This chapter presents a somatic approach to therapeutic outdoor play and provides support and guidance for therapeutic practitioners who are considering taking children outside. A child is born into an environment of sensation, learning to orientate herself through attachment to significant sensory experiences, which include the presence of her primary caregiver, the character and atmosphere of her home environment and transitional objects, sounds and textures. There is a balance to be struck between children's vital need for risk and challenge and adult concerns for their safety. In therapeutic outdoor play they are given permission to move in close relationship between earth and sky: to be belly flat on the ground, to roll, creep and crawl, to climb and swing. Therapeutic practitioners need to use their knowledge of the environment, the children and the particular circumstances in an ongoing process of assessment that places each child's interests and motivations at the heart of decision-making.