Effects of Urban Forest Therapy Program on Depression Patients.
Poung-Sik Yeon et al. (2022) · International journal of environmental research and public health
This study tested whether a nearby city park forest — not a remote wilderness — could help treat clinically diagnosed depression. Fifty adults aged 20 to 59 with a psychiatrist-confirmed diagnosis of mild depression were split into two groups: one attended a 6-week urban forest therapy program at Seoul Forest, a large accessible park in Seoul, South Korea, while the other continued their usual depression care (medication and/or counseling) without the forest program. Forty-seven people completed the study.
The forest group met once a week for two hours over six weeks, doing gentle activities built around the five senses — stretching, mindful forest walking, an emotional card game, and breathing and meditation exercises — following a three-step approach: noticing feelings, breaking negative thought patterns, and building new daily habits. Both groups filled out standard, validated questionnaires before and after the program measuring depression (self-reported and clinician-rated), sleep quality, and physical (somatic) symptoms often tied to depression.
The forest therapy group improved significantly on every measure: depression scores, sleep quality, and physical symptoms all got meaningfully better, while the group getting usual care alone showed little to no improvement on most of these. Most strikingly, on the clinician-rated depression scale, the forest group's average score dropped from a level indicating depression down to a score low enough to count as clinical remission — while the usual-care group's scores stayed in the depression range. On the self-reported depression scale, symptoms dropped by about a third, roughly comparable to what published studies find with cognitive behavioral therapy, a standard talk-therapy treatment.
These results suggest a simple, once-a-week program in an ordinary city park forest — no remote retreat required — could meaningfully help people with depression, on top of their regular treatment, not instead of it. The study was fairly small, mostly female, and only followed people for six weeks, so it can't say whether the benefits last, and it can't fully separate the effect of the forest setting from simply doing a structured group activity. Still, it points to accessible urban green space as a promising, low-cost tool that could be added to standard depression care.
The Salutary Influence of Forest Bathing on Elderly Patients with Chronic Heart Failure.
Genxiang Mao et al. (2017) · International journal of environmental research and public health
This study asked whether older adults with chronic heart failure (CHF) — a serious condition where the heart struggles to pump blood effectively — might benefit from a short forest retreat. Thirty-six CHF patients aged 65 to 80 from Hangzhou, China, were split into two groups: most went on a 4-day trip to a forest park, while a smaller group stayed in an urban area, under otherwise matched conditions (food, activity, lodging).
Both groups walked outdoors twice a day for about 90 minutes at a gentle, unhurried pace — safe enough that a nurse and doctor accompanied the walks — and avoided smoking, alcohol, and caffeine throughout the trip. Blood was drawn before and after to check heart-failure markers, blood vessel and hormone factors related to heart disease, inflammation, and antioxidant status, and everyone completed a standard mood questionnaire (POMS) before and after.
After the forest trip, participants had a significantly lower level of BNP, a key blood marker doctors use to gauge heart-failure severity, compared with both their own starting level and the city group — whose BNP didn't change. The forest group also had lower endothelin-1 (a blood-vessel-constricting hormone linked to heart disease) and lower interleukin-6 (an inflammation marker) than the city group, along with signs of less oxidative cell damage. Mood improved significantly in the forest group too — less tension, depression, anger, and confusion — while the city group's mood stayed about the same. The forest site's air was dramatically cleaner: about 30 times more of the negative ions associated with fresher air, and a small fraction of the fine-particle pollution found in the city.
These early results suggest that even a short, four-day forest trip may offer measurable benefits in people living with heart failure — studied as a complement to regular medical care, not a replacement for it. The study was small (33 people finished it) and short, tested in only one season, and can't fully separate the effect of the forest itself from other differences like travel, group size, or simply a change of routine. Larger, longer trials are needed before forest bathing becomes a standard recommendation for heart failure patients.
Therapeutic effects of forest bathing on older adult patients with essential hypertension: evidence from a subtropical evergreen broad-leaved forest.
Aibo Li et al. (2025) · Frontiers in public health
This study tested whether spending three days in a forest could help lower blood pressure in older adults who already have essential hypertension (high blood pressure with no single identifiable cause). Thirty-six adults aged 60 to 80 with diagnosed hypertension took part: 24 went to a subtropical forest national park in China for a 3-day retreat, while 12 stayed in the city of Hangzhou following the same daily schedule, so researchers could compare the two settings directly.
