{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T11:20:38Z","timestamp":1787743238927,"version":"build-2784847793"},"reference-count":66,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"unspecified","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100025520","name":"Medical Research Future Fund","doi-asserted-by":"crossref","award":["MRF2027972"],"award-info":[{"award-number":["MRF2027972"]}],"id":[{"id":"10.13039\/501100025520","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,28]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Walk-and-talk therapy integrates psychological support and physical activity conducted in outdoor environments, and has potential to better align with men\u2019s preferences and masculine norms around emotional communication. Conventional indoor psychotherapy is effective for treating depression but can be less engaging for men, leading to less satisfaction and high rates of dropout. This trial aims to determine whether walk-and-talk therapy offers men with depressive symptoms clinically meaningful benefits over conventional indoor therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This assessor-blinded, parallel group randomised controlled trial is comparing the efficacy of walk-and-talk therapy to conventional indoor therapy for men with depressive symptoms. After randomisation, all participants receive 10 fortnightly 1-hour individual psychotherapy sessions over 20 weeks as either: (1) conventional indoor therapy (sitting down indoors) or (2) walk-and-talk therapy (walking outdoors). Participants are assessed at \u2018pre-intervention\u2019 (baseline), \u2018post-intervention\u2019 (5 months post baseline) and \u2018follow-up\u2019 (12 months post baseline) time points. The primary outcome is change in overall psychological distress (21-item version of the Depression, Anxiety and Stress Scale (DASS-21)) at post-intervention. Secondary outcomes include male-type depression symptoms, mental well-being, suicidal ideation and quality of life. Costing data is being collected for cost-effectiveness analysis. Linear mixed models will be used to examine the impact of group (conventional indoor vs walk-and-talk), time (baseline, 5-month and 12-month) and the group-by-time interaction for primary and secondary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study is approved by the University of Newcastle Human Research Ethics Committee (H-2024-0090). Results will be published in an open access peer-reviewed journal and disseminated through conference presentations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ACTRN12624000794505.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-122564","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:40:32Z","timestamp":1787740832000},"page":"e122564","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Walk-and-talk versus conventional psychotherapy for men with depressive symptoms: study protocol of a randomised controlled trial"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0202-6485","authenticated-orcid":false,"given":"Casey Phyllis","family":"Regan","sequence":"first","affiliation":[{"name":"School of Science, The University of Newcastle, Callaghan, New South Wales, Australia"},{"name":"Global Sport and Movement Collaborative, The University of Newcastle, Callaghan, New South Wales, Australia"},{"name":"Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2215-5182","authenticated-orcid":false,"given":"Andrea","family":"Dickmeyer","sequence":"additional","affiliation":[{"name":"School of Science, The University of Newcastle, Callaghan, New South Wales, Australia"},{"name":"Global Sport and Movement Collaborative, The University of Newcastle, Callaghan, New South Wales, Australia"},{"name":"Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"O\u2019Hara","sequence":"additional","affiliation":[{"name":"School of Science, The University of Newcastle, Callaghan, New South Wales, Australia"},{"name":"Global Sport and Movement Collaborative, The University of Newcastle, Callaghan, New South Wales, Australia"},{"name":"Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4205-910X","authenticated-orcid":false,"given":"Sean Anthony","family":"Halpin","sequence":"additional","affiliation":[{"name":"School of Science, The University of Newcastle, Callaghan, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan James","family":"Smith","sequence":"additional","affiliation":[{"name":"Global Sport and Movement Collaborative, The University of