Nature-Based Health

Article

Research and method

– by biologist and PhD Thuri Kledal, expert in nature-based health promotionand Nordic forest bathing.

Nature-based health promotion is a research-based approach where contact with nature is used to strengthen mental health, regulate the nervous system, and prevent stress. Here you will find a consolidated introduction to nature-based health interventions (NBHIs), nature connectedness, and Nordic forest bathing—grounded in psychological and biological research.

What is nature-based health promotion?

Nature-Based Health Interventions (NBHIs)

Nature-Based Health Interventions (NBHIs) are structured health-promoting initiatives where contact with nature is used systematically to support mental health, reduce stress, and improve physiological regulation. The term is increasingly used in research as an umbrella concept for interventions where nature contact is a central component in prevention and treatment of both mental and physical states of strain (Frumkin et al., 2017; Shanahan et al., 2019).

NBHIs include, among others:

• guided nature contact

• forest bathing

• nature therapy

• nature-based stress reduction

• green rehabilitation

• nature-based activity programmes
  
  

Research indicates that nature-based interventions can have measurable effects on both mental health and physiological stress markers. Systematic reviews show, among other findings, associations between NBHIs and reduced stress levels, improved psychological well-being, and better self-regulation (Corazon et al., 2019; Bratman et al., 2019). A large meta-analysis also documents associations between access to nature and lower prevalence of stress-related illness, depression, and cardiovascular disease (Twohig-Bennett & Jones, 2018).

In public health, NBHIs are increasingly used as part of preventive strategies. In several European countries, so-called green prescriptionsare used, where nature-based activities are recommended as support for mental health and stress reduction (Bragg & Atkins, 2016; Frumkin et al., 2017). European research projects such as GreenME (Green Mind for Mental Health in Europe)similarly work to integrate nature-based interventions into health systems and document their significance for mental well-being and prevention of stress-related strain.

NBHIs can be understood within a bio-psycho-social framework, where nature acts as an active regulatory factor that influences nervous system functioning, emotional regulation, and cognitive processes (Engel, 1977; Ulrich et al., 1991). Time spent in natural environments is associated with reduced sympathetic activation and increased parasympathetic activity, supporting recovery and mental balance (Park et al., 2010; Song et al., 2016).

Research also suggests that the effects of nature-based interventions do not depend solely on the natural environment itself, but also on how nature is used. Structured programmes with guidance and sensory attention appear to produce more consistent outcomes than incidental nature contact (Bielinis et al., 2021; Hansen et al., 2017). This underlines the importance of professionally grounded methods within nature-based health promotion.

NBHIs therefore represent a development toward a more integrative understanding of mental health, where human well-being arises through the interaction of biology, psyche, and environment (Frumkin et al., 2017). Within this framework, practices such as forest bathing and nature therapy are concrete methods for working systematically with nature’s health-promoting potential.

Nature connectedness

Nature connectedness refers to the degree of experienced connection between human beings and living nature, and is today considered a central psychological construct within nature-based health promotion. The concept describes not only the frequency of nature contact, but the qualitative experience of being connected to nature through senses, emotions, and attention (Mayer & Frantz, 2004; Richardson et al., 2019).

Research shows that nature connectedness is associated with multiple indicators of mental health and psychological well-being. Systematic reviews and meta-analyses point to associations between nature connectedness and higher psychological well-being, lower perceived stress, and greater emotional stability (Capaldi et al., 2014; Pritchard et al., 2020; Martin et al., 2020). Studies also show that people with stronger nature connectedness more often report a sense of meaning and coherence in life—considered key elements of psychological health (Pritchard et al., 2020).

Research distinguishes between nature contactand nature connectedness. Nature contact refers to actual exposure to nature, while nature connectedness refers to the psychological relationship to nature. Studies show that it is not only the amount of time in nature, but the way nature is experienced, that matters for mental health (Richardson et al., 2019; Lumber et al., 2017).

Sensory attention, a slow pace, and direct experience of nature appear to be key factors in developing nature connectedness. Experimental studies show that nature connectedness can be strengthened through relatively simple practices such as attention to the senses, contact with natural materials, and slow movement through the landscape (Lumber et al., 2017; Richardson et al., 2019). These findings support the use of structured nature-based methods within NBHIs.

From a psychological perspective, nature connectedness can be understood as an experienced integration between the inner and outer environment. This integration may reduce the experience of mental fragmentation and support a sense of stability and coherence (Pritchard et al., 2020). Nature connectedness is therefore not only a matter of well-being, but also of how human beings fundamentally orient themselves in the world.