The forest group took part in daily gentle activities designed to immerse them in nature: eight trigrams boxing (a slow, breath-focused Qigong practice), a few hours of guided forest walking, a traditional tea ceremony, and a meditation session. Both groups ate the same meals and kept the same schedule. Before and after the trip, researchers measured blood pressure, heart rate, blood oxygen, heart-rate variability (a marker of nervous-system balance), several inflammation and stress-hormone markers in the blood, and mood using a standard questionnaire.
After the trip, the forest group's blood pressure was significantly lower than the city group's, both the top number (systolic, ~134 vs. 147) and bottom number (diastolic, ~78 vs. 85). Inflammation, measured by a sensitive CRP blood test, was also significantly lower in the forest group. Heart-rate variability shifted in a pattern the researchers interpreted as a healthy autonomic-nervous-system adjustment for this population. On mood, the forest group reported significantly less tension and anxiety and significantly more energy and vitality than the city group; other mood measures trended better but weren't statistically significant. Heart rate, blood oxygen, and most other blood markers (IL-6, cortisol, oxidative-stress markers) didn't differ significantly between the groups.
These results suggest a short forest retreat combining gentle nature-based activities may meaningfully help lower blood pressure, ease inflammation, and improve mood in older adults with hypertension, as a complement to standard care. Because the forest program bundled several practices together (forest walking, qigong, meditation, tea ceremony) and compared a larger forest group to a much smaller city group in a different location, it's hard to know how much came from the forest setting itself versus the other activities. The trial only lasted three days, so it can't say whether the benefits last, and larger, longer studies are needed before forest bathing becomes a standard recommendation for hypertension.
Forest bathing improves inflammatory markers, SpO2, and subjective symptoms related to chronic obstructive pulmonary disease (COPD) in male subjects at risk of developing COPD.
Qing Li et al. (2025) · Journal of occupational health
This randomized crossover trial studied 30 Japanese men, average age 63, who were at risk of developing chronic obstructive pulmonary disease (COPD) — a common lung condition that narrows airways and makes breathing harder over time, and one of the world's leading causes of death. Each man spent one day forest bathing (Shinrin-yoku, the Japanese practice of mindfully immersing yourself in a forest) in a cypress forest, and another day walking a similar distance through a nearby city, in random order — so each person acted as their own comparison.
Both walks covered the same distance at the same gentle pace under the guidance of a certified forest therapist, and participants avoided alcohol and ate the same meals throughout the 3-day trip. Researchers measured inflammation markers and oxygen levels in the blood before and after each walk, checked blood-oxygen saturation with a fingertip sensor, and had participants complete standard questionnaires about breathing symptoms, sleep quality, mood, and fatigue.
Forest bathing lowered several inflammation markers (CRP, IL-6, and α1-antitrypsin) significantly more than the city walk did, and raised blood-oxygen saturation, while the city walk produced no such oxygen improvement. COPD-related breathing symptoms dropped significantly after forest bathing but stayed about the same after the city walk. Sleep quality improved across most measures after forest bathing, and mood scores showed less anger, confusion, depression, and anxiety, with people feeling notably more energetic than after the city walk. Fatigue and physical discomfort also eased more after time in the forest. Both walks used the same amount of physical effort (confirmed by matched blood-lactate levels), meaning the extra benefits of the forest walk likely came from the forest environment itself — its cleaner air, plant-released aromatic compounds (phytoncides), and calming, multisensory setting — rather than simply from walking.
In people at risk of COPD, these results suggest that spending a day in a forest, walking gently and mindfully, may ease inflammation, improve breathing-related symptoms, and boost mood and sleep more than an equivalent walk in the city. Forest bathing is not a treatment for COPD; the authors caution that diagnosed COPD calls for medical supervision and flat, easy trails. The study is small (30 men) and tested only two single days, so it can't yet say whether these benefits last with regular practice or apply to women or other age groups.
Randomized controlled trial on the efficacy of forest walking compared to urban walking in enhancing mucosal immunity.
