To advance the theoretical and practical underpinnings for nature therapies, i.e. nature exposure as a means to improve mental health, we compared the most memorable sensory experiences reported by forest tourists in Australia, Chile, China and Japan. Sensory experiences are a fundamental driver of the psychological effects of nature exposure.
We first reviewed relevant research from each country and language. We then conducted 100 on-site interviews in Australia, 100 in Chile, and >500 in China, and compiled 1000 relevant social media posts from Japan. We analysed these datasets using directed-content qualitative thematic analyses, both in original languages and in translated texts, and compared outcomes from each country.
The key sensory experiences are universal: sights of plant shapes and colours; sounds of birdsong, running water and rustling leaves; smells of flowers, trees, and earth; taste and temperature of clean air and water; and touch of bark and rocks. Participants gave detailed descriptions of each. These fine-grained but widespread experiences are our principal finding.
These sensory experiences are at a scale that is broad enough to apply for prescriptible nature therapies in any forested region, but fine enough to be used in future quantitative research to test therapeutic designs, doses and durations. This distinguishes them from prior research, that is either too broad or too fine in scale for practical therapy design.
Future research aiming to maximise the mental health benefits of nature may not need to distinguish different countries and cultures, but may need to differentiate nature experiences more finely and precisely than in most therapy-related research to date.

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1 INTRODUCTION

Nature therapy is exposure to nature in order to improve health. Human mental health is declining worldwide (Ferrari et al., 2024), and efforts are under way to create nature therapy products that can be prescribed by medical practitioners and funded by medical insurance. To date, the outcomes of nature exposure are quantified, but mechanisms (Buckley, Zhang, et al., 2024; Buckley, Zhong, et al., 2024) and motivations (Astell-Burt et al., 2024) are not. Detailed data are needed for product design and reliability (Astell-Burt et al., 2023). Nature therapies act via the senses, biochemically and neurologically, to create psychological outcomes (Kühn & Gallinat, 2024; Sacchelli et al., 2020; White et al., 2023). This contrasts with drug therapies, which are biochemical, and counselling, which exerts psychological effects through language. Different sensory experiences create different effects, in the same way as different drugs or counselling. Before we can measure effect sizes across populations, we first need to know what specific sensory experiences to test (Zhong et al., 2024). Our aim here is to identify those experiences.

Poor mental health is widespread, affecting 10% of the world's population prior to the COVID-19 pandemic, and 30%–40% during peak pandemic (Brülhart et al., 2021; Santomauro et al., 2021). Mental health is also worsening: between 2010 and 2021, best estimates of mean global age-standardised DALY's, disability-adjusted life-years, increased by 16.7% for anxiety, and 16.4% for depressive disorders (Ferrari et al., 2024). Mental ill health has high economic costs, >10% of global GDP pre-pandemic and higher currently; and treatment is underfunded. Therefore, mental healthcare has become of high importance and urgency internationally, and is considered as a crisis.

Nature-based psychotherapies provide one possible policy response to this mental health crisis. Nature therapies are defined broadly (Mazzoleni et al., 2024) as immersing oneself in nature to promote one's health. Nature therapies are used principally for mental health, but can also provide physical and social health, which can contribute in turn to mental health (White et al., 2023). There are many different designs, aspects and outcomes (Mazzoleni et al., 2024; White et al., 2023). Nature-based psychotherapies have several advantages over expansion of counselling and drug-based therapies: lower costs, more rapid implementation, and lower addiction risks (Astell-Burt et al., 2023; Buckley, Zhang, et al., 2024).

As for any new class of medical treatments, adoption of nature-based psychotherapies is a complex and extended process, involving multiple stages in research, development and management (Buckley, Zhang, et al., 2024). The three principal stages are: pure-research proof-of-concept; applied-research design of therapies; and practicalities of implementation. These stages apply for all prescriptible therapies, and cannot be shortcut. Rigorous and extensive evidence is required at each step, to safeguard patient health.

There is now extensive evidence for health benefits of nature exposure. This includes physical (Nguyen et al., 2023) and mental components (Bratman, Mehta, et al., 2024), for healthy (Astell-Burt et al., 2023) and unhealthy patients (Chun et al., 2017; Watkins-Martin et al., 2022) across multiple countries (White et al., 2021). Outcomes depend on individual nature connectedness (Chang et al., 2024; Dan-Rakedzon et al., 2024) and preferences (Kachler et al., 2024), and on ecosystem characteristics (Clark et al., 2023; Výbošťok et al., 2024). There is less evidence as yet for dose (Shanahan et al., 2016; White et al., 2019), duration (Buckley & Westaway, 2020) and implementation (Astell-Burt et al., 2023; Buckley, 2023a; Buckley et al., 2022; Buckley, Zhang, et al., 2024; Buckley, Zhong, et al., 2024).

Here we focus on one component in the applied design stage: the sensory experiences of people visiting forests. Psychological mechanisms for mental health benefits from nature exposure are driven by sensory experiences (Bratman, Bembibre, et al., 2024; Buckley, Zhang, et al., 2024; Buckley, Zhong, et al., 2024; Kühn & Gallinat, 2024; Zhong et al., 2024), and most nature therapy research to date has been in forest ecosystems (Mazzoleni et al., 2024; Meneguzzo et al., 2021; Wen et al., 2019; Yau & Loke, 2020). Our aims were therefore to determine what principal sensory experiences are reported by forest visitors, as the next step in the design of nature therapies.

To contribute to development and implementation of nature therapies, evidence for this sensory component needs to be derived broadly, to be transferable to patients worldwide. We therefore conducted four separate studies, in Chile, Australia, Japan and China respectively, chosen for their practical adoption of nature therapies. At a scale appropriate for design of implementable nature-based psychotherapies, the four studies yielded very similar results, and we therefore present them jointly, to provide a basis for future research in this field.

