Early Findings from a Mindfulness-Based Therapeutic Nature Intervention for Supporting Individuals with Substance Use Disorder

Background and Purpose

Inpatient substance use treatment programs yield mixed results in supporting long-term recovery; providing clients with accessible tools for healing may increase the likelihood of long-term recovery. Growing evidence demonstrates the myriad health benefits of interaction with the natural environment. Nature-based ecotherapy interventions have been shown to reduce depression and anxiety, and expedite recovery from illness. However, little is known about the potential of nature-based interventions for supporting recovery from substance use disorder (SUD). A Baltimore non-profit, Nature Worx, and a university researcher have partnered to measure the effects of a mindfulness-informed therapeutic nature intervention on individuals enrolled in addiction treatment. The purpose of this pilot study is to establish preliminary findings regarding effectiveness of Nature Worx sessions as a supplement to traditional substance use treatment, for reducing anxiety, depression, and substance cravings.

Methods

We used a one-group post-test only design to measure attitudes towards nature, and perceived anxiety, depression, and substance cravings before and after participating in a 90-minute Nature Worx session. Each session is facilitated by trained guides who lead participants through a series of experiential activities promoting mindful connection with nature. Immediately after each session, participants complete a survey assessing attitudes towards nature, levels of anxiety, depression, and substance cravings, and perceptions of the session. All participants (N=821) were enrolled in an inpatient or an extended care residential program at the time of the study, between March 2020 and April 2022. All descriptive and bivariate analyses were conducted using STATA 16.

Results

Respondents experienced a mean 1.15-point reduction in anxiety (on a 1 to 5 scale) from pre- to post-intervention. Similarly, respondents reported reductions in depression (M=.74) and substance cravings (M=.43) after one session. A comparison of average change scores by baseline cravings indicates that respondents who reported “somewhat high” to “very high” cravings before the session experienced a significantly greater reduction in cravings compared to those with “very low” to “moderate” baseline cravings (t(786)=-11.31, p < .00). For those with high cravings at baseline, the average change from pre- to post-intervention was 1.4 points (SD=.16). Additionally, 89% of participants reported feeling more connected to the natural world, and 95% learned ways that nature could support their recovery.

Conclusions and Implications

These findings indicate the average participant experienced reduced anxiety, depression, and substance cravings after participating in a session. Additionally, the greatest reductions in cravings were found among the highest risk group, suggesting Nature Worx sessions may curb strong cravings. The majority of participants understood how nature could support their recovery, demonstrating that Nature Worx sessions give participants tools to use on their own. Although the study design is limited, this pilot lays the groundwork for an RCT in which we will rigorously evaluate the effectiveness of Nature Worx sessions for supporting individuals in their recovery. Therapeutic nature programs like Nature Worx sessions are affordable and accessible, and if proven effective in supporting long-term recovery, could be a sustainable supplement to traditional forms of substance use treatment.