Hiroko Ochiai et al. (2025) · Scientific reports
This randomized controlled trial with 78 healthy men aged 40 to 70 explored whether walking through a forest affects immune function differently than walking through a city. The researchers focused on secretory immunoglobulin A (sIgA), an antibody found in saliva that forms part of the body's mucosal immune system — the first line of defense lining the nose, mouth, and airways against viruses and bacteria. They also tracked cortisol, the body's primary stress hormone, and mood, on the idea that stress and immune function are closely linked through the body's hormonal stress-response system.
Eighty-four participants were randomly assigned to a 90-minute guided walk, either along a certified forest-therapy trail in a Tokyo forest park or an equivalent route through Tokyo's Ginza shopping district, walked in two 45-minute segments with a shared lunch. Guides kept pace, distance, and rest breaks consistent between groups and encouraged participants to engage their senses with surroundings appropriate to each setting. Saliva and blood were sampled before and after walking to measure sIgA, cortisol, and related markers, and mood was measured with the POMS2 questionnaire.
Forest walking significantly increased salivary sIgA compared with urban walking (adjusted difference +32.1 µg/mL, 95% CI 2.3–62.0, meaning a real, though modest, immune-marker boost; p = .035). Cortisol dropped significantly more after the forest walk (p = .007, indicating a stronger stress-hormone reduction), and dopamine — linked to pleasure and motivation — rose more as well (p = .048). Mood benefited too: participants felt more energized (higher Vigor-Activity, p = .001) and less generally distressed (lower Total Mood Disturbance, p = .007) after the forest walk than after the urban walk. Interestingly, white blood cells and certain immune cell counts (CD4+ and CD8+ T cells) rose more after the urban walk, which the researchers link to the body reacting to city air pollution rather than a benefit of urban walking. No one experienced side effects, and everyone who started the walks finished them.
These results suggest a single, unhurried forest walk can meaningfully support immune defenses and lower stress compared with an identical walk in the city, at an activity level gentle enough for most adults. The study only tested one walking session in healthy middle-aged and older Japanese men, so it can't say whether the benefits build with regular practice or extend to other groups. Participants and staff also knew which environment they were in, which could shape self-reported mood. Still, it adds solid evidence that time in nature is a low-risk way to support wellbeing.
Assessing the Impact of a Shinrin-Yoku (Forest Bathing) Intervention on Physician/Healthcare Professional Burnout: A Randomized, Controlled Trial.
John Kavanaugh et al. (2022) · International journal of environmental research and public health
This randomized controlled trial with 34 physicians and healthcare workers (24 in the forest-bathing group, 10 in a waitlist control group who took a day off instead) explored whether Shinrin-Yoku, Japanese for "forest bathing," a guided practice of mindfully sensing a forest environment rather than exercising through it, could ease professional burnout. Burnout was tracked with two validated tools: the Oldenburg Burnout Inventory (OLBI), which scores exhaustion and disengagement from work, and the Mini-Z, a shorter survey of job satisfaction and burnout risk. Physician burnout affects an estimated 33-50% of doctors and was worsened by the COVID-19 pandemic.
Participants, health sciences faculty and medical residents at a New Mexico teaching hospital, were randomized through REDCap. The intervention group completed a 3-hour guided walk of under half a mile through a pinon-juniper forest, led by certified Association of Nature and Forest Therapy guides: a 15-minute grounding exercise, several sensory "invitations" to notice their surroundings, a 20-minute solo "sit spot," and a closing gratitude circle with shared tea. Both groups completed the OLBI and Mini-Z before and after their respective activity.
Burnout scores stayed high in both groups throughout: median OLBI and Mini-Z scores never dropped below established burnout thresholds, before or after the walk. On the OLBI, there was no significant difference between the forest-bathing group's before-and-after scores, or between the two groups afterward (meaning the walk did not measurably shift standardized burnout scores). The Mini-Z initially showed a significant post-walk improvement in the intervention group versus control, but after adjusting for multiple comparisons (a standard statistical correction to avoid false positives), that difference was no longer significant. Separately, 34% of all participants said they had some burnout symptoms and 12% said those symptoms never let up. Yet the subjective side told a different story: of 20 participants who wrote in after their walk, 19 described feeling calmer, more relaxed, more appreciative, or less anxious; only one felt no different.