Newcastle, Callaghan, New South Wales, Australia"},{"name":"Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia"},{"name":"School of Education, The University of Newcastle, Callaghan, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Morgan","sequence":"additional","affiliation":[{"name":"Global Sport and Movement Collaborative, The University of Newcastle, Callaghan, New South Wales, Australia"},{"name":"Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia"},{"name":"School of Education, The University of Newcastle, Callaghan, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4906-2993","authenticated-orcid":false,"given":"Ryan J","family":"Drew","sequence":"additional","affiliation":[{"name":"Global Sport and Movement Collaborative, The University of Newcastle, Callaghan, New South Wales, Australia"},{"name":"Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia"},{"name":"School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0589-8521","authenticated-orcid":false,"given":"Victoria","family":"McCreanor","sequence":"additional","affiliation":[{"name":"Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia"},{"name":"School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia"},{"name":"AusHSI, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2259-4682","authenticated-orcid":false,"given":"Sarah Ruth","family":"Valkenborghs","sequence":"additional","affiliation":[{"name":"Global Sport and Movement Collaborative, The University of Newcastle, Callaghan, New South Wales, Australia"},{"name":"Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia"},{"name":"School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elliot","family":"Waters","sequence":"additional","affiliation":[{"name":"School of Science, The University of Newcastle, Callaghan, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zac","family":"Seidler","sequence":"additional","affiliation":[{"name":"Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Orygen, Parkville, Victoria, Australia"},{"name":"Movember Institute of Men\u2019s Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7670-9196","authenticated-orcid":false,"given":"Myles D","family":"Young","sequence":"additional","affiliation":[{"name":"School of Science, The University of Newcastle, Callaghan, New South Wales, Australia"},{"name":"Global Sport and Movement Collaborative, The University of Newcastle, Callaghan, New South Wales, Australia"},{"name":"Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"2026082603402019000_16.8.e122564.1","unstructured":"Yoch M , Sirull R . New global burden of disease analyses show depression and anxiety among the top causes of health loss worldwide, and a significant increase due to the covid-19 pandemic. Institute for Health Metrics and Evaluation; 2021."},{"key":"2026082603402019000_16.8.e122564.2","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/S2215-0366(24)00222-0","article-title":"Global Burden of Disease 2021: mental health messages","volume":"11","year":"2024","journal-title":"Lancet Psychiatry"},{"key":"2026082603402019000_16.8.e122564.3","doi-asserted-by":"crossref","DOI":"10.1155\/da\/5553491","article-title":"Trends in Prevalent Cases and Disability-Adjusted Life-Years of Depressive Disorders Worldwide: Findings From the Global Burden of Disease Study From 1990 to 2021","volume":"2025","author":"Chen","year":"2025","journal-title":"Depress Anxiety"},{"key":"2026082603402019000_16.8.e122564.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2010.03.035"},{"key":"2026082603402019000_16.8.e122564.5","unstructured":"Australian Bureau of Statistics . National study of mental health and wellbeing 2020\u20132022. Canberra: ABS, 2022."},{"key":"2026082603402019000_16.8.e122564.6","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1177\/0020764019886336","article-title":"What gets in the way? Men\u2019s perspectives of barriers to mental health services","volume":"66","author":"Seidler","year":"2020","journal-title":"Int J Soc Psychiatry"},{"key":"2026082603402019000_16.8.e122564.7","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1080\/17437199.2013.840954","article-title":"A systematic review of the factors associated with delays in medical and psychological help-seeking among men","volume":"9","author":"Yousaf","year":"2015","journal-title":"Health Psychol Rev"},{"key":"2026082603402019000_16.8.e122564.8","doi-asserted-by":"crossref","DOI":"10.1177\/15579883231157971","article-title":"Understanding Men\u2019s Engagement and Disengagement When