Forest Therapy and Mindfulness for Highly Sensitive Persons

NCT07368231 | Completed

• 2 other identifiers: HSP-FOREST-2025-RTC-CHSP-FOREST-2025-C
• Study Type: interventional
• Target: 310
• Locations: 1 country
• Sites: 2

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.

Conditions

Stress (Psychology); Mindfulness; Well-Being, Psychological; Mind-Body Therapies; Complementary Therapies; Preventive Medicine

Keywords

Forest Bathing; Forest Therapy; Shinrin Yoku; Mindfulness; Forest Medicine; Highly Sensitive Person (HSP); Stress reduction; Mental Health

Outcome Measures

Primary Outcomes (1)

• Change in Perceived Stress Score (PSS-10) From Baseline to End of Intervention

  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.

  Baseline to end of intervention (approximately 22 weeks)

Secondary Outcomes (1)

• Change in Psychological Well-Being Score (WHO-5) From Baseline to End of Intervention

  Baseline to end of intervention (approximately 22 weeks)

Study Arms (2)

Forest Therapy + Mindfulness + Psychotherapy

EXPERIMENTAL

Participants will undergo an approximately 22-week program with 4.5 hours weekly in forest settings. Sessions include a guided forest walk, mindfulness meditation, structured sensory awareness exercises, facilitated group reflection, and a brief psychotherapeutic component focused on emotional processing and cognitive regulation. Intervention delivery is standardized through facilitator training and a predefined session manual.

Behavioral: Forest Therapy + Mindfulness + Psychotherapy

Indoor Sensory Control (Art and Aromatherapy)

ACTIVE COMPARATOR

Structured indoor sensory-based group sessions delivered weekly over approximately 22 weeks. Sessions are designed to match the experimental intervention in duration, structure, facilitator contact, and social interaction, without exposure to forest or outdoor natural environments. Activities include creative tasks, guided aromatherapy, sensory-focused exercises, and facilitated group discussion according to a predefined protocol.

Behavioral: Behavioral: Indoor Sensory Control (Art and Aromatherapy)

Interventions

Forest Therapy + Mindfulness + Psychotherapy BEHAVIORAL

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).

Forest Therapy + Mindfulness + Psychotherapy

Behavioral: Indoor Sensory Control (Art and Aromatherapy) BEHAVIORAL

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.

Indoor Sensory Control (Art and Aromatherapy)

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• IFM International Forest Medicine: lead

Study Sites (2)

IFM International Forest Medicine

Ronda, Andalusia, 29492, Spain

Location

Sessions conducted in natural forest settings within the Serranía de Ronda, specifically the Valle del Genal area

Ronda, Andalusia, 29492, Spain

Location

Related Publications (1)

• Sánchez Hdz, Ana I. Forest Therapy and Mindfulness in Highly Sensitive Persons (HSP): Confirmatory Evidence from a Multicenter Randomized Controlled Trial with 6-Month Follow-up. Zenodo. DOI: 10.5281/zenodo.17361382. Available at: https://zenodo.org/records/17361382

  RESULT

Related Links

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

MeSH Terms

Conditions

Psychological Well-Being

Interventions

Forest Therapy; Mindfulness; Psychotherapy; Reproductive Techniques, Assisted; Aromatherapy

Condition Hierarchy (Ancestors)

Personal Satisfaction; Behavior

Intervention Hierarchy (Ancestors)

Relaxation Therapy; Mind-Body Therapies; Complementary Therapies; Therapeutics; Cognitive Behavioral Therapy; Behavior Therapy; Behavioral Disciplines and Activities; Reproductive Techniques; Investigative Techniques; Phytotherapy; Sensory Art Therapies

Study Officials

• Ana I Sánchez Hdz

  IFM International Forest Medicine

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: 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.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: 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.

Study Record Dates

• First Submitted: December 12, 2025
• First Posted: January 26, 2026
• Study Start: May 1, 2025
• Primary Completion: October 3, 2025
• Study Completion: October 3, 2025
• Last Updated: January 26, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL
• Time Frame: Beginning 6 months after publication and available for up to 36 months.
• Access Criteria: Access will be granted to qualified researchers upon reasonable request, subject to approval by the responsible ethics committee and execution of a data use agreement. Requests must include a research proposal and analysis plan.

Locations

ES (2)