trust, joining this journey;

Alon and Neta - My children, for creating the father within me;

Professor John McLeod – my PhD supervisor, for hearing my voice and teaching the dancer within me to talk and write;

Michal Doron, My former clinical supervisor and present colleague for supporting me in the creation and development of the Nature Therapy practice;

Arie Borshtine and Professor Mooli Lahad – my teachers, for teaching me the magic embedded in dance and improvisation, fantasy and story making;

To my clients and students – for constantly teaching me new things in Nature Therapy;

To the Golan wolves and the Banias river – for giving me new life;

My heart is with you.

 
Contents

1. Prologue
2. Opening the Door
3. Nature Therapy: A Framework for Practice
4. Research articles:
4 (a) Going on a Journey: Nature Therapy with a group of children with emotional and behavioral difficulties, a case study
4 (b) Building a Home in Nature: Nature Therapy with a group of children with learning disabilities, a case study
5. Nature Therapy with the Elderly
6. Closer and thought for the future… 

 
Prologue
It is with joy and excitement that this Nature Therapy Reader has been prepared for the First Nature Therapy Conference: Therapeutic-Educational Applications for Populations with Special Needs, that took place in Tel-Hai Academic College, Israel, in July 2005.
The Reader is an outcome of five intensive years of work, in which the Nature Therapy approach was created and developed from a personal semi-unconscious and spontaneous self-assistance mechanism into an therapeutic-educational approach which is now recognized as an independent therapeutic-educational discipline, and stands as a basis for the creation of therapeutic and educational programs and post- graduate training in various institutions, and with various populations in Israel, England and Scotland.
The Reader aims to highlight Nature Therapy's theoretical framework and practical techniques, giving examples from case studies and research which took place with different populations, and in various natural settings. It begins with the article "Opening the Doors…", presenting the option of conducting psychotherapeutic mind-body-spirit work in nature. It then continues with the article "Nature Therapy: A Framework for Practice", illustrating core principles of the approach and giving examples from practice. This is followed by two case study articles: (a) Going on a Journey; (b) Building a Home in Nature: these present and analyze ways in which Nature Therapy can be operated with children and youth with special needs and learning disabilities. It concludes with the article "Nature Therapy with the Elderly" illustrating a mode of working in which Nature Therapy can be implemented with old people.
All the articles published in the Reader were written by Ronen Berger; Nature Therapy's founder, a drama and body therapist, ecologist and dancer, and originally published in his M.Phil Appendix, which was delivered as part of his PhD in Abertay - Dundee University, May 2005.  Most of these articles have been reedited to shorter versions of articles which will be or have been published in various journals.
I hope this Reader is helpful…
Ronen Berger

(2)   Opening the Doors – illustrating the option of conducting psychotherapeutic mind-body-spirit work in nature while seeking to develop a framework for practice.
 
Based upon an article which was originally written in collaboration with John McLeod, Tayside Institute for Health Studies, University of Abertay Dundee

There is a growing appreciation that the patterns of living that have evolved within modern, industrialized, high-technology societies have resulted in the relationship between people and nature becoming distorted and fragmented. Many writers have suggested that the rupture between human communities and the natural world contributes to a lack of psychological well-being, and ultimately to emotional problems and ill-health (Kuhn, 2001; Pilisuk and Joy, 2001; Roszak et al, 1995; Roszac, 2001). The role of counseling and psychotherapy, as a potential vehicle for restoring the balance between people and nature, was explored in a recent paper in the Counseling and Psychotherapy Journal by Nick Totton (2003), which called for therapists to give greater attention to the 'ecological self' of clients. But how does an approach to therapy that takes nature seriously work in practice? In our view, the relationship between the individual and nature represents a powerful healing resource that can be used by counselors and psychotherapists in their work (Berger, 2003, 2004). Our aim in this article is to explore some of the key principles that might be used to inform this kind of work, and to provide some examples of practice.
Ritual, community, and contact with nature

          One of the central principles that underpin therapy carried out in a natural setting concerns the intentional use of ritual on the part of the therapist or group facilitator. It is important for those of us who have been socialized into urban life to be willing to learn from times when people lived in communities in nature. In those days, life was strongly connected to nature, as people depended directly on it for their physical, social and spiritual existence. There was a holistic attitude towards nature: the individual was part of a family, which was part of the tribe, which was part of nature, which was part of the universe. Each of these elements was connected to, embedded in, and interdependent on, the other. A change in one meant a change in the others (Eliade, 1959; Meged, 1998; Turner 1986). People lived within a predominant sense of collectiveness, which was expressed through religious rituals, and had a strong role and function in life. Ritual gave people a sense of order and security; fostered a feeling of togetherness, and provided a sense of control over the uncertainties of life. Ritual had an essential social function in helping individuals move from one social stage to another; in this sense rituals can be regarded as the forerunners of modern therapy.
A training workshop for counselors is conducted in an area lying between a wind-swept beach, a river, and a pine forest. On arriving at the site, the group is invited to form a circle, facing outwards, the arms of each person around his or her neighbor. Participants are instructed to be aware of what they hear, see and feel. The group moves around slowly, through a 360º rotation, letting its attention move between the natural view outside the circle and the view inside it – the eyes of all the group members. Later in the day, as the group moves on to other places within the landscape, it is invited to carry out the circle ritual again. What happens in this exercise? This simple ritual can provide many different types of learning, which can include the experience of being simultaneously connected to oneself, to others and to nature; a sense of what changes and what stays the same; an appreciation of the intricacy of the natural world; a willingness to support, lead, be held by, and belong with other people.
       From a contemporary perspective, the notion of ritual may seem distant and lacking in relevance. However, as modern, individualistic and secular people we deal with the same basic and universal issues as our predecessors: fear of the uncertain, the unknown and the uncontrollable. These are issues which can trigger difficult emotional and physical responses, and account for a large part of the reasons why people seek therapy. In approaches to counseling, psychotherapy and training that make use of nature, it is important to recognize that ritual provides a structure within which the relationship between the person, the therapist, and the natural world can be experienced and explored. As in traditional societies, therapeutic rituals can be used to develop an awareness of change (for instance, when the same ritual is repeated on different occasions, the attention of the person or the group may well be drawn to features of the experience that are different from previous occasions). Rituals can also support people at significant points of transition in their lives, such as finishing college, getting married and becoming parents.
    Using nature as a source to connect body, spirit and mind, Adventure Therapy,  various forms of outdoor pursuits, education and leadership training, use nature to expose the client to a controlled level of physical risk and challenge, such as canoeing down rapids or hiking through a wilderness. During this confrontation with nature, the aim is that the client will encounter his or her own fears and avoidance patterns and hopefully discover new and more efficient ways of coping with them, for example by making better use of group support (Beringer and Martin, 2003; Gillis and Ringer 1999). These forms of education and therapy place a primary emphasis on nature as a setting where such adventures can take place. However, another, softer way of working with the physical presence of the natural world can be illustrated in the following example.
Ran,  a successful health professional, experienced difficulties in relation to coping with the combined stress of a demanding job and his family life. He developed intestinal symptoms that could not be controlled by medical treatment, and turned to psychotherapy. During his first two sessions with his therapist, Ran described his stomach as a "hot, wet sponge" which was "not so nice to touch". Asked to say more, he described the exact location of his physical symptoms, as "wet soil", which was quite revolting and unpleasant to be in. He said that, when he had been in counseling in the past, he always stopped when he became aware of this "soil": "I avoid being in that place, at all costs". His therapist asked Ran if he would be interested in experiencing some real wet soil – offering to conduct the work in nature. He agreed to try this out. They spent the next few sessions at a riverbank. Ran first got to know the ground by digging his hands into dry warm sand. Later, he moved to the, wet sand and mud of the riverside. At first Ran hated touching this stuff, but as time progressed, together with the changing of the season he relaxed and even learned to enjoy the beautiful place. These sessions were held at the end of day, at the time when daylight changed to darkness.  Ran found a place where he felt safe enough to touch and enter the "wet soil", to talk about the memories and meanings it evoked for him, staying attentive to the transformation of the light in the experience he had in nature.

       In this example the therapist used an image given verbally by the client and extended the use of it, in a concrete fashion, in nature. For the crystallization of the process, the therapist chose a specific location and a time of day to conduct these sessions, which used a creative and embodied way of working.
There is always something, or some place, in nature, that has the capacity to trigger strong feelings, which vary from person to person. For Ran, wet sand and soil served to externalize a set of feelings that were central to the way he organized his life. For other people, the trigger provided by nature can be cold, water, animals, the fear of being lost, and much else. Working in nature makes it possible for a therapist to work with current emotions triggered by the natural environment.
Nature as a partner in storytelling
       In Drama Therapy, the theatre stage is often described as a “sacred space” (Pendzik 1994), an arena in which the actions and events from everyday life can be transformed into the fantastic - "as if" reality - and can be given additional meaning and perspective (Jennings 1998; Lanndy 1996). In a similar fashion, it is possible to use nature as a sacred space, one which is experiential and creative, and not merely verbal. This approach accepts the possibility that nature will assume a role in the process: in this sense, indeed, nature can be seen as a partner in an unfolding story. Nature "behaves" in independent ways: it may influence and shape the setting in various ways (for instance with the coming of rain or wind), thereby challenging the client (and therapist) to be flexible and to explore additional ways of being and relating to unexpected changes in life. Work with natural elements can therefore contribute to the expansion of a person's coping mechanisms, thus improving his or her overall functioning and well-being (Lahad, 1996). Nature can be the backdrop to the story, or it can be an active and dynamic participant.
Linda, in her forties, attended a nature-based three-day therapy group. At the first session, which took place in an indoor setting, near a river, the work started by inviting participants to construct an imaginative story that expressed the personal issues, needs and wishes that they had brought to the group. Linda told a fantastic story about a lonely starfish which lives in the ocean and has a soul mate that accompanies him in the sky. At this point Linda had not shared her grief with the group or with the therapist. The second day of the workshop began with a silent – meditative walk down the river. On arriving to a narrow bridge crossing the river, participants were asked to find a physical element from the surroundings that symbolized a sensation, feeling or thought that they would like to depart from;  to say something about it, or name it, and then to throw it into the river. At this stage, which produced strong feelings for most group members, Linda told the group about her grief. After crossing the bridge, the group arrived at a peaceful and quiet part of the river, where they were invited to create a representation of the story they had told the previous day, as a sculpture, picture or drama, using natural elements. Linda created a sculpture in the intermediate zone, where the water meets the shore. She gathered colorful flowers and placed them on two stones, which she later connected with a stick. She named her sculpture "the couple". The next day, on returning to the same location, Linda was surprised to discover that the live flowers that she had picked, and used to create her sculpture had now dried out and "lost their joy". This change, which was created by 'nature', allowed Linda to connect to her own feelings and to reflect on her family relationships at present. This made her realize that perhaps she was grieving not only for the one who had gone, but also for aspects of her marriage which still existed and perhaps needed to be revived. Coming back to the sculpture on the third day expanded Linda's perspective further, by drawing her attention to the clear running water that constantly flowed around her construction, and to the changing colors of the surrounding river. These simple observations, carried out at a time of grief, helped Linda to connect to concepts of continuity and cycling, and gave her hope and strength, which according to her, allowed her to return home as a new person, taking "some clean, running water" with her.
    The underlying principle here is that each person lives in and through a life narrative (McLeod, 1997), which expresses his or her goals, feelings, relationships with others and sense of the 'good life'. In conventional face-to-face verbal therapy, this story is primarily expressed in words, and secondarily expressed in action (for example, being late for sessions, patterns of behavior toward the therapist). In therapy that draws upon nature, by contrast, there is a wider range of objects and events that provide endless 'projection' opportunities, allowing stories to be constructed and told. Some of these natural resources possess immense symbolic meaning - earth, water, wind, and fire, flowers and animals. Moreover, one of the essential characteristics of nature is that it is forever changing, with the consequence that the elements of a story (for example, Linda's flowers) undergo change and invite re-telling of the story. The "six part story method" developed by Lahad (1992) provides a valuable framework for making sense of the process of storytelling in nature therapy. He describes a method of enabling a client to construct a journey narrative, in which the main character overcomes challenges, copes with problems, and decides what should happen next. Any approach to therapy that involves movement into nature, and then a return, creates the possibility for the person of the story he/she constructs, which expresses his or her basic existential patterns of being and doing, may undergo change and renewal.

Building a home in nature
       One of the most powerful aspects of working therapeutically in outdoor settings is the idea of building a home (i.e., a safe place) in nature. In the story of Joseph, which opened this article, the process of building a “home in nature” was central to his therapy. However, this process occurs, to a greater or lesser extent, in all forms of nature therapy. The construction and maintenance of the home are as much a part of the therapeutic process as is the fact of its being a sacred space that contains therapeutic work. The approach allows the possibility of the therapist and the client jointly constructing the space for their encounter, with nature as an active partner in the process. The activity of building a home invokes a wide range of choices and issues, such as where it is to be, what it contains, what it is built from, whether solid and permanent or mobile, what kind of borders it has… The existence of a home in nature invites reflection on the qualities of the home in the city, where the person has spent his or her life, and on a deeper sense that the person may possess, of either having, or not having, a sufficiently "secure base", sense of self, or definined boundaries.
 
