Out-Of-Office Experiences

Therapists – Clients Clinical, Social, Accidential and Non-Accidential Interactions Outside the Office


Resources & References

An Online Course:
Out-Of-Office Experiences: Ethical & Clinical Considerations for Encounters Outside The Office


Out of Office Experiences – Walk & Talk Therapy – Incidental or Chance Encounters – Attending Weddings, Ceremonies and other Celebrations Outside The Office Walls

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Adventure Therapy, Wilderness and Outdoor Therapy

  • What is Adventure Therapy
  • Legacy Outdoor Adventures
  • Adventure-Based Therapy: Theory, Characteristics, Ethics, and Research
  • Adventure Therapy – Terminology
  • Outdoor Wilderness Resources
  • Outdoor Education
  • Definitions
  • Bibliography
  • Significant Events in Adventure Therapy
  • Adventure-Based Counseling with Adolescents: Lessening Racial Effect on Group Cohesion
  • A healthier course
  • Therapy Gone Wild: More psychologists are using the wilderness as a backdrop and therapeutic tool in their work
  • Bibliographies:

  • http://reviewing.co.uk/research/adventure-therapy-bibliography.htm
  • http://leegillis.com/AT/pubs_LG_03_2005.htm
  • http://eric.ed.gov:80/ERICWebPortal/custom/portlets/recordDetails/detailmini.jsp?_nfpb=true&_&ERICExtSearch_SearchValue_0=ED399110&ERIC ExtSearch_SearchType_0=no&accno=ED399110
  • http://wilderdom.com/projectadventure/pabibliography.htm
  • References on Adventure Therapy, Wilderness and Outdoor Therapy