2 RESEARCH FRAMEWORK

2.1 Evidence that nature can improve mental health

There is extensive evidence that nature exposure improves mental health (Bratman et al., 2019; Coventry et al., 2021; Derose et al., 2021; Jimenez et al., 2021; Kotera et al., 2022; Nguyen et al., 2023; Wen et al., 2019; White et al., 2023; Yeon et al., 2021). Evidence includes cognitive, affective, behavioural, physiological and neurological measures (Kühn et al., 2022; Meneguzzo et al., 2021; Sacchelli et al., 2020; Sudimac et al., 2022; Tost et al., 2019). Findings apply across: degrees of mental ill health (Besser, 2021; Chun et al., 2017; Tester-Jones et al., 2020; Yau & Loke, 2020); personalities (Martin et al., 2020; van Agteren et al., 2021); socioeconomic and demographic subgroups (Maes et al., 2021; Subirana-Malaret et al., 2023); and countries (Guardini et al., 2023; White et al., 2021).

Research on nature therapies has used five main methods, each with different contributions and limitations. Multi-year panels (Astell-Burt et al., 2023; Geary et al., 2023) have demonstrated importance for national-scale public health, but treated nature exposure as a single ‘lifestyle’ parameter, like smoking or drinking. Nature deprivation effects of pandemic lockdowns provided a population-scale intervention (Fisher et al., 2021). Geographical pattern analyses (Feng et al., 2023) show coupling with socioeconomic factors, but use green colour-wavelengths in aerial or satellite imagery as indicators of plant cover. Controlled experiments (Corazon et al., 2018; Ho et al., 2022; Watkins-Martin et al., 2022) have demonstrated that mental health improvements are driven specifically by nature exposure, but most have tested only brief local-scale interventions (Mazzoleni et al., 2024; Meneguzzo et al., 2021). Qualitative methods (Buckley, 2020, 2022b; Johansson et al., 2024b) reveal how psychological mechanisms are perceived by the people involved, and what aspects of nature are most important to them, but most have limited transferability.

2.2 Effects of dose and duration

These mental health benefits of nature exposure provide opportunities for mental health recovery post-pandemic (Santomauro et al., 2021), if nature-based psychotherapies can be incorporated into national healthcare systems (Astell-Burt et al., 2023, 2024). To achieve that, requires research on diagnosis, design, dose, and duration (Bélanger et al., 2019; Shanahan et al., 2016; White et al., 2019), in order to construct prescriptible and insurable products, which can then be tested for effectiveness and cost-effectiveness relative to existing mental health treatments such as counselling or chemotherapy. It also requires research on political, logistic and financial practicalities of implementation (Buckley et al., 2022; Buckley, Zhang, et al., 2024; Mobarak, 2022).

Regarding dose and duration, a meta-analysis by White et al. (2019) indicated that people need at least 2 h of any kind of nature exposure every week, indefinitely, to report any self-assessed gains in well-being. Many experimental tests of nature exposure, in contrast, have considered only single interventions as brief as 15 min (Mazzoleni et al., 2024). Participants in an intensive 12-week practical course of group outdoor hiking nature therapy in Australia, 5 h per week, reported immediate benefits and sustained behavioural change, in the healthcare sense that they continued self-treatment after the therapy course concluded (Buckley & Westaway, 2020). That program also incorporates peer support, personal challenge, and a social-purpose incentive, to minimise drop-out. It has been offered several times per year for over a decade, with over 100,000 participants in total to date.

2.3 Nature therapy design components

Design of functional nature-based psychotherapies requires reliable experimental data on mechanisms and outcomes. These include sensory and emotional components (Bratman, Bembibre, et al., 2024; Bratman, Mehta, et al., 2024); and post-treatment persistence or fade-out: how long effects may continue, once a fixed-length course of nature therapy is completed. Data are needed for different people, settings and activities (Astell-Burt et al., 2023; Buckley, 2023a). People differ in personality, life history, physical capabilities, mental states, and social support. Nature settings differ in climate, terrain, ecosystem, biodiversity, and plant and animal species. Activities differ in type, intensity, frequency and duration. Nature experiences may be solo or social, with or without guides or therapists. These factors are recognised, tested, and reviewed on occasion (Astell-Burt et al., 2023; Clark et al., 2023; Fisher et al., 2022; White et al., 2023), but not yet in enough detail to design therapies (Buckley, Zhang, et al., 2024).

Research to date has focussed largely on differences between individual people (Subirana-Malaret et al., 2023; van Agteren et al., 2021). There have been comparisons between: different components of human psychology, such as cognition or emotion (Bratman, Bembibre, et al., 2024; Bratman, Mehta, et al., 2024; Guardini et al., 2023; Maes et al., 2021; Meneguzzo et al., 2021); individuals in good or poor mental health (Buckley et al., 2019); different types of mental ill health (Besser, 2021; Tester-Jones et al., 2020); and individuals with different demographic parameters, socioeconomic circumstances, and access to and capability within nature (Bratman et al., 2019; Buckley et al., 2019; Subirana-Malaret et al., 2023).

There is less research comparing mental health outcomes for the same or similar people, but different nature experiences, such as different ecosystems (Hatty et al., 2022; Manero, 2023; Remme et al., 2021; Selinske et al., 2023; Subirana-Malaret et al., 2023; Turunen et al., 2023; Wyles et al., 2019; Yin et al., 2022) or activities (Buckley, 2022a; Johansson et al., 2024a; Turunen et al., 2023). Evidence to date shows that the mental health benefits of nature exposure increase with: exercise (Bélanger et al., 2019; Nguyen et al., 2023; Singh et al., 2023); peer support (Buckley & Westaway, 2020); nature connectedness (Barragan-Jason et al., 2022; Chang et al., 2024; Huynh et al., 2022), sensory engagement (Zhong et al., 2024), and higher biodiversity (Fisher et al., 2023; Stobbe et al., 2022).

