AnxietyNCT07422545
The Effectiveness of Nature-Based Therapies for Anxiety and Depression in Adolescents
A study testing Nature-Based Therapy in people with Anxiety and Depression, run by Muş Alparslan University at 1 site in Turkey (Türkiye).
Trial summary
This three-phase study first assesses the prevalence of anxiety and depressive symptoms among adolescents, then evaluates the effectiveness of a randomized controlled nature-based therapy intervention. Read more about this study
- Who is it for?
- Ages 14 to 18 yearsHealthy volunteers can take part
- Conditions the study is for
- Anxiety, Depression
- What is being tested?
- Nature-Based Therapy
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Jan 2025to 3 Nov 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 14 to 18 years
- All sexes
- Healthy volunteers accepted
- Child, Adult
Who may be able to join
- Adolescents within the defined age range of the study
- Not having a psychiatric diagnosis
- Not receiving psychological or psychiatric support
- Not having a physical disability that would limit participation in therapy sessions
- Having obtained parental consent to participate in the study
Who cannot join
- Presence of severe psychiatric disorders requiring immediate clinical intervention (e.g., psychosis, severe suicidal risk)
- Ongoing intensive psychological or psychiatric treatment during the study period
- Physical or medical conditions limiting participation in outdoor activities
- Cognitive impairments preventing comprehension of intervention activities
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Outdoor Natural Settings (Nature-Based Therapy Sites)
Muş, Muş, 49100
About this study
Official title: Development and Evaluation of the Effectiveness of Nature-Based Therapies in the Treatment of Anxiety and Depression Symptoms: An Adolescent Population Sample
This three-phase study first assesses the prevalence of anxiety and depressive symptoms among adolescents, then evaluates the effectiveness of a randomized controlled nature-based therapy intervention. The final phase explores emotional, behavioral, and psychosocial changes through qualitative interviews with parents of adolescents in the intervention group. The study aims to provide evidence for nature-based therapies as effective complementary interventions for adolescent mental health.
Read the detailed description
This study aims to determine the prevalence of anxiety and depressive symptoms among adolescents, evaluate the effectiveness of a structured nature-based therapy (NBT) intervention, and explore psychosocial changes observed in adolescents through parental perspectives. Adolescence represents a critical developmental period marked by intense biological, emotional, and cognitive transitions that increase vulnerability to internalizing disorders such as anxiety and depression. When not addressed early, these symptoms may persist into adulthood and result in long-term psychological impairment.
The research is conducted using a three-phase mixed-methods design. In the first phase, a large-scale screening is implemented to assess the prevalence of anxiety and depressive symptoms within the adolescent population using standardized psychological assessment tools. This stage aims to identify individuals at elevated risk and determine eligibility for the intervention phase.
The second phase consists of a randomized controlled trial in which eligible participants are randomly assigned to either an experimental group receiving the nature-based therapy program or a control group receiving standard follow-up without therapeutic intervention. The nature-based therapy program is delivered in natural outdoor environments and incorporates experiential activities, group-based therapeutic exercises, emotional regulation practices, mindfulness-oriented techniques, and reflective components. The intervention is designed to enhance psychological well-being, reduce stress, improve emotional coping skills, strengthen social interaction, and promote adaptive functioning. Anxiety and depression levels are assessed at baseline, post-intervention, and follow-up to evaluate treatment effectiveness.
The third phase involves qualitative semi-structured interviews conducted with parents of adolescents who participated in the intervention group. These interviews aim to explore observed emotional, behavioral, social, and relational changes in adolescents following the therapy process. This qualitative component provides an in-depth understanding of therapeutic outcomes and supports the quantitative findings through parental observations.
Primary outcome measures include changes in anxiety and depressive symptom severity, while secondary outcomes focus on improvements in emotional regulation, psychosocial functioning, and overall psychological well-being. It is hypothesized that adolescents participating in the nature-based therapy program will demonstrate significant symptom reduction and enhanced psychosocial outcomes compared to the control group.
This study seeks to contribute robust empirical evidence regarding the clinical effectiveness of nature-based therapeutic interventions for adolescent mental health and to support their integration as accessible, holistic, and developmentally appropriate treatment approaches within mental health services.
