Effects of a Forest Meditation Therapy Program on Reducing Daily Stress and Promoting Coping

Article information

J. People Plants Environ. 2024;27(6):657-673
Publication date (electronic) : 2024 December 31
doi : https://doi.org/10.11628/ksppe.2024.27.6.657
1Ph.D. Candidate, Graduate of Department of Forest Therapy, Chungbuk National University, Cheongju 28644, Republic of Korea
2Ceo, Representative of Ecological Meditation Community, Goyang 10304, Republic of Korea
3Professor, Department of Forest Science, Chungbuk National University, Cheongju 28644, Republic of Korea
*Corresponding author: Won-Sop Shin, shinwon@chungbuk.ac.kr
First authorSoo-Young Yeo, younggamay@gmail.com
Received 2024 September 26; Revised 2024 October 31; Accepted 2024 November 18.

Abstract

Background and objective

This study aimed to assess the effectiveness of a Self-compassion-based forest meditation therapy program in reducing daily stress and enhancing coping resources. Based on growing evidence supporting nature-based interventions for mental health, this program was designed to explore the effects of forest meditation therapy on stress, connectedness to nature, and self-compassion.

Methods

Thirty participants (2 males, 28 females) recruited as adults (mean age 60 years) living in Seoul and Gyeonggi were assigned to experimental and control groups based on the order of enrollment. Two forest meditation therapy sessions were held between October and November 2023, with a two-week interval between sessions. Data were collected at three time points: before the intervention, after the first session, and after the second session. The primary measures included perceived stress, positive and negative affect, salivary cortisol levels, connectedness to nature, and self-compassion.

Results

The experimental group showed significant reductions in perceived stress (F = 6.213, p = .007) and increases in positive affect compared to the control group (F = 3.556, p =.036). While negative affect significantly decreased in the experimental group (F = 5.509, p = .024), no significant difference was observed between the two groups. Cortisol levels significantly decreased in the experimental group post-intervention (z = −2.341, p = .019). Furthermore, the experimental group showed significant improvements in connectedness to nature (F = 6.205, p = .007) and a significant positive trend toward increased self-compassion compared to the control group (F = 4.046, p = .023).

Conclusion

The Self-compassion-based Forest Meditation Therapy Program appears to be effective in managing stress and enhancing key coping resources such as connectedness to nature and self-compassion. These findings suggest that forest meditation therapy could serve as a valuable public health intervention for stress reduction. Future research with larger samples and extended follow-up periods is recommended to further explore its long-term benefits.

Introduction

Daily stressors, although less dramatic than major life events or chronic stressors, can accumulate and become chronic if not effectively managed, leading to significant long-term impacts on health and well-being (Piazza et al., 2013; Almeida, 2005). Emotional responses to daily stressors have been shown to predict the onset of chronic diseases, presenting a major public health challenge in the 21st century (Piazza et al., 2013). According to Lazarus and Folkman’s stress transaction model (1984), stress is activated not solely by the presence of stressors but by an individual’s perception of their coping resources as inadequate. This appraisal process influences the use of both internal and external coping strategies, and variations in individual responses to stress significantly affect well-being (Cohen et al., 2000).

In South Korea, daily stress is a widespread issue, as highlighted by the 2022 Community Health Survey conducted by the Korea Disease Control and Prevention Agency (KDCA). The survey found that 24.5% of adults reported experiencing high or extremely high levels of daily stress. Additionally, 63.9% of adults in Korea experienced at least one mental health issue, such as depression, stress, or insomnia, with stress being a predominant factor affecting mental health (National Center for Mental Health, 2022). The inability to manage daily stress can lead to an accumulation of perceived stress and negative emotions, eventually contributing to chronic health conditions and mood disorders (Piazza et al., 2013; Almeida, 2005). Therefore, there is a growing need for interventions that provide effective, affordable, and accessible coping resources to address daily stress and its related mental health challenges (Beames at al., 2021; Pretty and Barton, 2020).

Nature-based therapy and its benefits

The natural environment is increasingly recognized as a critical resource for promoting and sustaining mental health, particularly for individuals experiencing heightened levels of stress (Townsend at al., 2018). Exposure to nature induces unconscious autonomic responses, such as reduced physiological arousal and decreased negative affect, while simultaneously increasing positive affect, thereby alleviating both physiological and psychological stress (Kaplan and Kaplan, 1989; Ulrich et al., 1991; Jimenez et al., 2021). Numerous empirical studies have demonstrated that nature-based interventions reduce physiological stress markers—including blood pressure, heart rate, and cortisol levels —regardless of the mode of interaction with nature (active, passive, or virtual) (Jimenez et al., 2021; Shuda et al., 2020). Positive emotional changes are also consistently associated with psychological recovery from stress (Corazon et al., 2019; Bratman et al., 2015; Neill and Arbuthnott, 2019). Fredrickson’s broaden-and-build theory of posits that positive affect broadens cognitive and behavioral repertoires, enhancing mental flexibility and meaning-based coping, which leads to the construction of long-term psychological and social resources (Fredrickson, 2004; Conway et al., 2013).