Recent research also indicates that nature connectedness is linked not only to mental health but to environmental and pro-nature behaviour. People with higher nature connectedness show, on average, greater responsibility toward nature and stronger motivation for sustainable action (Martin et al., 2020; Richardson et al., 2020). Nature connectedness is therefore increasingly viewed as a key psychological foundation for a sustainable future.

Within nature-based health promotion, nature connectedness serves as a bridge between psychological processes and physiological regulation. Sensory presence in nature can also influence nervous system activity and support mental restoration—forming part of the physiological effects of nature contact described in the next section (Ulrich et al., 1991; Berman et al., 2008).

Nordic forest bathing

Nordic forest bathing is a structured nature-based practice where a slow pace, sensory attention, and calm presence in nature are used to support mental restoration and physiological regulation. The method is based on the Japanese practice Shinrin-Yoku (forest bathing), which since the 1980s has been used as a preventive public health approach, and has been further developed in a Nordic context with attention to local landscapes, seasonal rhythms, and sensory nature contact (Li, 2010; Song et al., 2016).

Forest bathing differs from ordinary walks in that the purpose is not exercise or performance, but calm and attentive presence in nature. The pace is slow, and participants are invited to notice sensory impressions such as light, sounds, temperature, movement, and organic forms. This form of attention is associated with reduced mental load and improved restoration (Song et al., 2016; Hansen et al., 2017).

Research on forest bathing shows measurable physiological changes during time spent in forest environments. Studies document lower levels of the stress hormone cortisol, lower pulse and blood pressure, and increased activity in the parasympathetic nervous system during forest bathing compared with time spent in urban environments (Park et al., 2010; Song et al., 2016; Lee et al., 2014). Forest bathing is also linked to improved immune function, including increased activity in natural killer (NK) cells following time spent in forest environments (Li, 2010).

Systematic reviews conclude that forest bathing can contribute to reduced stress, improved mental health, and better physiological balance (Hansen et al., 2017; Twohig-Bennett & Jones, 2018). The effects are explained, among other factors, by the interaction of sensory impressions, vegetation structure, natural sounds, and chemical signalling substances from plants and trees. Although research has investigated the physiological effects of forest bathing, further research is still needed to understand long-term effects, and to explore differences between forest types—for example, conifer-dominated forests compared with beech or other broadleaf-dominated forests (Thuri Kledal).

The Nordic approach places particular emphasis on meeting local nature and the changing seasons. Landscapes with open horizons, forests, coasts, and diverse vegetation offer different sensory experiences that can support attention and restoration. Seasonal shifts also influence light conditions, temperature, and vegetation dynamics, giving nature contact a rhythmic character.

Within nature-based health promotion, Nordic forest bathing is understood as a form of NBHI, where nature contact is used systematically to support mental health and regulate the nervous system (Corazon et al., 2019; Shanahan et al., 2019). Studies suggest that guided programmes can strengthen nature connectedness and produce more consistent effects than unstructured nature contact (Bielinis et al., 2021).

Nordic forest bathing developed by Thuri Kledal can thus be understood as a method where sensory attention, slow pace, and direct contact with natural environments support the body’s capacity for self-regulation. This process is closely linked to the physiological mechanisms activated during time spent in nature, described in the following section on physiological effects.

Physiological effects of nature contact

Research from medicine, physiology, and psychology shows that time spent in natural environments can lead to measurable physiological changes in the body. Contact with nature affects, among other things, the autonomic nervous system, hormonal balance, immune function, and the brain’s attention systems (Frumkin et al., 2017; Twohig-Bennett & Jones, 2018). These physiological responses are considered central mechanisms behind nature’s documented effects on mental health and stress reduction, and they form the basis for many nature-based health interventions (NBHIs).

Regulation of the nervous system

One of the best documented effects of nature contact is its influence on the autonomic nervous system. Studies show that time spent in nature is associated with reduced sympathetic activation and increased parasympathetic activity, supporting the body’s capacity for recovery and regulation (Park et al., 2010; Song et al., 2016; Lee et al., 2014).

This regulation can be measured, for example, as:

• lower heart rate (Song et al., 2016)

• lower blood pressure (Park et al., 2010)

• increased heart rate variability (Lee et al., 2014)

• reduced physiological stress response (Ulrich et al., 1991)
  
  

Systematic reviews show overall that nature contact is consistently associated with improved autonomic regulation and reduced physiological load (Twohig-Bennett & Jones, 2018; Corazon et al., 2019). Natural environments also appear to be interpreted by the brain as relatively safe settings, which helps dampen the body’s stress response and promote recovery (Ulrich et al., 1991; Bratman et al., 2019).

