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Means (and standard deviations) for all study variables per condition at baseline and post-intervention.
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Forest Bathing, where individuals use mindfulness to engage with nature, has been reported to increase heart rate variability and benefit wellbeing. To date, most Forest Bathing studies have been conducted in Asia. Accordingly, this paper reports the first pragmatic controlled trial of Forest Bathing in the United Kingdom, comparing Forest Bathing...
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Context 1
... repeated measures MANOVA was used to assess any within-subject differences in participants' scores between baseline and post-intervention and to assess any betweensubject differences between conditions. Descriptive statistics across all conditions are shown in Table 1. There was a statistically significant within-subject difference in participant scores between baseline and post-intervention (F(19,25) = 12.02, p = 0.000, η p 2 = 0.901). ...Context 2
... repeated measures MANOVA was used to assess any within-subject differences in participants' scores between baseline and post-intervention and to assess any betweensubject differences between conditions. Descriptive statistics across all conditions are shown in Table 1. There was a statistically significant within-subject difference in participant scores between baseline and post-intervention (F(19, 25) = 12.02, p = 0.000, ηp 2 = 0.901). ...Citations
... This supports the ART, which posits that natural environments can replenish directed attention and reduce anxiety levels [36]. Studies by McEwan et al. [41] and Olson et al. [42] have shown that the quality of green spaces, rather than their quantity, is critical for mental wellbeing, particularly among stressed populations such as university students. ...
... These individualized interventions, inspired by the study's structured protocol, represent scalable, low-cost strategies for cultivating emotional resilience and enhancing mental wellbeing, even outside formal interventions. Promoting student engagement in nature-based self-care practices also aligns with the emerging emphasis on self-directed mental health support within higher education contexts [34,41]. ...
Background. Students often face high levels of mental distress, which can adversely affect their academic performance and overall wellbeing. While forest bathing, as a nature-based solution (NBS), has recognized benefits for mental wellbeing, its specific impact on undergraduate students remains understudied. Purpose. This research brief aims to present the insights and lessons learned from a pilot study utilizing a five-step forest bathing protocol applied to higher education students. Method. A semester-long intervention study was conducted in natural urban parks in São José dos Campos, São Paulo, Brazil. Thirty-six newly enrolled university students participated in three NBS sessions, with data collected before and after each intervention using the Depression, Anxiety, and Stress Scale. The interventions were spaced approximately one month apart. For the paired comparison between repeated measurements, one-tailed tests were used based on Student’s t-test, with significance set at p < 0.05. Results: The protocol had significant and substantial effects on reducing anxiety (48.4%, dCohen = 0.415), depression (35.4%, dCohen = 0.431), and stress (33.5%, dCohen = 0.479) in participants, particularly after visiting parks with a higher degree of naturalness. Insights and Lessons Learned. The pilot study highlighted the critical role of naturalness in the effectiveness of forest bathing interventions. Parks with more natural elements provided greater reductions in mental distress, supporting theories such as attention restoration theory. Additionally, the findings suggest that integrating NBS programs into university settings can significantly enhance student mental wellbeing and emotional stability. The nuanced responses to different environmental settings underscore the need for well-designed green spaces in academic environments. These insights can inform the design and implementation of green spaces within universities, contributing to improved mental health outcomes for students.
... However, methodological limitations including a lack of long-term follow-up measures for ecotherapy interventions and heterogenous ecotherapy activities, locations, and measures of mental health limited direct comparability across studies. Another trial compared mindfulness-based forest bathing with an established wellbeing intervention called Compassionate Mind Training in university staff and students [16]. Both sessions were led by qualified practitioners and conducted in groups. ...
... The results revealed that the sum rank for negative ranks in the experimental group (sum rank=79.00) was notably higher than that for positive ranks (sum rank = 12.00), indicating a clear decrease in post-test cortisol lev- While self-compassion tended to increase gradually in the forest therapy meditation group and was significantly different from the control group. Therefore, self-compassion-based forest meditation therapy significantly increased the sense of connectedness to nature and tended to increase self-compassion, supporting the second hypothesis 2. In a previous study, McEwan et al. (2021) reported that a 2-hour intervention combining forest bathing and compassion training resulted in significant improvements in nature connectedness and self-compassion. However, in a similar study, Djernis et al. (2021) found that increases in self-compassion and nature connectedness were not significant immediately following a 5-day residential mindfulness program in a natural setting, with significant changes observed at a 3-month follow-up. ...
