Bouldering psychotherapy reduces depressive symptoms even when general physical activity is controlled for: A randomized controlled trial

Abstract

BackgroundBouldering psychotherapy (BPT) combines psychotherapeutic elements with physical activity (PA). It might be effective for reducing symptoms of depression, but so far, no study has assessed individuals' levels of PA to control for whether positive effects on depression can also be found when adjusting for participants' levels of PA. This is important because PA itself has been proven effective in reducing depression and therefore might be an important variable to account for – especially in therapies using sport as one therapeutic mechanism.MethodsUsing a waitlist control group design, outpatients with depression were assessed at baseline and after eight, 16, and 24 weeks. The intervention group took part in an eight-week bouldering psychotherapy which met once a week for three hours. Self-report measures before and after the intervention included the Symptom Checklist-90-R (SCL-90-R), the Beck Depression Inventory (BDI-II), and the questionnaire on resources and self-management skills (FERUS). PA was assessed during the first 16-week period via FitBit Zip accelerometers.ResultsAltogether, 47 complete cases (20 men and 27 women) were included in the final analyses. Depression scores dropped by up to 6.74 (CI 2.80–10.67) points on the SCL-90-R depression scale and by up to 8.26 (CI 4.21–12.31) points on the BDI-II during the BPT intervention, the control group remained stable (SCL-90-R Cohen's d = 0.60; BDI-II: Cohen's d = .50). All Participants accrued an average of 6,515 steps per day, which is considered “low-active.” Participants of the BPT intervention were significantly more likely to reduce their depressive symptoms (p = .025) than participants of the control group, even when PA was controlled for in a regression analysis.LimitationsLimitations of the study are the relatively small number of patients and the assessment of outcome scores via self-report.ConclusionsThis study provides evidence that short-term BPT can be effective for reducing symptoms of depression even if controlled for other therapeutically active confounders including antidepressant medication, psychotherapy and general level of PA.

Bouldering psychotherapy is more effective in the treatment of depression than physical exercise alone: results of a multicentre randomised controlled intervention study

“…As we expected, depressive symptoms were effectively reduced in both the bouldering therapy group and the exercise group during the ten-week intervention period. These results are in accordance with previous studies on the antidepressant effects of physical exercise [8] and also parallel previous findings by our work group on the benefits of psychotherapeutic bouldering in treating depressive symptoms [35,36]. What has not been shown before and therefore represents new insights into the relation between physical activity and depression is the finding that the effect of the BPT seems to go even further than the effect of only physical activity.…”

“…Simultaneously, in the confounder-adjusted regression analysis, group allocation (BPT vs. EP) emerged as the only relevant predictor of the post-intervention depression score measured with the MADRS. These findings underpin and augment the previous results of our work group's pilot trial [36], which suggested therapeutic effects of a bouldering psychotherapy intervention on depressive symptoms even when general activity was controlled for. With a moderate effect size (Cohen's d) of 0.55 for the MADRS, the effect of the BPT intervention applied in the current study was weaker than that of the BPT in the pilot study (Cohen's d = 0.77).…”

“…However, conclusions regarding bouldering as an effective treatment for depression must be drawn with caution because existing studies are often limited by methodological problems such as small sample sizes, the use of unstandardised psychometric measures, no randomisation, or even the absence of any control groups [34]. Our work group [35,36] conducted a randomised waitlist-controlled pilot study to investigate the effectiveness of an eight-week bouldering psychotherapeutic intervention on depressive symptoms in individuals with depression. Participants in the intervention group showed a significantly greater reduction in depressive symptoms (from a moderate to a mild severity level, Cohen's d = 0.77) as well as improvements in a number of other mental health outcomes (i.e.…”

Relation of Physical Activity with the Depression: A Short Review

“…If social support is provided then aerobic exercise can cause substantial improvements in the depression level. The effect of both psychotherapeutic and physical exercise on the depression was also studied [19]. patients [27].…”

A German climbing study on depression: a bouldering psychotherapeutic group intervention in outpatients compared with state-of-the-art cognitive behavioural group therapy and physical activation – study protocol for a multicentre randomised controlled trial

“…Different health outcomes were assessed with standardised psychological self-report questionnaires before and after the eight-week intervention period as well as 16 weeks after the end of the therapy. Participants in the intervention group reported a significant reduction in depressive symptoms compared with the control group, even when other types of physical activity was controlled for [33, 34]. With an effect size (Cohen’s d ) of 0.77 (moderate effect) the effect of the bouldering intervention on depressive symptoms was comparable to other short-term group therapies [35] and to physical activity (see above).…”