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This extract illustrates how a critical evaluation on creative helping practices in green and blue spaces can be organised for a 3,000-word assessment in a module such as PP5001 Creative Helping Practices. It works through the four knowledge domains the brief names: ethics, theory, research evidence, and practice and policy challenges. The live brief is on our PP5001 question page, and a planning guide sits in how to structure the critical evaluation. Citations use Harvard style. The extract is condensed, so a full submission needs more depth on each domain.
Framing the topic
Green and blue space practices use natural settings, such as gardens, woodland, parks, rivers, lakes and coastlines, as the medium or the setting for helping work. They range from therapeutic horticulture and green exercise to guided walks, conservation volunteering and water-based activity. Bragg and Atkins (2016) group nature-based interventions for mental health care into several forms, including green exercise, care farming, social and therapeutic horticulture, and ecotherapy. A critical evaluation should say which forms it focuses on, because the ethical and evidential picture differs between them.
The argument developed here is that these practices have a credible, if uneven, evidence base and sound theoretical rationales, but their ethical and policy challenges are about who gets access, on whose terms, and with what safeguards, not simply whether they work.
Domain 1: Ethical challenges for end users and professionals
Outdoor settings change the ethical terrain of helping. Confidentiality is harder to protect in a public park or on a shared shoreline, and the usual boundaries of a clinic room are replaced by changing weather, other park users and uneven terrain. Professionals must manage risk, such as slips, water safety, allergies and exposure, without becoming so cautious that the practice loses its purpose.
Consent also needs attention. Some service users may feel unable to decline an outdoor activity that peers or staff present as healthy, particularly in group or institutional settings. Capacity and informed choice matter especially with older adults, people with dementia or people with additional needs, groups that are often prioritised for nature-based programmes. In Singapore, the National Parks Board describes its therapeutic horticulture programmes as run by trained persons for groups such as senior citizens and people with dementia and other special needs (National Parks Board, n.d.). That is a positive signal on training, but it also raises questions about who is included, who is not, and how decisions are made.
Equity is a further ethical issue. If the best green and blue settings are in affluent areas or require travel, the practice can widen inequalities. Professionals also face dual-role dilemmas when they are both a facilitator and a participant in a shared outdoor activity.
Domain 2: Theories and power in the helping relationship
Two environmental psychology theories are often used to explain why nature may help. Attention restoration theory proposes that natural settings allow directed attention to recover, through being away, soft fascination, extent and compatibility (Kaplan, 1995). Stress recovery theory argues that exposure to natural scenes supports faster physiological recovery from stress than urban scenes, as tested in a laboratory experiment by Ulrich et al. (1991). Both offer plausible mechanisms, but each rests on particular study conditions and does not explain the relational side of helping.
That is where relationship theories matter. Rogers (1957) argued that empathy, unconditional positive regard and congruence are central conditions for therapeutic change. Outdoor settings can soften the formal hierarchy between professional and service user, since both are walking, planting or paddling rather than sitting across a desk. Yet power does not disappear. The professional still controls access, risk decisions and the framing of what counts as progress. A critical evaluation should therefore examine whether the shared activity truly shifts power, or whether it hides it behind a friendly setting, and how the service user’s voice enters decisions.
Domain 3: What the research evidence concludes
The wider evidence is promising but cautious in its conclusions. A systematic review and meta-analysis by Coventry et al. (2021) of nature-based outdoor activities, including green exercise, gardening and nature-based therapy, concluded that these interventions were effective for improving depressive mood and reducing anxiety in randomised controlled trials, while the evidence for physical health outcomes was weaker and the risk of bias was higher in the non-randomised studies, so those findings need caution. Bratman et al. (2019) set out the links between nature contact and mental health from an ecosystem service perspective, and point to the need for better understanding of mechanisms, dose and for whom benefits occur. For blue spaces, White et al. (2020) provide a narrative overview of potential wellbeing benefits drawn from varied study designs. They describe the results as not all clear-cut, note that most evidence comes from middle- and high-income countries, and remain cautious about causal conclusions.
| Source | Focus | Strength for your argument | Limitation to discuss |
|---|---|---|---|
| Coventry et al. (2021) | Nature-based outdoor activities, meta-analysis | Pooled trials; effective for depressive mood and anxiety | Higher risk of bias in non-randomised studies |
| Bratman et al. (2019) | Nature and mental health, ecosystem service view | Links evidence to mechanisms | Identifies gaps, not final answers |
| White et al. (2020) | Blue space and wellbeing, narrative overview | Covers water settings specifically | Narrative review, cautious on causality, mostly higher-income settings |
| Bragg and Atkins (2016) | Nature-based interventions, mental health care review | Practice-oriented and service-focused | England-focused; check how it describes its own evidence base |
The evidence for a Singapore audience can also draw on local institutional work. The National Parks Board reported four research studies, completed between 2018 and 2021, linking urban greenery with health and wellbeing, including a study of a therapeutic garden with clinically depressed participants (National Parks Board, 2022). Because this is an agency release rather than peer-reviewed synthesis, the evaluation should treat it as supportive context and note the provider’s interest in the programmes it describes.