  • Albright, R. L. (2016). The Qualitative Impact of Adventure Based Counseling on Sixth Grade General Education Students. Journal of School Counseling, 14(8), n8.
  • Banaka, W. H., & Young, D. W. (1985). Community coping skills enhanced by an adventure camp for adult chronic psychiatric patients. Hospital and Community Psychiatry, 36, 746-748.
  • Barton, J., Griffin M., & Pretty, J. (2011) Exercise, Nature and Socially Interactive Based Initiatives Improve Mood and Self-esteem in the Clinical PopulationPerspectives in Public Health, 132/2, 89-96.
  • Berger, R. (2006) Beyond Words: Nature-therapy in action Journal of Critical Psychology, Counseling and Psychotherapy, 6 (4) 195-199.
  • Berger, R. (2007). Nature Therapy: Developing a Framework for Practice, [Unpublished Ph.D. Dissertation] School of Health and Social Sciences, University of Abertay, Dundee.
  • Berger, R. & McLeod, J. (2006) Incorporating nature into therapy: A framework for practice, Journal of Systemic Therapies, 25 (2) 80-94.
  • Berger, R. & Lahad, M. (2013) The Healing Forest in Post-Crisis Work with Children: A Nature Therapy and Expressive Arts Program for Groups. London: Jesica Kingsley.
  • Berman, J. & Berman, D. (1994). Wilderness Therapy: Foundations Theory and Research.  Iowa: Kendall Hunt.
  • Bowen, D. J., Neill, J. T., & Crisp, S. J. (2016). Wilderness adventure therapy effects on the mental health of youth participants. Evaluation and Program Planning, 58, 49-59. https://doi.org/10.1016/j.evalprogplan.2016.05.005
  • Carpenter, C., Norton, C., & Pryor, A. (2015).  Adventure therapy around the globe: International perspectives and diverse approaches. Champaign, IL: Common Ground Publishers.
  • Christian, D. D., Perryman, K. L., & Portrie-Bethke, T. L. (2017). Improving the Parent–Adolescent Relationship With Adventure-Based Counseling: An Adlerian Perspective. Journal of Child and Adolescent Counseling, 3(1), 44-58. http://dx.doi.org/10.1080/23727810.2017.1281693
  • Davis-Berman, J. & Berman, D. (2009) The Promise of Wilderness Therapy. Association of Experiential Education.
  • Davis-Berman, J., & Berman, D. S. (1994). Wilderness therapy: Foundations, theory & research. Dubuque, IA: Kendall/Hunt.
  • DeDiego, A. C., Wheat, L. S., & Fletcher, T. B. (2016). Overcoming Obstacles: Exploring the Use of Adventure Based Counseling in Youth Grief Camps. Journal of Creativity in Mental Health, 1-13. http://dx.doi.org/10.1080/15401383.2016.1191403
  • Dobud, W. (2017). Towards an Evidence-Informed Adventure Therapy: Implementing Feedback-Informed Treatment in the Field. Journal of Evidence-Informed Social Work, 1-11. http://dx.doi.org/10.1080/23761407.2017.1304310
  • Eckstein, F., & Rüth, U. (2015). Adventure-based experiential therapy with inpatients in child and adolescent psychiatry: an approach to practicability and evaluation. Journal of Adventure Education & Outdoor Learning, 15(1), 53-63. http://dx.doi.org/10.1080/14729679.2013.844573
  • Gass, M. A., Gillis, H. L., & Russell, K. C. (2012). Adventure therapy: Theory, practice, & research. New York, NY: Routledge.
  • Glass, J. S., & Shoffner, M. F. (2001). Adventure-based counseling in schools. Professional School Counseling, 5, 42-47.
  • Greenway, R. (2009). The Wilderness Experience as Therapy: We’ve Been Here Before, in L. Buzzell, & C. Chalquist (eds), Ecotherapy – Healing with Nature in Mind, San Francisco: Sierra Club
  • Hegarty, J. (2010).  Out of the consulting room and into the woods? Experiences of nature- connectedness and self-healing, European Journal of Ecopsychology, 1, 64-84.
  • Herbert, J. T. (1996). Use of adventure-based counseling programs for persons with disabilities. Journal of Rehabilitation, 62, 3-9.
  • Hoag, M. J., Massey, K. E., & Roberts, S. D. (2014). Dissecting the wilderness therapy client: Examining clinical trends, findings, and patterns. Journal of Experiential Education, 37(4), 382-396. https://doi.org/10.1177/1053825914540837
  • Hoag, M. J., Massey, K. E., Roberts, S. D., & Logan, P. (2013). Efficacy of wilderness therapy for young adults: A first look. Residential Treatment for Children & Youth, 30(4), 294-305.http://dx.doi.org/10.1080/0886571X.2013.852452
  • Jeffery, H., & Wilson, L. (2017). New Zealand occupational therapists’ use of adventure therapy in mental health practice. New Zealand Journal of Occupational Therapy, 64(1), 32-38.
  • Jordan, M. (2009). Nature and Self: An ambivalent attachment? Ecopsychology,1(1), 26-31.
  • Jordan, M. (2009). Back To Nature, Therapy Today, 20(3), 26-28.