Seeking Support for Mental Health","volume":"17","author":"Kwon","year":"2023","journal-title":"Am J Mens Health"},{"key":"2026082603402019000_16.8.e122564.9","doi-asserted-by":"publisher","DOI":"10.1177\/1557988316630953"},{"key":"2026082603402019000_16.8.e122564.10","doi-asserted-by":"crossref","unstructured":"Pirkis J , Macdonald J , English DR . Introducing ten to men, the Australian longitudinal study on male health. Springer, 2016:1\u20134.","DOI":"10.1186\/s12889-016-3697-2"},{"key":"2026082603402019000_16.8.e122564.11","first-page":"2013","article-title":"Mental health of Australian males: depression, suicidality and loneliness","volume":"1","author":"Terhaag","year":"2020","journal-title":"Insights"},{"key":"2026082603402019000_16.8.e122564.12","unstructured":"World Health Organization . Suicide worldwide in 2021: global health estimates. World Health Organization, 2025."},{"key":"2026082603402019000_16.8.e122564.13","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1038\/s44220-025-00474-8","article-title":"Global, regional and national trends in suicide mortality rates across 102 countries from 1990 to 2021 with projections up to 2050","volume":"3","author":"Kim","year":"2025","journal-title":"Nat Mental Health"},{"key":"2026082603402019000_16.8.e122564.14","unstructured":"Australian Bureau of Statistics . Causes of death. Australia: ABS, 2024."},{"key":"2026082603402019000_16.8.e122564.15","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20860"},{"key":"2026082603402019000_16.8.e122564.16","doi-asserted-by":"crossref","DOI":"10.1177\/15579883211014776","article-title":"Men\u2019s Dropout From Mental Health Services: Results From a Survey of Australian Men Across the Life Span","volume":"15","author":"Seidler","year":"2021","journal-title":"Am J Mens Health"},{"key":"2026082603402019000_16.8.e122564.17","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/j.1467-9566.2011.01372.x","article-title":"Men\u2019s discourses of help\u2010seeking in the context of depression","volume":"34","author":"Johnson","year":"2012","journal-title":"Sociology Health & Illness"},{"key":"2026082603402019000_16.8.e122564.18","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1111\/1467-9566.13257","article-title":"Masculinities, emotions and men\u2019s suicide","volume":"43","author":"River","year":"2021","journal-title":"Sociology Health & Illness"},{"key":"2026082603402019000_16.8.e122564.19","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1177\/0091217420905182","article-title":"Once bitten, twice shy: Dissatisfaction with previous therapy and its implication for future help-seeking among men","volume":"55","author":"Seidler","year":"2020","journal-title":"Int J Psychiatry Med"},{"key":"2026082603402019000_16.8.e122564.20","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-020-02686-x","article-title":"Mental health professionals view about the impact of male gender for the treatment of men with depression - a qualitative study","volume":"20","author":"Stiawa","year":"2020","journal-title":"BMC Psychiatry"},{"key":"2026082603402019000_16.8.e122564.21","unstructured":"American Psychological Association . APA guidelines for psychological practice with boys and men. Washington, DC: American Psychological Association, 2018."},{"key":"2026082603402019000_16.8.e122564.22","doi-asserted-by":"publisher","DOI":"10.1177\/1060826517729406"},{"key":"2026082603402019000_16.8.e122564.23","doi-asserted-by":"crossref","DOI":"10.1177\/15579883231186463","article-title":"Designing Men\u2019s Health Programs: The 5C Framework","volume":"17","author":"Galdas","year":"2023","journal-title":"Am J Mens Health"},{"key":"2026082603402019000_16.8.e122564.24","doi-asserted-by":"crossref","first-page":"30322","DOI":"10.1007\/s12144-022-04017-7","article-title":"Male involvement in randomised trials testing psychotherapy or behavioural interventions for depression: a scoping review","volume":"42","author":"Knox","year":"2023","journal-title":"Curr Psychol"},{"key":"2026082603402019000_16.8.e122564.25","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1037\/amp0001250","article-title":"Five decades of research on psychological treatments of depression: A historical and meta-analytic overview","volume":"80","author":"Cuijpers","year":"2025","journal-title":"Am Psychol"},{"key":"2026082603402019000_16.8.e122564.26","first-page":"373","article-title":"Walk and Talk: an intervention for behaviorally challenged youths","volume":"39","author":"Doucette","year":"2004","journal-title":"Adolescence"},{"key":"2026082603402019000_16.8.e122564.27","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1002\/capr.12042","article-title":"Experiences of therapists who integrate walk and talk into their professional practice","volume":"16","author":"Revell","year":"2016","journal-title":"Couns and Psychother Res"},{"key":"2026082603402019000_16.8.e122564.