Bouldering out of depression
Bouldering Psychotherapy (BPT) combines action-oriented elements of bouldering (climbing on short outdoor boulders or artificial climbing walls without a rope or harness) with psychotherapeutic interventions, including cognitive behavioral therapy and mindfulness as well as relaxation exercises. It was developed for group treatment of individuals with depression and its effectiveness has been demonstrated in several scientific studies. Specifically, when compared with established approaches to depression treatment, Bouldering Psychotherapy has been shown to be more effective than physical activity alone and at least as effective as cognitive behavioral therapy.
The BouldApy manual provides interested therapists who previously participated in our survey with digital access to the evaluated treatment guide of bouldering psychotherapy. In addition, participants are given access to in-depth materials describing the therapy.
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Origins of the project
The KuS (Climbing and Mood) project
The “Klettern und Stimmung” (KuS) project (Climbing and Mood) was launched in 2013 by two psychiatric nurses (Stefan Först und Matthias Schopper) and a psychotherapist (project leader Prof. Dr. Katharina Luttenberger). The original idea - namely to combine action-oriented elements of bouldering with psychotherapeutic approaches to treat depression - led to the development of a first version of bouldertherapy (KuS therapy). Although therapeutic bouldering or climbing is and has been offered at a variety of hospitals, up to this point there has been no comprehensive manual for its implementation in the treatment of depression, nor any high-quality studies to evaluate its effectiveness. KuS therapy was integrated into the treatment of outpatients at the Psychiatric Institute Outpatient Clinic of the University Hospital Erlangen (www.kletternundstimmung.de) and evaluated in a pilot study (2013-2015). The promising results of the pilot study enabled us to further develop the therapy and to test its efficacy in a large-scale multicenter study (KuS study). Further development focused primarily on enrichment with psychotherapeutic content and an expansion from 8 to 10 hours. Thus, Bouldering Psychotherapy (BPT) was born. BPT group therapies have so far been conducted mainly in the Erlangen/Nuremberg area, but also in the Munich area (Weyarn) and in Berlin, treating over 500 patients.
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The therapy
Bouldering Psychotherapy
Bouldering Psychotherapy is a combination of psychotherapeutic techniques and sport activity through bouldering. In 10 units, various topics important for the therapy of depression are worked on. Unlike in classical behavioral therapy, this is not done in conversation, but in direct experience on the bouldering wall.
The manual
BouldApy
The manual offers interested therapists digital access to the evaluated therapy concept of bouldering psychotherapy. It contains detailed descriptions of the lessons and all included exercises. In the participants' area, more in-depth materials on the lessons can also be made accessible.
The manual is completely free of charge. However, in order to receive the access data, we ask you to participate in our survey in advance and to fill out a short anonymous online questionnaire about your professional background, qualifications and expectations for the manual (approx. 5-10 minutes).
The questionnaire, and further information on how to apply for access to the data, can be found here:
As a participant in a bouldering psychotherapy group, you will receive the access data from your therapist.
Networking
- Congress on Therapeutic Climbing/Bouldering:
- June 27 - 28, 2025 in Erlangen
- More information will follow here
- Email Distribution List:
If you are interested in connecting with other like-minded, we have created an open email distribution list that anyone can join who would like to exchange ideas about bouldering or climbing therapy. Through this, experiences with billing options or implementation modalities of Bouldering Psychotherapy can be shared. We will also join the email distribution list but will not moderate it. If you would like to join, you can find the link here: Therapeutisches Klettern Verteiler - Google Groups
Literature on therapeutic climbing/bouldering
Background
- Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of general psychiatry. 1994;51(1):8-19. Epub 1994/01/01.
- Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007;370(9590):851-8. Epub 2007/09/11. doi: 10.1016/S0140-6736(07)61415-9.
- Jacobi F, Wittchen H-U, Holting C, Hofler M, Pfister H, Muller N, et al. Prevalence, co-morbidity and correlates of mental disorders in the general population: results from the German Health Interview and Examination Survey (GHS). Psychol Med. 2004;34(4):597-611. Epub 2004/04/22. doi: 10.1017/s0033291703001399.
- Busch MA, Maske UE, Ryl L, Schlack R, Hapke U. Prävalenz von depressiver Symptomatik und diagnostizierter Depression bei Erwachsenen in Deutschland. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. 2013;56(5):733-9. doi: 10.1007/s00103-013-1688-3.
- World Health Organization. The International Classification of Functioning, Disability and Health: ICF. Geneva: World Health Organization; 2001.
- World Health Organization. Global Burden of Disease. 2004 update Genf: World Health Organization, 2008.
- Thornicroft G, Chatterji S, Evans-Lacko S, Gruber M, Sampson N, Aguilar-Gaxiola S, et al. Undertreatment of people with major depressive disorder in 21 countries. Br J Psychiatry. 2017;210(2):119-24. doi: 10.1192/bjp.bp.116.188078.
- Corrigan PW, Druss BG, Perlick DA. The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest. 2014;15(2):37-70.
- Buechter RB, Fechtelpeter D. Climbing for preventing and treating health problems: A systematic review of randomized controlled trials. Ger Med Sci. 2011;9. Epub 2011/08/25. doi: 10.3205/000142.
