Date of Award


Document Type

Scholarly Project

Degree Name

Doctor of Occupational Therapy (OTD)


Occupational Therapy

First Advisor

Cherie Graves


Title: Pathway Through Nature: A Nature-Based Occupational Therapy Program to Support Adolescent Mental Health

Background: Adolescent mental health conditions have risen 13% between 2007-2017, with increased rates of untreated and unrecognized mental health challenges (World Health Organization [WHO], 2021; WHO, n.d.). Primary challenges include anxiety, depression, suicidal ideation, stress, coping skills, and self-identity (Kim, 2021; Magson et al., 2021; Rapee et al., 2019). Decreased access to professionals within the mental health field have presented as a barrier to combat the rise of the challenges listed above (Asher & De Silva, 2017). Nature-based therapy provides services within the most natural context and has been shown to support emotional, physical, and cognitive needs (Gill, 2014, Weir, 2020).

Purpose: The purpose of this scholarly project was to develop a group protocol to address adolescent mental health and empower practitioners to address the increasing mental health needs through the utilization of nature. The program titled Pathway Through Nature is intended to improve occupational identity and performance by targeting adolescent mental health and skill development while forming a connection with nature.

Methods: A thorough literature review was conducted to explore adolescent development, adolescent mental health needs, benefits of nature, current determinants of mental health, and nature-based therapy practice guidelines. To guide the development of this group protocol, the Ecology of Human Performance model, attention restoration theory, theory of affordances, and the Directional Flow/Rhythm of a Therapeutic Nature Camp were utilized (Dunn, 2017; Gibson, 1979; Haverly, 2021; Kaplan, 1995).

Results: The created product is an eight-session, evidence-based group protocol that provides opportunity to address adolescent mental health within a natural context. The program facilitates nature connection, education on relevant topics, participation in hands-on learning, and discussion of topic application to everyday life. The product is intended to be led by an occupational therapy practitioner but opportunities to include members of the interprofessional team are present.

Conclusion: This program provides mental health education, opportunities to enhance skill development, and affords time and space to create a nature connection to improve occupational performance and identity. Practitioners will develop a comprehensive understanding of nature's benefits and gain confidence in effective implementation of these services.