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Out-Of-Office Experiences


This resource page is part of an Online Course
Out-Of-Office Experiences: Ethical & Clinical Considerations For Home Visits & Other Encounters Outside The Office


Out of Office Experiences - Walk & Talk Therapy - Incidental or Chance Encounters - Attending Weddings, Ceremonies and other Celebrations Outside The Office Walls

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Adventure Therapy, Wilderness and Outdoor Therapy

    Additional References on Adventure Therapy, Wilderness and Outdoor Therapy
  • Albright, R. L. (2016). The Qualitative Impact of Adventure Based Counseling on Sixth Grade General Education Students. Journal of School Counseling, 14(8), n8.
  • Banaka, W. H., & Young, D. W. (1985). Community coping skills enhanced by an adventure camp for adult chronic psychiatric patients. Hospital and Community Psychiatry, 36, 746-748.
  • Bowen, D. J., Neill, J. T., & Crisp, S. J. (2016). Wilderness adventure therapy effects on the mental health of youth participants. Evaluation and Program Planning, 58, 49-59.
  • Carpenter, C., Norton, C., & Pryor, A. (2015). Adventure therapy around the globe: International perspectives and diverse approaches. Champaign, IL: Common Ground Publishers.
  • Christian, D. D., Perryman, K. L., & Portrie-Bethke, T. L. (2017). Improving the Parent–Adolescent Relationship With Adventure-Based Counseling: An Adlerian Perspective. Journal of Child and Adolescent Counseling, 3(1), 44-58.
  • Davis-Berman, J., & Berman, D. S. (1994). Wilderness therapy: Foundations, theory & research. Dubuque, IA: Kendall/Hunt.
  • DeDiego, A. C., Wheat, L. S., & Fletcher, T. B. (2016). Overcoming Obstacles: Exploring the Use of Adventure Based Counseling in Youth Grief Camps. Journal of Creativity in Mental Health, 1-13.
  • Dobud, W. (2017). Towards an Evidence-Informed Adventure Therapy: Implementing Feedback-Informed Treatment in the Field. Journal of Evidence-Informed Social Work, 1-11.
  • Eckstein, F., & Rüth, U. (2015). Adventure-based experiential therapy with inpatients in child and adolescent psychiatry: an approach to practicability and evaluation. Journal of Adventure Education & Outdoor Learning, 15(1), 53-63.
  • Gass, M. A., Gillis, H. L., & Russell, K. C. (2012). Adventure therapy: Theory, practice, & research. New York, NY: Routledge.
  • Glass, J. S., & Shoffner, M. F. (2001). Adventure-based counseling in schools. Professional School Counseling, 5, 42-47.
  • Herbert, J. T. (1996). Use of adventure-based counseling programs for persons with disabilities. Journal of Rehabilitation, 62, 3-9.
  • Hoag, M. J., Massey, K. E., & Roberts, S. D. (2014). Dissecting the wilderness therapy client: Examining clinical trends, findings, and patterns. Journal of Experiential Education, 37(4), 382-396.
  • Hoag, M. J., Massey, K. E., Roberts, S. D., & Logan, P. (2013). Efficacy of wilderness therapy for young adults: A first look. Residential Treatment for Children & Youth, 30(4), 294-305.
  • Jeffery, H., & Wilson, L. (2017). New Zealand occupational therapists' use of adventure therapy in mental health practice. New Zealand Journal of Occupational Therapy, 64(1), 32-38.
  • Koperski, H.; Tucker, A.; Lung, M.; & Gass, M. A. (2015). The Impact of Community Based Adventure Therapy on Stress and Coping Skills in Adults. The Practitioner Scholar: Journal of Counseling and Professional Psychology, 4(1), 1-16.
  • Lowry, T. (1974). Camping therapy: Its uses in psychiatry and rehabilitation. Springfield, IL: Charles C. Thomas.
  • Mutz, M., & Müller, J. (2016). Mental health benefits of outdoor adventures: Results from two pilot studies. Journal of adolescence, 49, 105-114.
  • Newes, S. L. Adventure-Based Therapy: Theory, Characteristics, Ethics, and Research. A paper written to fulfill the comprehensive examination requirement. Doctoral Candidate, The Pennsylvania State University.
  • Norton, C. L., Tucker, A., Farnham-Stratton, M., Borroel, F., & Pelletier, A. (2017). Family Enrichment Adventure Therapy: A Mixed Methods Study Examining the Impact of Trauma-Informed Adventure Therapy on Children and Families Affected by Abuse. Journal of Child & Adolescent Trauma, 1-11. doi:10.1007/s40653-017-0133-4
  • Russell, K., & Gillis, H. L. (2017). The Adventure Therapy Experience Scale: The Psychometric Properties of a Scale to Measure the Unique Factors Moderating an Adventure Therapy Experience. Journal of Experiential Education, 40(2), 135-152.
  • Russell, K. C., Gillis, H. L., & Heppner, W. (2016). An Examination of Mindfulness-Based Experiences Through Adventure in Substance Use Disorder Treatment for Young Adult Males: a Pilot Study. Mindfulness, 7(2), 320-328. doi:10.1007/s12671-015-0441-4
  • Schimmel, C. J., Daniels, J. A., Wassif, J., & Jacobs, E. (2016). Learning the Ropes: A Creative Orientation Approach for Counseling Students. Journal of Creativity in Mental Health, 11(1), 27-38.
  • Schoel, J., Prouty, D., & Radcliffe, P. (1988). Islands of healing: A guide to adventure based counseling. Hamilton, MA: Project Adventure.
  • Tucker, A. R., Javorski, S., Tracy, J., & Beale, B. (2013). The use of adventure therapy in community-based mental health: Decreases in problem severity among youth clients. In Child & Youth Care Forum (Vol. 42, No. 2, pp. 155-179). New York, NY: Springer.
  • Tucker, A. R., Smith, A., & Gass, M. A. (2014). How presenting problems and individual characteristics impact successful treatment outcomes in residential and wilderness treatment programs. Residential Treatment for Children & Youth, 31(2), 135-153.
  • Tucker, A. R., Norton, C. L., Itin, C., Hobson, J., & Alvarez, M. A. (2016). Adventure Therapy: Nondeliberative Group Work in Action. Social Work with Groups, 39(2-3), 194-207.


