"Forest Therapy and Mindfulness for Stress Reduction and Well-being in Highly Sensitive Persons (Pilot RCT)" (HSP-FOREST)

IFM International Forest Medicine

Status: Completed

Treatments: Behavioral: Forest Therapy and Mindfulness; Behavioral: Indoor Wellness Control

Study type: Interventional

Funder types: Other

Identifiers

NCT07183917

HSP-FOREST-2025-RCT

Details and patient eligibility

About

This study aims to evaluate the effects of Shinrin-Yoku (Forest Bathing) and Forest Medicine interventions on psychological well-being, stress reduction, and overall health outcomes in adults. Shinrin-Yoku, originated in Japan, is a nature-based practice that involves mindful immersion in forest environments. The intervention combines exposure to natural ecosystems with evidence-based techniques such as mindfulness and guided relaxation.

Participants will be guided through structured sessions in natural forest settings to assess changes in stress biomarkers, emotional regulation, sleep quality, and quality of life. The study is designed as a non-pharmacological, non-invasive intervention, focusing on promoting mental health and preventive medicine.

The findings are expected to provide evidence on the benefits of Forest Medicine as a complementary health approach and contribute to the development of international standards for nature-based therapies.

Full description

The present study investigates the therapeutic potential of Shinrin-Yoku (Forest Bathing) and Forest Medicine interventions as structured nature-based health practices. Originating in Japan during the 1980s, Shinrin-Yoku has gained recognition worldwide for its reported psychological and physiological benefits. This research seeks to contribute to the scientific evidence supporting these interventions as complementary approaches in preventive and integrative medicine.

Participants will attend guided sessions in natural forest environments. Each session will include periods of mindful walking, sensory awareness exercises, and guided relaxation. No pharmacological or invasive procedures are involved. Outcome measures include validated psychological scales (e.g., stress, anxiety, depression, quality of life), as well as physiological indicators such as heart rate variability and sleep quality.

The study design follows an interventional model focusing on mental health and wellness promotion. Data collection will be conducted before, during, and after the intervention period to assess both immediate and sustained effects.

This project is intended to support the integration of Forest Medicine into broader health strategies, aligning with international research efforts in preventive care, psychosomatic health, and nature-based therapeutic modalities. The study also aims to establish standards for training and best practices in forest-based health interventions across Europe and beyond.

Enrollment: 131 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Adults aged 18 to 65 years.
• Self-identified as Highly Sensitive Person (HSP) with a score ≥70 on the Highly Sensitive Person Scale (HSP-SC).
• Able to attend weekly sessions for 8 consecutive weeks.
• Willing to provide written informed consent.

Exclusion criteria

• Current diagnosis of severe psychiatric disorder (e.g., schizophrenia, bipolar disorder not stabilized).
• Current substance abuse or dependence.
• Severe cardiovascular, respiratory, or mobility limitations preventing safe participation in outdoor walking or relaxation exercises.
• Participation in another clinical intervention study during the same period.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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131 participants in 2 patient groups

Experimental: Forest Therapy + Mindfulness

Experimental group

Description:

Weekly 2-hour guided sessions for 8 weeks in natural forest environments, including mindful walking, sensory awareness, breathing exercises, and guided relaxation.

Treatment:

Behavioral: Forest Therapy and Mindfulness

Active Comparator: Indoor Wellness Activities

Active Comparator group

Description:

Weekly 2-hour indoor sessions for 8 weeks in a classroom or community center setting, including health education talks, guided relaxation or music therapy, and eco-culinary tasting.

Treatment:

Behavioral: Indoor Wellness Control