Integrating nature into everyday therapeutic practice
       The space limitations of this paper do not allow the possibility for further discussion of important aspects of therapeutic work that involves nature, such as the role of spirituality, intuition and physicality, or the values base for this work. Also, it is essential to acknowledge that the examples given in this article all refer to practice in which the therapist actually accompanied, and was present with, the client or group in a natural setting. Although work of this kind in natural environments gives the most direct form of access to the connection between person and nature, there are ways of bringing nature into counseling and psychotherapy that takes place solely indoors. Some therapists make sure that objects from nature, such as stones, plants and wood, are on hand within the counseling room. Other therapists, for example Burns (1998), specifically invite clients to talk about their relationship with nature within therapy sessions, and suggest homework activities that may involve encounters with nature.
       The use of nature in therapy raises a number of issues for mainstream approaches to theory and practice. Nature represents an open space that belongs neither to the client, nor to therapist; it existed before their arrival and will remain long after they have gone. Working in nature questions cognitive and verbal ways of working, which may ignore or miss out on important nuances embedded in creative, spiritual, embodied and intuitive 'natural' processes of knowing. Nature-oriented therapy insists on viewing and addressing the client as part of a macrocosm; in relation not only with his “inner self” but also with other people, culture, landscape, animals and plants; seeking harmony with him or herself and the world as one continuous unified whole. In this sense Nature Therapy can allow the therapeutic encounter to work as a vehicle for raising ecological/natural conservation awareness, and to begin to move from an individual perspective to a social or collective one.
       At the present time there is very little research evidence concerning the use of nature-oriented methods in therapy, and few training programs. We are currently involved in carrying out research to evaluate the effectiveness of therapeutic and educational programs with different populations in various natural settings, and the issues involved in designing professional training in Nature Therapy. Our basic assumptions, in developing this approach, are that nature contains resources which can support emotional, spiritual, mental and physical personal well-being, which in turn can be used for psychotherapeutic purposes, and that the intentional use of nature as a resource can be effectively integrated into any approach to therapy. Our hope is that, as more counselors and psychotherapists develop and disseminate their own ways of doing therapy in nature, a broader set of case examples and research studies, and a more fully articulated theoretical framework can be built up.

References
Berger, R (2003) In the footsteps of nature. Horizons, 22, 27-32
Berger, R (2004) Therapeutic aspects of Nature Therapy. Therapy through the Arts –
    Journal of the Israeli Association of Creative and Expressive Therapies: 3: 60-69.
Beringer, A and Martin, P. (2003) On adventure therapy and the natural worlds:
    Respecting nature’s healing. Journal of Adventure Education and Outdoors Learning, 3: 29-40.
Burns, G.A. (1998) Nature-guided Therapy: Brief Intervention Strategies for Health and Well-Being. London: Taylor and Francis.
Eliade, M. (1959) The Sacred and the Profane. New York: Harcourt Brace Jovanovich.
Gillis, H. L. and Ringer, M. (1999). Adventure as therapy. In J.C. Miles and S. Priest (eds.) Adventure Programming. State College, PA: Venture Publishing.
Jennings, S. (1998). Introduction to Dramatherapy. London: Jessica Kingsley.
Kuhn, J.L. (2001) Toward an ecological humanistic psychology. Journal of Humanistic Psychology, 41: 9-24.
Lahad, M. (1992) Story-making in assessment method for coping with stress: six-piece story-making and BASIC Ph. In S. Jennings (ed.) Dramatherapy: Theory and Practice 2. London: Routledge.
Lanndy. R.J (1996). Essays in Drama Therapy. London: Jessica Kingsley.
McLeod, J. (1997) Narrative and psychotherapy. London: Sage.
Meged, N. (1998) Gates of Hope and Gates of Terror. Tel Aviv: Modan Publications. (in Hebrew).
Pendzik, S. (1994) The theatre stage and the sacred space. The Arts in
Psychotherapy, 21: 25-29.
Pilisuk, M. and Joy, M. (2001) Humanistic psychology and ecology. In Schnedier, K.J., Bugental, J.F.T. and Pierson, J.F. (eds.) The Handbook of Humanistic Psychology. Thousand Oaks, CA: Sage.
Roszak, T. (2001). The Voice of the Earth. Grand Rapids: Phanes Press
Roszak, T., Gomes, M. E., Kanner, A.D. (1995). Ecopsychology: restoring the mind, healing the earth. San Francisco, CA: Sierra Club Books.
Totton, N. (2003) The ecological self: introducing ecopsychology. Counseling and
Psychotherapy Journal. 14: 14-17.
Turner,V. (1986) The Anthropology of Experience. Evanston, ILL: Illinois
University Press.


 
(3) Nature Therapy: a framework for practice

Abstract:
This article aims to illustrate the main concepts, theory and techniques of Nature Therapy. Drawing on examples from interventions carried out with different populations in individual and group settings, these core principles are explained and highlighted. Since the approach is quite new, the paper also aims to call for dialogue and debate concerning some of the direct and indirect issues it may touch.

Prologue:
Nature-Therapy is an innovative therapeutic – educational approach taking place in nature. It is a creative and experiential approach which takes action in direct contact with nature in constant dialogue with it. As such, it addresses nature not only as a setting or toll provider but, furthermore, as a partner in the shaping of the setting and process. This way of relating to nature is rooted in the concept of "touching nature" claiming that in the actual touching "nature" one can also get in touch with elements of oneself and others (Abram, 1996). Since it works in a live, open and ever-changing environment it is designed in a way that invites the therapist to integrate theory and intuition. Therefore it is designed in a way which allows the therapist to work together with 'nature's' independent dynamics using its unique healing powers to support the therapeutic process. As such, Nature Therapy integrates elements from adventure therapy, experiential education, art and drama therapy, eco-psychology, gestalt and the narrative approach with elements from ancient rituals in a way that develops a unique theoretical framework, modes of working and code of ethics, suggesting a way to integrate therapeutic theories, intuition and the wisdom imbedded in nature.
The approach may set as a frame work, offering few guidelines which may assist the therapist who seeks to work in a creative yet structured manner. The aim of this article is to introduce the approach focusing on its practical aspects being its four modes of working. The article will include examples from therapeutic interventions, illustrating some of the ways in which the approach can be delivered with different populations, in individual and group setting. 


Setting a theoretical framework:
Nature Therapy relates to 'therapy' with the image of a journey taking place under a ritualistic orientation in nature (Berger 2003). This ritualistic approach to therapy can be found also in the roots of Drama-Therapy (Jennings, 1995, 1998; Jones, 1996; Pendzik, 1994) and can be traced back to Jerome Frank's book "Persuasion and Healing" (1963). Having a holistic orientation, Nature - Therapy relates to few basic concepts of Eco-psychology, acknowledging the human need for contact with nature as a key factor for well-being and personal healing (Roszak, 2001; Roszak et al, 1995; Totton, 2003). In this sense, one of the basic assumptions of the approach is that working in direct contact with nature can connect people with their primal and intuitive knowledge which may be deeper than any other – cultured one. Due to the difference between the traditional therapeutic setting; being the indoor clinic: a closed and static environment which is controlled and owned by the therapist and the natural setting: an open, live and ever changing one, not owned by the therapist, Nature Therapy develops unique concepts which offer the therapist a theoretical and philosophical framework which can support his or her work. These theoretical concepts are intertwined in the modes of working of the approach which will be presented later.

1. "The Three-way relationship between the therapist, client and nature":
This concept offers the therapist to address 'nature' not only as a "setting" or tool provider but furthermore as an active partner in the shaping of the setting and process. In this sense the therapist is invited to relate to the 'nature' as a kind of a co-therapist offering different elements to relate and work with. In this sense the therapist can relate to nature as a kind of story in the background; providing universal and live metaphors which the client can identify with, project on and reconstruct his or her personal narratives according to.
This narrative approach to therapy is based on the concept that each person lives in, and through a life story which expresses his or her goals, feelings, and relationships with others. The re-telling of these stories in alternative ways allows the person to view additional aspects of his or hers live including the option to reconstruct various aspects in them (McLeod 1997). This concept invites the therapist to address the unexpected changes 'nature' brings as a kind of therapeutic intervention; challenging the client (and therapist) to develop flexibility and to explore additional ways of being.  In this sense the work with the natural elements can expend a person's patterns and copping mechanisms and by that reduce the feeling of tension and improve a person's overall function and well-being (Lahad 1996).  In order to help the therapist visualize this term it may be helpful to imagine a triangle were the client makes its top crown while the therapist and 'nature' make its basis angles; providing ground and support. It is a dynamic triangle which can change the length of its arms; changing the distance between the client and nature and vice-a-versa (see Illustration 1). In this sense there may be times when the therapist "will take a step backwards" and let the client work directly with nature. Working with this concept has a strong implication on the process: expanding the casual therapeutic "person to person" alliance, allowing the client to explore his/her story in additional ways gaining additional context and meanings.

Client - Nature - Therapist
Illustration 1: The Three-way relationship between the therapist, client and nature
 
2. Nature as a Sacred Space and the concept of rituals
This concept comes to integrate the ritualistic manner of the approach together with the shamanic concept of the "sacred space". This integration comes to help the therapist put the therapeutic encounter held in nature in a unique context, helping the client to relate to the therapeutic experience in a special way, creating space for deep learning and transformation to take place.  The concept of nature as a sacred space is not new and goes back to the beginning of civilization. It can be found in most cultures taking an important role in shamanist and other healing cures. Its main function was to protect the enclosed, ritualistic site, from the intrusion of evil forces which might have entered and damage the delicate healing process. The creation of the sacred space is made by detaching a territory from its surrounding milieu and marking it as qualitatively different from the rest (Eliade, 1959. Pendzik, 1994. Turner, 1986). Relating to nature from a modern perspective, where most people live in an urban environment which are quite different and distanced than the "natural" one having different tempo, look and sensation, may help the therapist working in nature to create the "different" physical and emotional environment which is needed for therapy to take place.  Another important factor which promotes this concept lies in the primal symbolism of holiness people give natural places; such as the rivers Ganges, Jordan and Nile, mountains such as Sinai and Kilimanjaro, natural phenomena, such as thunder and sunrise, and to wild animals, such as the wolf and eagle, representing different meanings for people from different cultures. In this sense, working therapeutically in nature can help a person connect to the basic feeling of holiness, and get in touch with his or her primal knowledge, one that is embedded in the universal and cosmic wisdom. In this way, it will help the therapist to be aware also of historical stories embedded in the landscape, since they may have an important, multi-generational effect on the narratives of the clients. For example, working in an olive orchard may symbolize peace and harmony for a Jewish Israeli person, but in contrast, symbolize oppression and occupation for a Palestinian person. In this respect, the therapist may choose specific environments for specific purposes, using the contact with nature to unconsciously connect the person with primal aspects of his or her identity. This way of working can engage the client with his or her authenticity, allowing the exploration of basic issues, such as belonging and connectedness. In this sense, working with the knowledge that is embedded in nature goes together with the concept of the three-way relationship: hence, therapeutic learning can be achieved, not only through the contact and dialogue between therapist and client, but also through contact with nature.

Nature Therapy modes of working:
The practical aspect of the Nature therapy approach is expressed by four modes of working. Each of the models supports specific stages in group and individual development, having  unique orientation, characteristics and reference point which help the therapist to suit the therapeutic program according to the characteristics and needs of each and every client. These four modes of working illustrate a metaphoric development of human–nature relationships, moving from a challenging and controlling position in the first one towards an interdependent and coexistent in the last one. This axis of development supports another innovative concept of nature therapy: the transition between states of being and of doing. This outlook is based on the concept that the expansion and enlargement of a person's coping mechanisms can help him or her reduce the feeling of tension, and thereby  improve the client’s function and overall well-being (Lahad, 1996).
Before introducing these modes of working, it is important to emphasize that they can be integrated in various forms, using the image of a journey as a way to hold them within a narrative–ritualistic orientation. An example for such integration will be presented towards the end of the article. 

(a) Nature-Adventure
                The Nature-Adventure model offers a concrete, task-oriented approach to therapy, addressing nature as a provider of challenges and a trigger for a process oriented to adventure and problem-solving. It is composed mainly from the field of Adventure Therapy and exponential education, and hence relates to Ringer's definition of Adventure Therapy: "Originates activities involving the combination of physically and psychologically demanding outdoor activities and/or remote natural settings” (Ringer, 2003, pp. 19-20). This approach to therapy can be illustrated by an example given by Gillis and Ringer (1999, pp. 29): “Having two persons who have difficulties in their relationship, such as father and son or husband and wife, paddle a canoe will require them to cooperate in order to be successful. A 14-day backpacking trip for a group of adjudicated youth provides a self-containing purposeful therapeutic community, where tasks such as erecting tents, reading a compass, or cooking a meal provides challenges in communication and discipline which can be utilized for therapeutic outcomes”. Like the Adventure Therapy approach, "Nature Adventure" addresses nature as a “backdrop to or stage for adventure” (Beringer and Martin, 2003), which gives the participants a chance to encounter and confront their fears and patterns, and then, through appropriate interventions, discover additional, more efficient ways of coping. In addition to the way in which Adventure Therapy addresses the process, relating mainly to the concrete way in which the client deals with the challenges 'provided by nature' (Gillis & Ringer, 1999), exploring the process from a nature therapy orientation may use some eco-psychology ideas and relate to the relationship between the client and nature. This may expand the process, by exploring the ways in which the person copes with his or her basic need for control and certainty.
              Addressing nature as a setting and tool provider goes together with the first stage of the developmental axis of the human–nature relationships which was mentioned earlier: challenge and control. Another aspect of this active, task-oriented, approach is that it invites the client to experience and develop the “doing” states, and thereby to expand his/her ability in this respect.
          Like Adventure Therapy, Nature–Adventure  offers the therapist an effective, active, and concrete tool to facilitate such issues as communication, trust, intimacy and problem-solving (Bandoroff, 2003). Another aspect of this model, relating to the ritualistic orientation of Nature Therapy lies in its concrete and physical aspect. This aspect is expressed through a journey in nature whose concreteness helps to connect the symbolic and metaphoric work which is done through it (which will be illustrated in the later models) on the person's narrative, patterns and issues.

