Can nature-based therapies heal people and the planet? Study investigates holistic solutions

Apr 9 2025

Can nature heal more than just the individual? A groundbreaking scoping review protocol sets out to map how green interventions influence well-being at personal, societal, and ecological levels.

 Nature-based interventions for individual, collective and planetary wellbeing: A protocol for a scoping review. Image Credit: ullision / Shutterstock

In a recent study published in the journal PLOS ONE, researchers at Swansea University, Wales, described a scoping review protocol to synthesize evidence on the impact of nature-based interventions (NBIs) on individual, collective, and planetary well-being.

NBIs are interventions that leverage exposure to nature to improve human health and well-being. Besides, there is an opportunity to align them to promote planetary well-being. Several reviews have investigated the links between well-being and NBIs, typically focusing on narrow, individualistic conceptions. However, this approach reinforces neoliberal ideologies, stripping away socioecological contexts and isolating the individual from nature and community.

The Study

In the present study, researchers developed a protocol for a scoping review to synthesize evidence on the impact of NBIs across different well-being domains. The review will take approximately 12 months to complete, starting in October 2024. It will be informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews and Joanna Briggs Institute (JBI) methodology for scoping reviews.

Further, the protocol will involve five stages: identifying the research question, identifying relevant studies, study selection, data charting, and collating, summarizing, and reporting results. Research questions will be developed according to the JBI-recommended population, context, and concept framework. The main research question is how well-being has been conceptualized in works on NBIs.

Additional questions include when and how well-being arises from NBIs, what outcomes have been measured, what populations have been studied, what types of NBIs have been delivered (e.g., forest therapy, horticultural therapy, green exercise), and what theoretical frameworks underpin the research in this domain. The search strategy to identify relevant studies will be informed by JBI guidelines and a methodology proposed by another research group.

Consultation exercises will be held in two phases to develop a list of search terms related to NBIs and well-being, ensuring alignment with socioecological perspectives. In the first phase, an initial set of terms will be generated from the literature. In the second phase, search terms will be input into four databases (Scopus, Medline, APA PsycINFO, and Web of Science), and the resulting records will be collected. Unpublished dissertations will be identified from the ProQuest Dissertations and Theses Global database.

Studies will not be excluded based on participant characteristics. Further, studies must include deliberate exposure of participants to natural environments. Equine-assisted therapies in woodlands will be selected, while dog-assisted therapies in hospitals will be excluded as they do not represent exposure to the natural environment. The concept of well-being will be informed by social-ecological models of well-being, including the GENIAL framework’s biopsychosocial-ecological perspective, recognizing the breadth of domains.

These include the well-being of an individual, community-related measures, and measures of the health of planetary ecosystems and pro-environmental behaviors, including biodiversity conservation, which supports ecosystem services essential for human physical and mental health. Only peer-reviewed studies and theses will be included, with no restrictions on study design or methodology; grey literature will be excluded to maintain methodological consistency with scoping review standards. Following deduplication, titles and abstracts of the remaining texts will be screened; in this pilot exercise, each author will review 25 studies, and all authors will convene to compare studies.

Besides, at least 75% consensus will be needed to proceed with full screening protocols. Further, two independent reviewers will complete data extraction using a data charting form. The following data will be extracted: general study information (publication year, title, population demographics, and findings), the context (geographic location and targeted population), and concepts (NBI characteristics and well-being outcomes).

Subsequently, a consultation exercise will be held to review the suitability of the data analysis and presentation. Risk of bias assessments will not be included. Data synthesis and presentation will follow the multi-domain approach to well-being, informed by the GENIAL framework to integrate biological, psychological, social, and ecological dimensions. Quantitative synthesis will involve graphical and tabular summaries.

This will illustrate imbalances in study distribution across NBI type, methodology, theoretical framework, geographic location, psychotherapeutic approach, population, and outcome. Further, a narrative synthesis will assess how well-being is conceptualized and measured, and dual-display tables will synthesize qualitative and quantitative results across well-being domains. Overall, data synthesis will answer the questions proposed in the first stage.

Importantly, this protocol is situated within the emerging “third wave of positive psychology,” which emphasizes systemic and ecological approaches to human flourishing.

Conclusions

In sum, the study presented a protocol to provide a comprehensive overview of research on NBIs aimed at improving well-being. This will augment understanding of how different NBIs impact collective, planetary, and individual well-being through a systemic lens. Moreover, this review could support the development of interventions focused on well-being, with emphasis on better managing the intertwined “wicked problems,” defined as complex, interconnected challenges such as climate change and biodiversity loss, associated with ecological and planetary health.