This gap, unchanged scores next to strongly positive accounts, suggests one forest-bathing session may ease momentary stress without touching the deeper, cumulative syndrome burnout scales measure. The study was small (34 completers of 56 enrolled, notable dropout) and unblinded, testing only a one-time session; the authors and Shinrin-Yoku's founders note the practice is meant to be ongoing, not a single dose. Larger trials of repeated forest-bathing over months are needed before it can be recommended as a standalone burnout treatment, though it may help as a short-term stress reliever alongside other care.
An Exploratory Study on 'Vancharya' as a Therapeutic Approach to the Bio-field of Young Adults Using Electronic Photographic Imaging.
Madhu Pandey et al. (2025) · Annals of neurosciences
This study explores the therapeutic benefits of 'Vancharya', a nature-based intervention, on the bio-field of young adults. The research involved 50 participants and aimed to assess the impact of this ancient practice on various subtle energy systems, revealing significant improvements in energy metrics and overall well-being. The findings suggest that 'Vancharya' could serve as a valuable therapeutic option for enhancing mental health among young adults.
The study employed a non-experimental single-group pre- and post-research design with a sample size of 50 college students aged 17-19. Participants engaged in a seven-day intervention that included activities such as alternate nostril breathing, tree hugging, and listening to bird sounds, all conducted in a mango orchard setting. Outcomes were measured using a Biowell machine, which assessed parameters like aura field, chakra alignment, and stress levels before and after the intervention. Each session lasted one hour and occurred daily for seven consecutive days.
Results indicated significant improvements in the aura field (AF: M pre = 36.94, M post = 44.82, t = −12.40, p < .001), overall chakra alignment (OCA: M pre = 63.52, M post = 79.72, t = −7.44, p < .001), and overall chakra energy (OCE: M pre = 4.16, M post = 5.07, t = −8.44, p < .001). However, stress levels (SL: M pre = 6.79, M post = 5.58, p = 1.000) and overall energy levels (OEL: M pre = 45.61, M post = 49.38, p = .133) did not show significant changes. Participants reported qualitative improvements such as enhanced emotional stability and clarity of thought, with no adverse events noted during the study.
The findings suggest that 'Vancharya' may enhance emotional regulation and sleep quality among young adults, making it a potential addition to wellness programs aimed at addressing mental health issues. However, the study's limitations, including a small sample size and the lack of significant changes in stress levels, highlight the need for further research. The authors propose 'Vancharya' as a candidate component of mental health interventions, and call for longer intervention durations and more diverse populations to validate these results and understand the mechanisms involved.
Indo-Tibetan Philosophical and Medical Systems: Perspectives on the Biofield.
Shamini Jain et al. (2015) · Global advances in health and medicine
This study explores the concepts of consciousness and subtle energy within Indo-Tibetan philosophical and medical systems, aiming to enhance cross-cultural dialogue on the biofield. By examining the similarities and differences among Vedic, Jain, and Tibetan traditions, the research seeks to inform contemporary biofield science and improve understanding of health and healing practices. The integration of traditional knowledge with modern scientific methods is emphasized as a means to bridge the gap between ancient wisdom and contemporary health sciences.
The study employs a descriptive analysis to investigate the relationship between ancient Indo-Tibetan systems and modern biofield science. It does not involve a specific intervention or treatment but rather focuses on the philosophical concepts related to consciousness and subtle energy. The research highlights the importance of introspective inquiry in these ancient systems, paralleling modern scientific findings in health and wellness. The objective is to foster deeper cross-cultural dialogue and enhance understanding of biofields through the exploration of these traditional concepts.
The findings indicate that there are significant similarities and differences in the understanding of biofields across the three traditions studied. The authors suggest that integrating traditional diagnostic methods with contemporary biomarkers could inform treatment options and improve health outcomes. However, limitations include the need for more empirical studies to validate the proposed connections and the challenges of integrating diverse methodologies. The study aligns with previous research that has explored genetic and metabolic differences associated with traditional medicine systems, suggesting a valuable intersection between traditional and modern approaches.
The implications of this research are significant for practitioners and researchers in health and healing. By incorporating holistic approaches and traditional diagnostic methods alongside modern biomarkers, practitioners may enhance health assessments and treatment options. Key limitations include the necessity for empirical validation of the proposed links and the challenges in integrating methodologies from Eastern and Western perspectives. Future research should focus on empirical investigations of biofield practices and their effects on health outcomes, particularly regarding the mechanisms of subtle energy interactions.