 (b) “Art with Nature”
"Art with Nature" offers a creative mode of working in nature, like its title, it addresses nature not only as a tool provider and setting but furthermore as a partner in an experiential – therapeutic process. "Art with nature" is informed mainly by Drama Therapy and the Narrative approach and influenced by rituals from shamanistic heritage. According to Jennings (1992), one of Drama Therapy’s pioneers, Drama Therapy is the “Specific application of theatre structures and drama processes with a declared intention that is therapy". "Art with Nature" works in a similar way, offering a metaphoric, non-verbal approach to therapy. It addresses the creative work carried out in nature as a means to trigger therapeutic change relating to nature's dynamics and constant changing, as a kind of intervention which supports the learning process. As such, working with the concept of the three-way relationship, nature is addressed as a partner in the process, taking various roles in it.  It can be addressed as a story in the background, offering the client stories to identify with and relate to. These natural events and phenomena can help the client to connect and give voice to difficult stories which were trapped within and may have been regarded as taboo. Thus, an encounter with a dead animal can invite a person to share a story of grief and loss. In this aspect, the parallel between the personal story and the universal–natural one can be used to normalize personal suffering, in a way that acknowledges the individual’s personal suffering, while at the same time connecting the individual with the larger,  cosmic story, and thereby providing additional sense and meaning.
          Another strong element which is embedded in the concept of the three-way relationship and supports the work in "Art with Nature", relates to the independent influence that the natural elements, such as rain and water, have on the artistic process and product. The client can be encouraged to explore and relate to the ways in which the artistic work has been affected by these natural elements, and look into the insights that this process may unfold. This concept relates to a basic idea within art therapy, by which a person's creation is symbolic of his or hers personal narrative (Lahad, 2000). This way of addressing the process may also highlight the spiritual and ritualistic aspect of Nature Therapy,  relating to nature's mystical powers in a way that has a meaning in the process.
         Like Dramatherapy, which is, according to Lahad( )  (1992) a  "multi-modality of the art that manifests itself in the dramatic act" (pp. 179-182), so does "Art with Nature". The model integrates techniques, such as story-telling, story-making, art, drama, movement and dance, taking place in direct contact with nature. The approach relates to another core principle of Dramatherapy; the concept of ‘theatrical distance’ and the principle of the "two realities" - the fantastic and the concrete ones. According to these concepts, the work takes place in the fantastic-dramatic zone, which is qualitatively different to the client's everyday life. The entrance to this fantastic space, which is physically represented by the stage, allows the client to experience and explore behaviors and roles which were hard to explore in real–casual life. The shifts between the two realities helps to transfer the learning gained in the fantastic one into the person's concrete life. (Jennings, 1998a; Landy, 1996; Pendzik, 1994). Relating to these concepts, Nature Therapy addresses nature as an optimal setting to work in.  Its remoteness and difference  help the person to make the symbolic separation between the two realities, and therefore also the transition between them. This, paradoxically, supports the integration of the experience, making it concrete and transferable.   Another strong element which is present in nature and can support such creative work, arises from the fact that the natural elements arouse all the senses, providing endless metaphors and sensations which can trigger and support experiential and non-verbal creative processes (Abram, 1996).
           An additional element, within the “doing–being” dimension of the overall approach, is the opportunity this model gives the participants to move from the "doing" state, which was illustrated in the Nature–Adventure model, into a "being" state, inviting him or her to explore additional coping mechanisms and expand his or her basic patterns.

           Linda, in her forties, attended a nature-based three-day nature therapy group. At the first session, which took place in an indoor setting, near a river, the work started by inviting participants to construct an imaginative story that expressed the personal issues, needs and wishes that they had brought to the group. Linda told a fantastic story about a lonely starfish which lives in the ocean and has a soul mate that accompanies him in the sky. At this point Linda had not shared her grief with the group or with the therapist. The second day of the workshop began with a silent, meditative walk down the river. On arriving at a narrow bridge across the river, participants were asked to find a physical element from the surroundings that symbolized a sensation, feeling, memory or thought that they would like to depart from, to say something about it, and then to throw it into the river. At this stage, which produced strong feelings for most group members, Linda told the group about her grief, a case that happened only ten days before the training. After crossing the bridge they were invited to create a representation of the story they had told the previous day, as a sculpture, picture or drama, using the natural elements. Linda created a sculpture in the intermediate zone, where the water met the shore. She gathered colorful flowers and placed them on two stones, which she later connected with a stick. She named her sculpture "the couple". The next day, on returning to the same location, Linda was surprised to discover that the live flowers that she had picked and used to create her sculpture had now dried out and "lost their joy". This change, which was created by nature, allowed Linda to connect to her own feelings of loss and to reflect on her family relationships at present. This made her realize that perhaps she was grieving, not only for the one who had gone, but also for aspects of her marriage which still existed and perhaps needed to be revived. Coming back to the sculpture on the third day, expanded Linda's perspective further, by drawing her attention to the clear running water that constantly flowed around her construction, and to the changing colors of the surrounding river. These simple observations, carried out at a time of grief, helped Linda to connect to concepts of continuity and cycles, and gave her hope and strength, which according to her, allowed her to return home as a new person, taking "some clean, running water" with her.

          This example illustrates some of the potential that lies within creative and non-verbal work that uses the natural elements to raise the efficacy of the therapeutic process. This indirect way of working may help clients to give voice to stories that they did not find words for before, and enable them to relate to their story in additional ways, thereby broadening their identity and their coping mechanisms.

(c) Building a Home in Nature
           The Building a Home in Nature model originated from the author’s own experience, working with an autistic youngster.

          Jordan was a fourteen year old youngster with severe communication and social difficulties. When the therapeutic encounters began he did not want to go into the indoor clinic, and used to lead his therapist for walks near his classroom. In time, the boundaries of these walks expanded from the well-known interior of the institution to a nearby but unfamiliar river bank. Then, Jordan chose a specific place on the riverbank, under a willow tree, hidden from passersby. Since the therapeutic goal of the sessions was to help Jordan enlarge his social and communication skills, the encounters would commence in a concrete way, centered on a tea-making ceremony on a fire. As time progressed, it became evident that he was paying careful attention to maintaining the exact location, manner, and order in which the activities were held. In addition, it became clear that he was constructing a small barrier around the zone in which the “tea ceremony” took place, making sure it was performed in its center. As the barrier was built, through the direct physical encounter in nature and the repetition of the activities and ceremonies conducted in this specified different place, the relationship between Jordan and his therapist was slowly built. A crucial turning point occurred when the construction of the barrier around the “tea place” was completed and Jordan, very dramatically expanded his use of language, and the desire to connect with the therapist and tell him his story. Later on, as winter commenced, the sessions moved indoors to the clinic, working through story-making and art. When difficult situations arose, Jordan would once again lead the therapist to the place on the river bank, asking to check whether the safe sacred space that they physically built together was still there, exploring the changes it went through, and then reshaping it according to the new situation. It was as though Jordan needed to check and see whether the safe sacred space, which by then was titled  'home in nature', a space that also symbolized the therapeutic alliance, was still there.

             In this model, the client or group, accompanied by the therapist, builds a “Home in Nature” – a safe, sacred space where personal stories can be revealed and shared, and rituals can be performed. In this respect, the “Home in Nature” offers the clients a chance to build a secure place to bring forth their dilemmas, conflicts, and difficulties, offering a different, self-made environment to explore, reflect, and experience alternative, perhaps more satisfying ways to construct and live their lives according to.  Relating to some core principles from White and Epston’s narrative approach (1999), working with the concept of Building a Home in Nature can help a person to explore additional narratives, to provide a basis for the reconstruction of his or her life (Freedman &  Combs 1996; Meier 2002; White & Epston 1999).  The physical construction of the "home", and the constant observation and adaptation of it, can be addressed as an ongoing invitation to explore questions regarding basic issues, such as belonging, borders, security and attachment,  all relating in different ways to the concept of a person's home and identity. Integrating the concept of the three-way relationship between the therapist, the client and nature can be a powerful means to trigger work on such issues as control and flexibility, which may have been awakened by unexpected changes made by nature.
Another important principle of Nature Therapy which can be illustrated here is the concept of partnership and minimizing the hierarchy which lies between the therapist and the client. This can be illustrated by the actual,  physical construction of the therapeutic space, which is designed and build together by the therapist and client, inviting them to share the space which is not owned or controlled by either one of them. In this respect, both the therapist and client stand as equals before the wonders of nature.
Building a Home in Nature, in comparison with the two previous models, allows the therapist to take “a further step backwards”, allowing nature to take larger parts in the shaping of the process. It expands the dynamic movement between “doing” and “being“ , which becomes possible during the building of the Home and the creation of an enabling, safe place.

(d) Nature Conservation Therapy
Nature Conservation Therapy originated out of the author’s personal journey, working as an ecologist in wolf conservation projects, and then as a therapist, conducting therapeutic work in nature. This way of working takes place through the active treatment and care of natural resources, preferably wild animals. The core of Nature Conservation Therapy lies in the basic humanistic belief that, by seeing, giving, and helping others (people, animals, plants and landscapes), people can connect with their inner strengths and achieve a sense of meaning, purpose and value in life. In addition, another one of the model's basic assumptions is that, through an intimate encounter with wild animals in need, people can connect to parallel personal issues, which can thereby receive additional perspective and meaning.
           The practical work with the model consists of two parts: (a) diagnosis of the group, and determination of the therapeutic-educational aims;  (b) tracing a nature conservation project that can answer these aims.
          The work itself integrates techniques from Dramatherapy (or other creative approaches), which support the processing work of the issues that arise in the actual work with the animals. In this approach, nature is taken not only as a living object, which allows the participants to project and encounter their own personal issues, but also as live being, an entity which stands by its own right.  This allows the client to form a meaningful relationship with it. This concept, working therapeutically with animals, is not new and can be found in the growing field of animal-assisted therapy (Aubrey, 2000). During this work, while supporting the rehabilitation and later reintroduction process of the animal, the participants are invited to go through a parallel process which can help and support their own healing and development.
            An example of this way of working can be given from the program “To Fly”, which took place in a school for children with special needs, in the north of Israel. The program was the final unit in a year’s work with two groups of special needs teenagers. In addition to the classic organic emotional, and social issues that this population generally deals with, this group was also characterized by half of its members being adopted, living in foster parent homes. The aim of “To Fly” was to connect the participants with inner strength, to support the concluding stage of the year-long process, while at the same time assisting its members in processing issues such as abandonment, injury, maturation, healing, independence and separation.
The program, which took place two months before the end of the school year, began when two large acclimatization cages, holding four injured young falcons that had fallen from their nests, were brought to the school and placed in a room which was specifically designated for the purpose. This was designed in a way that allowed the group members to treat, rehabilitate and reintroduce these birds into the wild.
Exploring the therapeutic choices from a Dramatherapy perspective, shows that the therapist, using the concept of distancing, chose to bring to the group a story that was parallel to the one that its members were dealing with, presenting it from a metaphoric, yet live “story” perspective (Gersie, 1997; Jennings, 1998; Landy, 1996; Megged, 2001). This metaphoric way of working enabled the participants to touch and process their personal issues without becoming threatened or confronted. In addition to the treatment of the birds, which included feeding, cleaning, and caring, nesting boxes were built and placed in the nearby Nature Reserve. The purpose of the nesting boxes was to provide the mature falcons with a secure nesting place, and to allow the participants a chance to “stay in touch” with them. The methodology of the work was designed in a way that incorporated elements from “The story you need to hear now” (Lahad, 2001), a technique that uses universal truths and hypnotic principles, together with elements of Megged’s (2001) approach, in which the therapist writes a unique, therapeutic story for his clients, a story that he or she tells them at a specific time during the process.
In this case, the story touched the followings issues:
(1) Young birds falling from their nests – abandoned/neglected children.
(2) Injured young falcons – special needs/angered children.
(3) Young falcons which were taken out of their natural environment and placed in
large cages to be rehabilitated and later on reintroduced – special needs/injured   
children who were taken away from their peer environment and placed in a unique and safe environment in order to improve their well-being and, in some cases,    
rehabilitate them and hopefully allow them to integrate into a “normal” society
and environment.
(4) Building nesting boxes – introducing the issues of home, parenthood and foster
parents.
(5) The reintroduction of the birds into the wild  – maturation, the beginnings of   independence, separation, the conclusion of the therapeutic work, and parting from the therapist.

At the end of the process, when the birds had reached their full strength, a reintroduction ritual was held in the Nature Reserve, where the groups worked during the year,  witnessed and honored by all the children from the school, their parents and teachers. During this very exciting program, the participants learned to cope with complex personal issues, developed their ability to see, identify, and empathize with others, and learned about nature conservation values in an experiential and non-verbal way.
This example illustrates once again the way in which an intimate encounter and dialogue between a person and a natural element, plant or animal can connect a person with his or her personal story, to trigger and support therapeutic change. The approach works with a collective narrative, helping the individual step out of his or her feeling of loneliness by connecting him/her, not only to other people who share similar stories, but also to the universal story: animals, plants and landscape, and sharing one cyclic story of birth, life and death.
Forming an integration
In the previous sections, the four models of Nature Therapy were presented.  In practice the approach tends to integrate various elements of the models in a way that will be most supportive for the needs of the specific group or client.
In order to put this integration in context, the approach utilizes the image of a journey, using techniques of story-telling as a framework, to structure, direct, contain and give it meaning (Lahad, 1996; Megged, 2001).
An example for this way of working can be illustrated from the therapeutic– educational program, "Encounter in Nature“, which took place in a school for children with learning difficulties in the north of Israel. This year-long process was conducted with a group of young children characterized by severe behavioral and emotional difficulties. The aim of the work was to help them acclimate to the new school, adopt positive behavior and communication skills, increase their self-esteem and unite them as a group. Coming to this process, the group counselors used elements from Lahad's "Six piece story making” and from his "Story you need to hear now" techniques (Lahad 1992, Megged 2001), as a way to create the background which would give its participants a sense of the framework, aims, methods of the process, and the contract between clients and counselors. This story, which was told at the beginning of the year, told the story of a group of Indian adolescents who were about to set off on a traditional maturation journey. In order to succeed in this journey, the group members, accompanied by two older leaders (the group counselors) needed to overcome some of their personal obstacles, by coping with a number of “maturation assignments”. The journey was to conclude at the end of the year in a maturation ritual, facing and being recognized by the whole community (the school). The year's journey started with sessions which were constructed around the Nature–Adventure mode of working, using concrete and physical activities, such as navigation games, collecting food, crossing a river and making a fire, which bonded the group and helped it to assimilate the structure, aims and contract. The work continued in a softer, more creative way, around the concepts of Art with Nature and Building a Home in Nature, incorporating such activities as creating power totems and masks, preparing and giving gifts, building an outdoor stove, and designing, building and maintaining a group camp (home). This unit supported the building of intimacy within the group,  allowing its members to share and work through few complex issues. The concluding episode of the process was constructed around Nature Conservation Therapy, rehabilitating injured birds of prey, which were reintroduced into the wild in a final "maturation ceremony". This exciting unit supported the separation and gave the whole process meaning and context. The year-long work was structured by specific rituals, such as an opening ritual, sharing circles using a talking stick, and closing ceremonies, before getting back to the classroom and standard school ways of being. These rituals helped to hold the group and give the process structure and meaning. This example illustrates only one of many ways in which elements from the models of working can be integrated to form, in each case, a unique therapeutic program designed to fit the needs of each and every person and group.