To date, there is little experimental evidence on the persistence or fade-out of mental health benefits after a course of nature therapy, or the interactions between nature therapies and other treatments. There is also little evidence on the relative effects of group as compared to solo nature experiences (Buckley & Westaway, 2020), guided as compared to self-guided nature exposure (Kim & Shin, 2021; van den Berg & Beute, 2021), and adventurous as compared to contemplative nature-based activities (Buckley, 2022a, 2023b; Johansson et al., 2024a, 2024b). There is also limited evidence on the internal psychological and physiological mechanisms driving mental health benefits of nature exposure (Astell-Burt et al., 2023).

2.4 Frameworks for analysing nature therapy mechanisms

Recent research in this field has proposed several different frameworks for analysis of these mechanisms. The first was an ecosystem services approach (Bratman et al., 2019; Manero, 2023; Soga & Gaston, 2022, 2023). This approach also underlies economic valuations of nature conservation, and nature-based activities, via human mental health (Buckley et al., 2019, 2023; Buckley & Chauvenet, 2022; Grellier et al., 2024).

The second was a model derived from longstanding research in outdoor recreation and tourism (Buckley & Cooper, 2022), referred to in that literature as the senses-emotions-well-being framework (Zhong et al., 2024). Here we refer to this as a nature exposomics framework, by analogy with pollution exposomics (Vineis et al., 2020). It focusses on individual experiences as psychological drivers. The third, recently proposed, is referred to as a biopsychosocial framework (White et al., 2023). It focusses on patient outcomes, which it divides into physical (biological), mental (psychological) and social; and it frames these outcomes as three types of resilience, referred to as preventive, response, and recovery. The fourth approach is based on cognitive mapping (Dan-Rakedzon et al., 2024). These frameworks do not conflict, but each takes a different focus. Here we follow the nature exposomics framework, which considers how different sensory experiences can create different emotions and memories for different individuals.

2.5 Role of sensory experiences

Under the nature exposomics framework, the psychological mechanism of nature therapies is driven by moment-by-moment multi-sensory experiences of nature (Fisher et al., 2023; Zhong et al., 2024). Visitors to forest parks perceive strongly that senses drive emotions, and emotions drive subjective well-being (Zhong et al., 2024). For wildlife encounters, individual recollections focus on the intensity of sensory and emotional experiences (Buckley, 2022a; Johansson et al., 2024a). Sensory experiences reported by visitors to forest ecosystems in different countries include: sight (Nakadai, 2023); sound (Buxton et al., 2021; Cooper & Buckley, 2022; Francomano et al., 2022), notably birdsong (Echeverri et al., 2021; Ferraro et al., 2020; Hammoud et al., 2022; Stobbe et al., 2022); smell (Bentley et al., 2023; Bratman, Bembibre, et al., 2024; Khamsi, 2022), especially volatile organic chemicals (Antonelli et al., 2020; Mazzoleni et al., 2024); and touch (Ikei et al., 2017; Rickard & White, 2021). People in different cultures respond differently to scents, tastes, sounds, shapes, and colours (Duff et al., 2021; Majid et al., 2018).

Design of nature therapies therefore needs to consider what specific sensory experiences should be included. Sensory experiences, however, are too complex to quantify every parameter simultaneously. Sight includes lumens, colours, shapes and movements. Sound includes decibels, frequencies, chords, timing, and spatial origins (Sethi et al., 2020). Humans can distinguish over a million different scents (Shayya et al., 2022). Tastes include sweet, sour, salty, and bitter. Touch includes soft or hard, smooth or sharp. For quantitative trials, we first need qualitative research to determine which parameters of each sense are perceived as the most powerful parts of nature experiences. That is our goal here. It forms one small but critical step in adoption of nature-based psychotherapies within national healthcare systems.

3 METHODS

3.1 Data collection: Four country studies

We obtained data from separate studies in four countries, derived from 100 individual on-site interviews in Australia, 100 in Chile, and >500 in China, and 1000 online posts in Japan. Each study was substantially larger than required for theoretical saturation (Buckley, 2022b). For comparison, Johansson et al. (2024b) conducted 3 focus groups with 9–10 respondents each in Sweden; and Fisher et al. (2023) interviewed 194 visitors to two woodland areas in the UK. Data were collected during 2014–2023. All studies complied with relevant national and institutional human ethics protocols. An overriding Human Ethics protocol was approved by the Institutional Review Board of the lead author's university. Procedures for informed consents are described below for each country. All records were anonymous. No opinions were offered by the researchers. Each study was conducted in the official national language of that country, translated here. All four studies meet the reporting criteria for qualitative research prescribed by the American Psychological Association (APA, 2020) (Table 1).

TABLE 1. Compliance with American Psychological Association criteria for reporting primary qualitative research.