... Since self-compassion meditation training is based on a sense of safety, the author endeavored to create a safe environment and atmosphere.Like most meditation programs, participants were encouraged to remain silent throughout the program. Based on previous studies(McEwan et al., 2021;Park et al., 2021; ...
Background and objective: This study aimed to assess the effectiveness of a Self-compassion-based forest meditation therapy program in reducing daily stress and enhancing coping resources. Based on growing evidence supporting nature-based interventions for mental health, this program was designed to explore the effects of forest meditation therapy on stress, connectedness to nature, and self-compassion.Methods: Thirty participants (2 males, 28 females) recruited as adults (mean age 60 years) living in Seoul and Gyeonggi were assigned to experimental and control groups based on the order of enrollment. Two forest meditation therapy sessions were held between October and November 2023, with a two-week interval between sessions. Data were collected at three time points: before the intervention, after the first session, and after the second session. The primary measures included perceived stress, positive and negative affect, salivary cortisol levels, connectedness to nature, and self-compassion.Results: The experimental group showed significant reductions in perceived stress (F = 6.213, p = .007) and increases in positive affect compared to the control group (F = 3.556, p =.036). While negative affect significantly decreased in the experimental group (F = 5.509, p = .024), no significant difference was observed between the two groups. Cortisol levels significantly decreased in the experimental group post-intervention (z = -2.341, p = .019). Furthermore, the experimental group showed significant improvements in connectedness to nature (F = 6.205, p = .007) and a significant positive trend toward increased self-compassion compared to the control group (F = 4.046, p = .023).Conclusion: The Self-compassion-based Forest Meditation Therapy Program appears to be effective in managing stress and enhancing key coping resources such as connectedness to nature and self-compassion. These findings suggest that forest meditation therapy could serve as a valuable public health intervention for stress reduction. Future research with larger samples and extended follow-up periods is recommended to further explore its long-term benefits.
... flowers, birds, trees) showed higher Positive Affect while recovering from a stressor than participants who did not notice or did not share what they had seen. Other studies Holder 2017, Passmore et al. 2022) showed that mindfully noticing nature and the emotions evoked by it can increase Positive Affect, in particular low-arousal Positive Affect such as relaxation (McEwan et al. 2021). ...
... While forest bathing is already an integral health-promoting approach in Asian countries , it has not yet gained widespread acceptance in Western countries (Stier-Jarmer et al., 2021) despite the increasing use of mindfulness-based techniques in psychotherapeutic settings (Grossman & Reddemann, 2016). Forest bathing has been shown to be effective in improving physical health (Wen et al., 2019), fatigue (Lee et al., 2018;Muro et al., 2023), stress-related outcomes (Annerstedt et al., 2013;Antonelli et al., 2019;Morita et al., 2007;Park et al., 2007Park et al., , 2010, and psychological well-being (Bang et al., 2017;Bielinis et al., 2018;Komori et al., 2017;McEwan et al., 2021;Muro et al., 2023). Jimenez et al. (2021) found evidence for associations between nature exposure and improved cognitive function, brain activity (mainly related to emotion regulation), blood pressure, mental health, physical activity, and sleep. ...
... However, the observed pre-to-post changes were fairly consistent with improvements in Long/Post-COVID symptoms and psychological variables as they were already demonstrated for online forest bathing in a study employing a waitlist controlled, repeated-measures design (McEwan et al., 2022). In addition, previous studies have demonstrated that forest bathing is a suitable nature-based method to reduce negative affect (Komori et al., 2017;Sundara Rajoo et al., 2021) and symptoms of fatigue (Lee et al., 2018;Muro et al., 2023), improve cardiovascular parameters (Ideno et al., 2017;Komori et al., 2017;Lee et al., 2011;Lee & Lee, 2014;Li et al., 2011;Oh et al., 2017;Song et al., 2015;Tsunetsugu et al., 2010;Wen et al., 2019), enhance mindfulness states (Muro et al., 2023), reduce stress-related outcomes (Annerstedt et al., 2013;Antonelli et al., 2019;Morita et al., 2007;Park et al., 2007Park et al., , 2010, and improve physical and mental well-being (Bang et al., 2017;Bielinis et al., 2018;McEwan et al., 2021). ...
Objective: Long/Post-COVID patients are in urgent need of specialized treatment. Forest bathing has shown to
promote health and well-being, and thus may be an appropriate treatment option. This pilot study aimed to investigate both the feasibility of a two-week audio-guided and mindfulness-based forest bathing intervention and pre-to-post symptom changes in Long/Post-COVID patients.
