Nonprofit, independent journalism. Supported by readers.

Agate generously supports MinnPost’s Mental Health & Addiction coverage; learn why

Get yourself a prescription for it? Researcher finds healing in the great outdoors

Prof. Erica Timko Olson has made it her life’s work to get people to appreciate the restorative power of being in nature.

Erica Timko Olson, bottom center, with her husband and six children enjoying the outdoors.
Erica Timko Olson, bottom center, with her husband and six children enjoying the outdoors.
Courtesy of Erica Timko Olson

Erica Timko Olson’s favorite place to be is outside in the natural world. Growing up on a farm in rural Minnesota, she and her three siblings spent as little time as possible indoors. Some of that outdoor time was devoted to farm chores, but most was spent just having fun in nature. Timko Olson couldn’t get enough. 

“I don’t ever remember my parents having to tell me to get outside,” she recalled. “I was outside as much as I could.” All that outdoor time, she believes, kept her healthy, both physically and mentally.  

Timko Olson has worked hard to pass on her love of nature to her six children. She sees it as a healthy habit with nothing but positive side effects: “We find that as people spend time in nature it decreases their confusion and increases clarity and connectedness to self. It also lowers their blood pressure and decreases stress hormones. These are all good things.”

Article continues after advertisement

Today, as a clinical assistant professor at the University of Minnesota School of Nursing and the Earl E. Bakken Center for Spirituality and Healing A. Marilyn Sime research fellow, Timko Olson has made it her life’s work to get people to appreciate the restorative power of the natural world. Her academic research has focused on the role of nature and forest therapy on the psychosocial well-being of college students and young adult cancer survivors, among others.

Erica Timko Olson
Erica Timko Olson
Last week, Timko Olson stepped inside briefly to tell me more about her research, about the connection between forest bathing and mental health, and about the number of minutes she spends outside each day. 

MinnPost: Tell me more about what drew you to your research focus on the therapeutic impact of nature on young people. 

Erica Timko Olson: Back when I taught in undergraduate nursing programs, I saw all these college students who were highly stressed, highly vulnerable. My focus at the time was nursing students and anxiety, resilience and spirituality. I asked myself, “What can I do for these students? What’s an intervention that’s accessible and affordable, relatively easy and can have a big impact on their mental health?” 

That got me thinking about what I could learn from my own life. Nature was always a huge part of my childhood. I remember helping my grandfather collect sap from maple trees and boiling it down for syrup. Even at a young age it felt meaningful.

Article continues after advertisement

A lot of my upbringing was focused around being outside. I knew that was good for my emotional well-being. Every day my siblings and I were outside — summer, fall, winter. We kids would spend hours outside helping our dad on the farm. In the summer, I remember packing a lunch and going outside. We wouldn’t come home until dinner. It was what we were all drawn to. 

A close connection to nature was so important to my physical and mental health: I felt it was important to show these vulnerable young people in these nursing programs how valuable those connections can be for their mental health. So my early work focused on that. 

MinnPost: How are you working your interest in the healing power of nature into your more recent research? 

ETO: I’m just finishing up a study where I’m interviewing a group of young adults who have had cancer. I’m assessing their physical needs, their psychosocial needs. While usually their physical stuff is taken care of by their providers, the rest of their needs are often not met. I’m discovering that can be very challenging. Oftentimes it is not addressed at all. My research is about understanding the amount of time my participants spend in nature and its impact on their overall well-being.

Article continues after advertisement

MinnPost: How are you measuring that?  

ETO: I am gathering background on my participants’ physical needs, their mental health needs and their social needs. I am asking them very specific questions related to their interactions with nature, like “What does nature mean to you?” “What was your engagement with nature before you were diagnosed, what has it been through your cancer treatment and how is it today?” 

Then I also ask follow-up questions, which are very specific for my next study, which will be an intervention study. I ask, “If your provider had written you a prescription to participate in nature three times a week for 20 minutes a time during your treatment, would you have done that?” I’m also asking my interview subjects, “How would you do that? Through a solitary nature experience, or sitting on a park bench, or walking a short distance and engaging in nature?” and, “Would you prefer to do that in a small group or in a large group?” 

I’m trying to gauge their comfort levels with the natural world. 

MP: I know you’ve been interested in working with vulnerable populations throughout your career. Is there a specific reason why you chose to study young people who’ve experienced cancer? 

Article continues after advertisement

ETO: This is full circle for me. When I was much younger, my oldest brother was diagnosed with cancer and died quite quickly, just 13 months after his diagnosis. In the years since, I always wondered what I could do with that, what my purpose was in that. I put that experience away for almost 20 years, but it eventually became the catalyst for my research, my reason for supporting those young adults with cancer. 

There is a big focus on pediatric cancer and older adults with cancer, but young adults with cancer are in the middle and they sometimes get lost. Even if their cancer is in remission, many live a life of chronic challenges. With my research, I’m looking for interventions that can support them through that process, keeping them connected and grounded and supporting their well-being through interactions with nature. 

MP: How do you define an interaction with nature? 

ETO: Nature therapy encompasses so many things. It’s broad. Spending time in nature could be gardening. It could be stargazing. It could be kayaking or sitting on a boat in the water. It could also be forest bathing, with a guide or without a guide.  

Right now I’m designing a study that will include a guided forest-bathing component, but I will also be following participants through an app that monitors their nature dose and keeps track of where they are. Not only will I be looking at that forest-bathing experience but I will also be looking at their everyday time in nature and the quality of nature in that time. 

