Laura Park Figueroa [00:00:04]:
Hi everyone. Welcome to the Therapy in the Great Outdoors podcast where we talk all about the business and practice of nature based pediatric therapy of all kinds. My name is Laura Park Figueroa. I am a nature based pediatric practice owner. My practice has two locations in two different states and we are in the multi six figures now in our revenue. So I have helped many pediatric therapists to start their own nature based practices or programs and this podcast is here to help you do the same and to support you in your work if you are already doing nature based practice. I am so excited about the growth that I have seen in this niche in our industry as allied healthcare providers and I can't wait to see where this goes in the coming years. So we've been on a little break from the podcast for a few months and I'm super excited because I have a lot of really great guests scheduled to come on the podcast and do interviews with me in the next month or so.
Laura Park Figueroa [00:01:09]:
You guys are in for a real treat because these are some really unique practices that are doing nature based work as well as an expert that I am really hoping will say yes to my request for an interview. So stay tuned for some really great episodes coming forward today. This will be a solo episode. And the funniest thing happened because as I took a little break for the last few months, for those of you who don't know me, I finished my PhD in May of this year and then I just hit a wall emotionally and physically. I just felt like I could not keep up the work pace that I had before. So I have not even looked at any research in three or four months, you guys, because I was so tired of looking at research for my PhD. And so for this episode, I thought it would be good for me to circle back to Google Scholar and some of the search engines and just see if anything has been published. And then as I was looking for articles, I was like, duh, why have I not done a podcast episode about my own research? So instead of reviewing someone else's research, I'm going to share with you some about the research I personally did, which makes total sense.
Laura Park Figueroa [00:02:32]:
But sometimes the most obvious things have to smack you in the face for you to see them when you're running a couple of businesses and being super busy. So anyway, I am going to talk about my research today and share with you a little sneak peek of what may be being published. So I have submitted the article that is a portion of a dissertation. Yeah, I feel like I'm all over the place here. I'm getting back in the swing of podcasting. You all dissertation is generally not just one question. You generally are looking at multiple different research questions in your dissertation. And the final document I submitted, I think, was over 200 pages.
Laura Park Figueroa [00:03:14]:
So that obviously is a bit longer than a journal article. But I have finally synthesized it down to a journal sized article submission, and I've submitted it to a journal, and I'm waiting to see if they have accepted it. What you are getting in this episode is the pre publication version of my research and a little sneak peek into what that article will share. So a few of you may have seen this on Instagram. So when I first finished my dissertation, I shared an image of the model that I developed in my research. So I'm going to talk about that model. So my research was done with occupational therapists because I am an OT, and I don't even remember if I said that at the beginning. But I'm an OT, and I did my dissertation and my PhD in occupational therapy.
Laura Park Figueroa [00:04:13]:
So I interviewed occupational therapist for my research. The interesting thing is that I do think, and I want this to be tested I hope that other professions will take the model I developed and test it in their professions. But I do think that the takeaways from this model can apply to any pediatric practitioner that's working with children. Okay, so what did I do? The research that I did was called grounded theory. And it is I tell a lot of people. It's the kind of research that Brene Brown does. So most people know Brene Brown and her research. She does interviews with people, and then she pulls out the meaning in what people are saying and finds the commonalities or the threads of meaning that are inside of those in depth interviews that she and her team it's a wide team of people now that she has what the interviews are saying.
Laura Park Figueroa [00:05:03]:
So grounded theory is intended to examine and explain a process of something happening. My research question was, what model explains the nature based occupational therapy process? Or something like that? I'm not looking at it right now. It was something very similar to that question. What that means is, in the process of interviewing the therapist that I interviewed, I was looking to identify really the question of what is happening here? What is bringing about change when we do nature based therapy with children, when we take therapy outdoors into nature, what's the mechanism of change going on here? What is the process happening in the therapy session that's bringing about that change? And the model that I developed from interviewing 22 occupational therapists, it was over 550 pages of transcripts, I think, that I analyzed I forget how many hours. I think it was close to 28 hours of interview data that we had. And the model I developed is called the Ecology of Change in Outdoor therapy. Model So some of you may know I have a nature based therapy approach I developed. It's called the Contigo approach, connection and transformation in the great outdoors.
Laura Park Figueroa [00:06:24]:
You can read more about [email protected]. That's contigo. Now, the contigo approach is not the same thing as the therapy model. That would be unethical if I developed a model to support my other model that I'd already developed before I went to do my PhD in OT. This model is really looking at, again, the mechanisms of change, like what is happening in the therapy process. And it's supposed to illustrate the commonalities that therapists have and the phases that we go through in the nature based therapy process with children. So ecology means the systems that are involved, right? What is the ecosystem of nature based therapy? Essentially. So that's why I chose the word ecology of change.