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2020.101841"},{"key":"2026082603402019000_16.8.e122564.29","first-page":"334","article-title":"Successful mental health promotion with men: the evidence from \u201ctacit knowledge\u201d","volume":"33","author":"Robertson","year":"2018","journal-title":"Health Promot Int"},{"key":"2026082603402019000_16.8.e122564.30","doi-asserted-by":"publisher","DOI":"10.1080\/17437199.2015.1022901"},{"key":"2026082603402019000_16.8.e122564.31","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2018.06.030"},{"key":"2026082603402019000_16.8.e122564.32","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1177\/07067437211039194","article-title":"Walking Psychotherapy As a Health Promotion Strategy to Improve Mental and Physical Health for Patients and Therapists: Clinical Open-Label Feasibility Trial","volume":"67","author":"Koziel","year":"2022","journal-title":"Can J Psychiatry"},{"key":"2026082603402019000_16.8.e122564.33","doi-asserted-by":"crossref","DOI":"10.1002\/cpp.70035","article-title":"Walk\u2010and\u2010Talk Therapy Versus Conventional Indoor Therapy for Men With Low Mood: A Randomised Pilot Study","volume":"32","author":"Dickmeyer","year":"2025","journal-title":"Clin Psychology and Psychoth"},{"key":"2026082603402019000_16.8.e122564.34","doi-asserted-by":"publisher","DOI":"10.4103\/0976-500X.72352"},{"key":"2026082603402019000_16.8.e122564.35","unstructured":"Australian Bureau of Statistics . Socio-economic indexes for areas (SEIFA). Canberra: ABS, 2021."},{"key":"2026082603402019000_16.8.e122564.36","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"2026082603402019000_16.8.e122564.37","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1001\/jamapsychiatry.2013.1985","article-title":"The experience of symptoms of depression in men vs women: analysis of the National Comorbidity Survey Replication","volume":"70","author":"Martin","year":"2013","journal-title":"JAMA Psychiatry"},{"key":"2026082603402019000_16.8.e122564.38","unstructured":"Exercise & Sport Science Australia . Adult pre-exercise screening system (V2). ESSA, 2019."},{"key":"2026082603402019000_16.8.e122564.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.01.073"},{"key":"2026082603402019000_16.8.e122564.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2012.01.003"},{"key":"2026082603402019000_16.8.e122564.41","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(94)00075-U"},{"key":"2026082603402019000_16.8.e122564.42","doi-asserted-by":"publisher","DOI":"10.5694\/mjao12.10628"},{"key":"2026082603402019000_16.8.e122564.43","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2022-106195"},{"key":"2026082603402019000_16.8.e122564.44","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.healthplace.2019.02.002","article-title":"Green space and serious psychological distress among adults and teens: A population-based study in California","volume":"56","author":"Wang","year":"2019","journal-title":"Health & Place"},{"key":"2026082603402019000_16.8.e122564.45","first-page":"105","article-title":"Epidemiology of psychological distress","volume":"69","author":"Drapeau","year":"2012","journal-title":"Mental Illnesses-Understanding, Prediction and Control"},{"key":"2026082603402019000_16.8.e122564.46","doi-asserted-by":"publisher","DOI":"10.1002\/da.23113"},{"key":"2026082603402019000_16.8.e122564.47","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1037\/ccp0000671","article-title":"Impact of a self-guided, eHealth program targeting weight loss and depression in men: A randomized trial","volume":"89","author":"Young","year":"2021","journal-title":"J Consult Clin Psychol"},{"key":"2026082603402019000_16.8.e122564.48","unstructured":"Cohen J . Statistical power analysis for the behavioral sciences (revised ed). New York: Academic Press, 1977."},{"key":"2026082603402019000_16.8.e122564.49","unstructured":"World Health Organization . Depression and other common mental disorders global health estimates. WHO: Geneva, 2017."