APA JARS-qual requirement	Study 1, Australia	Study 2, Chile	Study 3, China	Study 4, Japan
Introduction
Identify key issues/topic	Forest visitors' perceptions of sensory experiences contributing to their mental health
Acknowledge conflicts of interest	None	None	None	None
Problem/question/objectives	Need information on specific sensory experiences in order to quantify effects in future
Review and critique literature	International review and critique of multi-lingual research literature provided
Identify key issues	Section 1 shows key issues via place in overall development of nature psychotherapies
Clarify knowledge gaps	Section 1 also identifies knowledge gaps, in this case specific forest sensory experiences
Purpose of this study	In all 4 studies, purpose is to obtain sensory experiences identified by forest visitors
Target audience, if specific	Researchers, practitioners and policy-makers in nature and mental health
Rationale for design used	Qualitative design provides respondent descriptions in breadth and depth
Approach (e.g. interpretive)	Interpretive grounded theory across all 4 studies, no directed-content approach
Relation to prior publications	Prior publications do not identify specific sensory experiences across forest types
Methods
Researchers' demographics, culture	In each country, researchers have same demographics and culture as participants
Credentials, experience, training	Researchers have prior publications, qualitative methods training, field experience
Numbers of participants, documents	100 participants	100 participants	524 participants	1000 posts
Participant characteristics	Current (S1, 2, 3) or recent (S4) visitors to forest parks and reserves in each country
Data sources (e.g., internet)	Interviews	Interviews	Social media posts	Interviews
Interactions with participants	Study only	Study only	Study only	None
Any prior ethical considerations	None	None	None	None
Participant recruitment	Face-to-face in field	Face-to-face in field	Face-to-face in field	Recent park visitors
Incentives or compensation	None	None	Small courtesy gift	Not applicable
Ethics and consent	Approved protocol	Approved protocol	Approved protocol	Approved protocol
Any attrition, reasons	Single encounter	Single encounter	Single encounter	Not applicable
Rationale for endpoint (saturation)	Ample saturation	Ample saturation	Ample saturation	Ample saturation
How study portrayed to participants	Transparently	Transparently	Transparently	Not applicable
Participant selection (eg max variation)	All, within timeslot	All, within timeslot	Random, at sites	Recent visitors only
Inclusion/exclusion criteria	1 per group, family	1 per group, family	Agreed to interview	Degree of detail
Where data were collected	Subtropical parks	Temperate parks	25 parks nationwide	Temperate parks
Transferability of findings	Similar results from multiple countries, varied methods, therefore highly transferable
Form of data (interviews, media)	Interview quotes	Interview quotes	Interview quotes	Social media posts
Data collection protocol	Notes on site	Notes on site	Notes on site	Extracts from posts
Were others also present	Sometimes	Generally	Sometimes	Not applicable
Number of times data collected	Many per site	Several per site	Once per site	Once per post
Duration of data collection	3 years	7 years	1 year	1 year
Interview time duration	~15 min each	~15 min each	~15 min each	Not applicable
Content and form of questions	Spoken question		Spoken question	Topic selection
Recording methods, field notes	Written notes	Voice notes	Written responses	Translated extracts
Analytical methods (e.g., thematic)	Thematic coding	Thematic coding	Thematic coding	Thematic coding
Coding categories (emergent or a priori)	Emergent	Emergent	Emergent	Emergent
Analytic scheme (directed or emergent)	Emergent	Emergent	Emergent	Emergent
Illustrate/describe analytic scheme	Joint coding tree	Joint coding tree	Joint coding tree	Joint coding tree
Indicate software, if used	No software	No software	No software	No software
Adequacy of data relative to goals	Amply adequate	Amply adequate	Amply adequate	Amply adequate
Findings grounded in evidence	Quotes provided	Quotes provided	Quotes provided	Quotes provided
Findings insightful re literature	New data and insights on detailed forest sensory experiences, not in prior literature
Context (e.g., sites, participants)	Subtropical forests	Temperate forests	Multiple latitudes	Temperate forests
Reconcile any discrepancies	No discrepancies	No discrepancies	No discrepancies	No discrepancies
Consistency, consensus, auditing	Consistent results across studies, sites, researchers, and between participants in each
Triangulation of sources, investigators	Triangulation across countries, forest types, cultures, languages, data sources, methods
Thick or thin descriptions and data	Thick spoken data	Thick spoken data	Thin written data	Thin written data
Findings
Research findings (e.g., themes)	Same themes from all four studies, summarised jointly in coding tree, Table 3
Meaning and understandings	Straightforward set of forest sensory experiences across all four countries and cultures
Support findings via quotes, excerpts	Quotes	Quotes	Quotes	Excerpts
Synthesis via diagrams, tables	Synthesis of themes from all four studies illustrated in joint coding tree, Table 3
Central contributions and significance	Small set of specific forest sensory experiences that can now be tested quantitatively
How findings can be utilised	Basis for more detailed quantitative research, and also for design of forest therapies
Differences from prior theories	Matches sensory model of nature exposure; prior research localised, less specific
Strengths	Large samples; comparisons across countries and cultures; implementable scale
Limitations	Qualitative, so no quantitative comparison of importance, or population distribution
Scope of transferability	Likely to be transferable worldwide, though local checks also needed in new countries
Any ethical challenges	None	None	None	None
Future research, policy, practice	Proceed to next stages in quantitative research and therapy design as outlined in Section 1

3.2 Study 1, Australia

Australian data were obtained from semi-structured or unstructured conversational interviews with independent forest visitors, on self-guided hiking tracks in the subtropical national parks in the Queensland section of Gondwana Rainforests of Australia World Heritage Area. These included Lamington, Springbrook, and Burleigh Heads National Parks, which support subtropical rainforest on volcanic soils; and Mt Barney National Park, with dry sclerophyll woodland on granitic soils. Interviews were conducted from 2021 to 2023, in all seasons. A total of 100 interviews were conducted, in English. Copying the approach described by Buckley (2020, pp. 1415–1416), interviewees were approached at halting points such as lookouts, track junctions, rest sites, and creek crossings. The researcher began conversations by offering to assist with photographs, or with neutral observations on topics such as weather, wildlife, scenery, clothing or equipment, or activities. If the interviewee responded, the interviewer led the conversation to participants' sensory experiences, and to the mental health and well-being aspects of their visits, as per Zhong et al. (2024). Enquiries about sensory experiences included probing, if required, to include all senses. The research was described, and participant consents sought, within these conversational interviews, and reconfirmed at the closure of each, following the protocol described in detail by Buckley (2020, p. 1416).

