Why Some Doctors Are Prescribing More Time Outdoors

Why some doctors are writing prescriptions for time outdoors.

- James Hamblin

The first time J. Phoenix Smith told me that soil has healing properties that can help thwart depression, I just nodded slowly.

Smith is an ecotherapist, a practitioner of nature-based exercises intended to address both mental and physical health. Which means she recommends certain therapies that trigger in me, as a medical doctor, more skepticism than serenity: Listen to birdsong, in your headphones if necessary. Start a garden, and think of the seeds’ growth as a metaphor for life transitions. Find a spot in a park and sit there for 20 minutes every week, without checking your phone, noting week-to-week and seasonal changes in a journal.

Ecotherapy is a fledgling profession,still unrestrained by such things as “standards of practice” and “licensing requirements.” It can mean regular outdoor sessions with a therapist or simple exercises undertaken on one’s own, and can be part of a general approach to wellbeing or a supplement to treatment for a medical condition. (It is not intended as a replacement for standard evidence-based treatments.)

Smith almost lost me at the part about not checking your phone. But I couldn’t dismiss her out of hand. Her certainty that she is doing something great for people was disarming. Plus, she has a background in public health: She worked in HIV prevention for 20 years, until she was laid of in 2010.

After Smith lost her job, aimlessness led to stress, which led to depression.But she found solace on long hikes in the Northern California hills, and was inspired to volunteer at a garden in East Oakland. “I remember walking into the garden, and I immediately felt better,” she told me. “I just saw wealth and abundance. There was food growing, and flowers. It really helped to shift my thinking.”