Thus, nature may provide more than temporary relief from stress, serving as a crucial setting for fostering adaptive coping mechanisms. Forest healing activities, a classic example of nature-based interventions, have shown potential for not only managing daily stress but also cultivating key inner resources essential for coping (McMahan and Estes, 2015; Shanahan et al., 2019; Huynh and Torquati, 2019; Mayer et al., 2009; Lee, 2014).

Connectedness to nature and self-compassion

Connectedness to nature, defined as the emotional bond between individuals and the natural environment, plays an important role in mediating the health benefits derived from nature exposure (Mayer and Frantz, 2004; Mantler and Logan, 2015). While exposure to nature often fosters this bond, the absence of attention and inability to cultivate this connectedness can impede the realization of nature’s potential health benefits (Mantler and Logan, 2015). Meta-analytical evidence suggests that heightened levels of connectedness to nature are linked to increased happiness and overall well-being (Capaldi et al., 2014; Pritchard et al., 2020). Recent findings by Bakir-Demir et al. (2021) have shown that a strong connectedness to nature is predictive of reduced perceived stress, facilitated by the reinforcement of adaptive emotion regulation strategies. Therefore, connectedness to nature serves as an important coping mechanism in managing stress and improving overall mental health.

Similarly, self-compassion—a concept derived from Buddhist traditions and now widely recognized for its mental health benefits—plays a crucial role in enhancing emotional well-being (Condon and Makransky, 2023; Strauss et al., 2016; Zessin et al., 2015). Self-compassion involves directing kindness and support toward oneself during difficult times, acknowledging one’s suffering as part of the shared human experience, and maintaining a balanced, mindful perspective on personal hardship (Neff and Dahm, 2015; McGehee et al., 2017). Elevated levels of self-compassion are associated with improved psychological well-being, as well as reduced depression, anxiety, and perceived stress (Trembath et al., 2019; Kim and Ko, 2018; Murfield et al., 2020; Han and Kim, 2023; Ferrari et al., 2019). In particular, self-compassion serves as a protective buffer against acute stressors and plays a role in regulating health-promoting behaviors and shaping the process of coping with stress (Neff et al., 2007; Homan and Sirois, 2017 Sirois et al., 2015; Rahimi-Ardabili et al., 2018; Ewert et al., 2021; Chishima et al., 2018).

Combining nature exposure with self-compassion training

There is growing interest in combining nature-based interventions with self-compassion training to enhance the psychological benefits of both approaches. McEwan et al. (2021) examined the effects of Compassion Mind Training (CMT), forest bathing, and a combined intervention of CMT and forest bathing. All three interventions showed equivalent improvements in well-being, connectedness to nature, and compassion. Notably, the combined intervention led to the greatest improvement in connectedness to nature, suggesting a synergistic relationship between nature exposure and compassion training.

In South Korea, forest therapy has been incorporated into public health and welfare services since the 2000s, providing accessible nature-based healing programs for the general public at minimal or no cost (Shin and Lee, 2020; Korea Forest Welfare Institute). Forest healing sites have expanded from 5 in 2015 to 43 in 2024, with increasing numbers of visitors seeking forest-based interventions (Korea Forest Welfare Institute). However, many individuals may find it difficult to regularly visit these sites, which has led to the development of single-session programs (Park et al., 2021). Given the growing demand for brief, evidence-based nature interventions, it is important to explore how self-compassion-based forest therapy programs can offer practical and accessible solutions for daily stress management.

Research objectives and hypotheses

We aim to obtain evidence supporting the use of a self-compassion-based forest therapy program as a public health intervention by investigating its potential to promote recovery from daily stress and foster connectedness to nature and self-compassion as coping resources. In this regard, we establish the following hypotheses to examine whether a brief forest therapy meditation program helps reduce daily stress and cultivates stress-coping resources. (1) A self-compassion-based forest therapy program will progressively improve psychological and physiological stress and affect. (2) A self-compassion-based forest therapy meditation program will progressively cultivate connectedness to nature and self-compassion.

Research Methods

Participants

The sample size for this study was determined using the G-Power 3.1.9.7 program to calculate the appropriate number of participants for statistical significance. Based on an effect size of 0.25 from the F distribution, a significance level of 0.05, and a power of 0.80, the required sample size was calculated to be 28 participants. To account for potential dropouts and ensure an adequate number of participants for the forest healing meditation program, the sample size was set at 30.