- Fruhauf A, Sevecke K, Kopp M. Ist-Stand der Fachliteratur zu Effekten des therapeutischen Kletterns auf die psychische Gesundheit – Fazit: viel zu tun [Current state of the scientific literature on effects of therapeutic climbing on mental health - conclusion: a lot to do]. Neuropsychiatrie. 2019;33(1):1-7. Epub 2018/08/22. doi: 10.1007/s40211-018-0283-0.
Papers
[Translate to English:]
- Schwarz L, Dorscht L, Book S, Stelzer EM, Kornhuber J, Luttenberger K. Long-term effects of bouldering psychotherapy on depression: benefits can be maintained across a 12-month follow-up. Heliyon. 2019;5(12):e02929. Epub 2019/12/25. doi: 10.1016/j.heliyon.2019.e02929. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6911955/
- Luttenberger K, Stelzer EM, Forst S, Schopper M, Kornhuber J, Book S. Indoor rock climbing (bouldering) as a new treatment for depression: study design of a waitlist-controlled randomized group pilot study and the first results. BMC Psychiatry. 2015;15:201. doi: 10.1186/s12888-015-0585-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4548691/
- Stelzer E-M, Book S, Graessel E, Hofner B, Kornhuber J, Luttenberger K. Bouldering psychotherapy reduces depressive symptoms even when general physical activity is controlled for: A randomized controlled trial. Heliyon. 2018;4(3):e00580. doi: 10.1016/j.heliyon.2018.e00580. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968135/
- Dorscht L, Karg N, Book S, Graessel E, Kornhuber J, Luttenberger K. 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. BMC Psychiatry. 2019;19(1):154. Epub 2019/05/19. doi: 10.1186/s12888-019-2140-5.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525374/ - Karg N, Dorscht L, Kornhuber J, Luttenberger K. Bouldering psychotherapy is more effective in the treatment of depression than physical exercise alone: results of a multicentre randomised controlled intervention study. BMC Psychiatry. 2020;20(1):116. Epub 2020/03/14. doi: 10.1186/s12888-020-02518-y.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7066840/ - Luttenberger K, Karg-Hefner N, Berking M, Kind L, Weiss M, Kornhuber J, Dorscht L. Bouldering psychotherapy is not inferior to cognitive behavioural therapy in the group treatment of depression: A randomized controlled trial. Br J Clin Psychol. 2021 Nov 17. doi: 10.1111/bjc.12347.
Bouldering psychotherapy is not inferior to cognitive behavioural therapy in the group treatment of depression: A randomized controlled trial - PubMed (nih.gov) - Kratzer A, Luttenberger K, Karg-Hefner N, Weiss M, Dorscht L. Bouldering psychotherapy is effective in enhancing perceived self-efficacy in people with depression: results from a multicenter randomized controlled trial. BMC Psychol. 2021 Aug 26;9(1):126. doi: 10.1186/s40359-021-00627-1. PMID: 34446114; PMCID: PMC8393466.
Bouldering psychotherapy is effective in enhancing perceived self-efficacy in people with depression: results from a multicenter randomized controlled trial - PubMed (nih.gov) - Schwarzkopf L, Dorscht L, Kraus L, Luttenberger K. Is bouldering-psychotherapy a cost-effective way to treat depression when compared to group cognitive behavioral therapy - results from a randomized controlled trial. BMC Health Serv Res. 2021 Oct 26;21(1):1162. doi: 10.1186/s12913-021-07153-1
Is bouldering-psychotherapy a cost-effective way to treat depression when compared to group cognitive behavioral therapy - results from a randomized controlled trial - PubMed (nih.gov)
Dipl.-Psych. Prof. Dr. Katharina Luttenberger
Psychological psychotherapist (behavioral therapy)
Bouldering therapist and climbing coach (DAV)
Leona Kind
Psychologist (M.Sc.)
Psychological Psychotherapist in Training (Behavioral Therapy)
Lola Herrmann
Psychologist (M.Sc.)
Psychological Psychotherapist in Training (Behavioral Therapy)
Former Employees / Development of the KuS Manual
Dipl.-Psych. Dr. rer. biol. hum. Lisa Dorscht
Psychological Psychotherapist (Behavioral Therapy)
Boulder and Climbing Therapist
Dr. rer. biol. hum. Nina Karg-Hefner, M.Sc.
Psychological Psychotherapist (Behavioral Therapy)
Boulder and Climbing Therapist
Stefan Fuchs
Health and medical nurse
Boulder and Climbing Therapist
Yoga instructor
Stefan Först
Health and medical nurse
Boulder and Climbing Therapist
Yoga instructor
Matthias Schopper
Specialist nurse for psychiatry and psychotherapy
Boulder and Climbing Therapist
Donations
With the research, further development and dissemination of the Bouldering Psychotherapy, we are making an important contribution to expanding the range of therapies for depression disorders.
If you would like to support our work, we would appreciate a donation to the following donation account:
Stadt- und Kreissparkasse Erlangen
Höchstadt Herzogenaurach
IBAN: DE84 7635 0000 0464 04
BIC: BYLADEM1ERH
Purpose: 36512066
A donation receipt will be issued automatically if you include your address in the subject line.
Thank you very much!