},{"key":"2026082603402019000_16.8.e122564.50","doi-asserted-by":"crossref","DOI":"10.1002\/capr.12847","article-title":"Walking and talking for well\u2010being: Exploring the effectiveness of walk and talk therapy","volume":"25","author":"Prince\u2010Llewellyn","year":"2025","journal-title":"Couns and Psychother Res"},{"key":"2026082603402019000_16.8.e122564.51","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1080\/15401383.2023.2247318","article-title":"\u201cPut on Your Walking Shoes\u201d: A Phenomenological Study of Clients\u2019 Experience of Walk and Talk Therapy","volume":"19","author":"Greenleaf","year":"2024","journal-title":"Journal of Creativity in Mental Health"},{"key":"2026082603402019000_16.8.e122564.52","doi-asserted-by":"crossref","first-page":"102064","DOI":"10.1016\/j.cpr.2021.102064","article-title":"Health-economic evaluation of psychological interventions for depression prevention: Systematic review","volume":"88","author":"Conejo-Cer\u00f3n","year":"2021","journal-title":"Clin Psychol Rev"},{"key":"2026082603402019000_16.8.e122564.53","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph182111599","article-title":"The Cost Effectiveness of Ecotherapy as a Healthcare Intervention, Separating the Wood from the Trees","volume":"18","author":"Hinde","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2026082603402019000_16.8.e122564.54","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-053650","article-title":"Brief assessment of male depression in clinical care: Validation of the Male Depression Risk Scale short form in a cross-sectional study of Australian men","volume":"12","author":"Herreen","year":"2022","journal-title":"BMJ Open"},{"key":"2026082603402019000_16.8.e122564.55","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-5-1"},{"key":"2026082603402019000_16.8.e122564.56","doi-asserted-by":"publisher","DOI":"10.1111\/sltb.12084"},{"key":"2026082603402019000_16.8.e122564.57","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199603000-00003"},{"key":"2026082603402019000_16.8.e122564.58","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1249\/01.MSS.0000078924.61453.FB","article-title":"International Physical Activity Questionnaire: 12-Country Reliability and Validity","volume":"35","author":"Craig","year":"2003","journal-title":"Medicine & Science in Sports & Exercise"},{"key":"2026082603402019000_16.8.e122564.59","doi-asserted-by":"crossref","unstructured":"Smyth C . The Pittsburgh sleep quality index (PSQI). Thorofare, NJ: SLACK Incorporated, 1999:10.","DOI":"10.3928\/0098-9134-19991201-10"},{"key":"2026082603402019000_16.8.e122564.60","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2007.10.008"},{"key":"2026082603402019000_16.8.e122564.61","doi-asserted-by":"publisher","DOI":"10.1016\/j.beth.2011.04.004"},{"key":"2026082603402019000_16.8.e122564.62","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1037\/1524-9220.4.1.3","article-title":"Conformity to Masculine Norms Inventory (CMNI)","volume":"4","author":"Mahalik","year":"2003","journal-title":"Psychol Men Masc"},{"key":"2026082603402019000_16.8.e122564.63","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyg.2020.01566","article-title":"The CN-12: A Brief, Multidimensional Connection With Nature Instrument","volume":"11","author":"Hatty","year":"2020","journal-title":"Front Psychol"},{"key":"2026082603402019000_16.8.e122564.64","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyg.2021.643866","article-title":"Affective Benefits of Nature Contact: The Role of Rumination","volume":"12","author":"Bratman","year":"2021","journal-title":"Front Psychol"},{"key":"2026082603402019000_16.8.e122564.65","doi-asserted-by":"publisher","DOI":"10.1002\/nur.20329"},{"key":"2026082603402019000_16.8.e122564.66","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/cpp.1892","article-title":"The Individual Therapy Process Questionnaire: Development and Validation of a Revised Measure to Evaluate General Change Mechanisms in Psychotherapy","volume":"22","author":"Mander","year":"2015","journal-title":"Clin Psychology and Psychoth"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2026-122564","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:40:38Z","timestamp":1787740838000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2026-122564"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":66,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,26]]},"published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1136\/bmjopen-2026-122564"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2026-122564","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]}}}