There is a strong association between nature engagement and stress reduction, restoration, and increased well-being. Recently, practitioners and researchers are integrating nature into psychotherapeutic interventions in clinical settings to address individuals’ mental health and wellness. The purpose of this systematic review is to (a) identify nature interventions that are currently integrated within counseling, (b) summarize the outcomes of research studies that integrate nature interventions, and (c) review the quality of research studies to date. We found that most nature interventions include forms of adventure and wilderness therapy. Counseling intervention protocol varies among nature interventions. Overall, we found preliminary evidence that nature engagement in the counseling process contributes to positive client outcomes. However, the methodology in the available studies makes it challenging to delineate the contribution of nature versus the counseling intervention in client outcomes, or what aspects of the nature intervention are helpful for clients.

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