- Conditions
- Anxiety, Depression
- Being tested
- Nature-Based Therapy
- Keywords
- Nature-based therapy, anxiety, depression, adolescent, prevalence
- Medical subject headings
- Anxiety Disorders, Depression
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Nature-Based TherapyBehavioural
The nature-based therapy program is a structured psychosocial intervention conducted in outdoor natural environments for adolescents experiencing anxiety and depressive symptoms. The program combines experiential activities in nature with therapeutic techniques including emotional regulation practices, mindfulness-based exercises, reflective discussions, and group-based interactions. Sessions emphasize active engagement with natural surroundings to support stress reduction, emotional awareness, attention regulation, and social connectedness. Therapeutic components aim to strengthen adaptive coping strategies, enhance psychological resilience, and improve interpersonal functioning within a supportive group setting. The intervention follows a standardized session framework to ensure consistency while allowing flexibility based on developmental needs.
| Study group | Role | What they receive |
|---|---|---|
| Nature-Based Therapy Intervention Group | Experimental | Participants assigned to this arm will receive a structured nature-based therapy program delivered in outdoor natural environments. The intervention includes experiential therapeutic activities, emotional regulation exercises, mindfulness-based practices, and group interaction sessions aimed at reducing anxiety and depressive symptoms and improving psychosocial functioning. Receives: Behavioral: Nature-Based Therapy |
| Control Group | No intervention | Participants assigned to the control group will not receive the nature-based therapy intervention during the study period and will continue with their usual daily routines. They will undergo the same assessment schedule as the intervention group, including baseline, post-intervention, and follow-up measurements to allow for comparative evaluation of outcomes. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Anxiety and Depression Symptom Severity
Changes in anxiety and depressive symptom severity will be assessed using standardized psychological assessment scales administered at baseline, post-intervention, and follow-up to evaluate the effectiveness of the nature-based therapy program.
Measured: Baseline (22.06.2025), post-intervention (27.07.2025), and Follow-up (27.10.2025) (Exactly 3 months after the last intervention program.)
Secondary outcomes (1)
Change in Environmental Attitudes Toward Nature
Change in adolescents' environmental attitudes and responsible environmental behaviors will be assessed using the Environmental Behavior Scale for Middle and High School Students, developed by Ardahan (2022). This self-report instrument consists of 13 items and 3 subscales designed to measure environmentally responsible behaviors and daily habits related to nature. Items are rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Higher total scores indicate greater environmental sensitivity and more frequent pro-environmental behaviors. The unit of measure is total score change from baseline to post-intervention and follow-up. The scale has demonstrated good internal consistency (Cronbach's alpha = 0.88).
Measured: Baseline (22.06.2025), post-intervention (27.07.2025), and follow-up (27.10.2025) (Exactly 3 months after the last intervention program.)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Feb 2026
- Study start1 Jan 2025
- Primary completion3 Aug 2025
- Study completion3 Nov 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for AnxietyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- This study utilizes a three-phase mixed-methods design. The first phase involves a large-scale screening to determine the prevalence of anxiety and depressive symptoms among adolescents using standardized assessment tools. In the second phase, eligible participants are randomly assigned to either a nature-based therapy intervention group or a control group in a randomized controlled trial. The intervention is delivered in natural outdoor environments and includes experiential therapeutic activities and emotional regulation practices. Quantitative assessments are conducted at baseline, post-intervention, and follow-up. The third phase consists of semi-structured qualitative interviews with parents of adolescents in the intervention group to explore observed psychosocial changes following therapy.
- Masking
- None (open label)
- Enrolment
- 60 participants (actual)
Sponsor and investigators
- Lead sponsor
- Muş Alparslan University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Murat GENÇ, PhD, Principal investigator, Muş Alparslan University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07422545
- Sponsor's protocol ID
- MSU-SGLK-MG-01
- Status last verified
- Feb 2026
- First submitted
- 6 Feb 2026
- Last updated
- 20 Feb 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data will not be shared to protect participant confidentiality and in accordance with ethical research guidelines and informed consent agreements.
Publications
Cuijpers P, Sijbrandij M, Koole SL, Andersson G, Beekman AT, Reynolds CF 3rd. The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta-analysis of direct comparisons. World Psychiatry. 2013 Jun;12(2):137-48. doi: 10.1002/wps.20038.
PubMed 23737423Bratman GN, Hamilton JP, Daily GC. The impacts of nature experience on human cognitive function and mental health. Ann N Y Acad Sci. 2012 Feb;1249:118-36. doi: 10.1111/j.1749-6632.2011.06400.x. Epub 2012 Feb 9.
PubMed 22320203Ulrich, R. S., Simons, R. F., Losito, B. D., Fiorito, E., Miles, M. A., & Zelson, M. (1991). Stress recovery during exposure to natural and urban environments. Journal of environmental psychology, 11(3), 201-230.