3.3 Study 2, Chile

Chilean data were derived from semi-structured or unstructured participant conversations, in Spanish or English, with 100 hikers, in 5 national parks and 3 private conservation reserves in the cool temperate forests of southern Chile. The sites were: Patagonia, Puyehue, Chiloe, Cerro Castillo, and Torres del Paine National Parks, and Huilo Huilo, Tagua Tagua, and Pullao Wetlands private conservation reserves. Data were collected between 2014 and 2021, in all seasons except winter. Some of the respondents were hiking solo, others in groups. Some were self-guided, others had commercial tour guides. The researchers focussed conversations on participants' immediate sensory experiences across all senses, and on the mental health and well-being aspects of their visits. For guided groups, the researchers used the tour guides' interpretation to catalyse unobtrusive conversations with individual participants. The guides themselves were not included as participants. Informed consents, to use the content of conversations in research, were embedded in the conversations themselves.

3.4 Study 3, China

Chinese data were collected from 524 on-site, in-person interviews, in Chinese, in 25 forest reserves, located throughout the forested area of China, from the cool northeast to the tropical south and southwest. The desert, mountain, and high-altitude plateaux of the northwestern provinces do not support forest. The Forest Reserves were: Bangshan, Bamuqi, Bipenggou, Dagu, Dujiangyan, Echengshan, Guangwushan, Hebaoshan, Jiuzhaigou, Kalonggou, Laojunfeng, Langtang, Nazhigou, Micangshan, Qingchengshan, Riwu, Shennongjia, Shibayuetan, Shiqu, Wawushan, Xiangcheng, Xiling, Xishan, Yading and Zhendalugu. Interviews were conducted by a group of Chinese researchers directed and employed for the purpose by LSZ. They were conducted during 2021–2022, in all seasons depending on latitude and visitation patterns. The interviews were formal and structured, asking respondents to list experiences involving each of the primary senses in turn. Informed consents were obtained at the outset of each interview.

3.5 Study 4, Japan

For the Japanese component, we used a different design and data collection approach. The Japanese data were obtained in 2020–2021, during intermittent COVID lockdowns in much of Japan. During this period, many individuals who were accustomed, pre-pandemic, to hiking regularly in forested montane national parks, continued to do so whenever possible, legally or not, and posted extensively about these experiences on Japanese-language social media. These posts formed part of national social debates about the benefits and disadvantages of lockdowns and included detailed descriptions of very recent experiences, posted during the forest visits or immediately afterwards. Many of these posts included information on drivers of self-perceived mental health, including sensory and emotional experiences. With Japanese financial assistance, we employed a Japanese researcher to search Japanese-language social media, identify relevant posts, extract those related to sensory experiences in recent forest visits, translate them to English, and anonymise the participants. The forest parks visited were nationwide, principally in the temperate forests of Honshu, and were spread across all seasons, but principally in warmer seasons. Posts were found using Facebook Groups® and Twitter hashtags. Data collection was halted once 1000 social media posts were extracted.

3.6 Data analyses: Directed-content thematic coding

We analysed each dataset independently, and compared results. For each dataset, we carried out analyses both on translated texts, and in the original language with subsequent translation to English. We adopted directed-content thematic analyses: extracting information on sensory experiences, excluding other topics; sorting data into themes of sight, sound, smell, taste, touch and temperature; and identifying and classifying subsidiary themes for each sense.

Qualitative social science methods rely on language to communicate and formalise information on individual perceptions of feelings, thoughts and actions. Limits are set by the awareness and memories of respondents, and their willingness to transfer information to researchers (Bercht, 2023). Researchers define overall scope, but interviewees choose topics to discuss, and in what order. Thematic analysis (Naeem et al., 2023; Squires, 2023) divides text into small-scale concepts, which can then be assembled into hierarchical coding trees: reproducible, comprehensible and efficient representations of knowledge across multiple respondents. It differentiates concepts and stakeholders, but it does not determine distributions, or include statistical significance tests.

The size of coding trees depends on how finely respondents and researchers differentiate concepts (Buckley, 2022b). In this analysis, we distinguished sensory experiences such as sounds of birds, wind, or water. This is finer than soundscape approaches (Francomano et al., 2022; Sethi et al., 2020), but coarser than separating the songs of different bird species (Buckley, 2023b). Similarly, we distinguished the scents of flowers in bloom, from those of trees derived from volatile terpenoids (Buckley, Zhong, et al., 2024; Mazzoleni et al., 2024), but we did not create finer-scale codes for individual plant species in either category. This reflects the scale at which most participants reported their sensory experiences: only a few identified individual plant or bird species by name.

4 RESULTS

4.1 Format, volume and presentation of qualitative data

The four country studies used comparable but somewhat different methodologies, and yielded data comparable in content but somewhat different in format and volume. The conversational interviews in Australia and Chile generated extended quotes, often incorporating individual personal reflections as well as observations of nature. The more formal interviews in China, and the social media posts in Japan, yield briefer descriptive information, but replicated many more times. In order to compare across countries, we present results below at a similar level of detail for each study, with a focus on specific sensory components of nature experiences.

In the subtropical forests in Australia, participants had opportunities to contemplate their natural surroundings in detail, and their contributions reflect this. For example:

The forest has a lot of sounds, mostly at dawn and dusk. On windy days there is the sound of the leaves, and on still days, all kinds of little rustling noises from birds and animals in the undergrowth, scratching about. If you get to hear a lyrebird doing a big song, that's a special day. You can stop by the waterfalls, listen to the sound of the water. If you pound on those big flat tree buttresses you get a booming noise, not super loud but sort of resonant.