Laura Park Figueroa [00:07:10]:
What are the mechanisms of change in outdoor therapy? And I specifically did not use the word occupational therapy because I want this model to be used outside of OT as well. There are so many theory that we as occupational therapists use or that other therapists use that are developed in other professions other than our own profession. And so the reason I called it ecology of change in outdoor therapy is because I am hoping that other professionals like speech therapists, physical therapists, mental health counselors, social workers, I'm hoping people will take this model and do some testing and see if they find the same thing in their research. So ecology of change in outdoor therapy model, now it's shortened to ecotherapy ecology change, outdoor therapy. Okay, so it's the ecotherapy model for short. All right, so what is the ecology of change in outdoor therapy model? It involves visual and I will share that visual in the show notes for this episode. So you should be able to find [email protected] slash podcast and you can see a visual of this model. I also have it pinned on my Instagram account at Laura Park Fig.
Laura Park Figueroa [00:08:23]:
So you can see it either of those places right at the top of my feed there. So it is a watercolor kind of image. It looks very Waldorfy and I did that on purpose to make it very natural so it looks like a big globe. And at the bottom of the visual you will see the actors in the nature based therapy process. And those actors, not surprisingly, are nature, the child, the therapist and the parent or caregiver. So I did not include in my model the parent and caregiver perspective because they were not interviewed for this study. And it was very confusing in the process to work out the phases of the mechanisms of change going on and the phases that the process goes through. If I was including parent perspective, child perspective, nature perspective and therapy perspective, the parents typically and the people I interviewed were not present in the session and so I did not include parents.
Laura Park Figueroa [00:09:24]:
The parents are on the model as like players in the actors in the process, but they are not part of the six phases that I'm going to share with you in a bit. The six phases of the nature based therapy process. Okay, so the titles I gave titles to each of the actors to help us remember what their role is in the process of nature based therapy. The caregivers are the contributing beneficiaries. They contribute to the process and they benefit from the process. So that's why I named them the contributing beneficiaries. The child is the motivated adventurer. The therapist is the attuned analyzer and modulator.
Laura Park Figueroa [00:10:04]:
And the context of nature which is behind all of these kind of superimposed, behind all of the actors, nature is the continual context and the blameless co therapist. So I'm going to unpack a little bit what those mean. So the child being the motivated adventurer refers to a lot of people in my research talked about how children were just more motivated outdoors. They were challenging themselves to do things that they normally would not do and that it made taking therapy outdoors made the session seem more like an adventure than like a special medical clinical thing that the child had to go to. So the motivated adventurer is the child. The therapist as the attuned, analyzer and modulator refers to the fact that the therapist role really in the process is to stay attuned to the child and attuned to nature and analyze what is going on in the process of therapy in order to help the child and themselves as a therapist modulate their responses. Nature as the continual context and blameless co therapist. Nature provides challenges that we can't anticipate that's going into the blameless co therapist.
Laura Park Figueroa [00:11:20]:
So maybe I'll talk about that first so nature doesn't get blamed when she offers things that are very challenging for kids. And in that way, nature serves as a co therapy with you in the session when you are out with children. So nature offers these opportunities for children to really push their limits and challenge themselves and manage big emotions when things don't go the way we expect and things like that. But the therapist is there to support the child in that. But the child seems to accept it more willingly from nature than they would from like a human therapist challenging them. And then finally, nature as the continual context means that nature is a context that parents can access in daily life. So it's all around us all the time. It is something nature based therapy is something that you can do anywhere you are.
Laura Park Figueroa [00:12:10]:
You don't even have to be outdoor. You could look outdoors, you could move your session near a window so that you have natural light and observe things outside. That is bringing nature into the session and noticing nature in a way that we may not have thought of before in our treatment sessions. Okay, so those are the actors. Nature, the child and the therapist are the main actors that are going to be in the phases coming forward. So now on the top of the model, there is a trail map drawn and there are six different kind of markers on the trail map. And those are the six different phases that I found in the interviews with the therapy. I called them iterative.
Laura Park Figueroa [00:12:57]:
That's some fancy word for saying that they don't necessarily happen in a perfect linear order. Therapist and child could cycle back through any of these phases at any point in time in an actual therapy session, but they seem like they do unfold in sequence to start. But then therapists move back and forth and children move back and forth in these phases all throughout the process as they go. So it's messy. All right, that is one thing that was so I think the thing that was so hard for me about doing this research is that it's so messy. I wrote in the article that I'm trying to get published that I had to really embrace this concept of nondualism, that it's not two, it's not dual, it's not like one or the other. Everything is intertwined. Everything is intermingled and it's very difficult to pull out exactly what is doing what in this process.