MinnPost: What are you learning about the impact of nature on the mental and physical health outcomes of young adults who’ve experienced cancer?

ETO: It can be very difficult to stay connected to yourself during and after cancer treatment. A lot of that connection can be built through a relationship with nature. Spending time in nature decreases cortisol levels. That changes our bodies, which can have a positive impact on our cancer and a positive impact on our mental health. That’s the goal of this kind of work. Cancer patients may be able to decrease their risk of secondary psychological distress symptoms by having regular interactions with nature. My study is trying to get at that idea. 

We’ve seen these kinds of results in “healthy” populations of people who don’t have chronic disease. And there have been positive results in other populations, too. During COVID, I participated in a study out of New Mexico where we gave people who had depression a nature “prescription,” or a provider’s reminder to spend time in nature. Those with a nature prescription had fewer depressive symptoms than those who were just encouraged to spend time in nature. 

MP: How does your belief in the restorative power of the natural world play out in the way you raise your own children? 

ETO: My kids spend a lot of time outside. Sometimes I’ll just say to them, “Get outside and get lost.” 

Growing up, I helped my mom with canning and freezing a lot of things and making jams and jellies. My husband and I do that with our kids. Every year in the fall, we make 50 quarts of apple sauce. We have a big garden, and everyone — my kids are aged 6 to 21 — has a responsibility in it. We grow huge sunflowers, berries, vegetables. We feed the birds. Our kids were planting seeds from the time they could hold a seed. We are very much into gardening and flowers. It’s how our family works.

MP: Have you always lived where you have easy access to the natural world? 

ETO: Not always. When my kids were younger, we moved to Philadelphia for my husband’s work. We thought we’d be there for three to five years. It was really hard for us to move into a city. Before that we’d always lived in the suburbs or the country. In the city, we were really missing nature and our connectedness to the natural world. 

I remember one day I called my dad and told him I was feeling disconnected and anxious. He asked, “When was the last time you saw the horizon?” I decided then that we would make a point of seeing the sun rise and set every day. We took the kids out of the city a lot. We went to the beach. It felt important to get out in nature as much as possible. It was our way of finding a healthy place in the city. 

MP: Now that you’ve back in Minnesota, do you still make a point of watching the sunrise and the sunset? 

ETO: I still do, absolutely. So does the rest of my family. We have a group text called “Fam Jam.” Almost every day someone sends a picture of the sunrise or sunset that they’ve taken on their way home or to school or work. My daughter is at Purdue in Indiana and she’s in the Eastern time zone and gets an earlier sunrise and sunset. So she usually beats us to it. 

It’s important to mark the beginning and the end of every day. There is a significance of the passing of time, the intention of gratitude. It is important for anyone, especially someone with cancer or someone living with depression or anxiety or someone just trying to make it through the day. These natural markers make each day feel significant. 

MinnPost: Have you come across any interesting interventions designed to help boost people’s time in nature? 

ETO: There is this program called PRA, or Park RX, that was created by Dr. Robert Zarr at Unity Health Care in Washington, D.C. In this program, physicians can create prescriptions for their patients to go outside and spend time in nature. Regular people can also write their own nature prescription and take it to their provider to make it official. In Canada they are trying to make this program a regular thing. Providers there are issuing nature prescriptions because it has so many positive outcomes. It works. 

MinnPost: Why is a nature prescription necessary? Isn’t it enough just to have your health care provider say, “Go outside and spend time in nature?”

ETO: If you have depression or anxiety, sometimes making daily decisions can be difficult, but if you have a prescription that says, “Take this pill at bedtime every night with a glass of water,” you know how to do that. That’s the thing with a nature prescription. If it says, “Go outdoors to your area park and spend 20 minutes three times a week in nature sitting on a bench or walking or birdwatching.” That takes the decision out of your hands. It might be just the encouragement a person needs.

MinnPost: Some people feel disconnected from the natural world. And some live in places where they are physically disconnected from nature. How would you encourage a person like that to spend more time outside? 

ETO: I understand that spending time in nature is harder to do in a busy world. But I think COVID opened a door to this idea that we don’t have to be tied to our work, that we deserve to spend more time outside. We can’t go back to what it was before. 

A lot of people understand that they feel better when they are outside. There is a reason why everyone in Minnesota wants to get out of the city in the summer. We feel better all over when we are out in nature. Now more and more people are interested in figuring out how we can make spending time in nature easier for everyone. 

MinnPost: How do you do that? 

ETO: An important part of that is recognizing just where nature is. While it’s easy to get into nature if you live out in the country, the natural world is in other, more accessible places, too. Think about how we took our family to the beach back when we lived in Philadelphia. Recently, I’ve been working with NatureQuant, a website where you can enter your address and learn your “nature score,” or the amount and quality of natural elements at any address. Their app is NatureDose

I live in Chaska. I have a park across from my house so my nature score is over 95. But anyone can find nature, and it doesn’t have to be that far away. Just spending 20 minutes a day sitting on a park bench can have a positive impact on your inflammatory process, decrease your risk for diabetes, reduce your blood pressure. It’s so important.

MP: How much time should a person spend outdoors to reap the greatest physical and mental health benefit? 

ETO: Spending 120 minutes a week in nature is a good marker. For maximum benefit, try 200 to 300 minutes a week. But there’s no limit. It’s all good. Last week I spent 1,400 minutes in nature.