In the cool temperate forests of southern Chile, participants referred to personal and recent experiences. For example, they mentioned that swimming even briefly in glacial lakes took their breath away, or that they had to fight against the force of the wind in the high valleys. They also mentioned awareness of their own bodies within those physical spaces, and how the sounds and colours created perceptions of magic. In China, many respondents used general terms such as ‘nature landscapes’ or ‘bird song’, and fewer nominated specific sensory experiences such as ‘bubbles in stream’ or ‘sounds of insect wings’. In regard to sound, they also used the evocative term ‘nature language’, not common in English.

4.2 Study 1, Australia

With regards to sight, some respondents mentioned views as attractions: ‘scenic lookouts, far across the forest, waterfalls’. Others included very specific observations: ‘green and black birdwing butterflies’, ‘huge old brush box trees’, ‘big fig trees’ (species names are listed in Table 2). Colours and shapes were mentioned: ‘restful on the eyes’; ‘green, calming’; ‘greens and browns… shapes… tiny fungi, fallen flowers’; ‘blue crayfish’; ‘all the different birds’. Some described their own behaviour: ‘I focus on what's all around, I look at everything’.

TABLE 2. Common and scientific names of species mentioned in Australian responses.

Standardised common name	Scientific name
Brush box	Lophostemon confertus
Black booyong	Argyrodendron actinophyllum
Strangler fig	Ficus spp. (several)
Pink lillipilli	Syzygium spp. (several)
Black apple	Planchonella australia
She-oak	Casuarina spp. (several)
Giant stinging tree	Dendocnide excelsa
Lawyer vine	Calamus muelleri
Red-legged pademelon wallaby	Thylogale stigmatica
Green catbird	Alluroedus crassirostris
Eastern whipbird	Psophodes olivaceus
Wompoo fruit-dove	Megaloprepia magnifia
Satin bower bird	Ptilonorhynchus violaceus
Albert's lyrebird	Menura alberti
Australian brush-turkey	Alectura lathami
Lamington crayfish	Euastacus sulcatus
Richmond Birdwing butterfly	Ornithoptera richmondia

Comments related to sounds included birdsong, animals, leaves rustling, and running water. ‘Bird calls, dawn and dusk’; ‘catbird, whipbird, wompoo pigeon, bower birds, lyrebirds’; ‘on windy days the sound of the leaves, on still days noises from birds and animals in the undergrowth, scrub turkeys, wallabies’; ‘waterfalls, the sound of the water’. Comments related to smells and scents focussed on freshness: ‘after rain, the forest air is cool and moist, smells clean’. They included earth and plants as well as air: ‘the forest has a good smell, earthy but clean, unpolluted’; ‘one tree with lemon scented leaves, and another with lemon smelling fruits’. Comments on taste mentioned clean water: ‘I drink the water from the side creeks, very clean and delicious’. Plant fruits were mentioned occasionally: ‘pink lillipilli, tart flavour, and black apple’. A few comments referred to touch: ‘rough bark on she-oak trees’; ‘slimy fungus on dead logs’; ‘swimming in the cold creek waterholes’. Some mentioned pain: ‘giant stinging trees … scratchy lawyer vines’.

4.3 Study 2, Chile

Common visual sensory experiences reported by forest tourists from southern Chile included: ‘the different greens of the new and old lenga leaves’ (the southern beech tree, Nothofagus pumilio), ‘the flicker of sun and shade across the forest floor when the wind is shaking the leaves and branches’, ‘the many different blues and greys of the lakes and rivers, each one is different and they change with the weather, the time of day, sun or cloud, wind or calm, reflections’. One mentioned ‘the pointy snout of the Darwin's Frog’ (an endangered forest frog species, Rhinoderma darwinii), and another recalled ‘the shape of condor wings taking off from a cliff, they bent right down underneath its body like an upside-down U’ (Andean condor, Vultur gryphus).

Bird song was mentioned frequently: for example, ‘the call of the chucao, a tiny bird with a big song’ (chucao tapaculo, Scelorchilus rubecula), and ‘the sound of the Magellan's woodpecker hitting a tree, slow and powerful’ (Magellanic woodpecker, Campephilus magellanicus). Some mentioned ‘the sound of waterfalls, first faint in the distance, then roaring when you are right beside them’, and others that ‘hiking up the high valleys, you're still in forest but you hear the wind’. The wind was also referred to as a tactile sensation, ‘you feel its force’. Other tactile sensations include: ‘a spiky bush, very sharp, I sat on one accidentally’. In relation to smell, one said that: ‘There aren't strong earthy scents like tropical forests, the air is colder and mostly it just smells clean’. Water temperature was also mentioned: ‘There are lakes and rivers, but ice cold. Some with actual ice, even glaciers’.

4.4 Study 3, China

In relation to sight, the most common responses in China were ‘natural landscapes’, ‘forest’, ‘trees’, ‘leaves’, and ‘green’. ‘Water’, ‘rocks’, ‘flowers’ and ‘animals’ were mentioned occasionally, and so were sights outside the forest, such as ‘mountains’, ‘snow-capped mountains’, and ‘blue sky, white cloud’. Sounds were also mentioned frequently, including ‘bird song’, ‘bird wings’, ‘running water’, ‘sound of rain’, ‘wind through leaves’, and ‘insects’.

