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5 Insider Tips for the Transition to Pediatric Nature-Based Occupational Therapy

Curious about what goes into becoming a nature-based occupational therapist? Maybe you’ve heard of the benefits of nature-based preschools or about how being in nature is SUPER good for kids. Or perhaps you’ve listened to bits and pieces about this emerging area of OT where sessions happen outside.


Have you ever wondered… “How do I become a nature-based therapist?”


As you’d probably suspect, you can’t just jump out of a clinic or school setting and waltz straight into the woods.

(Well, you could… but that would be stressful. Plus, jumping straight into the woods won’t set you or your clients up for the best possible success.)


And we know that because we’ve been there ourselves.


Oh hey there! I’m Marika Austin of Bearfoot OT. And Hi! I’m Angela Rosenburg of Treeline Enrichment. Combined we have 8 years of experience in nature-based OT and have helped multiple occupational therapist transition to roles inside our outdoor therapy practices. Together, we’re jazzed to simplify the journey for other occupational therapy practitioners who want to join nature-based practices.


Marika Austin and Angela Rosenburg on a hike together in Colorado

We’re here to spill the beans about what goes into the leap from traditional pediatric OT to becoming a seasoned pro as a nature-based OT.


That’s right, keep reading to discover what makes outdoor therapy practice different from a traditional pediatric therapy clinic.


Plus, we’ll throw in some practical tips – in case you’re making this transition yourself.


1. New Materials, New Therapy Activities

Working as a nature-based OT will require shifting how you design activities. Without so many available toys and materials to fall back on as you might in a traditional clinic setting, you’ll need to learn to curate a new toolbox of activities using items in nature.


This difference will hit you before you even step foot into the woods. Just thinking through your sessions, you’ll begin wondering about the materials and activities that will fill the time. Gone are the closets overflowing with toys and crafts representing hundreds of treatment options.


No more ceiling swing attachments, Lycra hammocks, or foam mats that stand ready at all times for gross motor and sensory skill development. But here’s the cool part.


Once you get the hang of this way of thinking, you’ll begin to see natural objects and the opportunities they present in an entirely new way. Following the lead of the kids you work with, your brain can learn to create incredible, creative, and effective therapy activities without all the extra stuff.

That’s part of what makes nature-based therapy so fun and satisfying. It’s the pinnacle of creativity and thinking on your feet as a therapist.


2. Outdoor OT Requires a Different Level of Physicality

If you’re a pediatric OT, you’re used to a job with physical demands. You’re playing on the floor, hanging up swings, and providing physical assistance to kids all day long.


BUT… when you take your therapy practice outdoors, you’ll immediately notice the physical demands are different.


As in, there are MORE physical demands on your strength, endurance, and coordination. That’s because you’re moving all day in ways that aren’t required in many other OT practice settings.


We’re talking hiking with every session, climbing trees, and hauling all the items you need for your sessions. Plus, dealing with the natural weather elements means your body is taxed by cold, heat, rain, snow, and more!


In fact, since you have fewer items available, you’re more likely to use your own body to support the needs of kids on your caseload. It's YOU pushing that swing or lifting that kid up into a tree. Until you’ve spent a full day in the woods, it’s easy to underestimate the energy that outdoor OT requires. Really, this makes you part therapist and part athlete. To manage this, it’s essential to take care of your body in ways you might not need to do in a different type of setting.


That’s why all nature-based OT practitioners should go above and beyond when it comes to self-care to fuel your day and your work.

  • Be highly intentional with the food you eat throughout the day.

  • Consume plenty of water.

  • Prevent injuries with good body mechanics and prioritize physical fitness and health.

  • Create a work routine that fuels your essential needs.

  • Manage smaller caseloads to decrease physical demands.

  • Plan physical recovery time into your weekly routine.

  • Always always always - keep lots of extra snacks in your car

For the right person with the proper self-care tools, the fresh air, and the abundance of physical activity is a dream job as an OT.


3. New Skills to Add to Your OT Toolbox

Let’s start with the good news — you’ll still draw from all your knowledge and skills as a pediatric OT.


That being said, your OT toolbox will need to expand to successfully take your practice outdoors. Especially in terms of clinical observation and outdoor-specific skills.


Recalibrate Those Clinical Observation Skills

Whether you know it or not, how you observe kids and translate those observations into clinical insights depends on the setting you're in. Up to now, you’ve honed clinical observations of how kids behave and move indoors. You’ll need some time and practice to get your brain to fire differently for clinical observations outdoors. It’s a different way of understanding kids and how they move. With practice, you’ll be able to watch a kid climb a log or problem-solve a fort and relate that information to specific skill development, goals, and the rest of life.

Pretty amazing, isn’t it?

