Nature therapy, sometimes referred to as ecotherapy, grounding, or earthing, is a practice that describes a broad group of techniques or treatments using nature to improve mental or physical health. Various types of nature therapy include forest therapy, forest bathing, shinrin-yoku, and Sami Lok. Spending time in nature has various physiological benefits such as relaxation and stress reduction.[1][2][3] Additionally, it can enhance cardiovascular health and reduce risks of high blood pressure.[4][5]
Recent studies also emphasized its role in supporting mental well-being by improving attention, emotional balance, and overall mood stability.[6][unreliable medical source?]
These effects are usually linked to the body's natural stress recovery process, in which contact with nature decreases cortisol levels and heart rate.[7]
History
Scientists in the 1950s looked into the reasons humans chose to spend time in nature.[8] There is relatively recent history of the term Shinrin-yoku (森林浴) or 'forest bathing' gaining momentum as a term and concept within American culture; the term 'forest bathing' and Shrinrin-yoku was first popularized in Japan by the former head of the Japanese Ministry of Agriculture, Forestry, and Fisheries, Tomohide Akiyama, in 1982 to encourage more people to visit the forests.[9][5][10][11][12]
This initiative was created to promote relaxation and reduce stress among Japan's urban population during the time of a rapid industrialization.[13][unreliable medical source?]
Several countries, including Finland and South Korea, later created national programs highlighting preventative and therapeutic health benefits tied to regular time in nature.[6]
Today, nature therapy continues to develop as an interdisciplinary field, connecting insights from public health, environmental science, as well as psychology.[14]
Health effects
Mood
Nature therapy has a is associated with reducing stress and improving a person's mood.[15][16] Even a small amount of interaction with nature, such as having a tree outside one's home in urban communities, is linked to human wellbeing and promote mental health.[17] This may be due to aesthetic reasons, encouragement of physical activity, or general feelings of connection to nature, where the increased proximity to nature creates higher feelings of connectivity.[17]
Newer research additionally implies that children are becoming persistent, expanding their stress management, and retaining efficient coping skills every day by participating in nature-based programs.[14]
Studies also show that sounds considered natural, like flowing water, birdsongs etc, have been linked to reduced blood pressure, a calmer heart rate, and a better mood.[7]
Forest therapy has been linked to some physiological benefits as indicated by neuroimaging and the profile of mood states psychological test.[18]
Stress and depression
Interaction with nature is associated with lower stress and depressive symptoms.[4][16][9][19] Forest therapy might help stress management for all age groups.[20]
A quantitative literature review discovered that forest bathing, outdoor learning, and other forest-based practices are related to decreased stress levels and overall improvement in emotional satisfaction in several different demographic groups.[13]
Social horticulture could help with depression and other mental health problems of PTSD, abuse, lonely elderly people,[21] drug or alcohol addicts, blind people, and other people with special needs.[22] Nature therapy could also improve self-management, self-esteem, social relations and skills, socio-political awareness and employability.[23] Nature therapy could reduce aggression and improve relationship skills.[24]
Sounds of nature alone can be enough to affect relaxation and enhance positive emotions while reducing negative emotions, including depression and anger.[25] Perceiving nature can lower stress levels and aid in recovery for diastolic and systolic blood pressures.[26][unreliable medical source?]
There is also evidence that implies if participation in nature-based activities is practiced consistently, it can lead to better and more persistent psychological benefits in comparison to brief exposure.[13]
Other possible benefits
Nature therapy could help with general medical recovery, pain reduction, Attention Deficit/Hyperactivity Disorder, dementia, obesity, and vitamin D deficiency.[27][unreliable medical source?] Interactions with nature environments enhance social connections, stewardship, sense of place, and increase environmental participation.[28] Connecting with nature also addresses needs such as intellectual capacity, emotional bonding, creativity, and imagination.[29] Overall, there seems to be benefits to time spent in nature including memory, cognitive flexibility, and attention control.[30]
Research also suggests that childhood experience in nature are crucial for children in their daily lives as it contributes to several developmental outcomes and various domains of their well-being. Essentially, these experiences also foster an intrinsic care for nature.[31] Studies suggest that the mental health benefits of nature may depend on how different cultures understand and value the human relationship with nature, meaning the effects can vary across communities.[32]
Spending time outdoors can also help people feel more connected to their community, especially when activities are done in shared public spaces or group programs.[32]
Nature therapy is also considered accessible and low-cost, since it can be practiced in nearby parks, community gardens, or other public outdoor spaces without requiring specialized equipment.[13]
Nature-based programs can strengthen cooperation and social interaction, as shared outdoor activities often involve communication, teamwork, and mutual trust.[32]
Additionally, social and therapeutic horticulture programs have been found to reduce symptoms of anxiety and depression, implying that regular, guided interaction with plants may support emotional well-being.[6]
Criticism
Recent reviews have noted that results often vary depending on study design and population, which makes it difficult to measure long-term effects of nature-based therapies with consistency.[13]
A 2012 systematic review study showed inconclusive results related to the methodology used in studies.[33] Spending time in forests demonstrated positive health effects, but not enough to generate clinical practice guidelines or demonstrate causality.[34]
Other scholars have noted that the growing popularity of nature-based therapies sometimes leads to overgeneralized claims, where emotional or cultural meanings of nature are emphasized more than scientific evidence.[32]
Additionally, there are concerns from researchers expressing that time spent in nature as a form of regenerative therapy is highly personal and entirely unpredictable.[8] Nature can be harmed in the process of human interaction.[8]
While there is growing interest in using nature for mental health treatment, experts warn that more randomized and controlled studies are needed to confirm these effects scientifically.[6]
Some reviews also highlight that many studies rely on self-reported feelings instead of objective measurements, which can make the results less reliable.[7]
Researchers have also noted that some nature-based studies use very small sample sizes, which limits how confidently the results can be applied to larger populations.[14]
Governmental support and professionalization
In Finland, researchers recommend spending about five hours a month in nature as a preventative health measure, based on studies suggesting that regular outdoor time can lower risks of depression and other stress-related issues.[6]South Korea's approach is more therapeutic, focusing on structured nature-based programs designed to support firefighters with post-traumatic stress disorder.[35] Canada uses a medical-prescription model, where physicians can formally "prescribe nature" to encourage patients to spend more time outdoors for both physical and mental health reasons.[36]
Several national health agencies have also begun funding research to test how structured nature-based programs can support public health, especially for stress related conditions.[13]
Some governments have partnered with environmental organizations to create certified training for nature-therapy practitioners, aiming to standardized skills and ensure safer program delivery.[32]
Government have expanded training programs for teachers and youth workers to integrate nature-based practices into educational and community settings, reflecting growing recognition of their developmental benefits.[14]
↑Onken, Lisa Simon (1998). "Behavioral therapy development and psychological science: If a tree falls in the forest and no one hears it...". Behavior Therapy. 29 (4): 539–543. doi:10.1016/S0005-7894(98)80049-X.
12Cutillo, A.; Rathore, N.; Reynolds, N.; Hilliard, L.; Haines, H.; Whelan, K.; Madan-Swain, A. (2015). "A Literature Review of Nature-Based Therapy and its Application in Cancer Care". Journal of Therapeutic Horticulture. 25 (1): 3–15. JSTOR24865255.
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