Stress hormones and hormonal balance

Several studies have documented that time spent in forest environments is associated with lower concentrations of the stress hormone cortisol compared to time spent in urban environments (Park et al., 2010; Song et al., 2016).

Cortisol plays a central role in the body’s stress response, and persistently elevated levels are associated with both mental and physical states of strain. A reduction in cortisol levels is therefore considered an important indicator of physiological recovery (McEwen, 2007). Nature contact is also associated with improved sleep quality and stabilization of circadian rhythms, partly through exposure to natural daylight and variations in light intensity (Hunter et al., 2019; Grigsby-Toussaint et al., 2020).

Immune function and phytoncides

Research suggests that time spent in forest environments may positively influence immune function. Studies have shown increased activity of the body’s natural killer (NK) cells after time spent in forest areas, indicating strengthened immune function (Li, 2010; Li et al., 2006). Part of the explanation may be exposure to volatile organic compounds from plants and trees, often referred to as phytoncides. These compounds are naturally released by trees and can influence human physiology through inhalation (Antonelli et al., 2020).

Phytoncides are associated, among other things, with:

• increased NK-cell activity

• reduced stress response

• improved autonomic regulation
  
  

Although the mechanisms are still being investigated, multiple studies suggest that plant-derived airborne compounds may be part of the explanation for the health-promoting effects of forest environments (Li, 2010; Antonelli et al., 2020).

Attention and mental restoration

Nature contact does not only affect the body, but also brain function. Psychological research shows that time spent in nature can improve attention and mental clarity compared to time spent in urban environments (Berman et al., 2008). This effect is explained in part by Attention Restoration Theory, which describes how natural environments allow the brain to recover after prolonged periods of attention-demanding work (Kaplan & Kaplan, 1989; Berman et al., 2008). Mental restoration is closely linked to the ability to make decisions, solve problems, and maintain overview in complex situations, making nature contact relevant for both mental health and working life (Bratman et al., 2019).

An integrated physiological response

The physiological effects of nature contact do not arise through a single mechanism, but through an interplay of multiple influences, including sensory input, movement, light conditions, and chemical signaling compounds from plants (Frumkin et al., 2017; Bratman et al., 2019). This combined influence can be understood as an integrated regulatory process in which the nervous system, endocrine system, and immune function are affected simultaneously. It is precisely this holistic effect that makes nature contact a central component of nature-based health promotion and NBHIs.

These physiological effects also provide a biological foundation for practices such as nature therapy and forest bathing, where nature contact is used systematically to support mental health and human well-being.

Nature contact and hormonal transition periods

More recent research suggests that nature contact may also be relevant for women’s well-being during perimenopause and menopause, where hormonal changes are often accompanied by sleep disturbances, increased stress sensitivity, and shifts in emotional stability. These life phases are characterized by changes in, among other things, estrogen levels, which affect nervous system regulation, sleep quality, and the body’s stress response (Greendale et al., 2019). Many women experience increased physiological vulnerability to stress exposure during this period and changes in autonomic regulation (Baker et al., 2018).

In this context, nature contact may contribute through the same regulatory mechanisms described for nature-based health promotion more broadly, including reduced stress response and improved autonomic balance (Twohig-Bennett & Jones, 2018; Hunter et al., 2019).

Studies show, for example, that access to green environments is associated with better mental health and lower stress levels among middle-aged women (Roe et al., 2017). Nature contact is also associated with improved sleep quality and stabilization of circadian rhythms, which is especially relevant during hormonal transition periods (Grigsby-Toussaint et al., 2020).

Time spent in natural environments may also support autonomic regulation and reduce physiological stress load, which may help alleviate some of the symptoms often experienced during menopause, such as restlessness, sleep problems, and mental fatigue (Song et al., 2016; Lee et al., 2014).

Although research on nature contact and menopause is still developing, existing studies indicate that nature-based health promotion may offer relevant support for well-being and regulation during this life phase. Nature contact can here be understood as a stabilizing factor that supports the body’s ability to adapt to hormonal changes through regulation of the nervous system, sleep, and stress response.

This connection illustrates how nature-based health promotion not only addresses illness or symptoms, but can also support the body’s natural adaptation processes across biological transitions throughout life.

