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Nidotherapy: Environmental Changes for Mental Well-Being

Written by Rob Alston

& Medically Reviewed by Dr. Trisha Sippel, PhD

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Last Updated - 07/15/2020

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Updated 07/15/2020

Nidothearpy can be beneficial in the treatment of a variety of mental health issues by changing a person’s environment.

Nidotherapy is an alternative to conventional therapies for mental health disorders that focuses on changing a person’s surroundings in order to better accommodate their mental health issue. It is based on the theory that surrounding a person with a better environment, either physically or socially, will give them a better chance at being successful with their therapy and coping with their mental health disorder or substance use disorder.

What Is Nidotherapy?

Nidotherapy was developed by Peter Tyrer, a professor at the Imperial College in London and an expert in the field for many years. The name of the therapy is derived from the Latin word “nidus,” which means nest, with the idea that a nest forms an environment that is especially suited for the needs of the bird. Nidothearpy is based on the concept that a person’s environment plays a large role in their mental health and should be shaped around the needs of an individual.

An individual’s environment includes not only their living situation, including physical housing and the people they live with but also their social surroundings, including work and where they spend their time for fun or leisure. The environment can be described in three categories: physical, social and personal. All three can play a role in how a person interacts with their surroundings and can be manipulated to make the surroundings better fit a person’s needs. The goal of nidotherapy is to remove environmental triggers that are interfering with a person’s mental treatment.

Principles and Components of Nidotherapy

Nidothearpy has five principles to make it an effective treatment:

Collateral Collocation

Observing the person’s environment from their point of view.

Formulation of Realistic Environmental Targets

Making clear goals for changing the person’s environment.

If the goals are targeting the correct changes in the environment, the person’s social function will improve; if not, the goals should be reexamined.

Personal Adaptation and Control

The person seeking change should take responsibility for making the change.

Wider Environmental Integration and Arbitrage

Involving other people in the process, including someone trusted by the therapist and patient, who can help make compromises when they are in disagreement about a change that should be made.

Nidotherapy has four components to be effectively used in practice:

  • Four Components
    1.Developing a relationship between the therapist and client, to understand what the client needs and what they want out of therapy 2. Analyzing the person’s environment, including the physical, social and personal aspects 3. Establishing a plan to change the environment according to the person’s needs 4. Implementing and monitoring the plan and changing it as needed  

The goal of nidotherapy is to have the therapist act as a guide to improve the person’s environment, rather than the therapist telling them what to do or how to do it.

How Is Nidotherapy Used in Addiction Treatment?

Nidotherapy has not traditionally been used in the treatment of substance use disorders; however, it can be used to treat co-occurring disorders, which is when a person has both a mental health disorder and a substance use disorder. The treatment of co-occurring disorders, or dual diagnosis treatment, focuses on addressing both conditions simultaneously to provide the most success for the person in overcoming both disorders.

Often a person’s environment can influence their mental health, or certain triggers in their environment could cause them to resort to substance use. Nidotherapy encourages a person to change their environment to better encourage recovery from their disorder(s). One study showed that patients with substance use disorders and co-occurring psychosis responded well to nidotherapy and spent less time in the hospital.

Mental Health Conditions Treated with Nidotherapy

Nidothearpy has been effective in treating multiple types of mental health conditions. It has mostly been used for the treatment of personality disorders, including schizophrenia. One pilot study showed that when nidotherapy was added to the standard of care treatment for schizophrenia patients, it slightly improved their social interactions, relationships, and mental state. Additionally, they spent less time in the hospital. Though these results are promising, larger controlled studies need to be done to determine the effectiveness of nidotherapy for schizophrenia.

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Nidotherapy Benefits & Treatment Effectiveness

Nidotherapy is especially beneficial for people who have not done well with other types of treatment. Most other treatments focus on changing the individual, which can be hard for anyone and especially hard for someone dealing with a mental health issue. Nidothearpy instead focuses on changing the environment around a person to ease triggers of mental health issues. When combined with other treatments for mental health disorders, it can be very effective.

If you or a loved one are dealing with a substance use disorder or a co-occurring disorder, The Recovery Village Palm Beach at Baptist Health can help. To learn more about our comprehensive treatment plans, call The Recovery Village Palm Beach at Baptist Health to speak with a representative today. Find out how professional addiction treatment can help you. Take the first step toward a healthier future and call today.

View Sources

Tyrer, Peter. “Nidotherapy: a cost‐effective systematic environmental intervention.” World Psychiatry, June 2019. Accessed September 12, 2019.

Tyrer, Peter; Bajaj, Priya. “Nidotherapy: making the environment do the therapeutic work.” Advances in Psychiatry Treatment, May 2005. Accessed September 12, 2019.

Tyrer, Peter; Milos˘eska, Katarina; Whittington, Craig; Ranger, Maja; Khaleel, Ibrahim; Crawford, Mike; North, Bernard; Barrett, Barbara. “Nidotherapy in the treatment of substance misuse, psychosis and personality disorder: secondary analysis of a controlled trial.” The Psychiatrist, 2001. Accessed September 12, 2019.

Chamberlain, Ian J.; Sampson, Stephanie. “Nidotherapy for people with schizophrenia.” The Cochrane Database of Systematic Reviews, March 28, 2013. Accessed September 12, 2019.