“Nature's effect on my mind” – Patients’ qualitative experiences of a forest-based rehabilitation programme

Abstract

AimThe aim of this study was to investigate the personal experiences and perceived effects on mind from visits to forest environments in a subset of patients with severe exhaustion disorder (ED), who participated in a randomised controlled trial for evaluation of forest-based rehabilitation. ParticipantsA subsample of 19 patients with diagnosed ED, who completed the three-month forest-based rehabilitation in the ForRest project, was interviewed. MethodThe forest-based rehabilitation consisted of repeated forest visits with the main objective of spending time in rest and solitude in a chosen forest setting. Semi-structured interviews were carried out and analysed using Grounded Theory. ResultA core category and five subcategories were set up to describe the patients’ experiences and development during the forest-based rehabilitation. As patients mostly reported that they strove to achieve peace of mind during the forest visits, Striving for serenity was chosen to be the core category. At first the patients were frustrated when left alone with their own thoughts in an unfamiliar forest environment. They gradually became familiar with the forest environments and also found their favourite places where they experienced peace of mind. They were then able to rest and begin reflective thinking about their life situation, which led to ambitions to change it. The preferred forest environments were characterised by openness, light and a good view, and were felt to be undemanding, peaceful and stimulating. ConclusionVisits to the forest provided favourite places for rest, were experienced as restorative, seemed to improve reflection and may have contributed to starting the coping process for these patients. However, forest visits, as the only treatment option, are not sufficient as rehabilitation from severe and long-term ED. We suggest that forest visits should be integrated with cognitive behavioural therapy to further improve the recovery and enhance coping in daily life for these patients.