Recovery rarely happens in one room. Most people who come through inpatient treatment spend their days moving between individual sessions, group work and the quieter hours in between, and a fair amount of that time is spent outdoors. At Freeman House Recovery, set in the Magaliesberg near Hartbeespoort, the natural surroundings aren’t a backdrop. They’re part of how the day is structured, alongside the clinical work that does the heavy lifting.
Ecotherapy, also called nature therapy, is the broad name for therapeutic activity that happens in or with the natural world. It covers everything from a guided walk and time in a garden to structured outdoor sessions with a counsellor present. It’s worth being clear from the start about where it sits: nature therapy is a support to evidence-based addiction treatment, not a replacement for it.
What ecotherapy actually is
You’ll hear several names for it. Some centres call it wilderness therapy, others adventure therapy or outdoor behavioural health. The terms overlap, and the differences mostly come down to how intense the activity is and who it’s designed for. Wilderness and adventure programmes lean towards physically demanding activities like hiking or climbing, and historically a lot of that work focused on adolescents with behavioural difficulties. The gentler end looks more like walking, gardening or simply sitting in a quiet outdoor space and paying attention to it.
What ties them together is the setting. Instead of a consulting room, the work happens somewhere green and open. The idea is that being in nature lowers the body’s stress response and creates a calmer space to do difficult emotional work, whether that’s a structured session or unstructured time to think.
The kinds of nature therapy used in recovery
In an inpatient setting, nature therapy usually takes a few practical forms:
- Walking and hiking in the surrounding terrain, sometimes as a group, sometimes with a therapist.
- Gardening or horticultural activity, which gives people a routine, something to tend to and a small sense of responsibility.
- Forest bathing, a Japanese practice (shinrin-yoku) of slowing right down and taking in the surroundings through the senses, rather than walking for exercise.
- Mindfulness outdoors, where breathing and grounding exercises are done in a natural setting rather than indoors.
None of these are dramatic. That’s rather the point. They’re low-pressure activities that sit comfortably alongside the harder clinical work happening through the rest of the day.
What the research says, and what it doesn’t
The evidence for nature-based activity in mental health is genuinely promising, and it’s also still developing. A systematic review and meta-analysis published in SSM – Population Health found that nature-based outdoor interventions were linked to reduced depressive symptoms and lower anxiety across a range of people, including those with serious mental illness, with forest bathing and green exercise showing consistent benefit (read the review here). The sessions that seemed to help most ran over several weeks, which matches how these activities are used during a longer inpatient stay rather than as a one-off.
That said, the picture is honest about its limits. Reviews of ecotherapy specifically describe the evidence as suggestive rather than conclusive, and much of the supporting research is small or of mixed quality. The same caution applies to relaxation techniques more broadly: the United States National Center for Complementary and Integrative Health notes that while approaches like these can help with stress and anxiety, a lot of the underlying research is rated low quality, and they’re best used alongside professional care rather than instead of it (see the NCCIH summary).
So the fair way to put it is this. Time in nature appears to lower stress, lift mood and give people room to reflect, and those are real assets in recovery. What it doesn’t do is treat the addiction on its own. That’s the work of medically supervised detox, therapy and the structured programme around it.
How nature therapy fits into treatment at Freeman House
At Freeman House, the clinical programme is the core. That means medically-assisted detox, individual and group therapy, psychiatric assessment, trauma counselling, and structured approaches like CBT and DBT, all delivered within a residential setting. Nature therapy is woven through that, not bolted onto the end of it.
The Magaliesberg location makes this practical rather than theoretical. Being away from the usual environment, the people, the routines and the triggers tied to substance use gives a person space to focus. The quiet helps. So does having somewhere calm to walk after a hard therapy session. This is part of a broader holistic approach to addiction treatment that also draws on yoga, meditation and mindfulness and other practices that support the body and mind during recovery.
Why the outdoor element matters for staying well
One of the harder parts of recovery is what happens after treatment, when the daily structure falls away. Activities learned during an inpatient stay can carry over. A person who has found that a long walk steadies them, or that meditation takes the edge off a craving, leaves with a tool they can actually use at home. Building those habits early gives them something to fall back on, which is part of why aftercare and ongoing support matter so much once the formal programme ends.
Frequently Asked Questions
Can nature therapy treat addiction on its own?
No. Nature therapy supports recovery, but it isn’t a standalone treatment for substance dependence. Addiction is a treatable health condition that’s managed through medically supervised care, therapy and ongoing support. Time in nature helps reduce stress and improve mood, which makes that clinical work more sustainable.
Is ecotherapy backed by evidence?
There’s growing research suggesting nature-based activity can help reduce anxiety and depressive symptoms, though much of it is still early-stage and the quality varies. It’s best understood as a helpful addition to proven treatment, not a substitute for it.
What does nature therapy look like during inpatient treatment?
It usually means structured time outdoors: walks and hikes, gardening, mindfulness practice in a natural setting, or simply quiet time in calm surroundings. At Freeman House the Magaliesberg location makes this a natural part of the daily routine alongside the clinical programme.
Who is nature therapy suitable for?
Most people in treatment can take part in some form of it, since the activities range from gentle to more physically active. The treatment team adjusts what’s offered to suit a person’s health and stage of recovery.
Talk to someone about getting help
If you or someone you love is struggling with addiction, reaching out is the hardest and most important step. Freeman House Recovery offers private inpatient treatment in the Magaliesberg, where the clinical programme and the natural setting work together to support recovery. You can call our team on +27 12 1111 739 for a confidential conversation about what treatment involves and whether it’s the right fit. If you need immediate mental health support anywhere in South Africa, the South African Depression and Anxiety Group (SADAG) runs free helplines that are open around the clock.
Freeman House Recovery is registered with the Department of Health and the Department of Social Development under the Prevention of and Treatment for Substance Abuse Act 70 of 2008.
