Green Care describes scientific and practical activities applying elements of nature, animals or plants with respect to physical, psychological, educational and social issues. A growing body of scientific and practical efforts focus on Green Care as a promising approach fostering rural development, environmental education and health promotion. While Green Care in agriculture is already established, the application in forestry is in its early stages. The present study was aimed at investigating scientific evidence for Green Care in forests.

We performed a systematic review using PRISMA guidelines. Searched databases were PsycINFO, PSYNDEXPlus, Scopus and Web of Science. We used three different search terms, namely forest*, tree*, and wood* and combined them with the following keywords: activit*, adverse effect*, “green care”, healing*, health*, intervention*, negative aspect*, recreat*, relax*, restorat*, therapy, “therapeutic landscapes”, well-being, wellbeing, “well being”, “quality of life”, mood, social*, risk*, inclusion, pedagogic*. If provided by the databases, search results were limited to research areas relevant for Green Care. Studies published between 1993 and October 2013 were included.

A 108 studies together with 32 additional records identified through other sources met the inclusion criteria. Results showed a significant increase of research papers during the observed period. A considerable number of studies were conducted in Southeast Asia following the concept of Shinrin-Yoku. The majority of studies concentrated on the impact of forest landscapes on physical and mental stress indicators. The reduction of physiological stress indicators such as pulse rate, salivary cortisol levels, heart rate variability and blood pressure represented significant findings. Mental measurements focused mainly on the contribution of forest landscapes for recreation, improvement of mood and the prevention of mental health. Duration of stay and physical activity correlated with the positive effects. A small number of laboratory studies focused on single factors such as noise, materials or visual impressions. However, the majority of studies examined the holistic effects of forest landscapes on individual factors. Studies on the impact of forests in a social context turned out to be rare. The possibility to participate in landscape planning processes turned out to be an important factor for social benefits in evaluation studies.

The growing body of research reflects a dynamic development in the field of Green Care in forests. Forest landscapes should gain importance for interventions in the domain of Public Health and therapy. Benefits could be found on the physiological, mental and social level. However, most of the studies originate from research in Asia. This could limitate the applicability of findings in other contexts. A main point of methodological limitation, especially in field studies, are small sample sizes and unstandardized testing conditions. Further research should concentrate on examining single mechanisms in order to design interventions based on evidence based factors. Both basic and applied research would profit from using a comparable inventory in research (i.e. POMS and SF-36 on an individual level and the PRS at the level of setting). Further, adverse effects and cost-benefit calculations is recommended to be considered in future studies.