Summary and Conclusions
The present article introduces the innovative Nature Therapy approach, emphasizing its practical aspects. It illustrates a specific way of working therapeutically in nature, relating to nature not only as a setting and tool provider, but also as a partner in the shaping of the setting and process.
The article also highlights some of the potential that lies in creative, non-cognitive and non-verbal ways of working – ways which may expand the clients’ narratives, unfold additional meanings and support them in their journey.  Thus, the approach addresses the connection with natural elements as a means to connect the individual with his/her primal and intuitive knowledge; one that can remind and bring forward elements which may have been forgotten or neglected in the intensive reality of everyday life.  This innovative, yet perhaps ancient concept of therapy, reflecting a time when people lived in communities in nature, seeks to expand the classic inter-personal psychotherapeutic approach, and put it within a larger context, addressing also the relationships with the culture and environment in which we live.  The article touched on some of the philosophy of the approach, relating to a person as a part of a social–ecological system, and therefore as one who does not stand solely on his/her own.  This element may also highlight the educational aspects of the approach, conferring nature conservation values through an intimate and strengthening experience in nature.
The approach is being developed by the author of this article through the Nature Therapy Center – Israel. It is undergoing current research, dealing with (a) its efficacy with different client groups; (b) the potential and role of different healing elements in nature; (c) the process of training and supervision for counselors and psychotherapists seeking to integrate a nature dimension into their work. At the moment, the approach is being implemented in several governmental and private therapeutic programs in Israel, and taught in an academic "Nature Therapy" training at Tel-Hai College in Israel.
Finally, in relating to the overall framework of this article, it may be useful to conclude with a few questions that emerge from it and resonate in the field of adventure therapy and experiential education. The article invites a dialogue about a number of issues that it touches on:
(1) What/where is the place of rituals, spiritualism and community in Adventure Therapy and Experiential Education?
(2) What/where is the place of nature and education toward nature conservation in Adventure Therapy?
(3) What/where is the place of intuition, partnership and creativity in Adventure Therapy?

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(5)  Research articles:


(5a)  Going on a Journey: Nature Therapy with a group of children with emotional and behavioral difficulties, a case study 

Abstract
This article presents a Nature Therapy work that took place with a group of children with emotional and behavioral difficulties within a school setting. The article describes a creative approach that relates to nature, not only as a setting, but as a partner in the process. It explores the therapeutic and educational impact that the work had on the children, and invites discussion on the Nature Therapy concept of addressing nature as mediator which can support therapeutic work.

Background

Galim is an elementary school for children with learning and behavioral difficulties, in the north of Israel. The children who attend it carry a wide range of diagnoses, involving learning, emotional, social and communication difficulties, and  a large proportion of them have behavioral problems. The program took place in a class  s comprising nine boys and two girls, aged 7 - 9, all in their first year in this school. The program, part of the national "Encounter in Nature" therapeutic – educational program (The Nature Therapy Center, Israel and the Israeli Ministry of Education) was conducted between September, 2003 and June, 2004, in weekly two-hour sessions. The program was delivered in the "natural" territory of the school, including a small grove and a wide, grassy space. It was facilitated in cooperation with Yara Shimson, a 42 year-old animal-assisted therapist, and Ayelet Levi, a 33 year-old home- teacher, specializing in working with children with special needs. Both facilitators took part in a week's nature therapy training,  which prepared them for the program. The work was supervised once every two weeks by the writer of this article, the founder of The Nature Therapy approach and this program. The aim of the program was to help its participants to acclimate in the new school, to adopt positive behavior, to acquire communication skills, to increase their self-esteem and to unite them as a group.
Outline of the process
The concept of rituals
Based on the ritualistic orientation of the Nature Therapy approach (Berger 2003, 2004), the program was designed around an imaginary story of Red Indian adolescents who were about the set off for their traditional maturation journey. In order to succeed in this journey, the members of this group, accompanied by two older leaders (i.e., the group facilitators) were called upon to encounter and overcome some of their 'personal obstacles', by coping with a number of 'maturation' assignments. The journey was to culminate at the end of the school year, in a maturation ritual, facing and being recognized by the whole community (i.e., the older schoolchildren and the staff). This story framework was made up by the facilitators, using elements from Lahad's "Six piece story making” and from his "Story you need to hear now" techniques (Lahad 1992, Meged 2001), seeking to produce an appropriate background story which would create the space, the framework, the aims, the contract (i.e., between therapist and client) and the methods of the year-long process. According to this ritualistic concept, each session began in the everyday classroom, when the two facilitators met the group, reminding them of the contract, and then leading them in alphabetic order to "the encounter in nature room", a room outside the main school's building, which was used only for this ceremony. There, after forming a circle, an opening ritual was conducted, with the object of hearing how the participants felt and what was on the agenda. The ritual was performed using a "talking stick", as a means to keep a structured yet creative dialogue. Then, after explaining the day's mission, a more open attitude was used, as the children were invited to depart the building in any way they chose, including running, dancing and shouting. At the end of each session the group met again in "the encounter space", this time for a closing ceremony. The ceremony began with the "talking stick" circle: summing up experiences from the day, continuing in a relaxation exercise, in which the children were invited to cover themselves in blankets, listen to harmonious and quiet music and to relax. The session ended with ringing the school bell, as the children set of for a break before returning to the everyday school program. The use of these rituals, repetitive and structured symbolic activities, was to help the participants (and facilitators) separate and move between the dual educational atmosphere of the school's casual setting and the therapeutic outdoor one.
Yara: "The opening and closing rituals drew a clear line between the classroom educational environment and the program's therapeutic one. It created order and gave the time we shared a special meaning. The talking stick ritual allowed us to keep order in the hectic group, using the known structure of the ritual as an outline for boundaries and authority".
Ayelet: "The ritual created a safe structure in which the kids could express themselves in any way they wished: talking, vocalizing, dancing… Having a clear, well known ritual freed me from the fear of losing control, of creativity turning into anarchy".
These open and closing rituals took place throughout the year, while other, more complex rituals were developed and performed for specific purposes. These rituals, such as a "name-giving" ritual and the reintroduction of the falcons' ritual will be presented later.

The journey – from adventure through creativity to nature conservation
The program opened with sessions which were built around adventures, using concrete and physical activities, such as navigation games, collecting food, crossing a river and making fire. This way of working made use of the basic concepts of adventure therapy (Ringer, 2003; Gillis & Ringer 1999), as a means to expand the participants’ communication skills and bond them as group. The challenges provided by nature allowed the group to confront with issues as boundaries and authority, helping the children to assimilate the structure and the contract, as well as the authority of the facilitators.
Yara: Crossing the river was a difficult assignment, as the children found it hard to keep in order and plan ahead.  Because Ben was pushed into the water and got quite wet, we facilitators stopped the assignment and reflected on it. In the following session, a week later, we tried again. This time Ben agreed to share his feelings of shame while the others listened and asked his forgiveness. This time they kept in line, helping and cheering each other as the bridge was successfully crossed. That was fun."  During this unit, a remote and unfamiliar "nature" space within the school's territory was picked as "the group's space". It was marked by the children with ribbons, defining its boundaries for themselves and for others who might pass by. Later a more specific location was marked within the large group zone. The discovery of a second location, a "cave-like space" inside a willow tree on the edge of the first territory made the children very excited as they worked together to turn it into their secret group home.
Yara: "This was the first time I could actually see them working together, planning, listening and taking decisions in a logical, non-impulsive manner. Fights gave way to active creation as the place was cleaned up and reorganized. A carpet, gate, chairs and ropes were brought from the near by and placed around, creating a new group space and reality."
This concept of designing, building and maintaining a "home in nature" is one of the basic concepts of the nature therapy approach (Berger 2004, 2005). According to this concept, this space, being a home in nature, can be received as a personal and/or collective sacred space, a place which is qualitatively different to its surroundings; a safe place where transformation can take place (Jung 1969). In addition, this process contains a number of therapeutic elements which allow the participants to work on such issues such as boundaries, control and flexibility, belonging and identity.
The simultaneously symbolic and concrete process of designing and building a "home-like" space does not only allow the participants to rebuild a personal safe space in their lives, but also helps them to acknowledge their responsibility for its future  maintenance, taking decisions, such as who or what will enter and what rules will be kept. Another strong element of this concept, which underlines the more equal client-therapist relationship within the Nature Therapy approach arises out the simple act that the children and therapist build the therapeutic space together. Hence, the building process is equivalent to the creation of the therapeutic alliance and potential space between the therapist and client (Winnicott 1971), and in the case of group work, also between the group members themselves (Berger 2003, 2005). These factors, in addition to the non-verbal and creative characteristics of the activity, emphasize the potential of this work in general, and with this population in particular.                       
Coming back to the framework story of the Indian journey, the home which was built under the tree acted as a physical base from which the group could set off on various expeditions, knowing they have a safe place to come back to. On this basis, other creative modes of working were incorporated, and replaced part of the previous adventurous way of working. This was an artistic mode, involving empowering activities, such as creating personal and group power totems, preparing and giving gifts and, finally, receiving new "mature names" in the "name-giving" ritual.
Yara: "The name-giving ritual was very important, as it gave the children a chance to receive new, empowering names. Since the names which were chosen, such as "open hurt", "fast runner" and "the thoughtful one"  were based on  positive social behavior which were revealed during the program, it gave the children something to strive and look forward to."
The principle that underpins this mode of working is rooted in the narrative approach which posits that each person lives in and through a life narrative (Freedman & Combs 1996; McLeod 1997). This narrative is expressed in the person's goals, feelings and relationships, with others creating an image of 'good life'. Hence, this giving an alternative new name, based on a positive perception of the child, can improve his/her self-image, inviting him/her to explore and develop additional ways of behaving and being in that specific group, and in his life in general.
The concluding unit of the year's program centered the process of rehabilitating injured birds of prey which were reintroduced in the final "maturation ceremony". This innovative concept is rooted in the "Nature Conservation Therapy" mode of working, one of Nature Therapy's main working models (Berger 2004). At the core of this approach lies the basic humanistic belief that, by seeing, giving, and helping others (people, animals, plants and landscapes), people can connect with their inner strengths and achieve a sense of meaning, purpose and value in life. Another basic, perhaps universal belief which underlines this approach is that, through an intimate encounter with a wild animal at need, people can connect to parallel personal issues which can thereby receive additional perspective and meaning (Berger 2004). Therefore, in order to support and process some of the issues that arose in the actual work with the animals, elements from drama therapy were integrated, relating to nature not only as an "object" which allows the participants to project and encounter their personal issues, but also as a living being, an entity which stands of its own right, thereby allowing the client to form a meaningful relationship with it. This concept of working therapeutically with animals is not new, and can be found in the growing field of animal-assisted therapy (Aubrey, 2000). During this work, the participants are invited to go through a parallel process which can help and support their own healing and development. The unit, which took place one month before the end of the school year, began when a large acclimatization cage was built in the kids "encounter space" – the room where the sessions used to begin. The cage and two injured falcon fledglings were brought by Bill Woodley, a 40 year-old ranger from the National Parks Authority who specializes in birds of prey.
Yara: "Bill's personality and way of communicating with the children made a strong impact upon them, as he addressed them as equal partners in this special task, giving them full responsibility on the birds’ future. He asked them to search for sticks that the birds could stand on, help to build the cage and, finally, to hold the falcons as he ringed them. It was beautiful to see how the children decided to give the "talking stick" to the birds as they gathered their strength, and entered the role of a parents taking care of their injured children."
Ayelet: "Specifically in a school for children with special needs like Galim, where the children who reach it may well have an image of being  bad or unsuccessful, including the situation where most of them are treated in so many therapies, the option of taking care of a wild and beautiful animal was very meaningful. Not only did it allow them to feel special and capable, but taking the role of a care taker also allowed them to encounter and process such issues as responsibility and empathy, through identifying with the birds’ injuries and vulnerability.
Exploring the therapeutic choices from a drama therapy perspective may highlight the way in which drama therapy’s concept of "distancing" was used (Gersie, 1997; Jennings, 1998; Landy, 1996; Megged, 2001). The presence and work with the injured birds provided the participants a distanced, yet parallel story to the one that they were dealing with. This metaphoric way of working enabled the participants to touch and process their personal issues, without becoming threatened or confronted. The rehabilitation and reintroduction to the wild of the birds was chosen as a non-verbal way of telling a story of maturation and independence, injury/vulnerability and healing, while introducing the concept of the coming separation between the children themselves, and them and the facilitators, as the academic year was about to conclude.
Ayelet: "Two weeks before the arrival of the birds, when we told the group about the project, personal stories were beginning to be revealed. One boy asked to know how they fell out of their nests – did their father push them? Another child asked about their mother and brothers – don't they miss him? Why did not they pick him up?" 
Yara: "For some children, the idea of setting the birds free was very difficult. Some were sad and angry because they felt abandoned, while others felt sad and guilty for abandoning the birds. Some were worried for their physical survival, while others asked whether they would come back to visit or nest."
           At the end of the year, parallel to the strengthening and recovery of the birds, a reintroduction ritual was enacted in front of the whole school. In this ritual, the children shared the story of their year-long journey, and then released the birds, offering a fresh start in the open spaces of nature. This exciting ending unit supported the closing and separation process, giving it additional meaning and context.