  • Jordan, M. (2009c) The living mountain: attachment to landscape and its importance in regulating emotions, Journal of holistic healthcare, 6(3) 14-17.
  • Jordan, M. (2012) Did Lacan Go Camping? Psychotherapy in search of an ecological self in M.J. Rust, & N. Totton (eds), Vital Signs: Psychological Responses to the Ecological Crisis, London: Karnac.
  • Jordan, M. & Marshall, H. (2010) Taking Therapy Outside: Deconstructing or reconstructing the therapeutic frame? European Journal of Psychotherapy, Counselling and Health, 12(4), 345—359.
  • Kaplan, R. & Kaplan, S. (1989). The Experience of Nature, A psychological perspective.Cambridge: Cambridge University Press.
  • Kearney, M. (2009). A Place of Healing: Working with Nature and Soul at the End of Life. New Orleans: Spring Journal Books.
  • Koperski, H.; Tucker, A.; Lung, M.; & Gass, M. A. (2015). The Impact of Community Based Adventure Therapy on Stress and Coping Skills in Adults. The Practitioner Scholar: Journal of Counseling and Professional Psychology, 4(1), 1-16.
  • Lee J, Park BJ, Tsunetsugu Y, Kagawa T, Miyazaki Y. (2011) Physiological benefits of forest environment: based on field research at 4 sites. Nihon Eiseigaku Zasshi, 66(4): 663-669.
  • Lowry, T. (1974). Camping therapy: Its uses in psychiatry and rehabilitation. Springfield, IL: Charles C. Thomas.
  • Mabey, R. (2008), Nature Cure, London: Vintage.
  • Moore, T. & Russell, K. (2002) Studies of the Use of Wilderness for Personal Growth, Therapy, Education, and Leadership Development: An Annotation and Evaluation. University of Idaho Wilderness Research Centre, College of Natural Resources, University of Idaho, Moscow, ID USA.
  • Mutz, M., & Müller, J. (2016). Mental health benefits of outdoor adventures: Results from two pilot studies. Journal of adolescence, 49, 105-114. https://doi.org/10.1016/j.adolescence.2016.03.009
  • Newes, S. L. Adventure-Based Therapy: Theory, Characteristics, Ethics, and Research. A paper written to fulfill the comprehensive examination requirement. Doctoral Candidate, The Pennsylvania State University.
  • Nicholls, L. (2008) ‘Touching the Void’ Mountains as transitional objects: Climbing as a defence against anxiety. Psychodynamic Practice 14(3), 249-262.
  • Norton, C. L., Tucker, A., Farnham-Stratton, M., Borroel, F., & Pelletier, A. (2017). Family Enrichment Adventure Therapy: A Mixed Methods Study Examining the Impact of Trauma-Informed Adventure Therapy on Children and Families Affected by Abuse. Journal of Child & Adolescent Trauma, 1-11. doi:10.1007/s40653-017-0133-4
  • Russell, K., & Gillis, H. L. (2017). The Adventure Therapy Experience Scale: The Psychometric Properties of a Scale to Measure the Unique Factors Moderating an Adventure Therapy Experience. Journal of Experiential Education, 40(2), 135-152. https://doi.org/10.1177/1053825917690541
  • Russell, K. C., Gillis, H. L., & Heppner, W. (2016). An Examination of Mindfulness-Based Experiences Through Adventure in Substance Use Disorder Treatment for Young Adult Males: a Pilot Study. Mindfulness, 7(2), 320-328. doi:10.1007/s12671-015-0441-4
  • Sahlin, E., Matuszczyk, J. F., Ahlborg, Jr. G. and Grahn, P. (2012) How do participants in nature-based therapy experience and evaluate their rehabilitation? Journal of Therapeutic. Horticulture 22(1), 9–22.
  • Schimmel, C. J., Daniels, J. A., Wassif, J., & Jacobs, E. (2016). Learning the Ropes: A Creative Orientation Approach for Counseling Students. Journal of Creativity in Mental Health, 11(1), 27-38. http://dx.doi.org/10.1080/15401383.2015.1095663
  • Schoel, J., Prouty, D., & Radcliffe, P. (1988). Islands of healing: A guide to adventure based counseling. Hamilton, MA: Project Adventure.
  • Tucker, A. R., Javorski, S., Tracy, J., & Beale, B. (2013). The use of adventure therapy in community-based mental health: Decreases in problem severity among youth clients. In Child & Youth Care Forum (Vol. 42, No. 2, pp. 155-179). New York, NY: Springer.
  • Tucker, A. R., Smith, A., & Gass, M. A. (2014). How presenting problems and individual characteristics impact successful treatment outcomes in residential and wilderness treatment programs. Residential Treatment for Children & Youth, 31(2), 135-153. http://dx.doi.org/10.1080/0886571X.2014.918446
  • Tucker, A. R., Norton, C. L., Itin, C., Hobson, J., & Alvarez, M. A. (2016). Adventure Therapy: Nondeliberative Group Work in Action. Social Work with Groups, 39(2-3), 194-207. http://dx.doi.org/10.1080/01609513.2015.1048416