In relation to smell and scent, respondents referred repeatedly to ‘fresh air’ and ‘freshness’. Some mentioned ‘flowers’, ‘trees’, ‘earth’, and ‘soil’. A few mentioned ‘rotten leaves’, ‘dirty water’, or ‘peculiar smells’. Several referred to smells of ‘smoke’, ‘scorching’, ‘burned smells’ and even ‘fireworks’. It was not clear if these were forest fires, cooking fires, or actual fireworks. Very few mentioned tastes or tactile sensations, though one referred to ‘touch of hand.’ Unlike the other countries, temperature and humidity were mentioned frequently. Some respondents quoted specific temperatures, ranging from −1°C to +37°C. Others used terms such as ‘cool’, ‘comfortable’, or ‘hot’.

4.5 Study 4, Japan

Comments related to sight referred to colour, such as ‘clear blue sky’ and especially ‘fresh greenery’, ‘bright green bamboo’, and ‘green is good for the eyes’. They mentioned ‘spring cherry blossom viewing’, ‘cherry blossoms blooming’, and ‘feeling at ease when we see flowers’. Several mentioned ‘watching the beautiful autumn leaves’, and ‘beautiful autumn leaves reflected in the water.’ One mentioned ‘sunrises and stars.’ Comments related to sound focussed on birdsong: ‘listen to the voices of birds’, ‘sounds of wild birds in the morning, voices of insects at night’. Those referring to smell and taste focussed on air quality: ‘natural fresh air’, ‘like breathing air for the first time in a long time.’ A few spoke of ‘touching nature’, or ‘touching nature for the first time.’ Some mentioned temperature, especially ‘hot springs’, and ‘hot springs for recovery from fatigue’.

A few mentioned multiple senses: ‘sharpening my five senses in a forest bath’, and ‘viewing cherry blossom while tasting sake.’ Many used the Japanese term shinrin-yoku, forest bathing, and some mentioned connections to well-being: ‘forest bathing felt really good, and the positive effects lasted for several days’, ‘my heart has become calm from the rainy shinrin-yoku’, ‘exercise in sun and forest’, ‘walking and bathing in the forest are good for your health’.

4.6 Themes and international comparison

The same sensory experiences were mentioned by forest visitors across all four countries and cultures (Table 3). Natural landscapes, shapes, colours, and movements in the forest canopy were the most frequently mentioned sights, and a few also added wildlife. Birdsong, wind in leaves, and running water were the most frequently mentioned sounds, and a few also added the sound of bird or insect wings. Fresh air was the most frequently mentioned smell, along with earth, flowers, and particular trees or shrubs. Some also mentioned less pleasant smells, such as rotting vegetation, smoke or burning. Few tastes were mentioned, with fresh stream water being the most frequent, followed by native fruits. Not many mentioned the sense of touch. Those that did, included rocks, bark, and fungi. Humidity and temperature were mentioned by many of the forest tourists in China, but fewer in other countries. Emphasis differed a little between countries, reflecting cool temperate or warm subtropical forests. Level of detail also differed slightly between countries, reflecting data collection methodologies. Both of these are at finer scale than in Table 3, and do not affect our principal results and conclusions.

TABLE 3. Principal sensory experiences identified by forest tourists.

Sense	Experiences identified by forest tourists	Study #
Sense	Experiences identified by forest tourists	1	2	3	4
Sight	Vegetation shapes, colours, movements	*	*	*	*
Sight	Individual wildlife and plants	*	*	*	*
Sound	Bird song	*	*	*	*
	Wind rustling leaves	*	*	*	*
	Running water, including waterfalls	*	*	*	*
Scent, smell	Fresh clean air	*	*	*	*
	Tree scents, e.g. fir, cedar, eucalyptus	*	*	*	*
	Scents of specific flowers	*	*	*	*
	Earthy smells	*		*
Taste	Clean water taste	*	*
Taste	Native forest fruits	*		*
Touch	Rock and bark surfaces	*		*
	Air temperature and humidity	*	*	*	*
	Water temperature	*	*	*

Note: Study 1 = Australia, 2 = Chile, 3 = China, 4 = Japan.

5 DISCUSSION

5.1 Research contributions and opportunities

Our findings show that reported sensory components of forest nature experiences are broadly similar across four continents: sights of plant shapes and colours; sounds of birdsong, running water, and rustling leaves; smells of flowers, trees, and earth; taste and temperature of clean air and water; and touch of bark and rocks. Nuances may differ with climate and forest type.

Details of sensory experiences, size of evidence base, and range of application, all represent advances over previous research. There is previous quantitative research on mental health outcomes of forest therapy (Nguyen et al., 2023; Wang et al., 2022), and previous qualitative research on sensory awareness of nature (Buckley, 2022a; Cooper & Buckley, 2022). Most recently, Fisher et al. (2023) applied principal components analysis to qualitative interview themes, showing variability between individuals; and Johansson et al. (2024a, 2024b) distinguished responses to potentially dangerous as compared to harmless wildlife species in Sweden. Cross-cultural similarities have been reported previously for urban greenspace (Edwards et al., 2022), but not in relation to sensory experiences.

5.2 Strengths and limitations

The first strength of these findings is they are derived from large samples of forest visitors across multiple countries and cultures, giving them high robustness and transferability. The four countries studied were selected as active in development of forest therapies, and for providing a range of different cultural contexts and languages. Additional countries can be included in future comparisons. Tester-Jones et al. (2020) and White et al. (2021) used a quantitative panel study across 18 nations, to compare the therapeutic effects of nature for multiple mental pathologies; and Buckley and Brough (2022) used mixed-method surveys across 17 countries to compare the role of nature in mental resilience to COVID lockdowns. The second key strength is that our findings are at a granularity applicable in design and testing of practical nature therapies. Most previous research is either very coarse-grained, e.g. panel studies treating ‘nature’ or ‘forest’ as a single variable (Besser, 2021; Geary et al., 2023; Lee et al., 2023); or very fine-grained, e.g. qualitative descriptions of wildlife experiences (Buckley, 2022a; Johansson et al., 2024a, 2024b).