Methods
In order to learn more about the efficacy of the program, including the specific roles and influence nature had upon the process, the work was accompanied by  follow-up research. This research was conducted by qualitative methods, using basic case study methods and established principles (McLeod 2002; McLeod 2003; Yin 1984). Data were collected, using open-ended questionnaires which were given to the facilitators at the end of the year's process, and then followed by a three-hour interview. The interview aimed to expand the information which gathered through the questionnaire and to explore it in depth. The questionnaires were filled up individually, but the interview was carried out together. Since that this follow-up research was practice-oriented, and therefore part of the program, the facilitators were evidently willing to take part in the research, understanding its contribution to practical future developments.
           Data were analyzed through basic qualitative research methods (McLeod 2002; McLeod 2003), dividing the data into relevant categories and exploring their meaning within the overall context of the work (Table 1). After the data was analyzed, using Reason's collective inquiry principles (McLeod 2002; Reason 1994), a draft paper was sent to the group facilitators, inviting their thoughts, which were then integrated into the writing of this article.

 
Results

Research findings
Table 1: Number of times categories are mentioned in the interviews
1. Nature    Total: 30
a. Nature influences the process – challenging, opening doors, changing situations     11
b. Calls for a different atmosphere than the classroom    7
c. Nature as supplier of materials     3
d. The children's attitude to nature    3
e. Other issues    6
2. The group and individual process    Total: 27
a. Building self esteem and confidence     6
b. Group building and development of
    positive communication skills      9
c. Processing personal issues around
    parenthood, anxieties, death and
    abandonment    5
e. Developing responsibility
    4
f. Developing the option of planning (as
   opposed to impulsive action)    3
3. Other elements    Total: 16
a. Training and supervision    7
b. The use of rituals to support the
    process    5
c. Personal process of the facilitators    4


Nature's role and influence on the process
The follow-up research found that "nature" had a strong influence upon the process. One of the strongest elements was how the independent dynamic of nature influenced and shaped the process.
Yara: "As we were organizing and cleaning the home (the cave-like space) one of the kids found a centipede. This caused a panic: the kids shouted and ran all over the place.
After I caught the centipede and calmed them down, they agreed to look at it from a short distance and then turned in to a "fear coping" ritual, as we released it. The next time we found a centipede, there was hardly any hysteria."
Ayelet: "Planning the activities was complicated, as we never new exactly what to expect. There was always the fear that we would wake up on the morning of the activity and be faced with heavy rain in winter, or a heat-wave in summer. It was very demanding: it challenged us to be creative and alert, to be ready to invent relevant activities which would suit both the group and the weather. Working in this uncontrolled setting summoned options for activities which we never thought about. For example, one rainy day, we all walked together under a big plastic sheet, to keep ourselves dry. At the same time of it being funny and enjoyable, it also called for group cooperation, leadership, physical intimacy and a creative way of thinking."
These variable situations, dictated by nature, created special circumstances, in which the counselors and the children were together in an ever-changing environment that was not under their control or ownership.  It appears that this element had one of the strongest implications in the process, raising the issue of coping with the uncontrolled and unexpected, developing flexibility and expanding coping mechanisms. This      independent dynamic of the setting challenged, not only the participants, but also the facilitators; raising the question whether this "uncontrolled" element should be addressed as an obstacle or disturbing factor? An alternative way to address nature, through the concept of the "three-way relationship: client – therapist – nature" (Berger 2004, 2005), is to relate to nature as a partner in the process, shaping and influencing it in various ways. In the first story mentioned above, "nature" provided an element which gave the group a chance to work on the issue of fear, while in the second story it called for work on issues, such as cooperation, intimacy and leadership. In this sense, facilitators working with nature are invited to address its dynamic as offerings, providing ground for specific interventions.
A different element which came out of the research findings was the potential that lies in the qualitative difference between nature and indoors settings.
Yara: "There is a substantial difference in the way the children behave in classroom activities and the way they act in nature. Apparently, nature raises the level of motivation and cooperation as children play, work and creates together. Work in nature calls for "creative doing" which gave our children, who come from wide-ranging "failing experiences", a chance for a positive experience, working and expressing themselves in ways which are not solely verbal or cognitive."
Hence, nature being a living, sensual place calls for work that involves all the senses and communication channels, whether physical, emotional, imaginative or spiritual (Abram 1996; Roszak 2001). In this respect, Nature Therapy can be used as a powerful vehicle to expand a person's communication channels, and to develop coping mechanisms which can improve a person's overall function (Lahad 1996).
Another element which came out of the research data was Nature’s contribution as a supplier of materials.
Ayelet: "I remember how they insisted on going on an expedition to collect herbs for tea on a day of heavy rain. In fact it turned into a bravery mission, and they returned wet but happy… I think that this aspect of searching, finding and preparing our own basic needs - a sheltered place, a warm fire, and herbs for tea - was very important, because it gave the kids a chance to prove they are able to take care of themselves, using materials which they have in the here and now." 
From these findings, it is evident that nature made a major impact on the process. Not only did it provide the physical space and materials for the encounters, but it also created a special atmosphere and way of working that called for experiences and learning which would probably never have been called for indoors.

The process of group and individual development
According to the research findings, a meaningful therapeutic process was provided, both on the personal and the group levels. Apparently the strongest affect of the work was on developing the children's self-esteem and self-confidence.  This achievement was possible through the use of an empowering approach which provided opportunity to succeed and be acknowledged as "good and worthwhile". This empowering approach involved such units as adventures missions, in which the children had to overcome various physical and emotional obstacles, the "name-giving ritual", in which each participant received a name based on a quality which was revealed during the work, and finally the successful process of rehabilitation and release of the birds.
Yara: "It was very exciting to be with them and see them in the ceremony in which birds were reintroduced into the wild. All the school came to see, and respected them for their work and process. It was beautiful to see them proudly taking the stage, reading out, their year-long story, and finally opening the cage and letting the birds fly free."
Ayelet: "Seeing them there, I felt sad and proud at the same time. They were so excited. For some it was probably the first time that being in the center was acknowledged by other adults as a positive thing, and not thanks to a fight or another act of misbehavior."
Another aspect of the work was to do with the process of group building, including the development of positive communication skills.
Yara: "At first, they were constantly fighting, using hands and bad language as the main mean to communicate. Fights were mainly concerned with their place in the group: who will sit next to us, who will light the fire, and so on. With time, through the adventure activities and the building of the camp, this sort of behavior decreased, other, more positive ways of communicating were developed and the group began to bond."
It appears that the clear maintenance of the contract supported the internalization of the collective behavioral norms, while the active physical and creative orientation of the activities helped to expand previous communication patterns into more positive ones. In order to reinforce the behavioral aspects of the work, and to enable the facilitators to safely send a child that broke the rules back to class, an assistant from the school was available to receive and take care of such a child when such an incident occurred. Another important aspect that contributed to this element was the precise maintenance of the structure of the sessions and the rituals, even when other factors remained flexible and changeable.
 Yara: "The opening and closing rituals were very important, because they provided order and security. Apparently, the simple fact that the children knew what to expect gave them a feeling of control and that calmed them down."
An interesting event that occurred after five months was that the closing "relaxation ritual" disappeared. One explanation may be that, as the children assimilated the behavioral norms and strengthened their "inner supervisor", the ritual was simply no longer necessary. Another important accomplishment of the work was the development of personal and group responsibility. This was achieved mainly around the process of designing, building and maintaining the camp – taking group decision around questions such as what will it look like? From what materials will it be built? What laws will be kept? who will be allowed to enter?
This process was further developed in the work with the birds, because the children were committed to taking care of their needs, feeding them with dead chicks, giving them water and cleaning the acclimatization cage.
Yara: "Although some of the kids were disgusted by the dead chicks, they insisted on taking part in feeding the falcons, insisting that the birds were dependent on them for their recovery, and therefore they must overcome their revulsion and feed them."
Another element which the process developed was the ability to plan and talk things through, as opposed to the impulsive pattern which was strongly expressed at the beginning of the year.
Ayelet: "As they were designing and building the camp, I saw them plan and think things through, talking about what needs to be done, by whom and when. That was the first time I actually saw them thinking as a group."
In addition to these group processes, another, more specific personal learning was also gained.
Yara: "Ron was a poor student who found it hard to cope with the verbal and cognitive class assignments.  He arrived in the group with severe behavioral issues. He was not popular, and he suffered from quite low self-esteem. During non-verbal and physical activities, Ron got a chance to do something he was good at and, in some cases, even the best in class. In the bridge crossing mission, he took the role of the leader, using his physical abilities to help the others. Over the year, Ron changed his position from being one of the disturbing children in class to one of its positive and popular leaders."
Ron's story highlights the potential that working in nature in experiential ways has as a medium for change. In this case, the qualitative different between nature and the indoor setting, including nature's sensuous and creative aspects, provided a chance that the indoor classroom setting and ways of working and being in it simply did not allow.
Another example for the personal learning process that took place during the program can be illustrated by David's story:
Ayelet: "At first, David found it very difficult to cope with the changes that the program involved: going out of the classroom and entering the encounter place, coming out of that into the open space, coming back to the encounter place and then coming into the classroom again. He expressed this difficulty through bursting into tears, or outbursts of anger or aggression towards anyone who was around. With time, through the insistence of the maintaining of the structure and behavioral norms, together with the changes nature brought, David learned to cope better. Apparently, the development of flexibility allowed him to let go of some control, and to allow himself to cope in a more flowing and relaxed way."
David's story therefore illustrates the potential that lies in the approach, combining the maintenance of the contract and the use of rituals, together with the independent dynamic nature exerts on it all. Work in nature can therefore act as a powerful means to developing the flexibility and expanding personal the individual’s repertoire.

Summary and conclusions
    Coming back to the aims of this study, it appears that the work in Nature Therapy made a significant contribution to the children who participated in the program, developing personal responsibility, communication skills and flexibility, important mechanisms which can improve a person's coping and overall function (Lahad 1992). In addition, the program raised self-esteem and self-confidence, while aggressive behavior decreased. Apparently, nature being an unfamiliar, perhaps unused space, clear of prejudices, allowed the participants to explore personal and interpersonal issues, and to expand their personal repertoires and narratives. From closer, perhaps spiritual observation, it appears that nature's important influence was also connected to its independent dynamic, which opened the option of relating to it as a co-therapist, triggering specific issues, while shaping the process in various ways. This unique situation, whose source lies in the fact that nature is a living being, opens perspectives and ways of working which are not likely to have the same impact (even to the extent that they are possible) in an indoor setting. The use of rituals was also important, providing the participants with a sense of security and order, together with the ongoing use of the Indian story which provided a helpful framework to put things in context and give the journey meaning. From the research evidence it seems that this use of ritual was crucial to the creation of a safe and empowering therapeutic space.
This case study presents an innovative therapeutic approach, working in nature at a school for children with learning and behavioral difficulties. It illustrates some of the ways in which "nature" can be addressed as a partner in the process, developing flexibility and expanding the personal repertoire. It also highlights the contribution that the use of rituals can have upon such process, providing a sense of security, order and meaning. Nature Therapy, as presented in this article, opens a space for discussion concerning the different places, functions and attitudes that nature provides, as well the concepts of rituals and spirituality in adventure therapy.

 
References
 
Abram, D. (1996). The Spell of the Sensuous. New York: Vintage Books.
Berger, R. (2003). In the footsteps of nature. Horizons. The Institute for Outdoor Learning,  22, 27-32.
Berger, R (2004). The Therapeutic Aspects of Nature Therapy. Therapy Through The   
      Arts, 3(2), 60-69.
Gillis, H. L., & and Ringer, M. (1999). Adventure as therapy. In J.C Miles, and S. Priest (Eds.).  Adventure programming (pp. 29-37). State College, PA: Venture Publishing.
Freedman, J. & Combs,G. (1996) Narrative Therapy – The social construction of preferred realities.  New York: W.W. Norton & Company.
Jung, C, G. (1969). The Archetypes and the Collective Unconscious. 
         New York: Princeton University Press.
Lahad, M. (1992) Story-making in assessment method for coping with stress: six-             piece story-making and BASIC Ph. In S. Jennings (Ed.) Dramatherapy: Theory and Practice 2. London: Routledge.
Lanndy, R.J. (1996). Essays in Drama Therapy. London: Jessica Kingsley.
McLeod, J. (1997) Narrative and Psychotherapy. London: Sage Publications.
McLeod, J. (2001). Qualitative Research in Counseling and Psychotherapy. London: Sage Publications.
McLeod, J. (2003). Doing Counseling Research. London: Sage Publications.
Megged, A. (2001). Fairies and Witches – Metaphoric stories in treatment for children at risk. Israel: Nord  Publications. (Hebrew).
Roszak, T. (2001). The Voice of the Earth. Grand Rapids: Phanes Press
Winnicott, D. W. (1999). Playing and Reality. London: Routledge
Yin, K. R. (1984). Case Study Research. London: Sage Publications.








(5b)  Building a Home in Nature: Nature Therapy with a group of children with learning disabilities, a case study

Abstract

The article is based on a case study carried out with a group of children with special needs.  The program was conducted in collaboration by the home school teacher and a dance therapist within a school setting. It explores the therapeutic and educational impact that this approach had, both on the children who participated in it and on the staff that facilitated it. The article also aims to initiate a dialogue around the option of working with this population in new ways, using group work, creativity and nature as a medium to support personal learning and growth.


