{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T12:03:19Z","timestamp":1774008199624,"version":"3.50.1"},"reference-count":45,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Canet Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Human health and well-being are dependent on natural environments, which is the core foundation of the growing discipline of outdoor therapies. However, as with psychotherapy research in general, the field of outdoor therapies lacks descriptive process-oriented theoretical frameworks that precisely reflect this multi-faceted practice. Therapeutic work, whether this takes place indoors or outdoors, comprises numerous implicit relational and environmental dimensions. Implicit aspects are largely sensed, embodied and intuitive, and therefore hard to pin down and describe accurately. In this exploratory study, a survey mapped implicit guiding frameworks amongst outdoor therapy practitioners (n = 68) representing 18 nations. A constructivist grounded theory analysis resulted in the proposition of a practice theory, called the implicit ecosystem of outdoor therapies, made up of eight interrelated components: (1) joint engagement and co-creating agendas; (2) a foundation of safety and trust; (3) being in parallel and not fix; (4) awareness and attunement here-now; (5) the dynamic of outer and inner landscapes; (6) a constantly moving and meaning-making endeavor; (7) creativity, play, and whole-body activation; and (8) working through natural barriers and rewriting narratives. This grounded theory offers a preliminary blueprint of a practice-guiding framework developed from within the outdoor therapy discipline intended to advance theory, training, and research.<\/jats:p>","DOI":"10.3390\/ijerph23030394","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T09:44:41Z","timestamp":1773999881000},"page":"394","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Implicit Ecosystem of Outdoor Therapies: A Grounded Theory Exploratory Study of International Practitioners\u2019 Guiding Frameworks and the Proposition of a Practice Theory"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0732-7407","authenticated-orcid":false,"given":"Carina R.","family":"Fernee","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Mental Health, S\u00f8rlandet Hospital, Egsveien 100, 4615 Kristiansand, Norway"},{"name":"Department of Sport Science and Physical Education, University of Agder, Universitetsveien 25, 4630 Kristiansand, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9063-8363","authenticated-orcid":false,"given":"Markus","family":"Mattsson","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Mental Health, S\u00f8rlandet Hospital, Egsveien 100, 4615 Kristiansand, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7345-7479","authenticated-orcid":false,"given":"Pekka","family":"Lyytinen","sequence":"additional","affiliation":[{"name":"Muutosloki Turku Ay, Yliopistonkatu 26b, 20100 Turku, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7828-2349","authenticated-orcid":false,"given":"Nevin J.","family":"Harper","sequence":"additional","affiliation":[{"name":"School of Exercise Science, Physical and Health Education, University of Victoria, P.O. Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"eaax0903","DOI":"10.1126\/sciadv.aax0903","article-title":"Nature and mental health: An ecosystem service perspective","volume":"55","author":"Bratman","year":"2019","journal-title":"Sci. Adv."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1289\/EHP1663","article-title":"Nature contact and human health: A research agenda","volume":"125","author":"Frumkin","year":"2017","journal-title":"Environ. Health Perspect."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"van den Bosch, M., and Bird, W. (2018). 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