Updated 1st April 2025
Green therapy: Forest bathing, ecotherapy, and more
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Green therapies, also called ecotherapies, focus on connecting with the great outdoors.
They’re based on the idea that communing with nature can improve your mental health and well-being and support physical health.
Although increasingly popular, this is not a new concept. Paracelsus, a 16th-century doctor, wrote: “The art of healing comes from nature, not from the physician.”
Today, scientists are still exploring the links between experiencing nature and health. In this article, we investigate whether green therapies really work.
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Ecotherapy evidence
Ecotherapies come in many forms, but they all involve interacting with nature — whether plants, animals, or both.
To date, they have received relatively little scientific attention, but there are some intriguing studies, which we’ll cover below.
However, they’re mostly small, meaning that we can’t draw solid conclusions from the results, but they do hint at some potential benefits.
Green exercise
Green exercise simply means exercising in a natural outdoor environment.
One pilot study recruited 14 office-based workers. They carried out exercise routines either outside in a green area or indoors.
After exercising, the green group reported better mood and had lower blood pressure than those exercising indoors.
The scientists also used cortisol measures to assess levels of stress. Again, those in the green group fared better, indicating that they had lower stress levels.
Green views
A fascinating study from the 1980s investigated how the view from a hospital window might affect patients.
The scientists found that patients recovered quicker after surgery and needed less pain medication when their room looked at a pleasant view rather than a building.
Horticultural (gardening) therapy
Many people swear by the mental health benefits of gardening. And there’s some scientific evidence behind this.
A study conducted in Hong Kong involved 22 people with mental health conditions.
Twelve of them continued with their usual treatment, while the remaining participants attended 10 gardening sessions during a 2-week period.
At the end of the study, compared with the control group, those who’d done gardening had improved symptoms of anxiety and depression.
Wilderness therapy
A number of studies have explored the positive effects of outdoor adventure activities for adolescents and young adults.
Some studies conclude that these retreats can improve resilience, psychological functioning, and self-esteem.
Animal-assisted therapy
Many of us love spending time with animals, and some research suggests that animal-based therapy may provide benefits for people with mental health conditions.
For instance, small studies have concluded that it improves the general well-being of people with schizophrenia, reduces depression in people with dementia, and improves anxiety for psychiatric patients.
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Just to reiterate, the studies outlined above are small, so the benefits are by no means set in stone.
Now, for the remainder of the article, we’ll focus on forest bathing, which has been studied more than other green therapies.
What is forest bathing?
The Japanese term for forest bathing is shinrin-yoku, which roughly means “being in the atmosphere of the forest.”
The term was first coined by the Ministry of Agriculture, Forestry and Fisheries of Japan in the 1980s.
Forest bathing simply involves spending time in forests, whether lying, sitting, or walking. People are also encouraged to use all of their senses to mindfully experience all that a forest has to offer.
Most studies on forest bathing are small, but they hint at some benefits.
Forest bathing and heart health
One study involved 19 middle-aged males who took a walk through both an urban landscape and a forest. The scientists found that their pulse rates were significantly lower after the forest walk.
Similarly, a review of 14 studies concluded that for people with hypertension, forest bathing reduced blood pressure, lowered pulse rate, and increased heart rate variability — a measure of how adaptive your nervous system is.
Other researchers have concluded that forest bathing can support the recovery of older adults with chronic heart failure.
Shinrin-yoku and stress
Scientists have also investigated whether spending time in a forest might reduce levels of the stress hormone cortisol.
For instance, in one study, 348 young males sat and viewed either an urban or forest landscape.
During the 15-minute session, the researchers found that average cortisol levels were significantly lower when looking at a forest.
A similar trial recruited 17 middle-aged females and measured cortisol before and during forest bathing. Again, they found that forest bathing was linked to reduced cortisol levels.
Trees, immunity, and inflammation
Perhaps the most commonly claimed benefits of forest bathing are improved immune health and reduced inflammation.
Some research suggests that forest bathing might influence the levels of some immune cells and reduce markers of inflammation, such as interleukin-6 and tumor necrosis factor-alpha.
Once again, these studies were small and most focused on participants with existing health conditions or those in older age. This makes it difficult to know whether forest bathing would have the same effects on healthy, younger people.
Woodland well-being
The majority of the research into forest bathing has focused on its potential benefits for mental health.
A review of 20 studies on shinrin-yoku and mental health concludes that it “can be effective in reducing mental health symptoms in the short term, particularly anxiety.”
However, the authors also call for larger, longer studies that include participants from more diverse backgrounds.
Similarly, the scientists behind a small study into the physical and psychological benefits of forest bathing concluded that:
“Forest bathing significantly increased scores of positive feelings and significantly decreased scores of negative feelings” compared with being in an urban environment.
And another trial found that forest bathing was linked to an increase in the neurotransmitter serotonin, which is associated with better mood.
Health benefits summary
As it stands, the evidence for the benefits of forest bathing is relatively slim due to the small size of studies.
Also, because these studies were run in different ways and measured different variables, it’s difficult to combine the results to develop a clear picture of what’s going on.
With that said, there is some evidence of benefits for heart, immune, and mental health. And there are no real health risks, so it’s certainly something worth trying.
Next, we’ll look at how forest bathing might provide benefits.
How might forest bathing influence health?
It’s likely that multiple factors are involved in the benefits of spending time in nature, including:
A sense of community and social interaction: Forest bathing is often carried out in groups. Meeting regularly with people and developing friendships can benefit mental health.
Exercise: Although some people literally bathe in a forest, others take a stroll. We know that exercise — even light exercise — can benefit all facets of health, including mental health.
A mental break: Sometimes, if you lead a stressful life, simply taking yourself away from your laptop, office, or home can boost your mood.
Access: People who have the time and resources to visit green spaces may come from higher socioeconomic backgrounds, which is linked to better mental and physical health.
Less air pollution: People who regularly forest bathe may spend less time in urban environments around air and noise pollution. Both air and noise pollution may be linked to poorer physical and mental health.
Another potential factor is compounds called phytoncides. Although they are still relatively mysterious, we’ll give them a quick mention because they’re fascinating.
What are phytoncides?
Phytoncides are compounds produced by all plants. They help protect them from predators and infection.
Plants release some phytoncides in response to a direct attack, but others are released constantly to proactively fend off fungi or attract pollinators.
These chemicals also work as messengers, warning neighboring plants of an imminent threat.
Most studies so far have used extracted phytoncides in lab-based studies, so there’s no conclusive evidence that phytoncides impact the immune system in a natural environment.
We already know that polyphenols — another form of plant defense chemicals — benefit our health when consumed, so maybe phytoncides are another health-boosting family of plant compounds.
We’ll have to wait and see.
Summary
Overall, there’s not a ton of evidence that forest bathing and other green therapies can have real, long-term health benefits.
However, it’s certainly something worth trying; there really aren’t any downsides. And you never know, it might just boost your mood.
We already know that exercise improves physical and mental health. So, if you can, exercise outdoors sometimes, it might just provide some extra benefits.