Laura Park Figueroa [00:13:56]:
Okay, so it's a nondualistic model. We have to remember that as I go through these different phases. Okay, so the first phase, which I have in a little house that does not have a door on it on purpose, it has a roof and a little box at the bottom. The first phase is longing for freedom. So the thing that I noticed across all of these interviews was that therapists tend to enter nature based practice because they have frustrations or things that bother them about the way that traditional occupational therapy, in this case, because it was OTS that I interviewed, I did not interview any OT assistants. I should say that I opened it to anyone that was an OT practitioner, but it was only occupational therapists that I interviewed, so I should say that. But most of the therapists were longing for freedom from the confines of traditional ways of practicing. And also the longing for freedom refers to the children.
Laura Park Figueroa [00:15:00]:
The therapists were observing that children are longing for freedom. Children are longing for freedom from the sitting all day at school and being told they have to sit and be quiet and learn and do all those things and not move while they're learning, things like that. Things that we all, as therapists know and are frustrated by those modern day childhood, things that we know are contributing to kids having real challenges developmentally, like screen time, things like that, were mentioned in many of the interviews. So therapists were longing for freedom for children, and they believed that children seemed to be longing for freedom too from some of those confines of modern day childhood. So one of the things, I will say it right now that was really interesting to me was that the process. At the top, these six phases, longing for freedom being the first one, the process actually was similar for the therapist and the child. And one of the things that came out in these interviews was that in nature, when you are in nature with a child, when you're outdoors with a child in a session or with a group of kids in a session, the therapist and child are really in it together. So it's not like the therapist has much control over the setting the way you would in a school or a clinic or things like that, where you could control the environment a little bit more, and in that way it levels the playing field.
Laura Park Figueroa [00:16:27]:
There was a lot of talk in different interviews about leveling the playing field and allowing the children to be better at some things. I had someone say that worked in a kind of nature program where they called people mentors. She said the children are sometimes better at catching fish than the mentors are, and so the children become the ones teaching. And so that was a really cool and that came up in other stories as well. That just the therapist and child being in it together in nature. That was a key finding, was that the therapist and child go through a similar process here. And this longing for freedom was the first step in the process. All right, so the second phase here on the map is called embarking on adventure.
Laura Park Figueroa [00:17:08]:
And I chose a little sun for that one because it feels very hopeful. And this is the part where initially the children are usually pretty excited to come to an outdoor session. It doesn't feel like therapy. It feels like camp or something like something kind of fun for them to do. And it's the same for the therapy. The therapists are super excited to be doing something differently. There's this sense of hopefulness and a sense of excitement about what they're doing. And that's a phase that you move into multiple times, I think in the nature based therapy process, depending on what you're doing that day with children, you can have that sense.
Laura Park Figueroa [00:17:45]:
Even if you're ten sessions in with a group or a child, there can be that sense of embarking on adventure and excitement that is there because the outdoors kind of contributes that to the therapy process. Okay, so one was longing for freedom. Two was embarking on adventure. Three is in the center of the very center of the model, of the circle globe shape of the model, and it's an image of a few trees with some birds, and there's a little hiker and a slightly bigger hiker behind them, like a little icon of a hiker. And this phase is called dancing with nature. And I had a really hard time coming up with the words for these. So one of the reasons that they are all ing words is because you're explaining a process. So you want it to be an action kind of word.
Laura Park Figueroa [00:18:37]:
So we have longing for freedom, embarking on adventure and then dancing with nature. So in Dancing with Nature, this is where the therapist and the child and nature are all working in symbiosis to bring about change in both the therapy and the child. Dancing with Nature involves the therapist really stepping into this role of the attuned, analyzer and modulator and really learning how to notice and how to help the child, support the child, but also how to notice things in nature and use that nature environment. Like help. I shouldn't say use, we try not to say using nature because it sounds so imperialistic or something. So I don't like to use that word even though it occasionally slips out as it just did. But Dancing with Nature was the intentional word that I used to describe this because it really is a dance. It's like sometimes nature takes the lead and the therapist just follows along.
