BackgroundBurnout is a major societal issue adversely affecting employees’ health and performance, which over time results in high sick leave costs for organizations. Traditional rehabilitation therapies show suboptimal effects on reducing burnout and the return-to-work process. Based on the health-promoting effects of nature, taking clients outdoors into nature is increasingly being used as a complementary approach to traditional therapies, and evidence of their effectiveness is growing. Theories explaining how the combination of general psychological support and outdoor-specific elements can trigger the (...) rehabilitation process in outdoor therapy are often lacking, however, impeding its systematic research.AimThe study aims to develop an intervention and evaluation model for outdoor therapy to understand and empirically evaluate whether and how such an outdoor intervention may work for rehabilitation after burnout.Methodological ApproachWe build on the exemplary case of an outdoor intervention for rehabilitation after burnout, developed by outdoor clinical psychologists in Netherlands. We combined the generic context, process, and outcome evaluation model and the burnout recovery model as an overarching deductive frame. We then inductively specified the intervention and evaluation model of outdoor therapy, building on the following qualitative data: semi-structured interviews with outdoor clinical psychologists and former clients; a content analysis of the intervention protocol; and reflective meetings with the intervention developers and health promotion experts.ResultsWe identified six key outdoor intervention elements: physical activity; reconnecting body and mind; nature metaphors; creating relationships; observing natural interactions; and experiential learning. The results further showed that the implementation of these elements may facilitate the rehabilitation process after burnout in which proximal, intermediate, and distal outcomes emerge. Finally, the results suggested that this implementation process depends on the context of the therapist, therapy, and of the clients.ConclusionThe intervention and evaluation model for outdoor therapy shows how key outdoor intervention elements may contribute to the rehabilitation process after burnout. However, our model needs to be further tested among a larger group of clients to empirically evaluate whether and how outdoor therapy can support rehabilitation. (shrink)

Several quantitative techniques for choosing among data models are available. Among these are techniques based on algorithmic information theory, minimum description length theory, and the Akaike information criterion. All these techniques are designed to identify a single model of a data set as being the closest to the truth. I argue, using examples, that many data sets in science show multiple patterns, providing evidence for multiple phenomena. For any such data set, there is more than one data model that must (...) be considered close to the truth. I conclude that, since the established techniques for choosing among data models are unequipped to handle these cases, they cannot be regarded as adequate. ‡I presented a previous version of this paper at the 20th Biennial Meeting of the Philosophy of Science Association, Vancouver, November 2006. I am grateful to the audience for constructive discussion. I thank Leiden University students Marjolein Eysink Smeets and Lenneke Schrier for suggesting the cortisol example, and Remko van der Geest for comments on a draft. †To contact the author, please write to: Faculty of Philosophy, University of Leiden, P.O. Box 9515, 2300 RA Leiden, The Netherlands; e-mail: [email protected]. (shrink)