There were minor methodological differences within our four-country comparison, described earlier. These are unlikely to constitute a limitation for the data from Australia, Chile and China. The data from Japan, however, were user-generated content derived from social media. This is now an extremely common approach in the social sciences, but is potentially subject to limitations such as self-selection of participants, and self-reinforcing crowd effects. Since the results from Japan proved very similar to those from elsewhere, it seems likely that any such effects were small in this case.

There are a number of general limitations, each of which can be overcome by future research. First, these findings focus only on forest ecosystems. There are comparable mental health benefits from other ecosystems, such as mountains and tundra, desert and savanna, shoreline and ocean (Buckley, 2023a; Manero, 2023; Yin et al., 2022), but specific sensory experiences are different. Second, all our participants visited forests voluntarily, at their own expense. Patients engaging in prescribed nature therapies may have somewhat different perceptions. For example, they may pay less attention to their senses, unless guides encourage them to do so. Third, our findings were not differentiated by visitor activity. For example, birdwatchers may emphasise different sensory experiences than trail-runners. Fourth, qualitative thematic analysis does not measure the relative importance of different sensory experiences for mental health, across entire populations.

5.3 Future research

Most immediately, future research can build on these qualitative findings, to measure how much each of the sensory experiences identified here contribute to mental health benefits of nature exposure. This will require quantitative analyses of representative population samples, with questions on the relative importance of each of the sensory experiences identified here. That is, we now have evidence firstly, that forest visitors perceive that sensory experiences directly affect their emotions and well-being (Zhong et al., 2024); and secondly, that there is a general consensus set of forest sensory experiences that forest visitors report as important. The next step is to quantify the relative contribution of each of those experiences to specific mental health outcomes, for different patient cohorts, using large-scale randomised samples.

Future research can also compare ecosystems, activities and individuals. These include the effects of activities, life histories, group sizes, and guides or therapists, either psychologists or occupational therapists (Firby & Raine, 2023). Some people are concerned about difficult terrain, bad weather, or wild animals (Johansson et al., 2024a, 2024b), and need guides to provide safety and information. Skilled tour guides can also influence clients' sensory experiences, to maximise emotional impact, memories and satisfaction, mood and mental health (Buckley, 2023a; Elvekrok & Gulbrandsøy, 2022).

5.4 Management implications

Routine prescription of nature therapies will need data on optimum formulations, doses, and treatment regimes, for patients with different sets of symptoms. Our findings here show that those designs should specify precise sensory experiences that reflect different ecosystems, but may not need to be customised to different human cultures. Once optimal designs, doses and durations are determined, randomised controlled trials will be needed to determine effect sizes and significance.

Policy analysis is also needed to determine how best to integrate nature-based therapies into healthcare systems. As yet, few countries operate large-scale public health programs aimed specifically at providing nature therapies (Buckley, Zhang, et al., 2024; Guardini et al., 2023). Many have publicly-funded parks that improve visitor mental health, but measures may be needed to reduce social barriers to access (Buckley & Cooper, 2022).

These approaches are likely to yield substantial economic payoffs. The mental health benefits of nature operate as cultural ecosystem services (Bratman et al., 2019; Huynh et al., 2022; Manero, 2023; Nakadai, 2023; Remme et al., 2021). Their economic value has been estimated at ~US$5.1 trillion per annum worldwide (Buckley et al., 2023; Buckley & Chauvenet, 2022). A limited proportion of that economic value is derived from exercise (Buckley et al., 2019; Grellier et al., 2024). In addition to applications in the health sector, that economic value could be harnessed to improve funding for biodiversity conservation (Buckley et al., 2019, 2023; Nikoo et al., 2024; Soga & Gaston, 2022, 2023).

6 CONCLUSIONS

Forest visitors in four culturally and linguistically different countries all appreciate the same sensory experiences. These sensory experiences are: the sights of plant colours and shapes; the sounds of birdsong, running water and rustling leaves; the scents of trees, flowers and earth; the tastes of clean air, clean water, and forest fruits; and the feel of touching bark and rocks. Therefore, in designing practical programs for nature-based mental healthcare, either preventive or therapeutic, these same sensory experiences should be included irrespective of differences in national healthcare institutions.

Different individuals, however, prefer different detailed sensory experiences. There are therefore two immediate priorities for future research on the mechanisms and outcomes from forest therapies. The first is how the specific sensory experiences listed above are perceived and valued by different individual people. The second is how these sensory experiences can best be provided through detailed design features of nature therapy products. Such features may include activity, group size and guiding. Each of these remains to be tested.

AUTHOR CONTRIBUTIONS

Ralf C. Buckley: Conceptualisation, methodology, validation, analysis, data curation, writing—original draft, writing—review and editing, supervision, project administration. Mary-Ann Cooper: Conceptualisation, methodology, validation, analysis, data curation, writing—review and editing. Linsheng Zhong: Conceptualisation, methodology, validation, resources, data curation, writing—review and editing, project administration, funding acquisition. All authors endorse publication.

ACKNOWLEDGEMENTS

Japanese social media data identified, extracted, and translated by Marina Tsuchiya (RA), funded by Japan Foundation. Griffith University ethics protocol 2017838. Open access publishing facilitated by Griffith University, as part of the Wiley - Griffith University agreement via the Council of Australian University Librarians.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflicts of interest.

Open Research

DATA AVAILABILITY STATEMENT

All data included in article.

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Citing Literature

Volume6, Issue6

December 2024

Pages 2480-2493

Principal sensory experiences of forest visitors in four countries, for evidence-based nature therapy

Abstract