Nature therapy

Nature therapy is a therapeutic practice in which nature is an active part of working with people’s mental, emotional, and bodily well-being. In nature therapy, the process takes place in direct contact with living environments—for example forests, landscapes, plants, weather, and seasonal rhythms—which become part of what supports regulation, insight, and change.

Nature therapy is based on the understanding that human beings are not separate from nature, but biologically and psychologically connected to it. When we are in nature with attention and presence, the body’s regulatory systems are affected. Stress can be reduced, attention can be restored, and emotional balance can be strengthened (Park et al., 2010; Berman et al., 2008; Bratman et al., 2019). Overall, research shows that nature-based interventions can support mental health and be used both preventively and therapeutically (Twohig-Bennett & Jones, 2018; Kaleta et al., 2025).

Research within nature therapy shows that structured nature-therapeutic programmes can contribute to reduced stress symptoms, improved mental health, and increased psychological stability (Annerstedt & Währborg, 2011; Corazon et al., 2019). Nature-based therapy programmes have, among other applications, been used in rehabilitation for stress-affected citizens and patients with burnout, where natural environments support both physiological regulation and psychological processing (Stigsdotter et al., 2018). Studies also suggest that nature-based therapy can strengthen experienced well-being and nature connectedness among participants (Joschko et al., 2023).

Nature therapy is today part of a growing European research field within NBHIs, where nature-based methods are applied in health promotion and treatment. European research projects such as Green Mind for Mental Health in Europe (GreenME) work to document and develop nature-based therapeutic methods and integrate nature-based interventions into health systems and preventive strategies (GreenME Consortium, 2023–).

In nature therapy, nature is therefore not understood merely as a setting or a place one happens to be. Nature is regarded as an environment that can, in itself, regulate, mirror, and support human processes. Nature’s rhythms, forms, and sensory impacts can provide access to experiences and insights that are often difficult to reach through reflection alone. Experienced connectedness to nature is closely linked to increased well-being and a sense of coherence between the person and their surroundings (Joschko et al., 2023).

The theoretical foundation of nature therapy

The theoretical foundations of nature therapy have been developed, among other fields, within ecopsychology, where human psychological well-being is understood as closely connected to the relationship with nature. Within radical ecopsychology, psychologist Andy Fisher describes human beings as part of larger ecological systems, where psychological balance does not depend solely on individual factors but also on relationship to the living world (Fisher, 2013). Psychological strain can, in this understanding, partly be seen as an expression of a weakened connection between human beings and the living environment.

Linda Buzzell and Craig Chalquist, in their work on ecotherapy, describe how nature contact can support psychological integration and create a sense of coherence between human beings and their surroundings. Nature functions here as an active participant in therapeutic processes rather than merely a backdrop for conversation (Buzzell & Chalquist, 2009).

British psychotherapist Martin Jordan has similarly described nature therapy as a relational practice in which therapeutic processes arise in the encounter between human beings and nature. Nature can, in this understanding, function as a regulating and stabilizing environment where the client can experience themselves within a larger context (Jordan, 2015).

These perspectives have helped shape modern nature therapy, where nature is seen as the primary therapeutic force, and where the professional role is, to a large extent, to support and facilitate the encounter between person and nature.

Nature as a therapeutic co-participant

The therapeutic work can take different forms. Sometimes the participant is supported through dialogue and reflection, where experiences from nature help create insight into emotions, patterns, or life situations. Other times, the focus is on direct bodily experience of nature’s regulating effect through sensory exercises, silence, and presence. In both cases, it is the encounter between human and nature that constitutes the central therapeutic element.

Nature therapy can therefore be used both as treatment in cases of psychological strain and as support for personal development, life clarification, and well-being. Common to all forms is that nature does not merely provide a background for the process but functions as an active, health-promoting co-participant, whose effects are experienced directly through the body.

Nature therapy is thus not a single method, but an umbrella term for different therapeutic approaches that use nature contact as a central part of the process. This may include sensory nature presence, clinically integrated psychotherapy in nature, developmental programmes in wild nature, or relational ecopsychological practices.

Overall, both research and theory suggest that nature therapy represents a holistic understanding of health, where biological regulation, psychological development, and the human relationship to nature are seen as closely interconnected dimensions of well-being. Nature therapy therefore constitutes a central part of modern NBHIs and a practical application of nature-based health promotion.