Methods: A repeated-measures design was employed to collect self-reported data on Long/Post-COVID symptoms, fatigue, well-being and stress-coping strategies from moderately affected Long/Post-COVID patients (N=46, N=36 included; recruited through media) prior to and following participation in the forest bathing program. Pulse rate was monitored through smartwatches. Feasibility was assessed by analysis of dropout rates.
Results: The dropout rate was 22 % due to physical and environmental conditions. We observed decreased overall
Long/Post-COVID symptoms (p < .001) and fatigue (p < .001), increased well-being (p < .001) and a more
adaptive use of stress-coping strategies (p < .01) over time. Participants` pulse rate fell within the normal range
after a forest “walk” (p < .001).
Conclusion: Our results suggest that further research on audio-guided and mindfulness-based forest bathing is
warranted, since this approach may offer a feasible and cost-effective method for the complementary treatment
of moderate Long/Post-COVID.
... Two studies examined the effects on rumination as well as selfcompassion. McEwan et al. (2021) revealed that forest bathing in the United Kingdom led reductions in rumination as well as reduced anxiety, depression, anger, confusion, and fatigue, enhanced positive emotions, and self-compassion. In another study (McEwan, Potter, et al., 2022) it was found that urban forest bathing significantly reduced rumination in adolescents during the pandemic, as well as improved their self-compassion. ...
... Practices such as Shinrin-Yoku have been reported as well accepted by participants of a Western culture [119]. However, further research is needed into diverse populations [120], including the at-risk PP populations identified above. ...
Background: Persistent pain (PP) is a complex mechanism affecting 35% to 51.3% of adults in the United Kingdom and is associated with significant reductions in quality of life. Understanding of PP and how best to treat it has developed over the past 50 years, but there is still a vacuum of research to inform novel applications for self-management. Mindfulness techniques and nature exposure have separately been found to have beneficial effects on general well-being and health. The integration of the two could produce much needed self-management strategies, improving quality of life in this patient group. Objectives: To determine if nature-based mindfulness (NBM) interventions improve pain and quality of life in adults with PP. Methods: Systematic literature review. Seven electronic databases were searched to identify quantitative papers investigating nature-based mindfulness and persistent pain. Included articles were appraised using the PEDro tool. Results: A total of 362 studies were identified. Of these, three were included in the final review. All studies reported statistically significant improvements in self-reported scores for pain (p � 0.001-0.006) and depression (p � 0.001-0.000). Other outcomes, such as stress and fatigue produced mixed results. Conclusion: Despite showing statistical significance in multiple outcomes, the minimal clinically important difference was not reached across all measures. Heterogeneity of interventions and outcomes, as well as methodological issues of internal and external validity, preclude definitive conclusions. Further research is required, employing explicit mindfulness interventions and outcome measures with greater relevance and specificity, as well as further investigation of theoretical mechanisms.
... In a recent study by McEwan et al., the effects of Compassion Mind Training (CMT) (an emotional regulation intervention established in the United Kingdom), forest bathing, and a combined intervention of forest bathing and CMT were compared [46]. All three conditions led to enhancements in indicators related to well-being, connectedness to nature, and compassion, with the 3 interventions showing equivalent effectiveness. ...
... The forest healing intervention was conducted every two weeks in a two-hour program for busy modern people based on previous studies [46,56,57]. Table 2 shows the composition of the selfcompassion-based forest healing meditation program. ...
... Regarding the second hypothesis, connectedness to nature and self-compassion, both of which were evaluated as potential resources for coping with stress, were significantly increased incrementally over time in the experimental group compared to the control group. This is consistent with the results of McEwan et al. [46], where a two-hour intervention combining forest bathing and compassion training significantly changed connectedness to nature and self-compassion. In a similar study addressing self-compassion and connectedness with nature based on natural environments, Djernis et al. [52] evaluated the effects of a five-day residential mindfulness training modeled on MBSR in a natural environment. ...
: This study aimed to validate the effects of self-compassion-based forest healing therapy as an intervention for reducing stress and promoting coping resources. Therefore, we investigated the effects of self-compassion-based forest healing therapy on stress, self-compassion, and connectedness to nature. A total of 30 participants were divided into an experimental and control group. Two sessions of forest healing meditation activities were held at the Forest of Healing every two weeks between October and November 2023. As a repeated measures experiment, data were collected before the intervention, after the first intervention, and after the second intervention. Perceived stress, positive and negative affect, and salivary cortisol were measured to assess physiological and psychological stress in participants. Connectedness to nature and self-compassion were measured to evaluate stress-coping resources. The results showed that the forest healing program had significant positive effects on stress and emotional states in the experimental group after the intervention. Further, there was a significant incremental effect on connectedness to nature and self-compassion in the experimental group. Therefore, self-compassion meditation-based forest healing therapy is a feasible and efficient approach for facilitating stress management and coping resource building.