Participants were recruited from September to early October 2023 by posting notices and banners at the JatHyanggi Green Forest Healing Center in Gyeonggi Province, South Korea. The inclusion criteria required participants to be middle-aged adults residing in the Seoul metropolitan area, healthy enough for daily activities, without limitations in outdoor activities, and capable of completing self-report questionnaires. A total of 30 participants were enrolled, with 15 allocated to the experimental group and 15 to the control group, based on a first-come, first-served basis.

All participants were informed about the study’s objectives and procedures and provided informed consent before participating. Upon completion of all measurements, participants in the experimental group were provided with lunch, while those in the control group received gift vouchers worth thirty thousand Korean won. The study was approved by the Institutional Review Board of Chungbuk National University (IRB number: CBNU-202307-HR-0167).

Study design

The study was designed as a 2 × 3 mixed study design. Data were collected before the intervention, after the first intervention, and after the second intervention two weeks later (Table 1). To address group homogeneity, external factors were controlled for by limiting the participants’ area of residence and age, and the gender ratio was adjusted. A total of 30 participants who provided consent were divided into the experimental group (n = 15) and control group (n = 15) based on the conditions of participation in the experiment.

Basic study design for program validation

The experiment was conducted for two hours, starting at 10:30 AM on the third week of October 2023 and two weeks later, in the first week of November. Participants in the experimental group arrived at the site one hour before the start of the program using their own transportation and completed the pre-test. After the conclusion of the program at 12:30 PM, they completed the post-test. They revisited two weeks later to participate in the program again and complete the second post-test. Salivary cortisol levels vary over time, so saliva was collected from both groups at the same time of day. The experimental group had salivary cortisol levels measured one more time before the second intervention for a pre- and post-intervention comparison.

Experimental site

The experiment was conducted in Jat-Hyanggi Green Forest in Gapyeong-gun, Gyeonggi-do, which was designated as “Forest of Healing” by the Korea Forest Service in 2017. The Jat-Hyanggi Green Forest is located approximately 45 km northeast of Seoul, making it a popular destination for urban residents and a suitable location for recruiting study participants among forest visitors (Fig. 1). The forest is equipped with a healing center, forest trails, barrier-free walking paths, meditation spaces, wildflower gardens, and water therapy areas, all designed to utilize environmental elements for health promotion. Situated at an altitude of 450–600 meters on the slopes of Mt. Chukryeong and Mt. Seori, it spans an area of 153 hectares and is home to the largest distribution of pine trees over 90 years old in Korea. The healing center within the forest offers forest therapy programs twice daily from March to early December, led by on-site forest therapy instructors. These programs are available for reservation on a first-come, first-served basis. This study was conducted with the cooperation of the Healing Forest management organization, and a safe, quiet, and undisturbed walking course suitable for the forest therapy meditation program was established in consultation with the on-site forest therapy instructors. The weather was clear during the first session and cloudy during the second session, held two weeks later. The average temperature in Gapyeong-gun during the experiment ranged from 13.4ºC to 18.4ºC.

Fig. 1

Location of Forest of Healing and the management center.

Self-compassion-based forest therapy program

In order to implement the Combining Nature Exposure with Self-Compassion Training proposed in the introduction, the self-compassion intervention was modeled on the main meditations and practices of the Mindful Self-Compassion (MSC) program developed by Neff and Germer (Neff, 2003; Germer et al., 2019; Germer and Neff, 2019). According to Neff’s model of self-compassion, self-compassion includes three core components: self-kindness, common humanity, and mindfulness. Self-kindness involves offering warmth and understanding to oneself instead of engaging in judgment and self-criticism. Common humanity encourages a connected perspective that views personal experiences not as isolated or individual, but as part of a shared human experience. Finally, as a prerequisite for practicing self-compassion, it involves mindfulness, which is the balanced awareness of one’s thoughts and feelings in a moment-to-moment experience, rather than over-identifying with them (Neff, 2003; McGehee et al., 2017).

The program consists of a series of basic meditation practices aimed at directly training mindfulness and self-compassion in natural environments, targeting general adults with little to no meditation experience (Fig. 2).

Fig. 2

Reference for forest therapy activities.

The meditation practices included movement (breathing, walking, stretching), staying still, sitting, or lying down and were comprised of affectionate breathing meditation, compassionate movement meditation, compassionate walking meditation, and compassion and loving-kindness meditation. Each practice incorporated present-moment awareness with an emphasis on sensory connection with the surrounding natural environment, and participants were guided to connect external sensory experiences to inner experiences. Singing bowls were used to signal the start and end of each activity.

