This content is associated with The Open University's Health and Wellbeing qualifications

Evidence suggests that being in nature for more than 120 - 150 minutes a week is related to the best possible physical as well as mental health and wellbeing.For many people caregiving can be a beneficial and rewarding role. However, there are many aspects of caring for someone with additional physical or psychological needs that can be stressful, and it is well established that carers sometimes do not prioritise their own physical and emotional needs. One of the key ways of maintaining wellbeing is having the opportunity to leave the house and spend time outdoors, ideally while doing a little exercise as well. A lot is known about the benefits of exercising on our mood, mental and physical health and wellbeing. However, there has been less research on how healing it is to spend time outdoors using green and blue spaces.

Research shows that people experiencing stress can use green and blue spaces to improve wellbeing through walking and exercise to improve mood, reduce stress and improve purpose and meaning and that interaction with nature can deliver benefits for people experiencing depression and/or sudden mood changes. Evidence suggests that being in nature for more than 120 - 150 minutes a week is related to the best possible physical as well as mental health and wellbeing.

Nature refers to many aspects of the physical landscape, including plants, animals, the landscape itself. It can refer to nature in urban settings (e.g. parks, gardens, allotments); farmland; natural forests (management of authentic vegetation); wild nature (spontaneous and with minimal management e.g. rivers, marshes). Studies explain how we can think of three levels of engagement with nature: viewing nature (through window, book, television); being in the presence of nature (e.g. cycling through a park); active participation in nature (e.g. gardening, farming, trekking). Nature includes green spaces (vegetation) and ‘blue spaces’ referring to the visible surface waters of lakes, rivers and coastal water.

Completing these activities outdoors may lead to much broader benefits than simply reducing symptoms of distress as they help people feel more empowered, content and connected with greater physical, mental and social wellbeing.Simply being in the presence of nature can be beneficial, as natural settings have been found to regulate physiological functioning by decreasing stress responses such as heart rate and blood pressure. There is also the potential to deliver effective interventions in outdoor settings. This may include using outdoor settings for activities involving nature, exercise, social contact, use of skills that facilitate wellbeing e.g. mindfulness. Completing these activities outdoors may lead to much broader benefits than simply reducing symptoms of distress as they help people feel more empowered, content and connected with greater physical, mental and social wellbeing. This can be especially valuable for carers.

The COVID-19 pandemic has led to an increased focus on the value of outdoor spaces, both for safety reasons and for peoples’ general wellbeing. The British Psychological Society has published guidance on providing therapy outdoors which explains how in addition to meeting social distancing criteria, outdoor talking therapy combines the benefits of conventional outcomes of indoor talking therapy and the benefits of being in nature. These include having an authentic person to person experience, promoting access to support for people who would find attending a therapy room uncomfortable (often due to this feeling too formal or anxiety provoking; or where people struggle with sustaining attention); helping people to feel they share the therapy space and relationship; freedom from everyday routines and environments that may be associated with difficulties; and the holistic benefit to their physical as well as psychological wellbeing.

Whilst considerations are needed for outdoor therapy including maintaining confidentiality, physical and psychological safety and boundaries in the therapeutic relationship, this is an exciting area for further development.