Background
From a review of the literature on the use of psychotherapy with children with learning disabilities, it appears that classical psychotherapy has been used little, and its efficacy has hardly been studied (Butz, Bowling and Bliss 2000; Nezu and Nezu 1994). This situation may arise from some of the problems psychotherapy has in working via an insight-oriented approach, and using symbolic and abstract verbal language with people whose IQ and abstraction skills are below the average standards. Such problems suggest that classic psychotherapy may be of little relevance for people with learning disabilities, in general, and for children in particular. This may explain why the clinical services for this population have been limited to behavioral modifications, rehabilitative socialization, and little else (Baroff 1986; Butz, Bowling and Bliss 2000). Nevertheless, in view of the trend over  the last 30 years of an increasing numbers of adults with mental retardation residing in the mainstream community (Butz, Bowling and Bliss 2000; Fletcher, 1998; Nezu and Nezu 1994), other therapeutic approaches have been emerging and developed. Nezu and Nezu (1994) claim that behavioral psychological approaches are the commonest of these, and perhaps the most effective when it comes to adults with learning disabilities. Although the published evidence on group therapy for children with learning disabilities is also limited, it seems that, in the few cases cited (Monfils (1989) and Nezu and Nezu (1994)), the use of the group process is effective as a mean to support personal learning. Benefits of group work include sharing information and experience, modeling, confrontation and catharsis, group support and group cohesion.  They may also provide an opportunity to develop problem-solving skills and serve as a viable alternative to individual psychotherapy (op. cit.).  To solve the problem that psychotherapy has in addressing this population, due to its verbal, cognitive and insight orientation, Butz, Bowling and Bliss (2000) suggest that several modifications should be made in order to fit psychotherapeutic practice to the characteristics and needs of the retarded person. These changes include simplification of language, while developing non-verbal means of communication, the development of active, structured, concrete problem, to solve ways of working, and integrating behavioral, psychodynamic and narrative work methods.
Addressing these proposed modifications, it seems that experiential therapies such as art therapy would be more useful. From the little published evidence, it seems that such an approach has been used successfully in group and individual settings, using creative, non-verbal media as a means to develop social skills, self-confidence and self-esteem, and providing opportunities for personal exploration and expression (Brudenell 1994; Polak 2000). This creative approach to therapy is based on a belief that objectivity might mislead the therapist, and block his or her the ability to work beyond the limitation of the handicap. It focuses on the strength of the person, providing opportunities to expend his/her horizons and life experience (Brudenell 1994).
The special needs education system in Israel is built on occupational education.  According to Ronen (1982), it aims to assist the child to adapt to his/her general environment: personal, social, financial and civil. Ronen claims that the work carried out in school should not focus on formal-theoretical learning, but rather on routes that can help the child to acclimatize into the "normal" environment. The policy of the Ministry of Education is that every school should incorporate a therapeutic unit, which is operated by an art therapist (art, drama, movement and music), a school counselor and an educational psychologist. In most cases, there is a strict division between therapeutic and educational work, leaving the therapists to conduct the first and the teachers the second. In most cases, the aims of such art therapy are to develop the children’s awareness of themselves and their environment,  to developing communication and individual skills, and to contribute to the self-esteem, self-worth and confidence (Thomas and Woods 2004). Due to the experiential character of this medium, work is not dependent on the ability of the individuals to verbalize their feelings and thoughts, as they are encouraged to express themselves in creative ways.
    Encounter in Nature is a therapeutic-educational program, designed to work with children with special needs. The program is presented to children with different kinds of learning disabilities, in schools for special needs children and a in psychiatric hospital in the north of Israel. The program, developed and supervised by the Nature Therapy Center, has been authorized by the Ministry of Education. It was designed with the aim of  addressing nature as a supportive medium, to conduct experiential therapeutic work (Berger 2004).
The case study presented here is part of the follow-up research on the Encounter in Nature Program which took place during 2003-2004, with four groups from three institutions in the north of Israel.
As there is only little published material exploring the option of working therapeutically with children with learning disabilities in nature, the aim of this study is to explore the impact of nature therapy work on such children within a school setting. The study also came to examine the specific roles "nature" had upon the process, using  concrete yet creative group work to support personal growth and learning.

Method
In order to learn more about this innovative way of working, to explore its impact on participants, and the specific roles and influence nature had upon the process the work,  qualitative follow-up research was conducted, using basic case study methods and established principles (McLeod 2002, 2003). Data were collected, using open ended questionnaires which were given to the group facilitators at the end of the year's process, followed by a three-hour interview.
The questionnaires were filled up individually, but interviews were carried out together. The latter aimed to extend the information gathered through the questionnaire and sought to explore it in depth. Both questionnaires and interviews referred to the group and individual processes, to the influence of nature on them and (in the case of this study) to the facilitator's parallel process. Recognizing that this research was practice-oriented, and therefore part of the program, and understanding its contribution to its practical development, the facilitators were apparently willing to take part in the research. Data were analyzed and categorized, to explore their meaning within the overall context of the work (see Appendix 1). Established principles were used in order to form and support the construction of a theory (McLeod 2002; McLeod 2003). After the data were analyzed, using Reason's collective inquiry principles (McLeod 2002; Reason 1994), a draft paper was sent to the group facilitators for their reactions, which were then integrated in the writing of this article.

The setting
Ilanot is a school for children with special needs, in the north of Israel. It is attended by children between the ages of six and twenty-one, mostly diagnosed as having minor - mild mental retardation. Some of the children have, in addition to the organic disability, further emotional, physical and /or behavioral difficulties; some are under psychiatric treatment. Most come from low to middle social-economic backgrounds, from different kind of settlements (cities, kibbutzim, villages) and cultures (Jewish/Arab, Jews/Moslems/Christians, secular/religious), all from Upper-Galilee. The school buildings are surrounded by a high fence and trees, enclosing a small garden and courtyard in which the program took place. The school works under an official program authorized by the Ministry of Education, and hence separating therapeutic and educational work, therapists and teachers. Hence, the teachers do not usually take part in the construction and facilitation of the therapeutic programs, and the therapists do not take part in the educational ones. Cooperation between the two is unusual.

Participants
The group consisted of five boys and two girls, aged 8 to 10. Like most of the pupils in this school, these children were of low intelligence and self-esteem, and lacked skills in emotional language, communication and socializing. In addition, they were quite hyperactive and very dependent on the adult, taking little initiative and responsibility for their actions and life.  The group was also characterized by a high level of anxiety that was expressed in times where it had to cope with changes or unexpected events.

 
Facilitators
The program was jointly implemented by Yafa Chnafi, a 44-year-old old female Special Needs home teacher, and Irit Ran, a 40-year-old female dance-movement therapist, both experienced with this population. A month before the program started, the staff attended a week-long training course, in which the basic concepts of the program were taught. Supervision was provided by the author of this article on a regular basis – a two-hour session, once every three weeks.

Timetable
The program was conducted between September, 2003, and June, 2004, in a one- hour session each week. It was held in such natural surroundings as were available within the school territory: a small garden and courtyard.

Aims
           The program aimed to develop communication skills, hoping to improve the children's positive interactions and their ability to work together as a group. It also aimed to improve their self-esteem and self-confidence, and to expand their life experience and overall perspective.

Results

In order to provide as detailed an account as possible of the experiences of participants in this therapeutic program, the analysis of interviews and questionnaire material is presented in two parts. First, the process that the group went through over the ten months of its enactment is described, then an account of the categories generated through established theory analysis is presented.

The process of the group

Autumn (first unit)
The first unit (sessions 1 - 6) of the program took place in the familiar classroom. These sessions were designed to introduce the overall framework of the program and various elements of it: the concept of conducting experiential, process-oriented group work in nature, cooperation between the home teacher and the therapist (each had a pervious acquaintance with it), and negotiating and signing of the group contract. This time was also used to complete the separation process from a number of classmates who left it the previous year, but apparently "were still with them". Since these issues deal with different aspects of the concept of beginnings and changes, the work in this unit was focused around these themes. This issue was well correlated with the "cyclic story of nature" - the seasonal transition from summer to autumn and the various changes it brought. The sessions in this unit began with an opening ritual – standing in a circle, singing the song "Together" (a popular Hebrew song which talks about togetherness, love and peace), while moving and dancing together, and concluding with the participants sharing current feelings. The work carried on by looking out of the window, describing what was seen, and then moving into an exchange of the thoughts and emotions that arose from this. The session concluded with a closing ceremony which was quite similar to the opening one, using the sharing to reflect on the day's process. The unit expanded itself by adding structured outings into the school's open territories, exploring them, picking up meaningful objects and bringing them back into the classroom, and then exploring them further in experiential ways. This unit was characterized by a high level of anxiety and a strong egocentric sense which was expressed by most of the children.
Yafa: "It was very difficult to collect and hold them, it seemed as if each one was busy only with his own, personal needs."
Irit: "There was a lot of anxiety, especially fear of insects and snakes. It seemed as though they were used to dealing only with fixed and predictable things. Therefore we worked gradually, coming out of and returning to the known ‘safe’ environment, the classroom." 
These outings expanded into longer explorations, aimed at locating a specific place to build a “home in nature”.

Winter (second unit)
The second unit of the program (sessions 8 - 20) followed in the structure which was built up in the first unit, while expanding through the concept of "Building a Home in Nature". The sessions opened with the indoor "together ritual", and continued in the chosen natural place, in an actual "Building a Home in Nature" activity. This concept of "building a home in nature" was developed in the Nature Therapy approach, and consists  of a concert and the creative activity of designing, building and maintaining a home in nature (Berger 2004). According to Berger (2004, 2005), this space, being the home in nature, can be accepted as a personal and/or sacred group space; a place which is qualitatively different to its surroundings; a safe place where transformation can take place (Jung 1969). In addition to this process, revisiting the home on a regular weekly basis allows the participants to explore and work on basic issues, such as boundaries, control and flexibility, belonging and identity. The physical process of building and containing the space is equivalent to the formation of the therapeutic alliance between the therapist and client, as well as a physical representation of the virtual potential space (see Winnicott 1971) (Berger 2003, 2005). These factors, in addition to the non-verbal and creative characteristics involved, make the process a powerful means for general therapeutic work, and with this population in particular.
The actual work began with a sorting-out activity, getting rid of garbage which had been dumped at the chosen location – a peripheral area within the school, not touched by others. The actual building process began with the group choosing to build individual homes as apposed to the option of building one mutual group home (or camp). These homes were located in a distance of 50 cm - 2 ms from each other, and were constructed from materials which were found on site. The homes were quite different to each other, in size, height, width of boundaries and materials used. Some were prominent, having a clear form and boundaries, while others were hardly seen or felt. The differences illustrated not only elements of each child's personality, relating to such issues as boundaries, use of space and dominance, but also the group dynamics, relating to who is in the center and who is outside. After the construction phase, some dialogs took place between the children. Some joined another’s home, while others stayed in their original one. Some wanted to stay and "be" in their homes, while others wanted to experience more "doing states", asking to wander to further locations and explore the surroundings. The weather and other "natural" elements that followed played a strong role in the shaping of the process.  As winter stepped in, the environment changed: rain and mud were present, plants sprouted, and animals, such as migrating birds and earthworms appeared. These elements intrigued the group members who were not accustomed to encounter such elements so directly within the school setting and perhaps not in their lives in general. This element pushed the group to set out from their "home in nature" to further areas, exploring what could be found in the "here and now". Some objects, such as mud and earthworms, were brought back into the classroom, where they were explored, by means of experiential learning principles.
Yafa: "The encounters with the natural elements gave the children a chance to experience and explore things which they never met. It was beautiful to see how their attitudes changed, not only towards the natural elements themselves, such as insects and mud, but beyond that to the option of opening themselves to experience and encounter with the world."
This unit was characterized by an individuation process, allowing the participants to explore various personal issues, while keeping a nourishing dialog with the other group members. Again, the conclusion of this unit and its development to the next stage were influenced and shaped by the change of the seasons: the end of winter, the spring budding and the onset of the warm summer.

Spring and summer (third unit, sessions 21 - 30)
As winter ended and the warm days of spring and summer moved in, together with the drying of the soil and wilting of the flora, a new voice was heard in the group. This voice was common to both participants and counselors, raising the option of leaving the present location, and looking for a new place which would suit the new circumstances better.
Irit: "The sheltered and pleasant feeling turned into a sensation of heat and hardship. It felt very strong – the reality changed and we had to adjust, to look for other alternatives and to change. It connected with some thing very primeval within me – the need to migrate."
The sessions in this unit focused around the concept and implementation of separation from the personal homes and the transition to a new chosen territory on which a new mutual group home would be build. The process was designed in a dramatic way, using the image of therapy as a ritualistic journey. This concept is not new: it was based on the story of the hero's journey, and is one of Drama Therapy's basic concepts (Lahad 1992; Jennings, 1995, Jennings 1998; Jones, 1996; Grainer, 1995). Nature Therapy recently adapted it to nature-oriented work (Berger 2004, 2005). In accordance with this concept, the sessions were oriented around questions such as: "where are we going to? What new reality do we intend to meet and create? What obstacles might come in our way? What can help us overcome them? What should we take with us and what should we leave behind?"
At the outset, a new place was chosen, this time closer to the school's center, surrounded by high trees which provided shelter from the sun and wind. Boundaries were then checked and marked.
Yafa: “It was beautiful to see how they organized themselves around this activity. They wanted to protect the place, declaring it as theirs by writing "No Entrance" signs and placing them on its borders. One boy even built 'traps' around the home – widening its territory and giving it additional (symbolic) protection. It might be that this action was related to a previous invasion made by an older student into one of the participant's private home in nature, or to the school’s everyday reality, since it had an ongoing history of burglary."
The actual building started by bringing materials from the former personal homes to the new space, including symbolic elements, building materials and even earth.
Irit: "It seemed as if they took all they could with them, overlooking the question what could be left behind.  Then, during the building of the new home choices were made."
Using sticks and sheets, which were tied to the surrounding trees, walls were built, providing separation from the school’s surroundings. The transition from the personal home to a communal one was not simple for all participants.
Yafa: Tory found the transition difficult. In the beginning he chose to build a personal home outside the communal one, near but separated. Later, when we started singing and talking inside the home territory he peeked inside but refused to enter. It took time until he came in and joined, constructing a personal space within the communal one."
Once the home was built, the participants followed their own interests, taking initiative for various activities. An interesting difference occurred between the boys and the girls: while the boys kept busy outside the home, making and playing with swords and weapons, going on symbolic hunting expeditions, the girls stayed at home cleaning and decorating it.
The final stage of the work took place towards the end of the school year, and consisted of two major closures and separators: one was a separation from the natural site, returning to the natural places which had been used and related to in different phases of the work, exploring them in perspective and giving them personal and group meanings. The second was from the therapist, who was about to go on a year’s sabbatical and leave the children, after working with them for several years.
Irit: "Because the whole process was very meaningful for me, it was hard to say goodbye. In the last ritual, many goodbye songs came up spontaneously, it was very moving."
This final unit was characterized by a process of group coherence, strengthening trust and intimacy within the group. This process found expressed in the action of taking active responsibility of the formation and maintenance of a group safe space – the building a mutual home in nature. It was centered around the group dynamic and narrative, in contrast to the previous phase, which was centered on the individual. The unit concluded with a closure and separation process, – departing not only from one of the group counselors but also from the "nature" which had given the group a space to experience, learn and grow.