The breathing meditation was guided towards feeling and experiencing the gentle rhythm of the breath, rather than focusing on concentration. The features of nature were linked to loving-kindness. The walking meditation guided participants to notice sensory contact with the natural environment through mindfulness and to fully savor the experience. The movement meditation guided participants to be aware of parts of the body where stress is felt and to allow natural movements to relieve stress.

All of the exercises structurally embedded here-and-now space mindfulness, guided sensory contact and mindfulness of the resulting feelings and thoughts, in order to induce a deep connection with nature. Participants were encouraged to savour the good sensory feelings that nature offers and, when noticing particularly unpleasant feelings or uncomfortable thoughts, to be kind to themselves and release them through inhalation and exhalation breathing.

The program was facilitated by a researcher who majored in forest therapy and is registered as a meditation instructor with the Korean Society for Meditation. The researcher has completed the instructor course for the MSC program. Since self-compassion meditation training is based on a sense of safety, the author endeavored to create a safe environment and atmosphere (Germer et al., 2019). Like most meditation programs, participants were encouraged to remain silent throughout the program. Based on previous studies (McEwan et al., 2021; Park et al., 2021; Yeo and Shin, 2023), the forest therapy intervention was delivered in a two-hour programme for people with demanding schedules (Table 2).

Self-compassion-based forest meditation therapy program

Data measurement

A self-report questionnaire was used to collect participants’ demographic information.

The Korean version of the Perceived Stress Scale (PSS), developed by Cohen et al. (1983) and adapted by Lee et al. (2012) was used to measure the degree of stress perceived by participants in their daily lives. This scale focuses on assessing subjective stress perception rather than objective stress situations. The scale consists of 10 items rated on a 5-point Likert scale (0–4). In this study, the reliability (Cronbach’s α) was 0.81.

Participants’ affective states were measured using the Korean version of the Positive and Negative Affect Scale (PANAS) developed by Watson et al. (1988) and adapted by Park and Lee (2016). The PANAS assesses positive and negative affect, with each affective state being assessed by 10 items rated on a 5-point Likert scale (1–5). In this study, the reliability was 0.94 for positive affect and 0.84 for negative affect.

Cortisol levels were measured as a physiological indicator of stress (Antonelli et al., 2019). Stressful stimuli are likely to increase cortisol production and disrupt the circadian secretion of this hormone (Tsigos et al., 2020; Aardal and Holm, 1995). Since cortisol secretion follows a circadian rhythm, peaking after waking and gradually declining throughout the day, saliva samples were collected before and after each intervention at consistent times. Samples were collected using a polypropylene salivary cortisol ELISA kit, and participants were instructed to avoid food intake for at least one hour before collection. Saliva samples were frozen and later analyzed in a laboratory using an ELISA reader (Biotek Instruments, USA). The unit of measurement for cortisol was ng/ml.

Connectedness to nature was assessed using the Connectedness to Nature Scale (CNS), developed by Mayer and Franz (2004) and adapted by Gim et al. (2019). This scale measures the emotional and experiential connection with the natural world. It includes 10 items rated on a 5-point Likert scale (1–5). In this study, the reliability (Cronbach’s α) was 0.89.

The Participants’ self-compassion was measured using the Self-Compassion Scale - Short Form (SCS-SF), developed by Raes et al. (2011) and adapted by Park (2014). The scale measures the degree of self-kindness and care when facing adversity, failure, or rejection. It consists of 12 items rated on a 5-point Likert scale (1–5). The reliability (Cronbach’s α) was 0.75 in this study.

Data analysis

Data were analyzed using SPSS 19.0 (IBM, Armonk, NY, USA) for Windows, with statistical significance set at p<0.05. Sociodemographic characteristics were analyzed using frequencies and percentages and assessed using chi-square tests. Group homogeneity was compared using t-tests based on means and standard deviations. The main outcome measures, including perceived stress, positive and negative affect, connection to nature, self-compassion, and cortisol, were analyzed using repeated measures analysis of variance. We also conducted a non-parametric statistical analysis, the Wilcoxon signed-rank test, to determine significant differences in cortisol levels before and after within each group, given the small sample size and no assumption of normality.

Initially, 30 participants were enrolled in the study. However, two participants were unable to complete the second experiment due to personal reasons, resulting in a total of 28 participants included in the analysis.

Results

Participants’ general characteristics and comparisons

A total of 28 subjects were evaluated in the final analysis, with 13 in the experimental group and 15 in the control group. No significant differences were found between the experimental and control groups in key demographic characteristics, including gender, age, education area of residence, and economic status.

