*Psychotherapy in Nature: Exploring an Alternative Psychotherapeutic Framework to Address… DOI: http://dx.doi.org/10.5772/intechopen.104627*

present as a barrier for engaging in psychotherapy in any setting, and efforts should be made to ensure that the service framework is inclusive and suitable for people from all economic backgrounds, and to think about things like affordability and accessibility if someone does not have transport. Many green spaces are not on main bus routes, and consequently when thinking about the location for the service, this factor should be considered, in order to not exclude certain people who may not own their own transport. It may be that you are able to offer a shuttle or taxi service as part of your service.

#### *2.9.2 Psychological risk factors*

Further consideration in the area of screening and procedures for referral in nature settings is imperative, just as with managing the safety and suitability of services, settings and practitioners, in relation to ethical frameworks such as British Association for Counselling and Psychotherapy [12] for room-based settings. Risks for working outside or in nature must be identified as part of this umbrella framework. The below **Table 2** lists some examples of the areas for consideration and identifies some presentations and behaviours that require risk assessments. Although risk assessments do require careful thinking and extra, detailed paperwork, in most cases, they can allow a diverse range of service users access to therapies that they may have been excluded from otherwise, thus supporting an inclusive, client-led framework.

**Table 2** illustrates some examples of areas that require careful thinking, planning, and risk assessment, and the list is endless; however, for the purposes of this chapter, limited examples have been provided. Aside to risk assessments and general considerations for direct harm to service users; it is also important to include the practitioner/ therapist and any support workers within these processes. Importantly, a lone working policy must be in place, and where necessary, extra support and human resources present/available. Considerations for health and safety for all stakeholders must also be in place, just as with other settings. It goes without saying that in any setting, when working with high-risk clients, regular supervision and self-care are of central importance in any case.



#### **Table 2.**

*Presentations relating to metal health diagnoses that require risk assessment.*