Codes of Ethics on Interactions/Therapy Outside the Office

Professional Association Codes of Ethics and Guidelines On Out-of-Office Therapy


CPT Codes for Out of Office Experiences

CPT Codes for Out-of-Office Services


Additional References on Out of Office Therapy

  • Adams, M., & Jordan, M. (2016). Growing together: Nature connectedness, belonging and social Identity in a mental health ecotherapy programme. Ecotherapy: Theory, Research and Practice, 122.

  • Cipriani, J., Benz, A., Holmgren, A., Kinter, D., McGarry, J., & Rufino, G. (2017). A systematic review of the effects of horticultural therapy on persons with mental health conditions. Occupational Therapy in Mental Health, 33(1), 47-69.

  • Christie, M., Thompson, M., Miller, P. K., & Cole, F. (2016). Personality disorder and intellectual disability: The impacts of horticultural therapy within a medium-secure unit. Journal of Therapeutic Horticulture, 26(1), 3-17.

  • DeMille, S. M., & Montgomery, M. (2016). Integrating narrative family therapy in an outdoor behavioral healthcare program: A case study. Contemporary Family Therapy, 38(1), 3-13. doi:10.1007/s10591-015-9362-6

  • Freeman, E. (2017). With nature in mind: The ecotherapy manual for mental health professionals. British Journal of Guidance & Counselling, 1–2.

  • Hart, J. (2016). Prescribing nature therapy for improved mental health. Alternative and Complementary Therapies, 22(4), 161-163.

  • Hawkins, B. L., Townsend, J. A., & Garst, B. A. (2016). Nature-based recreational therapy for military service members: A strengths approach. Therapeutic Recreation Journal, 50(1), 55-74.

  • Hegarty, J. R. (2010). Out of the consulting room and into the woods? Experiences of nature-connectedness and self-healing. European Journal of Ecopsychology, 1(1), 64-84. Retrieved from

  • Hinds, J., & Jordan, M. (Eds.). (2016). Ecotherapy: Theory, Research and Practice. London, UK: Palgrave.

  • Hooley, I. (2016). Ethical considerations for psychotherapy in natural settings. Ecopsychology, 8(4), 215-221.

  • Jordan, M. (2014). Nature and therapy: Understanding counselling and psychotherapy in outdoor spaces. New York, NY: Routledge.

  • Jordan, M. (2014). Moving beyond counselling and psychotherapy as it currently is–taking therapy outside. European Journal of Psychotherapy & Counselling, 16(4), 361-375.

  • Lai, C. K. Y., Lau, C. K. Y., Kan, W. Y., Lam, W. M., & Fung, C. Y. Y. (2017). The effect of horticultural therapy on the quality of life of palliative care patients. Journal of Psychosocial Oncology, 1-14.

  • Lazarus, A. A. & Zur, O. (Eds.) (2002). Dual Relationships and Psychotherapy. New York: Springer. 

  • Peterson, D., & Boswell, J. N. (2015). Play Therapy in a Natural Setting: A Case Example. Journal of Creativity in Mental Health, 10(1), 62-76.

  • Surgenor, H. (2015). Nature and therapy: Understanding counselling and psychotherapy in outdoor spaces. Existential Analysis, 26(2), 370-374. Retrieved from p=AONE&sw=w&issn=17525616&v=2.1&it=r&id=GALE%7CA428625373

  • Tucker, A. R., Paul, M., Hobson, J., Karoff, M., & Gass, M. (2016). Outdoor behavioral healthcare: Its impact on family functioning. Journal of Therapeutic Schools and Programs, 21-40. doi:10.19157/JTSP.issue.08.01.05

  • Tucker, A. R., Widmer, M. A., Faddis, T., Randolph, B., & Gass, M. (2016). Family therapy in outdoor behavioral healthcare: Current practices and future possibilities. Contemporary Family Therapy, 38(1), 32-42. doi:10.1007/s10591-015-9370-6

  • Westlund, S. (2014). Field exercises: How veterans are healing themselves through farming and outdoor activities. Gabriola Island, Canada: New Society Publishers.

  • Wise, J. (2014). Digging for victory: Horticultural therapy with veterans for post-traumatic growth. London, UK: Karnac Books.

  • Zur, O. (2001). Out-of-office experience: When crossing office boundaries and engaging in dual relationships are clinically beneficial and ethically sound. The Independent Practitioner, 21 (1), 96-100.

  • Zur, O. (2007). Boundaries in Psychotherapy: Ethical and Clinical Explorations. Washington, DC: American Psychological Association - APA Books.

  • Zur, O. (2015). Beyond the Office Walls: Home Visits, Celebrations, Adventure Therapy, Incidental Encounters and Other Encounters Outside the Office Walls. Retrieved from

  • Zur, O. (Ed.) (2017). Multiple Relationships in Psychotherapy and Counseling: Unavoidable, Common and Mandatory Dual Relations in Therapy. New York: Routledge.


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