Exploring the use of nature as an adjunct to psychological interventions for depression in young populations

Abstract

Depression in adolescence is a global priority and it is critical to identify effective and accessible interventions. This systematic review aimed to synthesise experimental research on nature-based interventions (NBIs), to determine effects on depressive symptoms in young people. The secondary research question sought to understand characteristics of effective NBIs. A comprehensive systematic search was conducted across major and grey literature databases and papers were screened according to specified criteria. Participants’ ages were required to be between 10 and 24 years and studies needed to use an experimental design, including a control group. Experimental conditions were defined by psychotherapeutic interventions with nature exposure and outcomes measured either clinical symptomatology or subjective states of depression. Ten papers were identified, quality assessed and summarised in a narrative synthesis. Thirteen significant effects were reported in nine studies, highlighting the potential for NBIs as effective interventions for depressive symptoms in young people. However, due to methodological biases, such as lack of randomisation or control over group differences and frequent use of passive control groups, there remains considerable uncertainty over the effectiveness of NBIs. Characteristics of effective NBIs are tentatively discussed, however, further work is needed to clarify which aspects specifically contribute to the beneficial effects observed. Future research should seek to address the limitations of small samples, selection biases and test NBIs against more comparable and evidence-based interventions. It is hoped future studies will consider the inclusion of clinical populations, to explore the utility of NBIs as a treatment option for adolescent depression.