Kaplan, R., & Kaplan, S. (1989). The experience of nature: A psychological perspective. Cambridge university press.
Hansen MM, Jones R, Tocchini K. Shinrin-Yoku (Forest Bathing) and Nature Therapy: A State-of-the-Art Review. Int J Environ Res Public Health. 2017 Jul 28;14(8):851. doi: 10.3390/ijerph14080851.
PubMed 28788101
Study at a glance
From the registry record, last updated by the sponsor on 20 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Development and Evaluation of the Effectiveness of Nature-Based Therapies in the Treatment of Anxiety and Depression Symptoms: An Adolescent Population Sample
- ClinicalTrials.gov ID
- NCT07422545
- Acronym / sponsor ID
- MSU-SGLK-MG-01
- Conditions
- Anxiety, Depression
- Keywords
- Nature-based therapy, anxiety, depression, adolescent, prevalence
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 60 participants (actual)
- Lead sponsor
- Muş Alparslan UniversityUniversity, hospital or other
- Study start
- 1 Jan 2025 (actual)
- Primary completion
- 3 Aug 2025 (actual)
- Study completion
- 3 Nov 2025 (actual)
- First posted
- 20 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This three-phase study first assesses the prevalence of anxiety and depressive symptoms among adolescents, then evaluates the effectiveness of a randomized controlled nature-based therapy intervention. The final phase explores emotional, behavioral, and psychosocial changes through qualitative interviews with parents of adolescents in the intervention group. The study aims to provide evidence for nature-based therapies as effective complementary interventions for adolescent mental health.
Detailed description
This study aims to determine the prevalence of anxiety and depressive symptoms among adolescents, evaluate the effectiveness of a structured nature-based therapy (NBT) intervention, and explore psychosocial changes observed in adolescents through parental perspectives. Adolescence represents a critical developmental period marked by intense biological, emotional, and cognitive transitions that increase vulnerability to internalizing disorders such as anxiety and depression. When not addressed early, these symptoms may persist into adulthood and result in long-term psychological impairment.
The research is conducted using a three-phase mixed-methods design. In the first phase, a large-scale screening is implemented to assess the prevalence of anxiety and depressive symptoms within the adolescent population using standardized psychological assessment tools. This stage aims to identify individuals at elevated risk and determine eligibility for the intervention phase.
The second phase consists of a randomized controlled trial in which eligible participants are randomly assigned to either an experimental group receiving the nature-based therapy program or a control group receiving standard follow-up without therapeutic intervention. The nature-based therapy program is delivered in natural outdoor environments and incorporates experiential activities, group-based therapeutic exercises, emotional regulation practices, mindfulness-oriented techniques, and reflective components. The intervention is designed to enhance psychological well-being, reduce stress, improve emotional coping skills, strengthen social interaction, and promote adaptive functioning. Anxiety and depression levels are assessed at baseline, post-intervention, and follow-up to evaluate treatment effectiveness.
The third phase involves qualitative semi-structured interviews conducted with parents of adolescents who participated in the intervention group. These interviews aim to explore observed emotional, behavioral, social, and relational changes in adolescents following the therapy process. This qualitative component provides an in-depth understanding of therapeutic outcomes and supports the quantitative findings through parental observations.
Primary outcome measures include changes in anxiety and depressive symptom severity, while secondary outcomes focus on improvements in emotional regulation, psychosocial functioning, and overall psychological well-being. It is hypothesized that adolescents participating in the nature-based therapy program will demonstrate significant symptom reduction and enhanced psychosocial outcomes compared to the control group.
This study seeks to contribute robust empirical evidence regarding the clinical effectiveness of nature-based therapeutic interventions for adolescent mental health and to support their integration as accessible, holistic, and developmentally appropriate treatment approaches within mental health services.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- This study utilizes a three-phase mixed-methods design. The first phase involves a large-scale screening to determine the prevalence of anxiety and depressive symptoms among adolescents using standardized assessment tools. In the second phase, eligible participants are randomly assigned to either a nature-based therapy intervention group or a control group in a randomized controlled trial. The intervention is delivered in natural outdoor environments and includes experiential therapeutic activities and emotional regulation practices. Quantitative assessments are conducted at baseline, post-intervention, and follow-up. The third phase consists of semi-structured qualitative interviews with parents of adolescents in the intervention group to explore observed psychosocial changes following therapy.
