Complementary Therapies, Mind-Body Therapies, Mindfulness, Preventive Medicine, Stress (Psychology), Well-Being, Psychological
Conditions
Keywords
Forest Bathing, Forest Therapy, Shinrin Yoku, Mindfulness, Forest Medicine, Highly Sensitive Person (HSP), Stress reduction, Mental Health
Brief summary
This randomized, multicenter interventional study evaluates a combined forest therapy (shinrin-yoku) and mindfulness-based program in adults with high sensory-processing sensitivity confirmed using a validated instrument. Participants are randomized (1:1) to either a forest-based intervention or an active indoor sensory control condition. The intervention is delivered over approximately 22 weeks according to a predefined protocol, with assessments conducted at baseline and at the end of the intervention.
Detailed description
This is a multicenter, randomized, parallel-group interventional study in adults with high sensory-processing sensitivity confirmed using a validated instrument. Participants are randomized 1:1 to one of two study arms at study entry and remain in their assigned group for the duration of the study. Intervention delivery is standardized across participating sites through facilitator training and a predefined session manual. The experimental arm consists of structured sessions conducted in forest environments and includes guided walking, mindfulness-based practices, and structured sensory awareness activities, with facilitated group reflection. The active comparator arm consists of structured indoor group activities designed to match the experimental arm in duration, group interaction, and facilitator contact, without exposure to forest or outdoor natural environments. Study procedures and assessment schedules are predefined in the protocol and implemented in accordance with applicable ethical requirements and Good Clinical Practice guidelines.
Interventions
BEHAVIORALForest Therapy + Mindfulness + Psychotherapy
Participants will undergo a approximately 22-week program with 4.5 hours weekly in forest settings. Each session includes: A 2-hour guided walk with scheduled rest/hydration breaks Mindfulness meditation (20-30 minutes) Discussion/reflection segment (\~20 minutes) for participants to express sensations, experiences, or doubts A psychotherapeutic component focused on emotional processing and cognitive regulation Sensory observation (5-10 minutes) of forest stimuli (olfactory, auditory, tactile, visual) Post-session journaling capturing emotional and sensory feedback Monitoring of environmental parameters (temperature, humidity, wind, estimated phytoncide levels) Standardized facilitator training and session protocols to ensure consistency across sites This protocol is distinguished by integrating forest immersion, mindfulness, psychotherapy, and sensory training in a unified intervention tailored for Highly Sensitive Persons (HSP).
BEHAVIORALBehavioral: Indoor Sensory Control (Art and Aromatherapy)
Structured indoor sensory-based group sessions delivered weekly over approximately 22 weeks. Activities include creative tasks, guided aromatherapy, and sensory-focused exercises conducted in indoor, non-forest environments. Sessions are designed to match the experimental intervention in duration, structure, facilitator contact, and social interaction, according to a predefined protocol.
Sponsors
IFM International Forest Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Due to the behavioral nature of the interventions, participants and care providers are not blinded. Outcome assessors are masked to group allocation during data collection and evaluation.
Intervention model description
This is a randomized, parallel-group interventional study in which participants are assigned in a 1:1 ratio to one of two arms: a forest therapy plus mindfulness intervention or an active indoor sensory control condition. Participants remain in their assigned arm for the full duration of the study.
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Age 18 to 65 years * High sensory-processing sensitivity confirmed using a validated instrument (e.g., HSPS/Aron scale) * Able to perform moderate physical activity (e.g., walking) * Able to provide written informed consent
Exclusion criteria
* Severe psychiatric disorder or acute clinical instability * Medical condition contraindicating moderate physical activity * Use of medications with strong autonomic or neuroendocrine effects (e.g., high-dose systemic corticosteroids; selected beta-blockers) * Recent participation in a structured mindfulness or forest-therapy program * Pregnancy or unstable medical condition
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Perceived Stress Score (PSS-10) From Baseline to End of Intervention | Baseline to end of intervention (approximately 22 weeks) | Measure the difference in total score on the Perceived Stress Scale (PSS-10) between baseline and the end of the intervention. PSS-10 comprises 10 items scored 0-40, with higher scores indicating greater perceived stress. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Psychological Well-Being Score (WHO-5) From Baseline to End of Intervention | Baseline to end of intervention (approximately 22 weeks) | Measure the difference in total score on the WHO-5 Well-Being Index between baseline and the end of the intervention. WHO-5 comprises 5 items scored 0-25, with higher scores indicating better well-being. |
Countries
Spain
Contacts
PRINCIPAL_INVESTIGATORAna I Sánchez Hdz
IFM International Forest Medicine
Outcome results
None listed