Bouldering psychotherapy effective against depression in the long term

A group of people bouldering.
Concentrating on the here and now – a must when bouldering. The group and therapist provide additional support. A broad-based study has now proven the long-term effectiveness of bouldering psychotherapy. (Photo: PD Dr. Katharina Luttenberger/Universitätsklinikum Erlangen)

Convincing results from the study ‘Climbing and Mood’.

Physical activity is one of the most effective treatments for depression. It carries less of a stigma than psychotherapy and medication-based treatment, and also has a positive effect on patients’ physical fitness. These advantages were the starting point for the ‘Climbing and Mood’ (Klettern und Stimmung) project of the Department of Psychiatry and Psychotherapy at Universitätsklinikum Erlangen at FAU.

Within the framework of this project, the researchers developed the new approach known as bouldering psychotherapy. Following on from the pilot study, the results of the broad-based follow-up study are now available. They indicate that bouldering psychotherapy is considerably more effective than physical activity alone and at least as effective as the current gold standard treatment for depression, behavioural therapy. What is more, the positive effects can still be felt at least a year after therapy.

‘Climbing and Mood’ was established in 2013 by project leader PD Dr. Katharina Luttenberger and her team. The idea was to combine the action-oriented elements of bouldering (climbing at low heights without using ropes) with psychotherapeutic approaches for treating depression. This led to the first version of bouldering psychotherapy, which has continued to be refined and improved ever since.

In ten units, the therapists work through various topics with their patients, but not just while talking like in traditional psychotherapy, but directly at the climbing wall, a literally hands-on experience. For example, when it comes to the topic ‘social relationships’, patients can experience which feelings and thoughts arise when they are connected to others with a rope and have to master the bouldering route together. In addition, the concentration required for bouldering helps patients to live in the here and now and break out of the vicious circle of worry and despair which is one of the main symptoms of depression.

Although therapeutic bouldering or climbing has already been offered at a number of hospitals, no standards have yet been developed for how it should be used to treat depression and there have not yet been any scientific studies to check its effectiveness. This is what led the researchers from Erlangen to investigate the effectiveness of the novel bouldering psychotherapy approach compared to a waiting list control group in a pilot study conducted between 2013 and 2015.

A second major study was conducted from 2016 in several regions in Germany, namely Berlin, the European Metropolitan Region of Nuremberg and the rural region Weyarn/Holzkirchen. This time the research team investigated the effectiveness of bouldering psychotherapy in comparison to established methods of treating depression: firstly, a general exercise programme aimed at encouraging patients to get active, and secondly a behavioural therapy group for fighting depression, the current gold standard.

Considerable decrease in symptoms of depression

A total of 233 people meeting the criteria for depression at the time of the study took part. They were allocated to one of the three groups at random and monitored for up to a year after treatment. The results showed that each of the methods were effective.

Participants in the bouldering psychotherapy group showed a visible decrease in symptoms of depression, shifting from a moderate to a mild form of depression. The improvement was considerably more marked than in the group which did exercises at home as part of the exercise programme aimed at getting patients active. In the behavioural therapy group for fighting depression there was, as expected, a considerable improvement in symptoms of depression, but not any more so than in the bouldering psychotherapy group.

Bouldering psychotherapy also led to considerable improvements in the areas of anxiety, body image, coping mechanisms, self-esteem and social behaviour. This indicated that the new form of therapy can easily hold its own against tried and tested forms of therapy and offers a useful extension to the forms of treatment on offer.

Nominated for health award – cast your votes!

The positive results of the study encouraged the research team to apply for the MSD Gesundheitspreis 2020. With the award, the company aims to acknowledge outstanding and innovative healthcare solutions and encourage them to be developed further. A prestigious jury has selected ten innovative projects for the audience prize worth 5,000 euros, including the bouldering psychotherapy project ‘Climbing and Mood’ run by the researchers in Erlangen. Anyone who is interested can cast their vote online by 12pm on Tuesday 8 September 2020, helping to elect the winner of the audience award.

Katharina Luttenberger is proud to have been nominated: ‘To be chosen from so many innovative ideas shows us that our project is going along the right lines.’ Now, of course, the team hopes to win one of the total of eight prizes. The researchers also know exactly what they would like to do with the prize money: ‘Our vision is to publish an online version of the manual, allowing boulder psychotherapy to be implemented easily throughout Germany,’ explains Katharina Luttenberger. ‘This could encourage more and more therapists to incorporate this option into their treatments.’

Further information

Website of the ‘Climbing and Mood’ project

PD Dr. Katharina Luttenberger
Phone: + 49 9131 8544621