Depression and anxiety: A systematic review on comparing ecotherapy with cognitive behavioral therapy

The positive effects of nature on people's mental health are not only relevant for boosting their lifestyles, but could also play a role in the treatment of mental illness. To this end, the following systematic review investigates whether ecotherapy can achieve similar success as conventional cognitive-behavioral psychotherapy with regard to the treatment of depression and anxiety disorders, and whether an integration of the two approaches might be useful. Search was conducted in several relevant databases. Following the PRISMA guidelines, forty-two articles were identified and integrated into the review after applying defined exclusion criteria. Overall, ecotherapy approaches were found to provide similar improvements in terms of short-term effects for depression as conventional psychotherapy. For anxiety disorders, there were also improvements, but data quality was low so that conclusive comparisons between ecotherapy and conventional psychotherapy are difficult to make. We discuss the potential for interventions assessing long-term effects of ecotherapy and possible use for short terms symptom reduction of ecotherapy.