Looking back

It all started with the late Leiv Einar Gabrielsen. Leiv completed his PhD work as a researcher at the Department of Child and Adolescent Mental Health (ABUP) at Sørlandet hospital.

In his studies, he explored what generated meaning for youth, where he found that a number of Norwegian teens tended to experience a sense of meaning when spending time in nature. Leiv, himself an outdoor enthusiast, therefore continued exploring this potential for health promotion and meaning seeking through nature-based approaches.

Leiv defended his doctoral thesis in 2012 and began at the same time the planning of a clinical research project concerning the connection between nature and health. Colleagues in ABUP, Carina Ribe Fernee and Gunnar Oland Åsen, were early on invited to contribute into this developmental work.

Both Carina and Gunnar had worked in ABUP for a number of years and had both an interest and experience from nature-based therapeutic work. A project group was established, where paediatrician and researcher Leif Thorvald Eskedal and professor of medical ethics Terje Mesel were invited along.

A research protocol was developed and external funding applied for, parallel to the initial clinical implementation of nature-based treatment.

Once having secured external funding from Sørlandet Knowledge Foundation, Leiv and Carina attended their first international conference in this field of practice, the Wilderness Therapy Symposium in Part City, USA, back in 2014. Later the same year, Leiv, Carina and Gunnar planned a study trip to adventure therapy milieus in Australia.

Here a number of key milieus within clinical practice and research welcomed the Norwegian trio. This study trip was extremely influential for the future work at Sørlandet hospital, through the knowledge and inspiration gained from Australian colleagues. This photo is form our visit with Adventure Works and David Clegg, Fiona Camaron, Ben Knowles, Pete Rae and Anita Pryor in Tasmania.

Other inspirational encounters were James Neill and Daniel Bowen at Canberra University, Will Dobud from True North Expeditions and Kylie Agnew at Operation Flinders in Adelaide, and spending time surrounded by kangaroos and koalas in Simon Crisp’s shed in the hills.

All of this acquired knowledge and initial experiences was then combined with available literature and research, as well as adapted to our Norwegian clinical context and friluftsliv tradition, resulting in the new term Friluftsterapi. During the years 2014-15, we applied the first version of Friluftsterapi (FT 1.0), accompanied with quantitative and qualitative research. In these first therapist teams, Leiv and Gunnar held central roles, whereas Carina entered into a researcher role as part of her PhD project “Into Nature” where she explored adolescents’ experience of participating in FT 1.0. Other central clinicians were Vibeke Palucha, Martin Hirte and Andreas Koksvik, who were all recruited at the time.


In 2015, Leiv and Carina attended their first world conference within this field. The 7th International Adventure Therapy Conference (7IATC) was hosted in Denver, USA that summer. This conference series is held triennially and is the gathering point of the international collaborative network of Adventure Therapy International Committee (ATIC). Leiv and Carina had their first international conference presentation where they shared their experiences from running a clinical research project in mental health services in Norway.

Their presentation and presence was very well received, particularly since there had been very few attendants from the Nordic countries previously and many were curious to learn more about the friluftsliv tradition. Leiv and Carina were invited as the first Norwegian representatives in ATIC and also got to know a third Scandinavian who happened to attend the conference, Tinna J. Mariager from Denmark. Upon returning home, together the trio initiated the first Nordic network, later called the Nordic Outdoor Therapy Network (NOTN).

Based on clinical experiences and feedback from participants in FT 1.0, we then developed Friluftsterapi version 2.0, which was implemented over the next couple of years (2017-18). This version was more time intensive, reduced from ten weeks to three weeks. In addition, we moved further away from civilisation by entering into the beautiful mountains of Setesdals Austhei during the hike.

In 2019, three years had already passed since the conference in Denver and at the 8th International Adventure Therapy Conference (8IATC) in Sydney, Australia, a much larger delegation from the Nordic countries, but also from Agder, participated. The reason was that already at 7IATC, the dream aspired in Leiv and Carina to host the world conference six years ahead. Sounding like a crazy idea at the time, they still believed that it could be enough time to build momentum throughout the Agder region and Norway. A systematic and strategic work followed, where first Kristiansand Municipality teamed up with ABUP, later accompanied by Blue Cross and University of Agder with the support of Agder County Council, finally hosting the 9th International Adventure Therapy Conference (9IATC) in June 2022.
Since 2018, we have moved into a new phase where we have developed a number of nature- and activity-based day programmes across ABUPs three locations. Basecamp was developed as a day programme in nearby nature for youth who are not able to attend school full-time. Climbing therapy and paddling therapy were developed as activity-based approaches to treatment in Arendal, whereas in Kristiansand, mindfulness and MediYoga are offered as part of our nature-based services. From 2019, started the development of nature-based family therapy in close collaboration with local and international partners.

The year of 2020 was the time that everything all of a sudden changed where the majority of our activities had to be cancelled due to the pandemic. When the planned Friluftsterapi intervention in June that year was cancelled due to hospital regulations, opened the possibility for a team workshop instead, whereby the Frilufts team spent four days together in Setesdals Austhei.

These days were magical, where especially the spectacular sunset Midsummer night at the top of Mount Reinådalsheii made a lasting impression. Little did we know at the time that Leiv shortly after became diagnosed with cancer and passed away few months later at March 31st 2021.

When 400 people from more than 40 nations gathered for the 9th International Adventure Therapy Conference (9IATC)/3rd Gathering for Adventure Therapy Europe (3GATE) in Agder in June 2022, we hiked together to the mountain top of Nos in Leiv’s memory on Midsummer night exactly two years after the above photo. Together we added rocks to the Varde (a collection of rocks) on the mountain top. The purpose of a Varde is often a landmark that shows the way, where this Varde can symbolise that we together build a field of practice that can lead the way into the future.

In our increasingly hectic and fragmented lives, there is a need for moments where we may pause to breathe, take notice and be present. Nature invites such moments to calm down and reconnect. In a final message to the Frilufts team, Leiv reminded us of the importance of these moments of tranquillity and attentive presence.

He wrote: “We shall not wander about and worry, but instead remember that everything is changeable and one day things will be different. In this way, we open up for presence and gratitude in our lives, which are also key factors in outdoor therapy”.

Photo: Lars Verket