Regenerative leadership

Regenerative leadership is an approach to organisation and leadership in which human well-being, organisational resilience, and responsible stewardship of natural resources are understood as mutually interconnected. Regenerative leadership is based on the recognition that organisations function as living systems, where people, materials, energy, and environments continuously influence one another. Within this understanding, well-being and mental health are not merely individual matters, but fundamental conditions for an organisation’s capacity to function stably and evolve over time (Hutchins & Storm, 2019; Wahl, 2016; Capra & Luisi, 2014).

Regenerative leadership represents a shift from a linear understanding of organisations as production units toward an ecosystemic understanding, where companies are seen as embedded in larger biological and social systems. Organisational stability in this view depends both on employee well-being and on responsible management of natural resources (Wahl, 2016; Capra & Luisi, 2014).

In recent years, there has been growing interest in regenerative organisational forms as a response to widespread work-related stress and organisational complexity. Research shows that chronic workload and sustained stress exposure affect decision-making, collaboration, and organisational stability (McEwen, 2007; Ganster & Rosen, 2013). Leadership approaches that support recovery and psychological safety have therefore become central in modern organisational research (Edmondson, 2019).

International organisational studies also show that companies that work systematically with employee well-being and health achieve higher productivity, lower sickness absence, and better retention. Analyses from the McKinsey Health Institute indicate that improved employee health not only impacts well-being but can also create substantial economic value through increased productivity and organisational stability (McKinsey Health Institute, 2023). These results support the understanding of well-being as a strategic factor in organisations’ long-term development.

Nature-based health promotion plays an important role in this context by supporting employees’ and leaders’ physiological regulation and mental clarity. Studies show that nature contact can improve attention and decision-making—core competencies in complex work situations (Berman et al., 2008; Bratman et al., 2019). Reduction in physiological stress load is also linked to better collaboration and greater organisational stability (McEwen, 2007; Ganster & Rosen, 2013).

Resources and material cycles

A central dimension of regenerative leadership is an organisation’s relationship to raw materials and resources. Regenerative organisations work not only with human resources but also with the material cycles that underpin production and value creation. Organisations are understood as embedded in ecological cycles, where resource consumption and value creation are closely connected (Wahl, 2016; Capra & Luisi, 2014).

In biological systems, stability is maintained through circulation of energy and materials, where waste from one process becomes a resource in another. These principles have inspired the development of regenerative organisational models and circular production forms (Geissdoerfer et al., 2017; Ellen MacArthur Foundation, 2019).

The circular economy is a central element of this development. Products and processes are designed for reuse, repair, and recycling so that resource consumption is reduced and the value of materials is preserved for longer periods (Geissdoerfer et al., 2017).

Organisations working with circular principles therefore aim to create stable material cycles as part of their long-term strategy.

Regenerative leadership expands this understanding by focusing not only on reducing harm, but also on rebuilding resources and ecological systems. Organisations may, for example, work with biodiversity, regenerative agriculture, or reduction of environmental impact as integrated parts of their business model (Hutchins & Storm, 2019; Wahl, 2016).

Biomimicry and nature’s principles

A key source of inspiration in regenerative leadership is biomimicry, where nature’s organisational and design principles are used as models for innovation and organisational development. Biomimicry is based on the recognition that biological systems, through evolution, have developed effective ways to organise resources, energy, and collaboration (Benyus, 1997).

In nature, stability is maintained through balance between growth and recovery, variation in pace, and collaboration among different organisms. These principles can inspire organisations seeking more stable and adaptive structures (Capra & Luisi, 2014; Wahl, 2016).

Biological inspiration is now used in product design, material choices, and organisational development, where natural systems’ capacity for self-regulation and resource efficiency serves as a model for innovation (Benyus, 1997).

ESG and sustainable value creation

In business, regenerative principles are increasingly integrated through frameworks such as ESG (Environmental, Social and Governance), where companies work systematically with environmental impact, social conditions, and responsible governance. ESG represents a step toward a more holistic understanding of corporate responsibility and long-term stability (Eccles et al., 2014).

Companies with strong ESG strategies show, on average, greater stability and lower risk profiles, contributing to growing investor interest in sustainable organisational forms (Eccles et al., 2014).

Regenerative leadership can be seen as a further development of sustainability and ESG approaches, where the focus is not only on reducing negative impact, but on creating positive contributions to both people and ecosystems (Hutchins & Storm, 2019; Wahl, 2016).

A holistic organisational perspective

Regenerative leadership can thus be understood as a holistic approach in which organisations work with both:

• human well-being and physiological regulation

• organisational collaboration and culture

• resource consumption and material cycles

• financial stability

• impacts on ecosystems
  
  

In this understanding, organisations are seen as living systems where human and material resources participate in shared cycles. Organisational stability therefore depends both on employee well-being and on responsible stewardship of natural resources.