... Studies indicated that after forest bathing, POMS scores for participants on the ve negative subscales signi cantly decreased [4,11,12], reduced anxiety [8, 11,13], tension [14], and stress [11], increased mindfulness [15], optimized social connection [8, 15,16], positive affect [11,15], connection with nature [4,11], compassion for oneself [11], depressive symptoms [6, 11,14,15,17,18], negative emoticons [16,19], the cardioprotective effect [13], and sleep [14]. Regarding vigor, four studies indicate that it increased [13,14,16,17], and two other studies indicate that it did not vary signi cantly [8,20]. ...
... Studies indicated that after forest bathing, POMS scores for participants on the ve negative subscales signi cantly decreased [4,11,12], reduced anxiety [8, 11,13], tension [14], and stress [11], increased mindfulness [15], optimized social connection [8, 15,16], positive affect [11,15], connection with nature [4,11], compassion for oneself [11], depressive symptoms [6, 11,14,15,17,18], negative emoticons [16,19], the cardioprotective effect [13], and sleep [14]. Regarding vigor, four studies indicate that it increased [13,14,16,17], and two other studies indicate that it did not vary signi cantly [8,20]. ...
... Studies indicated that after forest bathing, POMS scores for participants on the ve negative subscales signi cantly decreased [4,11,12], reduced anxiety [8, 11,13], tension [14], and stress [11], increased mindfulness [15], optimized social connection [8, 15,16], positive affect [11,15], connection with nature [4,11], compassion for oneself [11], depressive symptoms [6, 11,14,15,17,18], negative emoticons [16,19], the cardioprotective effect [13], and sleep [14]. Regarding vigor, four studies indicate that it increased [13,14,16,17], and two other studies indicate that it did not vary signi cantly [8,20]. ...
Introducion: The Shinrin-yoku exercise or forest bath is an oriental therapeutic technique for human interaction with nature. Through this practice, it is possible to obtain benefits for both the physical and mental health of the individual. Due to the growing pressure related to the need to improve performance, the academic community has gradually been experiencing adversities regarding their mental health, especially medical students, who have grueling study days in a highly competitive environment.
Objectivo: Thus, the objective of this article is to evaluate the mood states of these students before and after the forest bathing technique, using the Brunel Mood Scale (BRUMS).
Method: The participants, medical students who were in their first and fourth semesters of graduation, were tested in terms of sex, semester and yoga practice.
Results: After the forest bathing sessions, the positive mood indicator (vigor) increased, while the negative indicators (tension, confusion, fatigue, depression and anger) decreased significantly (p < 0.001), pointing to positive aspects of this practice. With regard to gender, girls were more confused, and there were no differences related to yoga practice.
... This increase in Positive Affect was independent of other well-being-related variables, such as Nature Connectedness and engagement with beauty. Similarly, noticing nature with all senses during a forest bathing session [75] improved Positive Affect as much as a session of Compassionate Mind Training, which is a more established intervention to improve well-being. ...
Green spaces can support human stress reduction and foster positive emotional well-being. Previous research has suggested that biodiversity (i.e. the variety of species of plants and animals in a given location) can enhance recovery from stress even further. However, there is limited experimental evidence testing this hypothesis and results, to date, have been mixed. This study aimed to provide further understanding of the role of biodiversity (actual or perceived) on human well-being by experimentally manipulating species richness and stress. Participants (372 in total) took part in an online experiment, where they received an episode of mild stress before watching a 360-degree video to recover. The video showed the same location, an urban woodland, but at one of four artificially manipulated levels of biodiversity. The participants reported their Positive and Negative Affect before and after the stress induction and after watching the video, providing a measure of their stress and well-being throughout the experiment. Participants also reported their perceptions of biodiversity (i.e. how diverse they thought the location was) and elaborated on their responses with brief comments. Repeated Measure Analysis of Variance revealed that exposure to all levels of biodiversity reduced the participants’ Negative Affect, but with no significant difference between the conditions. However, the analysis showed higher Positive Affect in those participants who perceived the environment as more biodiverse. Comments from participants indicated that those who reported noticing flowers and trees in the environment also showed higher Positive Affect. This suggests that perceiving biodiversity promotes more positive emotions, but critically one needs to actually notice (engage with) the components of biodiversity to elicit these extra benefits.