Most participants were women (92.9%), and 92.8% were aged 50 or older, with only two participants (6.7%) aged 40–49. Regarding education, 46.4% had a college degree, 35.7% completed high school, 14.3% had a graduate degree, and 3.6% completed middle school. The majority (64.3%) resided in Gyeonggi-do, while 35.7% lived in Seoul. In terms of subjective economic status, 82.1% identified as middle class, 10.7% as low class, and 7.1% as high class.

Additionally, there were no significant differences in experience visiting forest therapy sites (χ2 = 2.184), experience with forest therapy programs (χ2 = 1.532), and prior participation in meditation (χ2 = 1.152) between the two groups. Overall, 67.9% of participants had never visited a healing forest, 85.7% had never participated in a forest therapy program, and 64.3% had no prior experience with meditation (Table 3).

Participants’ general characteristics

Table 4 shows the differences in participants’ outcome variables between the two groups at baseline. There were no significant differences in the outcome measures, namely perceived stress (t = 1.575, p = .127), positive and negative affect (t = 0.835, p = .411), connectedness to nature (t = 0.708, p = .485), self-compassion (t = −0.059, p = .953), and cortisol (t = 0.769, p = .456).

Comparison of groups at the baseline

Results of hypothesis 1

Table 5 presents the findings of the stress assessment, which included measurements of perceived stress, positive and negative affect, and cortisol levels.

Changes and differences in outcome variables between and within groups

Perceived stress

The experimental group showed a significant decrease in stress over time (F = 6.213, p = .007). The mean pre-score (M = 19.15) decreased from Post1 (M = 16.69) to Post2 (M = 14.84). The control group’s mean scores did not change significantly at pre, post1, or post2. There was a significant difference in perceived stress between the two groups over time (F = 4.529, p = .023).

Positive and negative affect

An increasing trend in positive affect over time was observed in the experimental group (F = 3.378, p = .051), with the mean score increasing from pre-test (M = 25.00) to post-test 1 (M = 28.85) and post-test 2 (M = 30.15). In contrast, the control group showed no significant changes. The interaction effect between time and group showed a significant difference in positive affect between the two groups (F = 3.556, p = .036).

For negative affect, a significant decrease over time was observed in the experimental group (F = 5.509, p = .024), with the mean score decreasing from pre-test (M = 19.46) to post-test 1 (M = 14.00) and post-test 2 (M = 13.92). In the control group, negative affect did not change significantly over time. However, there was no significant difference in changes between the two groups.

In addition to the independent analysis of positive and negative affect, we analyzed the total PANAS score to provide a broader view of affective changes over time. For the total PANAS score, a significant increase over time was observed in the experimental group (F = 6. 437, p = .006), with mean scores rising from pre-test (M = 65.54) to post-test 1 (M = 74.85) and post-test 2 (M = 76.23). In contrast, the control group showed no significant change over time.

Cortisol

In the repeated measures analysis (across three time points), no significant changes were observed within or between the groups for cortisol levels (Table 5). Therefore, we further analyzed the difference between pre and post cortisol scores and found that there was a significant difference between pre and post cortisol levels in the experimental group (Z = −2.341, p = .019), with negative ranks (sum rank = 79.00) being higher than positive ranks (sum rank = 12.00), indicating a decrease in post levels. In the control group, there was no significant difference in cortisol levels from pre to post (Table 6).

Changes in cortisol levels across pre-test and post-test

Results of hypothesis 2

The results for natural connectedness and self-compassion, measured as coping resources for stress, are as follows (Table 7).

Changes and differences in connectedness to nature

Connectedness to nature

In the experimental group, the connectedness to nature significantly increased over time (F = 6.205, p = .007). The pre-test mean score (M = 35. 30) gradually increased in post-test 1 (M = 39.46) and post-test 2 (M = 42.69). In the control group, there was little change in the connectedness to nature, and it was not statistically significant. The mean scores for the control group were 33.60 at pretest, 35.13 at post-test 1, and 34.93 at post-test 2, showing almost no change. The difference in the connectedness to nature between the two groups over time was statistically significant (F = 3.678, p = .042).

Self-compassion

In the experimental group, self-compassion scores tended to increase over time, although the change was not statistically significant. The mean self-compassion score increased from pre-test (M = 42.00) to post-test 1 (M = 42.23) and post-test 2 (M = 44.46). In the control group, self-compassion scores did not show any significant changes over time. However, the interaction effect between time and group showed a significant difference in self-compassion changes between the two groups (F = 4.046, p = .023).

Discussion

This study hypothesized and validated the effectiveness of a self-compassion-based forest therapy intervention in alleviating daily stress and enhancing coping resources by evaluating the psychological and physiological changes in participants. First, perceived stress, affects, and salivary cortisol were assessed to validate stress improvement, and second, personal coping resources included connection to nature and compassion for oneself. Participants’ psychological and physiological changes were assessed before the program intervention, after one session of intervention, and after the second session two weeks later.

