Development of a Novel Nature-Based Physical Activity Therapy Group for University Counseling Centers

PurposeTo address high levels of depression and anxiety among college students, innovative, feasible, and effective treatment approaches with high potential for dissemination in university counseling centers are needed. This pilot study aimed to develop a toolkit and training intervention to support implementation of nature-based physical activity into group therapy in a university counseling center, and to evaluate the feasibility, acceptability, and preliminary effectiveness of the intervention from the perspective of both therapists and participating clients. MethodsPhysical activity researchers and staff therapists collaborated to develop an 8-week therapy group, with each 90-minute weekly session incorporating discussions of cognitive behavioral strategies for managing anxiety and 30 minutes of moderate-intensity outdoor physical activity. Measures included staff surveys completed pre/post training, standard client assessments (Group Session Rating Scale and Counseling Center Assessment of Psychological Symptoms), and a group facilitator interview. ResultsIn Spring 2025, six students enrolled in the inaugural group. All students completed the group, demonstrated high satisfaction (M=8.78/10 across all sessions), and reductions in depression (d=0.96) and social anxiety (d=0.82). Staff confidence to discuss and recommend nature-based physical activity increased from 7.05 (pre-training) to 8.48 (follow-up). Group therapy facilitators reported high enjoyment and desire to continue offering the group. ConclusionThis study highlights an innovative intervention with promise for translation across university counseling center contexts. The toolkit and training intervention developed for this study could provide a blueprint for other university counseling centers to offer similar therapy groups and expand the integration of nature-based physical activity into mental health services. Keywords: anxiety, college students, group therapy, physical activity, nature