Get Yourself Some New “Outdoorsy” Skills

Some skills are essential for outdoor practice but completely foreign to your traditional training program as an OT.


Here are some new skills you’ll have to learn as you head out into the woods:

  • How to safely hang a swing outside. Yup, totally possible without ceiling mounts.

  • How to build a fire. This classic outdoor activity is perfect for a range of therapy goals.

  • Fort Building 101. This includes knots, tarp hanging, and tree branch knowledge.

These definitely aren’t covered in your typical education curriculum or fieldwork experiences. Which means that you’ll need to learn them on your own or with a mentor.


4. Safety in the Woods

When you take occupational therapy sessions out to the woods, you need to be prepared as the therapist to amp up how you think about safety.


First, the outdoors are not a static, controlled environment like the clinic. Each and every time you enter the woods, you need to assess the situation for safety.


Are trees or the ground more slippery because of rain?

Is that tree or those rocks sturdy enough at this moment for climbing?


Not to mention added safety concerns with the kids, which includes:

  • Balancing good risky play like tree climbing or rocking jumping with injury prevention.

  • Tracking kids in the open environment, so no one wanders off.

  • High-level problem-solving when kids demonstrate challenging behaviors in the woods.

  • Offering basic first aid for minor injuries that happen with outdoor play.

If safety in the woods initially feels overwhelming, remember that all of this is manageable and becomes second nature to you with guidance and practice.

5. Leaving Behind the Comforts of the Clinic

Talk about an office with a view! Nature-based therapy puts you in the front seat of all the beauty and benefits that nature has to offer. There is so much to love!


However, when considering taking yourself outdoors as a pediatric OT, it’s a good idea to open your eyes to the creature comforts of the clinic you’re leaving behind.


Actually, more than creature comforts, there are some important logistics you’ll need to be aware of to successfully make this transition.


Here’s an insider peek at what to consider.

  • Limited computer access: Outdoors means limited ability to use a computer. This means you’ll likely need to save your documentation, email, and other online work until after your sessions. Instead of squeezing in documentation between sessions, spend this time on reflection, snacking, or prepping your materials.

  • Working out of your car: Swap out your desk for your car. It’s your storage and your hangout pad for the whole day.

  • All-weather: You’ll find yourself making all sorts of decisions around the weather. It impacts your sessions and your clothing. When rain hits during a session, you’ll be faced with new decisions like, “Do I go to my car between sessions or just embrace my soggy situation?”

With some advance planning and flexibility, you’ll figure these logistics out. In many ways, this becomes a lifestyle where each day represents freedom and adventure that only exist beyond the walls of a building.


Also, think about the comfort of kids and the perceptions of parents.

It’s not only you that’s leaving behind the comforts of the clinic. It’s the kids and their parents too.

Parents know and understand the premise of a traditional clinic. Nature-based OT requires them to step outside their comfort zone too.

As a professional, you are their guide. It’s up to you to answer questions and calm their concerns.

Some of the frequent topics of conversation include:

  • The benefits of risky play outdoors

  • Preparation and benefits of outdoor therapy in different weather conditions

  • Embracing the dirt and mess of outdoor play

  • Specifics about bathrooms, clothing, or drop-off expectations

With the proper education, you’ll discover that your clients and their parents become some of the fiercest champions of outdoor OT.

Nature-based OT Is an Incredible Way to Offer OT Services

If you’re still here, we’ll let you in on a little secret. We’ve seen so many therapists fall in love with nature-based therapy. For the right person with the key tools for success, it’s a magical way to offer occupational therapy services.



What’s to love about outdoor occupational therapy?

  • Rewarding results — Tons of research backs up the success you’ll witness with clients.

  • Freedom — You’re not confined to the hustle and bustle of traditional clinic space, schedule, or expectations.

  • Feels good — Outdoor work offers a unique alignment to childhood development and the values and ideals of the OT profession.

And because it’s such a fulfilling way to work, we want more therapists to be able to successfully and joyfully provide this service. This is bigger than just our practices. It paves a new path to OT provision and career satisfaction for those looking for something different.


What started as a partnership between Bearfoot OT and Treeline Enrichment to prepare our own team members for nature-based therapy has turned into more than we could have ever imagined. We’ve created an online training program to assist others to begin working in outdoor practices.

Check out the Nature-Based Therapy Boot Camp. This comprehensive but no-fluff outdoor OT training program will guide your skills from nature novice to nature pro.

It’s the nitty-gritting essentials of outdoor therapy sessions, so you (or your new OT employee) are ready for nature-based OT in 30 days or less!

Our training program is packed with essentials such as:

  • Self-care

  • Activity ideas

  • Safety knowledge

  • Wilderness skills

  • Navigating daily logistics

And so much more!

Get on the fast track to the knowledge you need without stressing yourself through the transition!


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