The study participants were based in Gyeonggi-do and Seoul, and most had never participated in a forest therapy program (85.7%) and 64.3% had no prior experience with meditation.

In relation to the first hypothesis, participants in the self-compassion intervention through forest therapy meditation showed a significant decrease in perceived stress over time, with notable differences compared to the control group. This is consistent with previous research on stress-related factors, where perceived stress, although a subjective, self-reported health variable, has been shown to overlap significantly with chronic health conditions and medical diagnoses, making it a useful indicator for public health interventions (Cohen and Rodriguez, 1995).

Positive affect tended to increase gradually in the forest therapy meditation group and was significantly different from the control group. These results are consistent with a systematic review by Corazon et al. (2019) that positive affect plays an important role in stress recovery in nature-based interventions. In contrast, although negative affect was significantly reduced in the experimental group, no significant difference was observed between the two groups, suggesting that although the change in negative affect may have been a result of the intervention, the difference was not particularly large compared to the control group. Further research is needed to better understand why negative affect was reduced and to isolate the effect of the intervention from other potential factors.

Regarding cortisol levels, repeated measures analyses showed no significant differences within or between groups. Therefore, considering the circadian rhythm of cortisol, we further analyzed the difference between pre- and post-cortisol scores. The results revealed that the sum rank for negative ranks in the experimental group (sum rank=79.00) was notably higher than that for positive ranks (sum rank = 12.00), indicating a clear decrease in post-test cortisol levels and a downward trend following the intervention. These findings suggest that substantial changes occurred in the experimental group immediately after the intervention. This result aligns with findings from Kim et al. (2023), who demonstrated that combined forest therapy and gardening interventions effectively reduced stress indicators. Thus, self-compassion-based forest therapy activities gradually improved perceived stress and positive affect while reducing cortisol levels immediately after the intervention, supporting Hypothesis 1.

Regarding the second hypothesis, the experimental group showed a significant increase in their connectedness to nature, a potential resource for coping with stress, compared to the control group. This suggests that meditation may play an important role in fostering a deeper connection to the natural environment (Aspy and Proeve, 2017; Huynh and Torquati, 2019). Exposure to nature often fosters a sense of connection; however, without focused attention, this connectedness may not develop, potentially hindering the realization of nature’s health benefits (Mantler and Logan, 2015). Connectedness to nature is known to partially mediate and moderate the relationship between nature exposure and positive health outcomes (Mayer et al., 2009; Martin et al., 2020). Bakir-Demir et al. (2021) found that a strong connection to nature predicts a reduction in perceived stress through the enhancement of adaptive emotion regulation strategies. Kaplan (2001), who proposed the restorative effects of nature, emphasized early on the ways individuals relate to nature. Specifically, he proposed meditation interventions as a way to actively engage individuals in interacting with nature, suggesting that meditative engagement can positively impact attention management. Fan (2023) found a positive association between connection to nature and self-compassion, suggesting that self-compassion interventions—which involve viewing one’s experiences and adversity as part of the broader human experience, while recognizing thoughts and feelings as they are without over-identifying with them—could serve as a pathway to strengthen connection to nature. This encourages individuals to recognize themselves as part of a larger natural system with shared experiences within the natural world. Fan also suggests that strengthening connection to nature, extending beyond the universality of shared human experience, could be an alternative intervention to increase compassion for oneself.

While self-compassion tended to increase gradually in the forest therapy meditation group and was significantly different from the control group. Therefore, self-compassion-based forest meditation therapy significantly increased the sense of connectedness to nature and tended to increase self-compassion, supporting the second hypothesis 2. In a previous study, McEwan et al. (2021) reported that a 2-hour intervention combining forest bathing and compassion training resulted in significant improvements in nature connectedness and self-compassion. However, in a similar study, Djernis et al. (2021) found that increases in self-compassion and nature connectedness were not significant immediately following a 5-day residential mindfulness program in a natural setting, with significant changes observed at a 3-month follow-up. These findings suggest that the effects of self-compassion may emerge gradually. Given this, future studies on self-compassion interventions should examine the effects of more frequent and repeated interventions.

Meditation is a key element of forest therapy interventions and the most widely used mental intervention within forest therapy in Korea (Lee et al., 2011; Yeo and Shin, 2023). There have been numerous empirical studies on the effects of nature-based meditation intervention activities and programs to address mental health issues and stress (Djernis et al., 2021; Djernis et al., 2019). However, the impact of forest therapy activities that explicitly emphasize self-compassion has not been sufficiently reported. Thus, the psychological and physiological changes revealed in this study can provide a basis for applying self-compassion interventions in forest activities aimed at managing everyday stress in adults. The results of this study indicate that a short-duration self-compassion-based forest activities provided over a two-week interval can serve as an effective resource for managing daily stress and building resources in adults.