Laura Park Figueroa [00:19:37]:
Sometimes the child takes the lead, sometimes the therapist steps in and takes the lead. And that is central to the change that happens in nature based therapy, is all that kind of dance of just knowing when the therapists themselves, knowing when to step back and let nature do their job and when to step in and support the child if they need it. That is the dancing with nature phase. That's pretty central to the process, I would say. That is one of the central constructs and then I'll share the other one in just a bit. So we have longing for freedom, embarking on adventure, dancing with Nature, and then the next phase is claiming self agency. So this process of the longing for freedom, embarking on adventure and dancing with nature then results in the child and the therapy both claiming self agency. Being able to say that they know that they have an impact in the world, that they have agency, they have the ability to make changes in the world, and they have improved self confidence.
Laura Park Figueroa [00:20:47]:
They have lots of the internal social emotional benefits theory come from those first three phases. And this claiming self agency is just having this internal awareness that you can make change. You actually have the power to be able to change things in your own life and in people around you and in the world. Once the child and therapist kind of experience that self agency and are sensing that internal change, of being able to know that they have that ability to actually make change in themselves and in the world around them. That leads us into the next phase, which is the mountain range at the top of the model, which there's a series of six or five or six mountains there and the trail kind of goes up the tallest one and then down and through the mountains. This phase in the mountains little icon is braving real life challenges. And this is the central construct to the nature based therapy model. Here to the ecology of change and outdoor therapy model.
Laura Park Figueroa [00:21:58]:
Braving real life challenges is only possible once the child and the therapist have gone through all these previous kind of I guess it's not only possible I shouldn't say that it's not only possible, but it's a result of the ability to brave real life challenges. The things that happen in nature that nature just dishes out for us that are real life things. The ability to brave those real life challenges actually comes from going through all of those phases before. We longed for freedom. We were excited. We embarked on the adventure. If we never went on the adventure, we'd never have the challenges. We danced with nature.
Laura Park Figueroa [00:22:39]:
We claimed self agency for ourselves, and then we were willing and able to brave the real life challenges. So I want to read for you from this one quote from my study because it was so unbelievably, just it was such a valuable story of Braving real life challenges. And I want to share this story with you direct from my dissertation because I think that you will really get the concept of the real life challenge if I read this story. So let me pull it up here. Okay? This was a therapist describing a thunderstorm that rolled in much sooner than expected in the middle of an outdoor session. And I don't think I put this entire quote in the actual article that's going to come out. So you're hearing it first and you're hearing the whole thing right here. Okay? So she said the thunderstorm hit half an hour early, so we had to transition kids really fast from the woods back to my barn because it was clearly like, very dark.
Laura Park Figueroa [00:23:53]:
The wind picked up, the rain started happening. It was like, okay, go. And I think she clapped her hands too. They're like, go, get out of here. So as soon as we stepped foot into the barn, it was so windy, it was hailing, it was pouring down rain. And then the thunder and lightning clapped right above us. So I had nine year old boys who were bullies all week long. We were working on social skills with them.
Laura Park Figueroa [00:24:16]:
I had them under the table crying because they were so scared from this natural environmental thing. So it was an incredible opportunity to work on regulation and feelings and everything, like adapting. So you could hear this quote from her and you could be like, that's awful that you made kids cry or that the experience made kids cry. And you could say that, but you also could see it as this was a real thing that would happen in the real world. And the ability of this type of situation to happen in a therapy session is much higher than an even smaller kind of challenges than this was a good example of a big challenge of a real breathing of real life challenges, but the potential for these type of real life challenges to be offered to children. The therapist I interviewed seemed to say that it's much higher in a nature based therapy session. So you have this ability of a therapy session in nature to offer children more opportunities to adapt with the support of a therapist and the kind and supportive support of a therapist being nearby to help them modulate and help them process those emotions that come up when these things happen. But you can't replicate real life situations like this.
Laura Park Figueroa [00:25:49]:
It's hard to not even replicate. That's not the right word. You can't manufacture things like this, right? Like you can't manufacture things like this happening and the potential for them to happen seems much higher in nature based work. So I do want to say quickly, this is not to bash anyone who works in a clinic or in a school or in an indoor setting. This is just contemplating the things that may be contributing to nature based therapy having a meaningful effect on change in children. Okay? So this potential for nature to offer these real life challenges is very great. And lots of people mentioned that in nature, you just can't predict. You don't know what you're going to get.
Laura Park Figueroa [00:26:37]:
Sometimes you come and a tree fell over or like something's all wet or something disappeared that was there the week before. There's just things that you can't predict happening and those are therapeutic opportunities for kids to adapt. While we're here, maybe let me move into the last phase here because I just said adapt and the last phase after braving real life challenges is growing adaptive capacity. And so all of those previous phases, the longing for freedom, embarking on adventure, dancing with nature, claiming self agency, braving real life challenges, all of those things result in the child and therapist growing adaptive capacity. Now, here I really do more, the focus is more on the child in this phase because I'm wondering what brings about change in the children. That was the research question, really was what I was thinking at the beginning. It was a surprise finding that therapists kind of go on this process too. But a child being able to grow adaptive capacity.
