The healing power of nature in recovery from substance dependence
By Dr Wendy Masterton, Programme Director, MSc Substance Use, University of Stirling
What are nature-based health programmes?
Nature-based programmes are defined as health programmes that are run outside. Examples include gardening groups, forest walks, meditation in nature, conservation, wild swimming, hillwalking, bushcraft, and many other activities of both high and low physical impact. There is growing evidence that these groups can be an important part of people’s recovery journey, both in early recovery and in longer-term recovery.
Three reasons why nature-based groups are beneficial for recovery
There are different reasons why nature-based groups are said to be beneficial for recovery at different timepoints. Three of the main reasons are:
The therapeutic effect of nature and the feeling of ‘being away’ from day-to-day stresses and out of a person’s daily environment, even for a short time.
Feelings of purpose and learning new skills which can lead to improved confidence.
Increased social connectedness and reduced isolation. People who have taken part in these types of groups often explain how much of a bonding experience it is being alongside a range of different people and realising that, regardless of background, everyone is experiencing their own issues and challenges.
Jennifer (L) and Shona (R) have found friendship on their recovery journey and bonded through being outdoors.
From ‘shaking like a leaf’ to ‘my confidence is sky high’: How nature-based programmes lead to togetherness
The experience of bonding while at these groups is important, because feeling different from others can contribute to stigma.
Within recovery, stigma is often described as a feeling of being alienated or looked down on due to lived experience of substance use. Research from the University of Stirling based in the Salvation Army Centre for Addiction Services and Research has shown that many people arrive at nature-based groups feeling anxious about how others will perceive them, describing themselves as “shaking like a leaf”. However, realising that everyone has their own challenges was said to lead to a sense of togetherness. One attendee explained, “now it’s the camaraderie and my confidence is sky high”.
Stigma can also be experienced in different ways, and the same research team also spoke to people who experienced self-stigma and saw themselves in a negative light compared with others. When they attended nature-based groups, they said that this helped reduce these feelings. They explained how they felt less defined by their substance use and instead as “someone who can use a set of loppers, and remove some rhododendron, and plant a tree that will grow and serve a benefit”. This positive change in self-identify is an important part of sustained recovery.
A Phoenix Future ‘Recovery Through Nature’ group undertaking conservation work.
Nature-based groups provide support whatever the stage of recovery
Some programmes have strict criteria for attendance such as being abstinent for a set period before attending, whilst many nature-based groups provide support at any stage of recovery. These groups are also often viewed as non-medicalised; “a very non-threatening, supportive place… compared with clinical appointments”. This helps people stay engaged and reduces the feelings of stigma in healthcare settings. Some attendees have shared that the natural environments feel welcoming, especially for those who often feel like they are “moved on and not welcome in the usual healthcare spaces”.
Within the therapeutic space of nature, staff and attendees work alongside each other which breaks down barriers and encourages open communication. One staff member that ran a forest group explained “If we stand on the side-lines and don’t get involved, you’ve still got that sort of official role that you are playing. But when you get your sleeves up and start getting involved with them, you start chatting about this, that, and the next thing, and then they suddenly feel a bit more comfortable”.
A Branching Out group in South Aberdeenshire walk together at Crathes Castle (National Trust for Scotland).
How to get people who use/used involved in nature-based groups
The benefits are clear that there is potential for these approaches to be more established within routes of support for people who use/used drugs. One of the key challenges is how to get people involved in the first place.
Research at the University of Stirling has supported this by developing tools to help with engagement of potential attendees:
A buy-in/engagement guide has been designed to help service staff, support workers, referrers (those directing participants to programmes), link workers (those supporting or 'linking' participants onto programmes), and/or other people working with potential attendees, to build trust and engagement (‘buy-in’) for nature-based programmes, particularly for those unsure about them. It also provides insight into key considerations when signposting or ‘referring’ people to programmes. This can be found here: https://greenspace.stir.ac.uk/
The team has developed a documentary film which features people attending nature-based activities across different parts of Scotland. It also details their struggles with poor mental health, and how these programmes helped them cope in different ways. The film shares stories not only of recovery, but also of friendship, connection, reduced isolation, and reductions in stigma as participants embraced nature as part of their daily routines. The film could be used to showcase the benefits of nature-based groups when encouraging people to initially attend, no matter what stage of their recovery journey they are at. The film is available here with subtitles: https://vimeo.com/1120244812
Nature in recovery should be available to anyone
While it is generally well known that time outside is beneficial for mental health, the exploration of benefits to people with lived and living experience of substance use is of particular importance in the landscape of high drug-related harms. Not only do nature-based programmes provide therapeutic effects from being in nature, but the psychological, physical, and social benefits of structured groups are substantial.
Standard treatment often does not provide such holistic benefits and can inadvertently increase stigma and feelings of isolation. Nature-based groups “sound such a simple solution for something so difficult we are struggling with” but are firmly supported by science. Innovation is needed around ways people could be supported alongside and outside of structured treatment. Nature in recovery deserves recognition as a powerful, growing area of support that should be available to anyone, regardless of life experience.