However, this study has several limitations. Firstly, the small sample size limits the generalizability of the findings. Further research with larger samples is needed to address this issue. Secondly, as the pretest data were collected in a natural environment, the effects of exposure to nature may have influenced the baseline scores. To minimize such effects, future studies could consider collecting pretest data in an indoor environment with minimal exposure to nature, introducing a waiting period after the pretest to reduce the transient effects of nature exposure, or conducting multiple pretests and using the average scores. Thirdly, the small group size of 15 participants posed limitations in creating an immersive experience and ensuring adequate personal space. Therefore, future studies should investigate the effect of group size and assess the impact of more frequent interventions. Furthermore, in the context of modern society, intermittent visits may be more practical than continuous or long-term visits. Investigating the effects of different visitation frequencies in future studies would help to provide more specific strategies for stress management and coping interventions.

Conclusion

This study demonstrates that nature-based meditation interventions can be effective in managing daily stress and enhancing psychological resources. The finding that short-term, self-compassion-based forest therapy meditation program is effective for managing daily stress in adults provides practical insights for public health strategies. Specifically, self-compassion-based forest therapy offered at two-week intervals can be an effective resource for building adults’ sense of connectedness to nature and fostering self-compassion. Additionally, this study is significant in that it evaluates the effectiveness of a comprehensive intervention addressing the core aspects of meditation practice, which support both psychological recovery and a deeper connectedness to nature. This approach contrasts with most meditation interventions in Korean forest therapy, which are typically implemented as stand-alone activities (Ju et al., 2021).

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Article information Continued

Fig. 1

Location of Forest of Healing and the management center.

Fig. 2

Reference for forest therapy activities.

Table 1

Basic study design for program validation

Group Pre Treatment 1st post Treatment 2nd post
Experimental group (n = 15) O1 T1 O2 T2 O3
Control group (n = 15) O1 O2 O3

Interval between T1 and T2: 2 weeks.

Table 2

Self-compassion-based forest meditation therapy program

Step Time (minutes) Activities Description
Opening 10 Introduction Greeting the facilitator and participants
Present-moment awareness
Introduction to the program’s purpose and activities
Confirmation of motivation and guidance on participation rules
Health and safety check for participants
Forest Therapy Activity 20 Compassionate Movement Meditation Present-moment awareness
Gentle stretching
Awareness of body sensations and feelings
Checking the state of mind
(Excessive effort vs. self-care)
10 Walking through the Forest Trail Quietly, slowly, freely
20 Affectionate Breathing Meditation Comfortable and supportive posture
Present-moment awareness
Awareness of body and breath sensations
Using supportive touch
Gently redirecting attention
Connection with simply being
25 Compassionate Walking Meditation Paying attention to the surrounding environment through external senses
Savoring pleasant feelings
If discomfort is felt, stop and take deep breaths, provide supportive touch
25 Compassion Meditation Comfortable and supportive posture
Present-moment awareness
Self-contact through internal bodily sensations
Connecting with loving-kindness through natural imagery
Giving and receiving compassion
Providing compassionate phrases
Wrap-up 10 Briefly Sharing Experiences Active listening

Table 3

Participants’ general characteristics

Category Class Experimental (n = 13) Control (n = 15) Total (N = 28) χ2 (p)
Gender Men 1 (7.7) 1 (6.7) 2 (7.1) 0.011 (0.916)
Women 12 (92.3) 14 (93.3) 26 (92.9)

Age (years) 40–49 1 (7.7) 1 (6.7) 2 (7.1) 2.738 (0.254)
50–59 1 (7.7) 5 (33.3) 6 (21.4)
60–69 11 (84.6) 9 (60.0) 20 (71.4)
M(SD) 62.54 (5.75) 59.60 (6.38) 60.96 (6.17)

Education Middle school or less 1 (7.7) 0 (0) 1 (3.6) 7.217 (0.065)
High school 4 (30.8) 6 (40) 10 (35.7)
College 4 (30.8) 9 (60) 13 (46.4)
Graduate school or more 4 (30.8) 0 (0) 4 (14.3)

Area of residence Seoul 5 (38.5) 5 (33.3) 10 (35.7) 0.080 (0.778)
Gyeonggi-do 8 (61.5) 10 (66.7) 18 (64.3)

Subjective economic status High 1 (7.7) 1 (6.7) 2 (7.1) 2.915 (0.233)
Middle 12 (92.3) 11 (73.3) 23 (82.1)
Low 0 (0) 3 (20.0) 3 (10.7)

