Mechanisms of Change in Nature-Based Pediatric Occupational Therapy: The Ecology of Change in Outdoor Therapy Model.

The purpose of this qualitative constructivist grounded theory study was to develop a model to explain potential mechanisms of change in the nature-based pediatric occupational therapy process, based on analysis of the perspectives of occupational therapy practitioners currently engaging in nature-based practice with children. Using 27 photos and interview data from 22 participants the was developed. The model suggests mechanisms of change in nature-based pediatric occupational therapy may involve six iterative phases: The practitioner and child experiencing these phases throughout the nature-based occupational therapy process may lead to improved participation and performance in the child's daily life.