Established theory analysis
Grounded theory analysis of data from interviews and questionnaires provided by the facilitators generated the following main categories:

1. Nature's role and influence on the process;
2. The impact of the program on group participants;
3. The parallel experience of being a facilitator.

1. Nature's role and influence upon the process
Thus research found that "nature" had a major influence upon the process, in a number of ways. One of the strongest elements which influenced the process related to nature's independent dynamic, namely the change of seasons, and the dynamics of animals and plants. This element influenced not only the physical space, constantly shaping the setting, but also influenced the art forms and the homes built "inside" it. This situation created a unique therapeutic circumstance, in which the counselors and participants were both present in an ever-changing environment that was not under their control or ownership.  It appears that this element exercised one of the strongest implications on the process, raising the issue of coping with the uncontrolled and unexpected, and developing flexibility and coping mechanisms.
Irit: "The biggest influence that the program had upon the children was around the question of coping with an ever-changing environment. This reality brought up many opportunities to work on the question ‘how do I cope and function with the unexpected changes that life may bring?’"
    This factor challenged not only the children who participated in the program but also the counselors, raising the question whether "nature" is an obstacle and disturbing factor, and thereby getting in the way of the counselor's original plans to oblige them to work in correlation with it; keeping an open and flexible mode of working.
Yafa: "These changes, the drying of the earth and the growth of the thorns, all had to be coped with, encouraging us to keep a flexible mode of working. This way of working makes you really be present and work in the here and now."
During the program, with the assistance of Nature Therapy-oriented supervision, a different perspective was developed, namely learning how to relate to nature's dynamic as a form of therapeutic intervention which presents the participants with a spontaneous, rather than planned, perspective or activity.
Irit: "Then the rain came, giving the children a chance to get wet and dirty, to touch mud and bringing them into touch with their senses."
In this sense, nature gave the children an opportunity they would never find in the classroom, not only in the concrete aspect of the encounter with the rain and mud, but also presenting them with the chance of "doing something which is not allowed" within a permissive therapeutic framework. This aspect of nature "pushed" the group into one of its most important transitions, from the personal into a group home in nature.
Another significant element that influenced the process was the way in which nature provided the group with an alterative space offering a different atmosphere from the classroom.  According to the research findings, this difference had an important impact, not only on the physicality of the setting, being outdoors, large and open, but also on the whole atmosphere it contained. This atmosphere may be emotional, physical, spiritual or esthetic and had few implications on the process.  It brought up the use of the experiential mode of working and increased the participant's connection with themselves and others.
Irit: "What is special about the work in nature comes out of the differences within the space. It calls for metaphors, creativity and physicality and less for concreteness. In school every thing is around skill, here (in nature) they had an other opportunity." 
This aspect is inherently connected to the counselors’ choices of methods; keeping a dialogue between the structured and deductive to flowing and creative ways of working, using creative and non-verbal modes of working, staying in the experience without cognitive and verbal processing.
Part of this special atmosphere provided by nature can be addressed as a kind of supportive space or element which encourages listening and connecting with emotions and additional ways of being.
Irit: "It seemed like certain behaviors and emotions which were hardly expressed in the classroom were frequently expressed in nature: caring for each other, a sense of belonging, curiosity, and personal and group responsibility. There was no need to ask for permission to talk, or any need to remain sitting on chairs, which reduced conflicts and invited calmness and togetherness. Since the space was so big and varied, each child had the opportunity to find something of interest: an insect, a rock or a plant. In this sense, when someone had difficulty with a specific activity, he/she could find an alternative one and stay within the overall framework without breaking it down."
Yafa: "In the classroom, they have to sit down and be quiet, and this causes violence. In the activities done in nature this demand did not exist: there was constant movement and physical release, so there was hardly any violence".
In addition, this aspect of the experience helped the group reach new levels of intimacy and allowed its members to find variety within it.
Yafa: "There was something in nature that made them connect in a different way. Perhaps it was fear of nature that made them bond, looking for support from each other. Some took leadership roles and became very active. This element was present also in the classroom, but it was more prominent in nature."
There is no doubt that this "permission" and the supportive elements of nature are connected with the atmosphere and emotional space which was created, held and maintained by the group counselors, yet it seems as if there was something additional, which made this special satisfaction possible. It may be that it can be explained by the difference of the space: inviting people to leave their prejudices about themselves and the day-to-day "indoors", and arriving fresh and open to nature, allowing alternative narratives to be expressed and developed. It may also be that there is something in the environment itself, perhaps the spiritual and emotional wisdom of good old Mother Earth that provides a feeling of contentment and freedom.
           A additional kind of contribution nature offered was its ability to supply physical materials which were needed for this active and creative "home building" process.
Yafa: "The home [i.e., the new group home] was built out of materials which were found on site and elements which were brought from the previous, personal homes. Branches and sheets were used to create walls and borders.” This element has an important symbolic meaning, making the statement ‘we can construct our new reality and narrative using the things we have, right now, creating the future out of the present.’
These findings, illustrating nature's role and influence, are consistent with one of Nature Therapy's basic concepts concerning the three-way relationship between the therapist, the client and nature. The findings support this concept by illustrating "nature", not only as a physical setting which providing space and materials, but also as a partner in the process, shaping the setting, the facilitator's interventions and methodological choices; and hence expanding the therapeutic influence of the entire process (Berger 2003, 2005).
 
2. The impact of the program on the participants
According to the research findings, a meaningful therapeutic process took place. This process included a process of dispersal to the formation of a group, whereby a collection of individuals who hardly communicated bonded into a functioning group whose members cared, communicated, interacted and worked with each other.
Irit: "In the beginning, it seemed as if each of the children was busy with himself.  Choosing to build individual houses, avoiding the option to work in couples or threes. With time, a gradual change took place: spontaneous collaborations emerged and relationships were built."
This process was empowered and received concrete meaning through building homes in nature, involving the transition from individual to group home. Group and personal responsibility was also developed as the group became more active and bonded.
Yafa: "They placed 'No Entry' signs and asked to close the place with walls to prevent other children coming in. I enjoyed watching this active-protest action. It is so rare to see them behave that way, taking an active responsibility on themselves."
Throughout this process, a varied personal learning was also gained, and communication skills were developed as violence decreased.
Irit: "In the beginning they did not know how to talk to each other; mainly they just swore or used their hands against each other… during the process they learned to communicate, to talk, listen and share. Today there is hardly any fighting or swearing."
The creative mode of working encouraged the development of self expression, including the development of non-verbal and creative communication skills:
Yafa: "During the year's work, the opening ritual changed. It became more creative and open, because they used their bodies more freely, initiating more movement and vocalization."
Throughout the whole process, self-esteem and self-confidence were built up, as the group changed its meeting place, from a marginal and neglected location (where the first personal homes were built) into a more central and popular area (where the group home was constructed). Similarly, individuals found a voice and became more dominant: 
Irit: "Marisa went through a big change. In the beginning, I wondered if I would ever hear her say anything. She used to be afraid of leaving the class room or going out to the courtyard during the breaks. Now I am amazed, watching her play with the others during the breaks, communicating and expressing herself. She even learned how to resist and stand up for herself."
Personal and group cohesion was also developed as the level of anxiety decreased and a sense of belonging was formed.
Yafa: "In the beginning, we would come out of the classroom in a clear structure: I  walked in front and Irit walked at the back, trying to give them a sense of security. As time went by, the children were able to let go of this protective structure, and simply ran and enjoyed themselves together."
In addition to the personal learning which they achieved, the participants also changed their attitude and behavior towards nature, moving from fear and alienation to familiarity, belonging and caring, expressing curiosity and affection towards it.
Yafa: "At first, they were afraid of every animal and shouted when they saw one. With time, through the experiential encounters with the natural elements (fauna and flora), exploring them in direct ways, their attitude changed to one of curiosity and affection, as the shouts turned into calls of excitement, inviting others to see the animal that was found."  It appears this change is connected to the feeling of belonging which was developed during the process of building the home in nature. This sense of belonging came about not only between the participants, but also between them and the actual place – nature.
Irit: "They tried to turn nature in to some thing familiar, into their home. It was as if they wanted to bring in transitional objects, things which would give them confidence". According to these findings it appears that there is an interesting correlation between the process of building a home in nature and the process of familiarization with nature. Apparently a direct encounter between the persona and nature was necessary in order to let go of the feelings of fear and alienation, transmuting them into feelings such as belonging, partnership and ownership. This finding strengthens one of Nature Therapy’s basic assumptions, claiming that granting love and care for nature are possible though a personal-emotional process and not only through the behavioral approaches which are so often used in  the environmental education programs (Berger 2003). Hence, Nature Therapy may be addressed as an innovative environmental education approach, working together with the basic Ecopsychology concept which argues that, in order to change people's attitude and behavior towards nature, they must go through a personal – emotional process of feeling for nature as if they are part of, as if it was their home (Roszak 2001; Totton 2003).
From an overall perspective, it appears that this specific way of working in nature triggered a number of basic psychological themes; such as fear of the uncontrolled and unpredictable, together with identity issues, such as the concept of personal boundaries, and the need to belong to other people and/or place. It appears that the direct contact with the natural element triggered these basic humanistic, perhaps universal issues, allowing the participants to explore and develop them within a therapeutic environment.

3. The experience of being a facilitator / the facilitator's parallel process
Analysis of the research findings allowed an unexpected finding to emerge regarding the parallel process that the facilitators went through. This process expressed itself in two major aspects. One concerned the professional and personal learning process, developing specific skills and qualities, and the other was the special team-building process, using Nature Therapy as a medium to bridge gaps in a way that forms strong collaboration.
On the personal aspect it appears that the work in "Encounters in Nature" empowered the teacher's self confidence, allowing her to expand her creativity and flexibility, and open herself to the option of working in a therapeutic,  process- oriented way (as opposed to the deductive way she was accustomed to, and perhaps expected to use throughout her years in the system).
Yafa: "The program allowed me to acknowledge my strength and initiatives. It feels as if my creativity was depressed for years, and here I got a chance to open myself and create; to work like I really wanted to, without doing what the others (teachers) think or say. I was accustomed to work with a structured and clear program, but here I was challenged to work in a flowing and 'less knowing' way. Working with the unexpected changes that nature brought, under a creative orientation, helped me to expand my flexibility and my ability to work in the here and now."
In addition, supported by to the collaborative work with the therapist and the accompanying supervision, the teacher developed her therapeutic skills.
Irit: "Your whole way of observing things changed. Things which were meaningless for you became important and full of meaning."
The therapists gained other benefits from the work, expanding the ability to work as a couple, to trust, to give space and to collaborate.
Irit: "My strongest experience from the program was the collaborative work withYafa. At first, it brought many questions regarding the differences between our languages and ways of working (i.e., the therapeutic and the educational), the hierarchy and roles within the school. Normally working in collaboration is not easy for me, as I prefer to work alone; with Yafa a special relationship was built, one of trust and collaboration."
Another kind of contribution gained from the program was around the team building process, developing the ability to work in collaboration. This style of working, integrating therapeutic and educational modes of working, is quite rare in the school system in Israel where a clear separation is generally made between them. This way of working improved the efficacy of the work and changed the staff's experience of the school system. 
Irit: "Working with Yafa allowed me to feel legitimate in the school. This feeling of belonging and "being O.K" was new for me after years of working there and feeling like an outsider."  Exploring this process in perspective, it appears that nature, being a neutral place, allowed the teacher and therapist to meet on equal ground and build their relationship and collaboration there, distanced from the school's hierarchy and casual way of addressing things.
Concluding this section, it appears that one of the most important elements which were gained through this work was the option of conducting therapeutic-educational programs in nature, outside the familiar classroom, using process-oriented, creative and non-verbal ways of working under an integrated therapeutic-educational mode of working.

Discussion
Coming back to the aims of this case study, its conclusions can be divided into three major sections: nature's potential as a therapeutic medium, the process that the  participants went through, and the parallel process of the group facilitators. It appears that nature provided the participants (and staff) with an alternative space, clean of prejudice and human hierarchy, and thereby allowed them to explore personal and interpersonal issues, develop skills and expand personal narratives. From a closer, perhaps spiritual observation, it seems that nature's important influence was also connected to living things, allowing it to perform as an active medium, a co-therapist perhaps, creating space and triggering specific issues, while shaping the process in various ways.
Regarding the process that participants went through, it appears that Nature Therapy was an effective approach to use with this particular population, contributing a  group building process, as well as for empowering and developing such issues as personal responsibility,  communication, cooperation, creativity, curiosity and flexibility. These are important coping mechanisms, which can improve a person's overall function and well-being (Lahad 1992). In addition, the program increased self-esteem, while anxiety and aggressive behavior decreased. Another interesting outcome of the program was the change that took place in the children’s attitude towards nature, changing from alienation and fear into one of familiarity, belonging and caring.
With respect to the third parameter of this research, the facilitator's process, it appears that Nature Therapy also had a significant impact on the staff that facilitated the program, contributing to their personal and professional learning, developing creativity, flexibility and communication skill. In addition, it is evident that the approach also impacted on the team-building process, bridging the gap between therapists and teachers, therapy and education.
Observing the process from a wider perspective, it appears that the program opened a new working possibility within the school, using nature and a dialogue with it as an experiential, non-verbal medium to support therapeutic and educational learning.

