Depressive Symptoms May Improve More Outdoors Than Indoors or Control During Mindfulness-Based Behavioral Activation

Nature-based therapy (NBT) has been growing as a therapeutic option and has demonstrated effectiveness in addressing numerous mental health issues. However, many NBT study designs are limited in their external validity because the intervention is complicated and time intensive, appropriate comparison groups are not included, and the effect of nature cannot be isolated. Using Behavioral Activation with Mindfulness exercises, this study uses three treatment conditions (Outdoor, Indoor, Control) to isolate the effect of nature. While taking part in physical activity, participants in the active treatment conditions are taught four mindfulness exercises in either an outdoor or indoor setting. Using linear mixed models analyses, results indicate that the Outdoor condition may have more impact on improvement of depressive symptoms, connectedness to nature, and mindfulness than Indoor and Control. Implications for clinicians and future research directions are discussed.