| Arm | Type | Receives |
|---|---|---|
| Nature-Based Therapy Intervention Group | Experimental | Behavioral: Nature-Based TherapyParticipants assigned to this arm will receive a structured nature-based therapy program delivered in outdoor natural environments. The intervention includes experiential therapeutic activities, emotional regulation exercises, mindfulness-based practices, and group interaction sessions aimed at reducing anxiety and depressive symptoms and improving psychosocial functioning. |
| Control Group | No intervention | –Participants assigned to the control group will not receive the nature-based therapy intervention during the study period and will continue with their usual daily routines. They will undergo the same assessment schedule as the intervention group, including baseline, post-intervention, and follow-up measurements to allow for comparative evaluation of outcomes. |
Who may qualify
- Ages
- 14 to 18 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult
Key inclusion criteria (5 listed)
- Adolescents within the defined age range of the study
- Not having a psychiatric diagnosis
- Not receiving psychological or psychiatric support
- Not having a physical disability that would limit participation in therapy sessions
- Having obtained parental consent to participate in the study
Key exclusion criteria (4 listed)
- Presence of severe psychiatric disorders requiring immediate clinical intervention (e.g., psychosis, severe suicidal risk)
- Ongoing intensive psychological or psychiatric treatment during the study period
- Physical or medical conditions limiting participation in outdoor activities
- Cognitive impairments preventing comprehension of intervention activities
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Nature-Based TherapyThe nature-based therapy program is a structured psychosocial intervention conducted in outdoor natural environments for adolescents experiencing anxiety and depressive symptoms. The program combines experiential activities in nature with therapeutic techniques including emotional regulation practices, mindfulness-based exercises, reflective discussions, and group-based interactions. Sessions emphasize active engagement with natural surroundings to support stress reduction, emotional awareness, attention regulation, and social connectedness. Therapeutic components aim to strengthen adaptive coping strategies, enhance psychological resilience, and improve interpersonal functioning within a supportive group setting. The intervention follows a standardized session framework to ensure consistency while allowing flexibility based on developmental needs. | Behavioural | Nature-Based Therapy Intervention Group |
Primary outcome
Anxiety and Depression Symptom Severity
Time frame: Baseline (22.06.2025), post-intervention (27.07.2025), and Follow-up (27.10.2025) (Exactly 3 months after the last intervention program.)
Changes in anxiety and depressive symptom severity will be assessed using standardized psychological assessment scales administered at baseline, post-intervention, and follow-up to evaluate the effectiveness of the nature-based therapy program.
1 secondary outcome
Change in Environmental Attitudes Toward Nature
Time frame: Baseline (22.06.2025), post-intervention (27.07.2025), and follow-up (27.10.2025) (Exactly 3 months after the last intervention program.)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 Feb 2026.
- Results publication: PubMed 23737423Cuijpers P, Sijbrandij M, Koole SL, Andersson G, Beekman AT, Reynolds CF 3rd. The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta-analysis of direct comparisons. World Psychiatry. 2013 Jun;12(2):137-48. doi: 10.1002/wps.20038.
- Results publication: PubMed 22320203Bratman GN, Hamilton JP, Daily GC. The impacts of nature experience on human cognitive function and mental health. Ann N Y Acad Sci. 2012 Feb;1249:118-36. doi: 10.1111/j.1749-6632.2011.06400.x. Epub 2012 Feb 9.
- Results publicationUlrich, R. S., Simons, R. F., Losito, B. D., Fiorito, E., Miles, M. A., & Zelson, M. (1991). Stress recovery during exposure to natural and urban environments. Journal of environmental psychology, 11(3), 201-230.
- Results publicationKaplan, R., & Kaplan, S. (1989). The experience of nature: A psychological perspective. Cambridge university press.
- Results publication: PubMed 28788101Hansen MM, Jones R, Tocchini K. Shinrin-Yoku (Forest Bathing) and Nature Therapy: A State-of-the-Art Review. Int J Environ Res Public Health. 2017 Jul 28;14(8):851. doi: 10.3390/ijerph14080851.
- Individual participant dataSharing planned: No. Individual participant data will not be shared to protect participant confidentiality and in accordance with ethical research guidelines and informed consent agreements.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Murat GENÇ, PhD principal investigator
Muş Alparslan University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Nature-Based Therapy in people with Anxiety and Depression, run by Muş Alparslan University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 20 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Anxiety and Depression Symptom Severity (time frame: Baseline (22.06.2025), post-intervention (27.07.2025), and Follow-up (27.10.2025) (Exactly 3 months after the last intervention program.)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07422545, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Feb 2026.