Not just a walk in the park: Implementing nature walking groups in rural mental health services as a transdiagnostic approach on mental health recovery.

A total of four Nature Walking Groups (NWGs) with 10 participants in each group will be conducted in the two sites over 12 months by the trained Nature Walking Group facilitators. Intervention participants (Group A; n=40) will participate in one NWG, receiving 1 hour per week in nature for a continuous period of 12 weeks (twelve walks per participant), while still also receiving treatment as usual (TAU). Participants can only join one walking group and the first 10 people to register interest and pass the screening assessment will be included. On each walk facilitators will draw participant attention to one of the natural features and guide participants through stress reduction and mindfulness activities, lasting 3 to 10 minutes in duration. Attendance checklists and observations conducted by a research assistant will monitor participation in the group and various routines. A sample routine that will be used is - Five Finger Breathing Routine Summary: This breathing technique encourages you to use your fingers to take five deep breaths. This helps to process big emotions, connect to the present moment and feel more relaxed and comfortable. This breathing technique allows you to pause and use your fingers to take five deep breaths to help you to relax. Where to use it: In a location where users can sit in a relaxing location and away from busy and noisy areas. How will it make you feel: Practicing slow breathing techniques reduces symptoms of anxiety and stress by increasing feelings of calm, relaxation and alertness and enhancing sleep quality. Using your non-dominant hand creates new pathways in your brain, helping to improve your creativity and perspective on life. Length: This activity takes between 2-3 minutes. Script: Step 1: Start by placing one hand on the earth (or in the air in front of you) and spread your fingers wide apart. Step 2: Using your pointer finger from your other hand, slowly begin to trace up the outside of the thumb as you breathe in. Pause a little at the top of your thumb while holding your breath. Then trace down the inside of the thumb as you breathe out. Remember to pause again at the bottom. Step 3: Repeat this for the remaining fingers, always making sure to breathe in as you trace up each finger and breathe out as you trace back down. Repeat this breathing exercise as many times as you like - try for at least three cycles. Try tracing with your non-dominant hand - the one that you don’t usually write with. Other routines are available from https://www.naturefix.life/