Can’t see the wood for the trees — what forest therapy research keeps missing

A few weeks ago I was introduced to a room of professors, clinicians, practitioners, social workers, teachers and leaders at the RCSI Positive Health Summit in Dublin.

The lecture hall was one of the oldest in the city. The kind of room that has heard a great deal of important thinking over a very long time. Rows of seats rising five deep in a semicircle, the audience close enough that I could touch them.

My heart was in my mouth. My brain was doing what brains do in the moments before you speak to a room full of people who know a great deal about the thing you are about to talk about.

And then it happened.

I stepped away from the lectern. Away from my notes. Into the floor space directly in front of the first row, right next to the people sitting closest to me. The chatter in my head quietened. And I spoke from somewhere that wasn’t the scripted version of what I had planned to say.

I have been thinking about that moment ever since. About what it means when the body knows something before the mind has caught up with it. About the felt sense of a room, and of a subject, and of why you are standing there saying what you are saying.

What I was saying matters. Here it is.

The title of my presentation was, in the way of academic titles, functional rather than beautiful: forest-based therapeutic interventions for the wellbeing and mental health of young people. Talking through my systematic review: a particular kind of research where you don’t go in with an answer to prove, you go in with a question and follow wherever the evidence leads.

I thought I would learn about forest-based therapies. What I actually discovered may lie beneath an urgent, largely unacknowledged crisis.

Young people across North West Europe and beyond are suffering. Not quietly, not at the margins, but in numbers that should be commanding the full attention of every public health authority, every school system, every hospital and institution that exists to support them. The mental health crisis in adolescence is well documented. What is less discussed is one of its most significant contributing conditions: the systematic removal of young people from the natural world.

We have built systems, educational and healthcare and social, that keep children indoors. Under artificial light. In environments that do not move, do not breathe, do not change with the seasons. Environments that, if we are honest about what the neuroscience tells us, are profoundly ill-suited to the developing nervous systems they are supposed to serve.

The forest is not a backdrop. It is not a pleasant setting for activities that could happen anywhere. There is a growing body of evidence that nature-based environments do something specific and measurable to the human body and mind, particularly to young people in states of distress. Something that clinical environments, however well-resourced and well-intentioned, cannot easily replicate.

I am in the second year of a PhD within Forest4Youth, a large EU and Interreg funded research project spanning five countries, dedicated to understanding and evidencing forest-based therapeutic interventions for young people in adolescent psychiatric care (https://forest4youth.nweurope.eu/).

For my presentation at RCSI I drew on a systematic review of thirty-seven studies. Twelve countries. 6,276 participants. An enormous amount of research effort, representing thousands of hours of work by researchers who care deeply about this population.

What the review showed stopped me when I first encountered it. And it stopped the room when I shared it.

In all of those papers, the forest was barely mentioned.

In study after study of forest-based therapeutic interventions, the forest itself, its specific features, its qualities, what it actually offers to a nervous system in distress, is treated as if it were simply a backdrop. A setting. The wallpaper behind the real intervention. As if the trees, the light, the air, the ground, the particular quality of attention that nature asks of us, were incidental to the outcome rather than central to it.

And the people surrounding each of those six thousand participants? The families, the parents, the siblings, the communities that each young person returns to after every session, that hold the context in which any intervention either takes root or doesn’t? Barely mentioned either. As if the young person existed in isolation from every relationship and environment that shaped them.

I saw a second gap that runs alongside this one and compounds it. We have no standardised, agreed way of measuring embodied wellbeing. We talk, rightly and increasingly, about the inseparability of body and mind. About the way trauma lives in the body, not just the mind. About how memory, response, pattern and healing are all embodied processes. And yet the evidence base reflects none of this coherently, because we have never agreed on how to measure it.

This matters enormously. Not as an academic problem. As a public health problem.

Because the evidence base is what changes policy. It is what persuades public health authorities, school systems, hospitals and institutions to do things differently. Without it, researchers can each produce rigorous, careful, important work, and nothing changes. The systems that are keeping young people indoors, in environments that do not serve their nervous systems, keep running as they always have.

Forest4Youth exists to change that.

It is one of the largest coordinated research efforts in this area ever undertaken in North West Europe. Five countries. Multiple institutions. A shared commitment to building the standardised, rigorous, cross-national evidence base that has been missing. My doctoral study sits within it, focused specifically on the people the existing research has most consistently overlooked: the family members and carers who surround each young person, whose experience shapes the context of every intervention, and who have almost never been asked what any of this is actually like from the inside.

That is what I brought to life in that room in Dublin. The gaps, the urgency, and the work that is beginning to close them.

I stepped away from my notes because the subject asked me to. Because some things cannot be said from behind a lectern at a distance from the people you are saying them to.

The response in the room told me the subject had landed. Not as an academic exercise. As something that people who work with young people, who care about positive health, who know the gap between what the evidence currently supports and what their own practice tells them is true, had been waiting for someone to say clearly.

I am a speaker registered with Raise the Bar. I speak at conferences, leadership events and organisational sessions on trauma-informed practice, performance under pressure, and the evidence on resilience and change.

The work I brought to RCSI sits at the intersection of all of it. The body under pressure. What the research misses when it treats people as isolated from their contexts, communities and the natural world. And what becomes possible when we stop doing that.

If you are organising an event where this kind of thinking would be a good fit, I would be glad to have a conversation. The organisations I work with as a speaker tend to be ones where positive health, human performance, and genuine wellbeing are understood as connected rather than separate concerns.

Where the audience is senior enough to want the evidence and experienced enough to recognise the gaps in it.

You can find my speaker profile at Raise the Bar, https://raisethebar.co.uk/speaker/kate-brassington/, or reach me directly at kate@katebrassington.com, or website contact page.

Forest4Youth is an Interreg NWE project co-funded by the EU 2025-2028. Check out their website and sign up for the newsletter to hear what happens next https://forest4youth.nweurope.eu/

Kate Brassington is a Coaching Psychologist, EMCC Senior Practitioner, ICF PCC and published researcher specialising in trauma-informed coaching psychology for high-achieving professionals. She works with private clients and organisations worldwide from her base in Luxembourg. If this resonated, you can book a free 30-minute discovery call [https://katebrassington.com/contact-me/] to explore working together.