Nature-based health promotion is part of this perspective as a method for supporting the human dimension of regenerative organisations and for connecting biological knowledge about human regulation with organisational practice.

Nature-based methods in working life

Nature-based health promotion can be integrated into working life through concrete methods that support physiological regulation, mental clarity, and collaboration. These methods make it possible to translate principles from nature-based health promotion and regenerative leadership into practical organisational development.

Research shows that even brief contact with nature can have measurable effects on stress levels, attention, and emotional regulation (Bratman et al., 2019; Twohig-Bennett & Jones, 2018). Nature-based methods can therefore be integrated into the workday to support both well-being and organisational stability.

Outdoor meetings

Outdoor meetings are a simple and effective way to integrate nature contact into working life. Time spent in green environments is associated with lower stress levels and improved mental restoration compared to time spent indoors (Hartig et al., 2014). Outdoor meetings also reduce sedentary strain and give participants an opportunity to regulate attention and stress through contact with the environment. Natural settings can create a more open and less hierarchical meeting format, which can support dialogue and collaboration. Studies show that employees with access to green environments at the workplace report higher well-being and lower stress levels (Lottrup et al., 2013).

Walk-and-talk meetings

Walk-and-talk meetings combine movement with nature contact and are increasingly used in organisations. Experimental studies show that walking meetings can improve creativity and problem solving compared to sitting meetings (Oppezzo & Schwartz, 2014). Movement stimulates circulation and supports cognitive functioning, while nature contact contributes to mental restoration. The combination can therefore support reflection and decision-making in complex work situations. Walk-and-talk meetings are used, for example, in leadership coaching and strategic conversations, where the informal setting can support reflection and clarity.

Nature-based team building

Nature-based team-building programmes use natural settings as the framework for collaboration exercises and shared reflection. Natural environments can reduce stress levels and increase a sense of connectedness, strengthening relationships and collaboration in teams (Bratman et al., 2019). Studies show that nature-based group programmes can improve well-being and social cohesion and reduce perceived stress (Corazon et al., 2019; Stigsdotter et al., 2018). Nature-based team building can also support the development of psychological safety and shared direction in teams, which are key factors for organisational performance (Edmondson, 2019).

Leadership coaching in nature

Leadership coaching in nature uses natural environments as a setting for reflection and decision processes. Nature contact can improve attention and mental clarity and support reflection on complex issues (Berman et al., 2008; Kaplan & Kaplan, 1989). Time spent in natural environments can also reduce physiological stress load, which may improve leaders’ decision-making and emotional regulation (McEwen, 2007). Nature-based coaching is increasingly used as a method for creating calm, overview, and long-term perspective in leadership work.

Short sensory nature breaks

Even short stays in nature can influence physiological regulation. Studies show that brief time spent in green environments can support restoration and mental clarity (Hunter et al., 2019). Short nature breaks can be integrated into the workday through time in green areas, brief sensory exercises, or quiet outdoor pauses. These breaks can reduce cumulative stress load across the workday and support stable energy and concentration.

Nature-based virtual reality

When direct access to nature is not possible, nature-based virtual reality can serve as a supplement to physical nature contact. Research shows that virtual nature environments can reduce stress and improve mood, especially where access to nature is limited (Kalantari et al., 2022; Hubbard et al., 2025). Studies also show that exposure to simulated nature can increase positive emotions, reduce perceived stress, and improve mental state, even with relatively short exposures (Li et al., 2023). Research on immersive virtual nature environments further suggests that virtual nature experiences can support a sense of nature connectedness and increase motivation for contact with real nature (Brambilla et al., 2024; Chan et al., 2023).

Digitised nature-based interventions have, among other developments, been created as an extension of forest bathing, where virtual nature experiences are used to make nature-based methods accessible to people with limited access to nature. Studies on digitised forest bathing suggest that technology can support stress reduction and well-being through guided nature experiences (Bagger et al., 2024).

At the same time, research highlights clear limitations of virtual nature experiences. Virtual nature primarily engages visual and auditory senses, while multisensory inputs such as air, temperature, smells, and microbial exposure exist only in real nature. These factors likely play an important role in the physiological effects of nature (Li et al., 2023). Virtual nature contact can therefore be understood as a supplement to physical nature contact rather than a replacement. In modern working life, nature-based virtual reality can be used as short restorative breaks or as a way to bring nature contact into environments where access to nature is limited.