Codes of Ethics on Interactions/Therapy Outside the Office

Professional Association Codes of Ethics and Guidelines OnOut-of-Office Therapy


CPT Codes for Out of Office Experiences

CPT Codes for Out-of-Office Services


References on Out of Office Therapy

  • Adams, M., & Jordan, M. (2016). Growing together: Nature connectedness, belonging and social Identity in a mental health ecotherapy programme. Ecotherapy: Theory, Research and Practice, 122.
  • Cipriani, J., Benz, A., Holmgren, A., Kinter, D., McGarry, J., & Rufino, G. (2017). A systematic review of the effects of horticultural therapy on persons with mental health conditions. Occupational Therapy in Mental Health, 33(1), 47-69. http://dx.doi.org/10.1080/0164212X.2016.1231602
  • Christie, M., Thompson, M., Miller, P. K., & Cole, F. (2016). Personality disorder and intellectual disability: The impacts of horticultural therapy within a medium-secure unit. Journal of Therapeutic Horticulture, 26(1), 3-17.
  • DeMille, S. M., & Montgomery, M. (2016). Integrating narrative family therapy in an outdoor behavioral healthcare program: A case study. Contemporary Family Therapy, 38(1), 3-13.doi:10.1007/s10591-015-9362-6
  • Freeman, E. (2017). With nature in mind: The ecotherapy manual for mental health professionals. British Journal of Guidance & Counselling, 1–2. http://dx.doi.org/10.1080/03069885.2017.1317713
  • Hart, J. (2016). Prescribing nature therapy for improved mental health. Alternative and Complementary Therapies, 22(4), 161-163. https://doi.org/10.1089/act.2016.29067.jha
  • Hawkins, B. L., Townsend, J. A., & Garst, B. A. (2016). Nature-based recreational therapy for military service members: A strengths approach. Therapeutic Recreation Journal, 50(1), 55-74.http://dx.doi.org/10.18666/TRJ-2016-V50-I1-6793
  • Hegarty, J. R. (2010). Out of the consulting room and into the woods? Experiences of nature-connectedness and self-healing. European Journal of Ecopsychology, 1(1), 64-84. Retrieved from http://eje.naturalresourceswellbeing.com/v1/EJE%20v1_Hegarty.pdf
  • Hinds, J., & Jordan, M. (Eds.). (2016). Ecotherapy: Theory, Research and Practice. London, UK: Palgrave.
  • Hooley, I. (2016). Ethical considerations for psychotherapy in natural settings. Ecopsychology, 8(4), 215-221. https://doi.org/10.1089/eco.2016.0008
  • Jordan, M, (2013).  Talking Therapy Outside – A Narrative Inquiry into Counseling and Psychotherapy in Outdoor Natural Spaces.  A thesis submitted in partial fulfillment of the requirements of the University of Brighton for the degree of Doctor of Philosophy.
  • Jordan, M. (2014). Nature and therapy: Understanding counselling and psychotherapy in outdoor spaces. New York, NY: Routledge.
  • Jordan, M. (2014). Moving beyond counselling and psychotherapy as it currently is–taking therapy outside. European Journal of Psychotherapy & Counselling, 16(4), 361-375. http://dx.doi.org/10.1080/13642537.2014.956773
  • Lai, C. K. Y., Lau, C. K. Y., Kan, W. Y., Lam, W. M., & Fung, C. Y. Y. (2017). The effect of horticultural therapy on the quality of life of palliative care patients. Journal of Psychosocial Oncology, 1-14. http://dx.doi.org/10.1080/07347332.2017.1286699
  • Lazarus, A. A. & Zur, O. (Eds.) (2002). Dual Relationships and Psychotherapy. New York: Springer. 
  • Peterson, D., & Boswell, J. N. (2015). Play Therapy in a Natural Setting: A Case Example. Journal of Creativity in Mental Health, 10(1), 62-76. http://dx.doi.org/10.1080/15401383.2014.935545
  • Richards, K. & Peel, J (2005) Outdoor Cure. Therapy Today 16(10). 3-8.
  • Sahlin, E., Matuszczyk, J. F., Ahlborg, Jr. G. and Grahn, P. (2012) How do participants in nature-based therapy experience and evaluate their rehabilitation? Journal of Therapeutic. Horticulture22(1), 9–22.
  • Surgenor, H. (2015). Nature and therapy: Understanding counselling and psychotherapy in outdoor spaces. Existential Analysis, 26(2), 370-374. Retrieved from http://go.galegroup.com/ps/anonymous? p=AONE&sw=w&issn=17525616&v=2.1&it=r&id=GALE%7CA428625373
  • Tucker, A. R., Paul, M., Hobson, J., Karoff, M., & Gass, M. (2016). Outdoor behavioral healthcare: Its impact on family functioning. Journal of Therapeutic Schools and Programs, 21-40. doi:10.19157/JTSP.issue.08.01.05
  • Tucker, A. R., Widmer, M. A., Faddis, T., Randolph, B., & Gass, M. (2016). Family therapy in outdoor behavioral healthcare: Current practices and future possibilities. Contemporary Family Therapy, 38(1), 32-42. doi:10.1007/s10591-015-9370-6
  • Westlund, S. (2014). Field exercises: How veterans are healing themselves through farming and outdoor activities. Gabriola Island, Canada: New Society Publishers.
  • Wilson, N. W., Jones, R. J., Fleming, S., Lafferty, K., Knifton, L., Catherine, K., & McNish, H. (2011) Branching Out: The Impact of a Mental Health Ecotherapy Programme, Ecopsychology, 3(1), 51-57 
  • Wise, J. (2014). Digging for victory: Horticultural therapy with veterans for post-traumatic growth. London, UK: Karnac Books.
  • Zur, O. (2001). Out-of-office experience: When crossing office boundaries and engaging in dual relationships are clinically beneficial and ethically sound. The Independent Practitioner, 21 (1), 96-100.
  • Zur, O. (2007). Boundaries in Psychotherapy: Ethical and Clinical Explorations. Washington, DC: American Psychological Association – APA Books.
  • Zur, O. (2015). Beyond the Office Walls: Home Visits, Celebrations, Adventure Therapy, Incidental Encounters and Other Encounters Outside the Office Walls. Retrieved from https://www.zurinstitute.com/outofofficeexperiences.html
  • Zur, O. (Ed.) (2017). Multiple Relationships in Psychotherapy and Counseling: Unavoidable, Common and Mandatory Dual Relations in Therapy. New York: Routledge.


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