Interventions for eco-anxiety: A systematic review of design, implementation and effectiveness

Abstract

Eco-anxiety, characterised by persistent or intense anxiety about environmental crises, is a growing global mental health concern. Yet, the design, effectiveness and implementation of interventions specifically targeting eco-anxiety lack a comprehensive synthesis. This systematic review examined peer-reviewed studies published between 2010 and 2025 that reported on interventions designed to prevent, manage or reduce eco-anxiety or closely related climate-related psychological distress, defined as sustained emotional, cognitive or functional impairment linked to environmental change. Searches were conducted across CINAHL, PsycINFO, MEDLINE, Scopus, ProQuest Environmental Science Collection and the Cochrane Central Register of Controlled Trials. Twenty-two studies met the inclusion criteria from an initial 1,259 records. Most were published between 2017 and 2025, primarily in high-income Western countries, and encompassed a broad range of interventions including educational programmes, messaging strategies, cognitive-behavioural and mindfulness-based therapies, group resilience training, nature-based approaches and community participation initiatives. Cognitive-behavioural and mindfulness-based interventions showed the most consistent positive findings within the current evidence base, including repeated reports of reductions in eco-anxiety or climate-related distress and, in some studies, maintenance of improvements at short-term follow-up. Educational and community-focused interventions were more likely to be associated with emotional engagement, agency and peer support rather than solely increasing knowledge, with some approaches increasing concern or emotional engagement without reducing distress. However, substantial heterogeneity in outcome measures, short intervention durations and limited follow-up periods constrained comparison across studies and assessment of longer-term impact. Implementation challenges included issues of scalability, cultural relevance and the predominance of researcher-led, time-bound interventions. Within the limited literature to date, interventions integrating emotional resilience training with group or community engagement appeared to show promising findings. Further research using standardised outcome measures, longer follow-up periods and more culturally diverse and participatory designs is required to strengthen the evidence base and inform scalable, context-sensitive responses to eco-anxiety.