A bio-psycho-social and ecological understanding of nature-based health promotion

Nature-based health promotion is grounded in an understanding of human beings as biological, psychological, and social organisms who are constantly influenced by their surroundings. Human well-being cannot therefore be understood in isolation from the environments in which we live and work. The bio-psycho-social model describes how biological processes, psychological experiences, and social relationships together form the foundation for mental health and physical well-being (Engel, 1977).

Within this understanding, nature is an active factor in the regulation of human physiology and psychology. Nature contact influences nervous system balance, stress response, attention, and emotional stability and thus constitutes an important part of the conditions that support human well-being (Ulrich et al., 1991; Bratman et al., 2019; Twohig-Bennett & Jones, 2018).

Research on nature connectedness also shows that an experienced connection to nature is linked to better mental health and greater responsibility toward the living world (Capaldi et al., 2014; Pritchard et al., 2020). Nature-based health promotion can therefore contribute to both individual well-being and a more sustainable societal development.

Within health promotion and mental well-being, NBHIs are increasingly recognised as an important field in which nature-based activities are integrated into prevention and treatment of stress and psychological strain (Kaleta et al., 2025). Nature-based interventions represent an expansion of health understanding from a predominantly biomedical approach toward a more integrative and holistic understanding of what it means to be human.

This holistic understanding is closely aligned with perspectives from ecopsychology, where human psychological well-being is seen as connected to the relationship with the living world. Within radical ecopsychology, Andy Fisher describes human beings as part of larger ecological systems, where psychological balance depends not only on individual factors but also on relationship to nature and ecological surroundings (Fisher, 2013). Psychological problems can, in this understanding, partly be seen as expressions of a disrupted relationship between human beings and the living environment.

Similar perspectives are found within modern nature therapy and ecopsychology, where nature is understood as an active participant in therapeutic processes. Linda Buzzell and Craig Chalquist describe how nature contact can support psychological integration and create a sense of coherence between human beings and the living world (Buzzell & Chalquist, 2009). Martin Jordan has similarly described how nature-based therapy can be understood as a relational encounter between the person and the environment, where therapeutic processes arise through direct experience of nature (Jordan, 2015).

These perspectives point toward an expansion of the bio-psycho-social model to also include an ecological dimension. Human well-being, in this understanding, emerges through the interaction of:

• biological regulatory processes

• psychological experiences

• social relationships

• ecological environments
  
  

Nature-based health promotion can therefore be understood as a practice that works with these dimensions as an integrated whole rather than as separate parts. This development points to a paradigm shift in the understanding of mental health, where well-being is not only understood as the absence of disease, but as a result of stable relationships between the person and their surroundings. Nature contact can, in this context, be seen as a foundational condition for human regulation and functioning.

Understanding human nature—biologically, psychologically, and relationally—thus becomes a prerequisite for navigating a complex world. When nature-based methods are integrated into everyday life, health work, and organisations, the focus is not only on symptoms, but on the basic conditions for stability and well-being.

Nature-based health promotion therefore represents not a single method, but an interdisciplinary field in which biology, psychology, medicine, ecology, and organisational understanding meet. Through nature contact, people can rebuild regulation, attention, and coherence—processes that form the foundation for both mental health and sustainable development.

In this understanding, nature becomes not merely a setting for human activity, but an active co-participant in the development of well-being, stability, and responsible action. Nature-based health promotion thus links human inner regulation with the larger ecological systems on which life depends.

This holistic understanding forms the foundation for modern nature-based health promotion and points toward a future where human health and nature’s balance are understood as mutually dependent.

References

The references below form the scientific foundation for the article on nature-based health promotion. The references are organised according to the article’s academic sections.

What is nature-based health promotion?

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Nature-Based Health Interventions (NBHIs)

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Nature connectedness

Capaldi, C. A., Dopko, R. L., & Zelenski, J. M. (2014). The relationship between nature connectedness and well-being. Frontiers in Psychology, 5.

Pritchard, A., Richardson, M., Sheffield, D., & McEwan, K. (2020). The relationship between nature connectedness and eudaimonic well-being. Journal of Happiness Studies.

Richardson, M., Passmore, H., Lumber, R., Thomas, R., & Hunt, A. (2020). The Green Care Code. Biological Conservation.

Joschko, L., Pálsdóttir, A. M., Grahn, P., & Hinse, M. (2023). Nature-based therapy and connectedness to nature. International Journal of Environmental Research and Public Health, 20.

