There is a wide and diverse evidence base for ecotherapy theory and practice. Below we list only recent, peer-reviewed scientific papers appropriate for General Practitioners and referring therapists and health care workers. We can also provide evidence from the social and psychological science sectors, as well as material from outdoor education and ecopsychology. Please email us if you have specific evidence enquiries.


References for Health Care Professionals (2000 – 2014)

Annerstedt M and Währborg P (2011) Nature-assisted therapy: systematic review of controlled and observational studies. Scandinavian Journal of Public Health 39, 371–388

Antonioli C and Reveley M (2005) Randomised controlled trial of animal facilitated therapy with dolphins in the treatment of depression. British Medical Journal 331 (7527) 1231-1234

Astell-Burt T, Mitchell R and Hartig T (2014) The association between green space and mental health varies across the lifecourse. A longitudinal study. Journal of Epidemiology and Community Health 68 (5) 578-583

Barton J and J Pretty (2010) What is the best dose of nature and green exercise for improving mental health? A multi-study analysis. Environmental Science and Technology 44, 3947-3955

Berman M, Jonides J, and Kaplan S (2008) The cognitive benefits of interacting with nature. Physiological Science 19 (12) 1207-1212

Berman M G Kross E and Jonides J (2012) Interacting with nature improves cognition and affect for individuals with depression. Journal of Affective Disorders 140 (3) 300-305

Berto R (2005) Exposure to restorative environments helps restore attentional capacity. Journal of Environmental Psychology 25 (3) 249-259

Bowler D, Buyung-Ali L, Knight T and Pullin A (2010) A systematic review of evidence for the added benefits to health of exposure to natural environments. BMC Public Health 10 (456) 1-10

Cimprich B and Ronis D (2003) An environmental intervention to restore attention in women with newly diagnosed breast cancer. Cancer Nursing 26 284–292

Coon J Thompson, Boddy K, Stein K, Whear R, Barton J, and Depledge M (2011) Does participating in physical activity in outdoor natural environments have a greater effect on physical and mental wellbeing than physical activity indoors? A systematic review. Environmental Science and Technology 45, 1761-1773

Dallimer M, Irvine K, Skinner A, Davies Z, Rouquette J, Maltby L, Warren P, Armsworth P, and Gaston K (2012). Biodiversity and the feel-good factor: understanding associations between self-reported human well-being and species richness. BioScience 62, 47–55.

Diette G, Lechtzin N, Haponik E, Devrotes A and Rubin H (2003). Distraction therapy with nature sights and sounds reduces pain during flexible bronchoscopy – a complementary approach to routine analgesia. Chest Journal 123 941–48

Elley C, Kerse N, Arroll B, and Robinson E (2003) Effectiveness of counselling patients on physical activity in general practice: cluster randomised control trial. British Journal of General Practice 326 (7393), 793-796

Fuller R, Irvine K, Devine-Wright P, Warren P and Gaston K (2007) Psychological benefits of green space increase with biodiversity. Biological Letters 3: 390-394

Gonzalez M, Hartig T, Patil G, Martinsen E and Kirkevold M (2010) Therapeutic horticulture in clinical depression: a prospective study of active components. Journal of Advanced Nursing, 66 (9) 2002–2013

Grant C, Goodenough T, Harvey I and Hine C ( 2000) A randomised controlled trial and economic evaluation of a referrals facilitator between primary care and the voluntary sector. British Medical Journal 320 (7232) 419-423

Grayer J, Cape J, Orpwood L, Leibowitz J and Buszewicz M (2008) Facilitating access to voluntary and community services for patients with psychosocial problems: a before-after evaluation. BMC Family Practice 9 (1) 27-36.

Hartig T, Mitchell R, de Vries S and Frumkin H (2014) Nature and health. Annual Review of Public Health 35, 207-228

Kuo F and Taylor A (2004) A potential natural treatment for Attention-Deficit/Hyperactivity Disorder: evidence from a national study. American Journal of Public Health 94 (9) 1580-1586

Lachowycz K and Jones A (2011) Greenspace and obesity: a systematic review of the evidence. Obesity Reviews 12, e183–e189

Leung W, Ashton T, Kolt G, Schofield G, Garrett N, Kerse N and Patel A (2012) Cost- effectiveness of pedometer-based versus time-based Green Prescriptions: the Healthy Steps Study. Australian Journal of Primary Health 18 (3) 204-211

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

Lovell R, Wheeler B, Higgins S, Irvine K, Depledge M (2014) A systematic review of the health and well-being benefits of biodiverse environments. Journal of Toxicology and Environmental Health Part B 17, 1–20

Maas J, Verheij R, de Vries S, Spreeuwenberg P, Schellevis F and Groenewegen P (2009) Morbidity is related to a green living environment. Journal Of Epidemiology And Community Health 63 (12) 967-973

Maller C, Townsend M, Pryor A, Brown P, and St. Leger L (2005) Healthy nature healthy people: ‘contact with nature’ as an upstream health promotion intervention for populations. Health Promotion International 21: 45-54

Mao G-X, Cao Y-B, Lan X-G, He Z-H, Chen Z-M, Wang Y-Z, Hu X-L, Lv Y-D, Wang G-F, and Yan J (2012) Therapeutic effect of forest bathing on human hypertension in the elderly. Journal of Cardiology 60 (5-6) 495-502

Mitchell R and Popham F (2008) Effect of exposure to natural environment on health inequalities: an observational population study. The Lancet 372 (9650) 1655-1660

Sugiyama T, Leslie E, Giles-Corti B and Owen N (2008) Associations of neighbourhood greenness with physical and mental health: do walking, social coherence and local social interaction explain the relationships? Journal of Epidemiology and Community Health 62 (5) e9

Swinburn B, Walter L, Arroll B, Tilyard M, and Russell D (1997) Green prescriptions: attitudes and perceptions of general practitioners towards prescribing exercise. British Journal of General Practice 47, 567-569

van den Berg A and Clusters M (2011) Gardening promotes neuroendocrine and affective restoration from stress. Journal of Health Psychology 16, 3-11

Wheeler B, White M, Stahl-Timmins W, Depledge M (2012) Does living by the coast improve health and wellbeing? Health and Place 18 (5) 1198-1201