Experience visiting forest therapy sites No 7 (53.8) 12 (80.0) 19 (67.9) 2.184 (0.139)
Yes 6 (46.2) 3 (20.0) 9 (32.1)

Experience with forest therapy programs No 10 (76.9) 14 (93.3) 24 (85.7) 1.532 (0.216)
yes 3 (23.1) 1 (6.7) 4 (14.3)

Prior participation in meditation No 7 (53.8) 11 (73.3) 18 (64.3) 1.152 (0.283)
yes 6 (46.2) 4 (26.7) 10 (35.7)

Table 4

Comparison of groups at the baseline

Variable Group N M(SD) t (p)
PSS Experimental 13 1.92 (0.45) 1.575 (0.127)
Control 15 1.63 (0.51) Cohen’s d = 0.60

PANAS Experimental 13 3.28 (0.52) 0.835 (0.411)
Control 15 3.44 (0.51) Cohen’s d = 0.31

CNS Experimental 13 3.53 (0.81) 0.708 (0.485)
Control 15 3.36 (0.43) Cohen’s d = 0.26

SCS Experimental 13 3.50 (0.60) 0.059 (0.953)
Control 15 3.49 (0.39) Cohen’s d = 0.20

Cortisol Experimental 13 5.17 (9.18) 0.769 (0.456)
Control 15 3.18 (1.88) Cohen’s d = 0.30

Footnotes:

- PSS: Perceived Stress Scale. PANAS: Positive and Negative Affect Scale. CNS: Connectedness to Nature Scale. SCS: Self-Compassion Scale.

- M: Mean score. SD: Standard deviation; t (p). t-test and p-value for baseline group comparisons.

- Cohen’s d: Represents effect size, where values of approximately 0.2 indicate small effects, 0.5 medium effects, and 0.8 or above large effects.

- Significance level: p < .05. No baseline differences were significant.

Table 5

Changes and differences in outcome variables between and within groups

Variable Group Pre 1st Post 2nd Post Time Within Group Group × time



M SE M SE M SE
PSS Experimental 19.15a 1.34 16.69 1.30 14.84b 1.26 F = 6.213, p = .007** F = 4.529, p = .022*ηp2 = 0.148

Control 16.26 1.25 15.93 1.21 16.13 1.18 F = 0.104, p = .820

PANAS Experimental 32.77c 1.43 37.42d 1.37 38.12 e 1.17 F = 6.437, p = .006** F = 4.928, p = .011*
ηp2 = 0.159

Control 34.40 1.33 35.03 1.27 34.17 1.08 F = 0.424, p = .659

Positive affect Experimental 25.00 1.83 28.85 1.99 30.15 1.84 F = 3.378, p = .051 F = 3.556, p = .036*
ηp2 = 0.120

Control 27.67 1.70 26.73 1.85 26.40 1.71 F = 0.385, p = .684

Negative affect Experimental 19.46f 2.38 14.00g 1.57 13.92 1.54 F = 5.509, p = 0.024* F = 1.905, p = .172

Control 18.86 2.21 16.67 1.46 18.07 1.43 F = 0.954, p = .370

Cortisol Experimental 5.17 1.77 2.52 1.07 1.31 0.21 F =2.279, p = .151 F = 0.971, p = .352

Control 3.18 1.65 2.13 1.00 1.83 0.19 F = 3.048, p = 0.086

M: Mean of total score. SD: Standard deviation. PANAS: Based on positive affect. Bonferroni: a > b, c < d, c < e, f > g (p < .05).

Table 6

Changes in cortisol levels across pre-test and post-test

Variable Group Post test-pretest Mean rank Sum rank z p
Cortisol Experimental (n = 13) Negative ranks 8.78 79.00 −2.341 0.019*
Positive ranks 3.00 12.00

Control (n = 15) Negative ranks 7.55 83.00 −1.306 0.191
Positive ranks 9.25 37.00

Table 7

Changes and differences in connectedness to nature

Variable Group Pre 1st Post 2nd Post Time Within Group Group × time



M SE M SE M SE
Connectedness to nature Experimental 35.31a 1.76 39.46b 2.01 42.69c 1.72 F = 6.205, p = .007** F = 3.678, p = .042*
ηp2 = 0.124

Control 33.60 1.64 35.13 1.87 34.93 1.60 F = 1.340
p = .278

Self-compassion Experimental 42.00 1.65 42.23 1.40 44.46 1.36 F = 1.751, p = .195 F = 4.046, p = .023*
ηp2 = 0.135

Control 41.87 1.54 41.93 1.30 40.53 1.27 F = 3.171, p = .057

M: Mean of total score. SD: Standard deviation. Bonferroni: a < b, a < c (p < .05).