Summary
This case study article presents an innovative therapeutic approach of working with children with learning disabilities by addressing nature as a medium for experiential and non-verbal work. This group work took place within a school setting, and was facilitated in collaboration by the class home teacher and the school's dance-movement therapist. The article presents and discusses the unique role that nature played in the work, taking part in the shaping of both the setting and the process. It presented a successful learning process, on both the group and the personal level, illustrating some of the ways in which the facilitators worked with "nature" to improve the outcomes of the program. In addition, the article presents the ways in which the collaborative work in nature supported the facilitators’ parallel process; expanding skills, bridging gaps and forming a strong, well-functioning and versatile team. The proposal arising from these findings is to go beyond the common behavioral and cognitive approaches used with children with learning disabilities, on the basis that these classical ways of working can be better adapted to suit the special characteristics and needs of this specific (less verbal and less cognitive) population.
Further research could focus on more specific element that contributed or interrupted the work, including widening the number of participants, and allowing the research to use quantitative and statistical analysis.


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Nature-Therapy with the Elderly   

Mostly, when we talk about therapeutic work with the elderly, we refer to therapies carried out in a confined and static space, a room,  fully controlled by the therapist. Even in theoretical writing, the possibility of therapeutic treatment for the elderly in nature is hardly ever considered, as if getting old is not a natural process, or perhaps as if nature is too consumed to have the elderly. 
The purpose of this article is to highlight the opportunities existing in nature for therapeutic work with old people: to point out special elements, to offer different ways of intervention, and to open a dialogue on the subject. 
The leading theory incorporated into this article is that each person lives through his own narrative,  a dominant story that he tells himself and the people  around him. This narrative expresses his wishes, feelings and dreams, and paves the way to the life he will design and build and live (McLeod 1997).  Care given, using this approach, will enable the old person to tell his story, providing space for the "quiet voices" to be told, and add on to the dominant story, to widen the story’s horizons and enrich it, and thus make it possible to live the remaining years of life in a better sense of well-being (McLeod 1997, White and Epston 1990). The Nature-Therapy approach presented in this article looks upon the old person as a capable person, perhaps asking to linger in the “being” state and observe his own journey in a way which will help him to complete, and even reconstruct it, in a satisfying way.

Brian, a 65 old social worker participated in a Nature Therapy workshop designed for professionals, which took place in Scotland.  In the opening session, while the group stood in a circle,  on the beach, between a forest and the sea, Brian shared with the group his fears and queries about the future: "Now that my children have left home and are parents themselves and I have retired, I find difficulties finding purpose and value in life. Sometimes, I wake up in the morning and do not know what to do. I wonder if this is the time to depart and die."
The next day, on the beach, after activities using elements taken from Tai Chi and guided-imagination, connecting the participants with the wave-whisper and sand-movement, I suggested to Brian to take a meditative-walk imagining each step he took in the sand as a chapter in his voyage along life. Coming back from his walk Brian had a calm expression on his face as he told the group that he had reached the conclusion that he is not ready yet to depart.  As I asked him about his tear- filled eyes, he said that he is sad to realize that some episodes in his life have been completed and he does not know how to continue and what to do. In order to explore the subject in a creative, non-cognitive fashion, I suggested to Brian to continue the former work by finding  a suitable spot on the sand and  create there a two-faced monument: one side would express a grave or memorial, and the other a composition, using his intuition to guide him. An hour later, he came back laughing: "The grave being sand is not so frightening". When I inquired as to his composition, he said: “I did not compose anything; I just sat there, and looked at the sea gulls in the sky, watching the incoming tide and the last rays of the sun, life is beautiful …".

Brian's story represents the way a narrative creative work, connecting the body, the mind and the spirit can bring insight and transformation to a person's life (Jennings 1998, Lahad 1992, McLeod 1997, Megged 2001, White & Apston 1990). Additional observation, using the Nature-Therapy approach (Berger 2004) will reveal that the work consisted of several additional components, natural ones, which helped the process to progress, allowing it to develop in a ways that might not have been possible in an indoor setting.
Nature is an open space, alive, dynamic and constantly changing. Pregnancy, birth, adolescence, aging and death are natural processes, occurring in an open and normative way.
Observing this state opens the possibility for the elderly to join and associate with the natural cycle in a manner that not only supports the aging process as natural and proper, but allows them to feel harmonious with themselves and their surrounding (Davis 1998). This way of working in nature may answer the needs and wishes of the "young" elders, healthy people who have retired and have the time and the readiness to take time for themselves in nature.
An additional quality of Nature Therapy that can help healing processes and awareness is hidden in the potential that nature has to connect the person to senses and ways of communication that are not used in the everyday urban environment (Abram 1996, Berger & McLeod 2005).  A direct sensual link can widen the intake capacity, the cognitive and verbal expression and develop additional channels which are not in use every day: feeling, body and imagination. Parts of those qualities come from the legitimization which nature provided for Brian to play and create.  The play with the sand can evoke memories and feelings from the childhood of the old person, inviting them to revisit in the here and now. The creative work in the beauty of nature - the waves, the sunset and sea gulls - can connect the person to the aesthetic experience, and hence to an interior illumination that gives birth to new hopes and strength.  In the above example, the seaside was used as a physical metaphor for Brian's life-span, enabling him to cast into it his steps throughout life, leave his footmarks, and observe them from a new and distant angle. In contrast to work with art therapy, where the page is static and the artist (client) active, nature is an active space, dynamic and uncontrollable to the old person (as well as to the therapist). A most important element in using nature therapy with elderly people lies in this particular ingredient, where the constant changing processes invites the person to ask basic questions, such as the way he deals with the uncontrollable and unexpected, or issues regarding the cycle of birth and death. Hence, the contact with the duality and the cycle which both exist in nature can provide the person with a kind of universal legitimization, to touch his own dual issues, and  bypass cultural defence mechanisms. The dialectic discussion developed between the two generators, the aged and nature, gives the old person an additional chance to process his life story and to find different solutions.  At the same instant that the creative work of the old person is being completed in changing nature, he can observe a flying bird, a dying plant, or a blooming flower that will invite him to identify with their story, thus creating space for an old story to be told or perhaps inventing a new imaginary one. In this way the encounter in nature may enable the telling of stories which the client would normally  have find it difficult to tell (Berger 2004, Berger & McLeod 2005).

Opening the Door…
To any of us who were educated and trained in the conventional manner, the idea proposed in this article – to work with the elderly in open space, in nature, might seem unrealistic, frightening and impossible. Is it possible to take an old man who has walking difficulties to the seaside and ask him to sit on the sand and play?  What will happen to the therapeutic contract, to the borders and hierarchy, and what other meanings will this setting have? Who will pay for it? Will insurance cover it? And many more questions…
The Nature-Therapy approach has been developed in order to offer special means of work adopted for therapy in nature. The approach encompasses elements from ecopsychology, art therapy, narrative approach, Gestalt and Shamanism, in a way that creates theoretical terms and modes of working.  These arise from the outlook that nature contains elements which may promote healing and , transformation through connection with them (Davis 1998, Roszak 2001). The term "to touch nature", which is one of the basic concepts of this approach, claims that, by coming into direct contact with nature, the person can touch his own deeper parts, receive insights and feel authenticity. This "touch with nature" can help him to develop personal components and ways of living which might be difficult to express in the intensive modern life style conducted usually (Berger 2004, 2005).
The term "three-way relationship: Client – Therapist – Nature" is another major concept of this approach which helps the therapist relate to nature as an active partner, influencing not only the setting, but the whole of the therapeutic process. 
In this respect, the therapist is invited to maneuver with nature, as he may take a central position, working directly with the client, or he may take the quiet role of a mediator, allowing nature to guide the client, while he takes the role of witness and container (Berger 2004).
Another aspect of this concept deals with the different ways in which the therapist can use the uncontrollable dynamics of nature, as well as the various physical and energetic elements which exist in it, to create ceremonies and therapeutic non-verbal interventions, experiential ones  which may mean more than cognitive– conventional intervention.
It is important to point out that presence in the natural environment has a beneficial effect on man (Davis 1998, Roszak 2001). With old people, in additional to the calming effect nature has, it can provide them with another opportunity for a friendly social meeting. In this respect, nature does not involve a cultural context, but enables the old to meet the other in a simple and authentic manner. Going outdoors, getting some fresh air, involves a measure of physical activity, which is important for the well-being of the elderly.  It is important to point out that “nature” can be a wilderness, a public garden, the hospital garden or the old-peoples’ home garden. It is possible that all that is needed is to open the door….  In this way, Nature Therapy can be used as medium for personal development work, or even simply as a leisure activity that supports a sense of well-being.
For the Road…..
It might be interesting and challenging, if you, the reader will allow yourself to open the door for yourself and your elderly client to go out for a "short meeting" with nature.  You may take your old client to a convenient spot nearby, and use the same tactics as you always use, but in this different setting. If you "take the chance" it will be interesting to observe your own feelings towards the "unpredictable" as well as to listen to what passes between you and your client in the contact, connection and the story told.  
I will be happy to hear your experience: www.naturetherapy.org

References
Abram, D. (1996). The Spell of the Sensuous. Vintage Books.
Berger, R (2004) Therapeutic aspects of Nature Therapy. Therapy through the Arts – the  Journal of the Israeli Association of Creative and Expressive Therapies: 3, 60-69.
Berger, R. (2005). Working with Nature – Introducing the Nature-Therapy Approach. The Journal of Experiential Learning (in print).
Berger, R & McLeod, J. (2005). Doing Therapy in Nature. Counseling and Psychotherapy  Journal (in print).
Davis, J. (1998). The Transpersonal Dimensions of Ecopsychology: Nature, Nonduality, and Spiritual Practice. The Humanistic Psychologist. Vol. 26(1-3), 60-100.
Jennings, S. (1998). Introduction to Dramatherapy. London: Jessica Kingsley.
Lahad, M. (1992). "Story-making in assessment method for coping with stress: six-piece story-making and BASICPh". In S. Jennings (ed.) Dramatherapy: Theory and Practice 2. London: Routledge.
McLeod, J. (1997) Narrative and Psychotherapy. London: Sage.
Roszak, T. (2001). The Voice of the Earth. Grand Rapids: Phanes Press.
White, M. & Epston, D. (1990). Narrative Means to Therapeutic Ends. New York:  W.W. Norton.



Thoughts for future

This reader aims illustrate the basic theoretical framework and techniques that constitute the Nature Therapy approach. It also aims to highlight the present status of Nature Therapy, as it is recognized by the Department of Special Needs of the Israeli Ministry of Education, where it is has been used to assist children and youth with special needs. It is also recognized by NATAL – The Israeli Center for Victims of Terror and War, where it is used to support the recovery of people which have been exposed to emotional trauma. It is taught as post-graduate trainings in two different courses, a basic one in Tel-Hai Academic College and an advanced one in Tel-Aviv University, in Israel. In addition, intensive courses are given on a regular basis in Anglia Polytechnic University, England and at the University of Abertay, Dundee, Scotland, apart from other sorts of training given around the world. The approach is developed and researched on an ongoing basis by the Nature Therapy Center, which runs the programs and trainings listed above, as well as carrying out independent work: therapy, supervisions, trainings, and conferences.
To conclude this Reader, it is important to emphasize that the approach is still quite young and needs to be researched and developed further. It therefore seems appropriate to use this opportunity to highlight some issues that needs to be developed further:
1. A deeper and wider theoretical framework: concepts, intervention techniques and diagnostic tools should be developed. Additional theories should be integrated and synthesized into a clearer independent theory. This development will expand and deepen the practitioner's tools and concepts, and allow his/her work to have a better impact.
2.  To conduct in-depth research exploring the various implications and influences that different natural elements (sun, water, wind…) and natural settings (desert, forest, ocean…), times of day and season (morning, noon and night, spring, summer, autumn…) have upon different therapeutic process. The effect of these elements should be explored with different populations and in different periods of their process.
3. To develop measurement tools that can be used to monitor and explore specific issues within Nature Therapy, for example tools that can explore the change in the participant's attitude toward nature
4. To expand the work to additional populations and to explore its impact upon them. Thus, to examine Nature Therapy's therapeutic potential in specific populations, and in specific therapeutic-educational-self-developmental issues. These issues can be correlated to the specific "healing elements of nature” (Berger 2003) and the ways they can be used to assist specific therapeutic goals can be explored. My assumption is that, due to Nature Therapy's engagement with universal-natural laws and natural cycles, it has a strong potential to support basic human issues, such as coping with complex and unexplainable emotional and spiritual elements which are embedded in such issues as birth and death, separation and unity, loneliness and a sense of togetherness, flexibility and stability.
5. To explore and decide about the professional profile of the Nature Therapist, and to build an in-depth code of ethics. On this foundation, a full Nature Therapy training course can be designed and delivered.

Personally, my short-term intentions are:
1. To extend and deepen my knowledge of the connection between Nature Therapy and spirituality, developing a framework in which Nature Therapy can be used as a medium to create and perform rituals within an individualistic and multi-cultural society.
2. To develop the Building a Home in Nature mode of working into a diagnostic tool.
3. To seek for ways in which Nature Therapy can be used to bring together people and nature and bring forwards nature conservation issues.
4. To take part in the building of an international network of practitioners and researchers who can work together to deepen the research in the field and the issues that emerge from it.

Ronen Begrer can be reached at
Web: www.naturetherapy.org
E-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Tel: 00-972-523-294203