Science

According to studies by the WHO, depression is one of the most common mental illnesses worldwide, with a lifetime prevalence of 17% [1] and a 12-month prevalence of 3.2% [2]: this means that more than one in ten people will suffer from at least one depressive episode during their lifetime [3, 4]. Moreover, according to WHO estimates, depression will be the most common disease in industrialized nations by 2030 [5, 6].

Despite existing effective therapeutic approaches such as psychotherapy and medication, only about one third of those currently suffering from depression in Germany receive adequate treatment [7]. Reasons for this include high barriers to seeking professional support, such as the stigma associated with mental illness in our society [8], but also the long wait times to access psychotherapy. This highlights the need for testing and research into new, effective, attractive, and low-threshold therapy services to reduce barriers to uptake and thus steadily improve care for people with depression.

Although studies have shown that physical activity is just as effective in treating depression as psychotherapy or medication with antidepressants, there are currently hardly any formal offers for this in the outpatient sector. Yet physical activity has positive effects not only on the psyche, but also on a variety of physical problems. It also has the potential to be a lower-threshold and less stigmatizing treatment approach than conducting psychotherapy or taking medication. Mindfulness-based practices, as well as relaxation techniques, have also been shown to be effective in the treatment of depression and are recommended as complementary forms of therapy.

Also - but not only - patients with aversions to conventional therapy methods or negative previous experiences with them are facilitated access to psychotherapeutic care through the sport therapy component. In our experience, bouldering together encourages participants to network after the completion of group therapy in order to maintain their newly acquired hobby.

In the KuS study, the manual of bouldertherapy was developed further: it was extended from eight therapy hours to ten, psychotherapeutic contents were added, as well as additional mindfulness and relaxation exercises. With this, Bouldering Psychotherapy (BPT) was born!

Scientific testing of Bouldering Psychotherapy took place in a study across several institutes in several German cities (Dorscht et al. 2019). In this scientific testing Bouldering Psychotherapy was compared with services offered in mainstream care. 233 patients were randomly assigned one of the following interventions: Bouldering Psychotherapy (BPT), cognitive behavioral therapy (CBT) (both in groups), or an activating exercise program. The latter consisted of a home-based, guided exercise program that used similar muscle groups as bouldering psychotherapy. Participants were assessed once before therapy, once immediately after therapy, and three more times up to one year after the end of therapy. The assessment of depressive symptomatology was externally assessed by trained raters during a diagnostic interview (MADRS, Montgomery and Asberg Depression Scale). This was done because external assessments are considered less susceptible to bias than self-assessments.