Good critical evaluation does not stop at listing findings. It asks who was studied, how outcomes were measured, whether the control conditions were credible, and whether short-term gains persist. It also notes that the voices of service users in creative, relational practices can be lost in outcome scales.
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Domain 4: Practice challenges and policy implications
In practice, the main challenges are logistical, financial and organisational. Programmes depend on trained staff, safe sites, insurance, transport and weather contingencies. The National Parks Board states that healthcare or community care facilities applying for therapeutic horticulture sessions bring groups of 5 to 10 participants and apply at least a month ahead (National Parks Board, n.d.). Such rules are sensible for safety, but they show how access can be shaped by organisational routines rather than individual need.
Policy implications follow. Bragg and Atkins (2016) reviewed provision in England, so their findings transfer to Singapore only with care, but the policy lesson that commissioning depends on consistent, comparable outcome data travels well. In Singapore, the 2022 announcement of a network of nine therapeutic gardens with a goal of 30 by 2030 signals institutional commitment (National Parks Board, 2022). A critical evaluation would ask whether provision keeps pace with demand, whether health and social service providers are integrated into planning, and how training for professionals is maintained.
Compared with traditional interventions, creative nature-based practices are often seen as lower in stigma and more engaging, yet harder to standardise and fund. Recommendations should be specific: embed participatory evaluation, set clear safeguarding and consent protocols for outdoor settings, widen access beyond a single age or diagnostic group, and link nature-based provision to mainstream care pathways.
Concluding evaluation
Creative helping practices in green and blue spaces are best viewed as promising, relationally rich approaches whose strongest case lies in complementing, not replacing, mainstream care. The ethical test is whether access, consent and power sharing are real. The evidential test is whether future studies can show for whom, how and for how long they work.
About the expert
Reviewed by Liling Tay, Master in Nursing from Nanyang Technological University, Singapore. Her profile covers nursing-related topics including psychiatric nursing and community health nursing.
Next steps
If you want guidance on your own critical evaluation, read our nursing assignment help page or see our student reviews. We provide model answers and structured support; how you use them must follow your institution’s rules.
References
- Bragg, R. and Atkins, G. (2016) A review of nature-based interventions for mental health care. Natural England Commissioned Reports, Number 204. York: Natural England.
- Bratman, G.N., Anderson, C.B., Berman, M.G., Cochran, B., de Vries, S., Flanders, J., Folke, C., Frumkin, H., Gross, J.J., Hartig, T., Kahn, P.H., Kuo, M., Lawler, J.J., Levin, P.S., Lindahl, T., Meyer-Lindenberg, A., Mitchell, R., Ouyang, Z., Roe, J., Scarlett, L., Smith, J.R., van den Bosch, M., Wheeler, B.W., White, M.P., Zheng, H. and Daily, G.C. (2019) ‘Nature and mental health: an ecosystem service perspective’, Science Advances, 5(7), eaax0903.
- Coventry, P.A., Brown, J.V.E., Pervin, J., Brabyn, S., Pateman, R., Breedvelt, J., Gilbody, S., Stancliffe, R., McEachan, R. and White, P.C.L. (2021) ‘Nature-based outdoor activities for mental and physical health: systematic review and meta-analysis’, SSM – Population Health, 16, 100934.
- Kaplan, S. (1995) ‘The restorative benefits of nature: toward an integrative framework’, Journal of Environmental Psychology, 15(3), pp. 169–182.
- National Parks Board (2022) Four evidence-based research studies confirm contributions of urban nature to health and well-being. News release, 28 February. Available at: https://www.nparks.gov.sg/news/2022/2/four-evidence-based-research-studies-confirm-contributions-of-urban-nature-to-health-and-well-being (Accessed: 31 October 2026).
- National Parks Board (n.d.) Therapeutic horticulture experiences. Available at: https://www.nparks.gov.sg/gardens-parks-and-nature/therapeutic-gardens/therapeutic-horticulture-programmes/therapeutic-horticulture-experiences (Accessed: 31 October 2026).
- Rogers, C.R. (1957) ‘The necessary and sufficient conditions of therapeutic personality change’, Journal of Consulting Psychology, 21(2), pp. 95–103.
- Ulrich, R.S., Simons, R.F., Losito, B.D., Fiorito, E., Miles, M.A. and Zelson, M. (1991) ‘Stress recovery during exposure to natural and urban environments’, Journal of Environmental Psychology, 11(3), pp. 201–230.
- White, M.P., Elliott, L.R., Gascon, M., Roberts, B. and Fleming, L.E. (2020) ‘Blue space, health and well-being: a narrative overview and synthesis of potential benefits’, Environmental Research, 191, 110169.