Laura Park Figueroa [00:27:38]:
Adaptive capacity refers to the person's ability to perceive the need to change, modify or refine a variety of responses to occupational challenges in the environment. So that's from 2019 and Scotty and Schultz's original work in 1992 on occupational adaptation theory. So when a person has increased adaptive capacity, they're able to notice when something needs to change, they're able to problem solve, to come up with solutions and they're able to use their skills or gain new skills to attempt those solutions. So it's a sequence of noticing, problem solving and using skills. And you have to do this continually throughout life. This is like what adaptation is. When adaptation is effective, new awareness from experiences are integrated into your internal repertoire of responses for then facing future challenges in life. So when the child's adaptive capacity improves, then they are more ready to leave the nature based therapy process and go off into the real world where they're going to brave real life challenges in real daily life situations.
Laura Park Figueroa [00:28:46]:
So that's it the full cycle. Longing for freedom, embarking on adventure, dancing with nature, claiming self agency, braving real life challenges and finally growing adaptive capacity. The thing that I was thinking about saying earlier and I continued with the 6th phase because I wanted to finish up that explanation of all the phases is that one of the key findings from this study was that nature offers these experiences which have a hermetic effect. So if you've never heard of the term hormesis it's a biological concept that refers to the health benefits of low to moderate level stressors that disrupt homeostasis in the human body requiring the body to generate an adaptive response. The nature based therapy process is not easy. I haven't really focused on that in this podcast but it is not easy. I said the other day on Instagram nature based therapists have to be a little bit really it's not easy to do therapy. It's I think sometimes we have this idyllic view that it's going to be all like a bed of roses and it's just not.
Laura Park Figueroa [00:29:54]:
Sometimes it's really hard. But that is the actual thing that brings about change. These real life challenges that come up have a hermetic effect where they are not easy. So human adaptation is ultimately a process of being exposed to some level of discomfort or pain. Too much pain can harm or even kill us but likewise not enough pain does nothing to ignite adaptive processes in the body. Humans thrive with the right amount of adversity and stress to cause healthy adaptive responses. So things like fasting vigorous exercise, heat exposure in a sauna, cold plunging these practices may have hormetic effects on the human body. Like they're moderately painful for a short period of time but they can have ongoing health benefits afterwards in the body and they require tenacity grit and a willingness to do the hard thing for the greater good in the long run.
Laura Park Figueroa [00:30:52]:
I'm reading a bit from my dissertation so I haven't seen hormesis fully explored or applied in the OT profession. I'm not sure if it's been explored in PT or speech or mental health, but it really seems a good concept to apply in this discussion of comparing the just right challenge, which is this common idea we have in therapy of giving the child the just right challenge to challenge them just enough, but not stress them too much in comparison to the real life challenge that's offered in nature during nature based sessions. Because how do we know? How do we know if the just right challenge? I know it's a skilled therapy technique, right? To know when the just right challenge. What the Just Right challenge is for a child. But how do we know if that standard? Just Right challenge is enough to really induce a hermetic effect in a child's nervous system to cause a highly effective adaptive response. Maybe this embracing of the idea of braving the real life challenges is actually what we need in order for maximal adaptive responses to take place. I could go on and on. I have a whole section in my dissertation about this, but I just want to throw that idea out there and you guys can let me know what you think about it.
Laura Park Figueroa [00:32:07]:
In the comments on this episode, I've talked a really long time. I wanted this to be like 20 minutes, but it was a lot of research to cover. That was my dissertation. Quick overview I have a couple of other episodes I could do on this topic. So if this is interesting to you all, please let me know. Inside of the Therapy in the Great Outdoors Community so I did not say this at the beginning. If you're still hanging around here, you will be interested in joining the Therapy in the Great Outdoors community. You can go to therapyinthegreatoutdoors.com to join.
Laura Park Figueroa [00:32:38]:
It's a free community for nature based pediatric therapy discussion and camaraderie and community. It is a great place to get resources and where I help people out to help them support their nature based business and practice startup and growth. That's it, y'all. I'm already feeling, oh my gosh, how many times did I mess up in this episode? But I'm not going to heavily edit. You all know me. I'm going to just keep it real. You can hear me just talk through the research and I hope that it was interesting to you. Please reach out to me.
Laura Park Figueroa [00:33:19]:
I love hearing from all of you. So until next time, get outside, connect, reflect and enjoy the business and practice of therapy in the great outdoors. Bye.