Nordic Forest Bathing

Li, Q. (2010). Effect of forest bathing trips on human immune function. Environmental Health and Preventive Medicine, 15(1), 9–17.

Park, B. J., Tsunetsugu, Y., Kasetani, T., et al. (2010). The physiological effects of Shinrin-yoku. Environmental Health and Preventive Medicine.

Song, C., Ikei, H., & Miyazaki, Y. (2015). Physiological and psychological effects of forest therapy. Evidence-Based Complementary and Alternative Medicine.

Antonelli, M. et al. (2020). Forest volatile organic compounds. IJERPH

Physiological effects

Ulrich, R. S., Simons, R. F., Losito, B. D., et al. (1991). Stress recovery during exposure to natural and urban environments. Journal of Environmental Psychology.

Berman, M. G., Jonides, J., & Kaplan, S. (2008). The cognitive benefits of interacting with nature. Psychological Science.

Hunter, M. R., Gillespie, B. W., & Chen, S. Y. (2019). Urban nature experiences reduce stress. Frontiers in Psychology.

McEwen, B. S. (2007). Physiology and neurobiology of stress. Physiological Reviews.

Bratman et al. (2019). Nature and mental health. Science Advances.

Nature contact and hormonal transition periods

Hunter, M. R. et al. (2019). Nature experiences reduce stress biomarkers. Frontiers in Psychology.

Bratman et al. (2019). Nature and mental health. Science Advances.

McEwen, B. S. (2007). Stress physiology and hormonal regulation. Physiological Reviews.

Twohig-Bennett & Jones (2018). Greenspace and health outcomes. Environmental Research

Nature therapy

Annerstedt, M., & Währborg, P. (2011). Nature-assisted therapy: Systematic review. Scandinavian Journal of Public Health.

Corazon, S. S., Sidenius, U., Poulsen, D. V., et al. (2019). Nature-based therapy and stress reduction. International Journal of Environmental Research and Public Health.

Stigsdotter, U. K., Corazon, S. S., Sidenius, U., et al. (2018). Nature-based rehabilitation. Urban Forestry & Urban Greening.

Buzzell, L., & Chalquist, C. (2009). Ecotherapy. Sierra Club Books.

Jordan, M. (2015). Nature and Therapy. Routledge.

Fisher, A. (2013). Radical Ecopsychology. SUNY Press.

Joschko et al. (2023). Nature-based therapy. IJERPH.

Kaleta et al. (2025). Nature-based interventions review. Frontiers in Psychology.

Regenerative leadership

Hutchins, G., & Storm, L. (2019). Regenerative Leadership.

Wahl, D. (2016). Designing Regenerative Cultures.

Capra, F., & Luisi, P. L. (2014). The Systems View of Life.

McKinsey Health Institute (2023). Thriving Workplaces.

Ganster, D. C., & Rosen, C. C. (2013). Work stress and employee health. Journal of Management.
Edmondson, A. (2019). The Fearless Organization.

Geissdoerfer, M. et al. (2017). Circular economy. Journal of Cleaner Production.

Eccles, R. G. et al. (2014). Corporate sustainability. Management Science.

Benyus, J. (1997). Biomimicry.

Ellen MacArthur Foundation (2019). Circular economy.

Nature-based methods in working life

Oppezzo, M., & Schwartz, D. (2014). Walking improves creativity. Journal of Experimental Psychology.

Lottrup, L., Grahn, P., & Stigsdotter, U. (2013). Workplace greenery. Landscape Research.

Kaplan, R., & Kaplan, S. (1989). The Experience of Nature.

Hartig et al. (2014). Nature and health. Annual Review Public Health.

Bagger, C. et al. (2024). Digital forest bathing. Nordisk Sygeplejeforskning https://www.scup.com/doi/abs/10.18261/nsf.14.1.4

Browning, M. H. E. M. et al. (2020). Virtual nature. Urban Forestry & Urban Greening.

White, M. P. et al. (2018). Simulated natural environments. Environment and Behavior.

Kahn, P. H. et al. (2008). Technological nature. Current Directions in Psychological Science.

A bio-psycho-social and ecological understanding of nature-based health promotion

Engel, G. L. (1977). Biopsychosocial model. Science.

Capaldi et al. (2014). Nature connectedness. Frontiers Psychology.

Buzzell & Chalquist (2009). Ecotherapy.

Jordan (2015). Nature and Therapy.

Fisher (2013). Radical Ecopsychology.

Kaleta et al. (2025). NBHI review.