Effects of a Cognitive Behavioral Therapy-Based Agro-Healing Horticultural Therapy Program on Depression and EEG in High-Risk Groups for Depression

Background and objective: This study aimed to empirically evaluate the effectiveness of an agro-healing program that integrates the plant life cycle with cognitive-behavioral strategies as an emotional and cognitive intervention for individuals at high risk of depression. Specifically, a cognitive behavioral therapy (CBT)-based agro-healing horticultural therapy program was applied to assess its effects on both psychological and physiological outcomes, including depressive symptoms and electroencephalogram (EEG) changes.Methods: Conducted in ten weekly 90-minute sessions, the horticultural activity-based program was conducted by incorporating five core components of cognitive-behavioral strategies—identification of cognitive distortions, problem-solving, socialization, reward, and cognitive restructuring—into the stages of the plant life cycle, including sowing, cultivation, harvesting, and utilization.Results: In the control group, which received only conventional psychiatric treatment, scores for interpersonal problems—a subdomain of depression—significantly increased following the intervention. In contrast, the experimental group, which participated in the CBT-based agro-healing horticultural therapy program in addition to conventional care, demonstrated an overall reduction in depression levels. Statistically significant improvements were observed in somatic retardation, interpersonal problems, depressive affect, and total depression scores. Moreover, compared with the control group, the experimental group exhibited significantly greater reductions across these domains. These findings suggest that vulnerability to depression extends beyond emotional symptoms and is structurally associated with impairments in social cognition, interpersonal functioning, and relationship maintenance.Conclusion: The findings indicate that an agro-healing horticultural therapy program integrating cognitive-behavioral strategies into plant-based activities may effectively reduce depressive symptoms and promote psychological stability in individuals at high risk of depression. Furthermore, this study is meaningful in that it provides integrated evidence based on both psychological scales and EEG measures.