Top

Published in:

Open Access 01-12-2023 | Psychotherapy | Study protocol

New ways to cope with depression—study protocol for a randomized controlled mixed methods trial of bouldering psychotherapy (BPT) and mental model therapy (MMT)

Authors: Leona Kind, Katharina Luttenberger, Vivien Leßmann, Lisa Dorscht, Christiane Mühle, Christian P. Müller, Eva-Maria Siegmann, Sophia Schneider, Johannes Kornhuber

Published in: Trials | Issue 1/2023

Abstract

Background

Due to the growing gap between the demand and supply of therapeutic services for people suffering from depression, with this study, we are investigating the effectiveness and factors of influence of new approaches in group treatments for depression. Two previous studies have already identified bouldering psychotherapy (BPT) as an effective option. It combines psychotherapeutic interventions with action- and body-oriented bouldering exercises. Mental model therapy (MMT) is a new cognitive-behavioral approach for treating depression. It focuses on identifying cognitive distortions, biases in decision making, and false assumptions and aims to correct and replace them with useful mental models. We aim to investigate the effectiveness of the interventions compared with a control group (CG) and to assess the factors of influence in a mixed methods approach.

Methods

The study is being conducted as a randomized controlled intervention trial. Adult participants with unipolar depression are being randomized into three groups (BPT, MMT, or CG), and the first two groups are undergoing a 10-week treatment phase. CG follows their individual standard treatment as usual. A priori power analysis revealed that about 120 people should be included to capture a moderate effect. The primary outcome of the study is depression rated with the Montgomery and Asberg Depression Rating Scale (MADRS) before (t0), directly after (t1), and 12 months after the intervention phase (t2). Data are being collected via questionnaires, computer-assisted video interviews, and physical examinations. The primary hypotheses will be statistically analyzed by mixed model ANOVAs to compare the three groups over time. For secondary outcomes, further multivariate methods (e.g., mixed model ANOVAs and regression analyses) will be conducted. Qualitative data will be evaluated on the basis of the qualitative thematic analysis.

Discussion

This study is investigating psychological and physical effects of BPT and MMT and its factors of influence on outpatients suffering from depression compared with a CG in a highly naturalistic design. The study could therefore provide insight into the modes of action of group therapy for depression and help to establish new short-term group treatments. Methodological limitations of the study might be the clinical heterogeneity of the sample and confounding effects due to simultaneous individual psychotherapy.

Trial registration

ISRCTN, ISRCTN12347878. Registered 28 March 2022, https://www.isrctn.com/ISRCTN12347878.

Available only for authorised users

Lim GY, Tam WW, Lu Y, Ho CS, Zhang MW, Ho RC. Prevalence of depression in the community from 30 countries between 1994 and 2014. Sci Rep. 2018;8(1):1–10.CrossRef

World Health Organization. Global Burden of Disease: 2004 update. Geneva: World Health Organization; 2008. http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf . Accessed 24 Jan 2023 .

Lépine J-P, Briley M. The increasing burden of depression. Neuropsychiatr Dis Treat. 2011;7(1):3–7. https://doi.org/10.2147/NDT.S19617 .CrossRefPubMedPubMedCentral

Wittchen H-U, Jacobi F, Rehm J, Gustavsson A, Svensson M, Jönsson B, et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011;21(9):655–79.CrossRefPubMed

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):733-9; https://doi.org/10.1007/s00103-013-1688-3.

DGPPN, BÄK, KBV, AWMF (Hrsg.). S3-Leitlinie/Nationale VersorgungsLeitlinie Unipolare Depression - Kurzfassung. 2017. https://www.leitlinien.de/themen/depression/version-3. Accessed 9 May 2023.

NICE. Depression in adults: treatment and management. National Institute for Health and Care Excellence; 2022. https://www.nice.org.uk/guidance/ng222. Accessed 9 May 2023.

Cuijpers P, Karyotaki E, de Wit L, Ebert DD. The effects of fifteen evidence-supported therapies for adult depression: a meta-analytic review. Psychother Res. 2020;30(3):279–93. https://doi.org/10.1080/10503307.2019.1649732.CrossRefPubMed

Cuijpers P, Quero S, Noma H, Ciharova M, Miguel C, Karyotaki E, et al. Psychotherapies for depression: a network meta-analysis covering efficacy, acceptability and long-term outcomes of all main treatment types. World Psychiatry. 2021;20(2):283–93.CrossRefPubMedPubMedCentral

10.

Cuijpers P, Karyotaki E, Ciharova M, Miguel C, Noma H, Furukawa TA. The effects of psychotherapies for depression on response, remission, reliable change, and deterioration: a meta-analysis. Acta Psychiatr Scand. 2021;144(3):288–99. https://doi.org/10.1111/acps.13335.CrossRefPubMedPubMedCentral

11.

World Health Organization. Mental health and COVID-19: early evidence of the pandemic’s impact: scientific brief, 2 March 2022. Geneva: World Health Organization; 2022. https://www.who.int/publications/i/item/WHO-2019-nCoV-Sci_Brief-Mental_health-2022.1 . Accessed 1 May 2023 .

12.

Whittingham M, Lefforge NL, Marmarosh C. Group psychotherapy as a specialty: an inconvenient truth. Am J Psychother. 2021;74(2):60–6.CrossRefPubMed

13.

Huntley AL, Araya R, Salisbury C. Group psychological therapies for depression in the community: systematic review and meta-analysis. Br J Psychiatry. 2012;200(3):184–90.CrossRefPubMed

14.

Liu S, Gong X, Li H, Li Y. The origin, application and mechanism of therapeutic climbing: a narrative review. Int J Environ Res Public Health. 2022;19(15); https://doi.org/10.3390/ijerph19159696 .

15.

Mehl K, Wolf M. Erfahrungsorientiertes Lernen in der Psychotherapie - Evaluation psychophysischer Expositionen auf dem Hochseil im Rahmen eines multimethodalen stationären Behandlungskonzeptes [Experiential learning in psychotherapy. Evaluation of psychophysical exposure to a tightrope course as adjunct to inpatient psychotherapeutic treatment]. Psychotherapeut. 2008;53:35–42. https://doi.org/10.1007/s00278-007-0569-3.

16.

Bichler CS, Niedermeier M, Hüfner K, Gálffy M, Gostner JM, Nelles P, et al. Climbing as an add-on treatment option for patients with severe anxiety disorders and PTSD: feasibility analysis and first results of a randomized controlled longitudinal clinical pilot trial. Int J Environ Res Public Health. 2022;19(18); https://doi.org/10.3390/ijerph191811622.

17.

Bichler CS, Niedermeier M, Hüfner K, Gálffy M, Sperner-Unterweger B, Kopp M. Affective responses to both climbing and nordic walking exercise are associated with intermediate-term increases in physical activity in patients with anxiety and posttraumatic stress disorder-a randomized longitudinal controlled clinical pilot trial. Front Psychiatry. 2022;13; https://doi.org/10.3389/fpsyt.2022.856730.

18.

Schnitzler EE. Loslassen, um weiter zu kommen - Praxisbericht: Therapeutisches Klettern in der psychosomatischen Rehabilitation. [Letting go in order to move on - clinical report: therapeutic climbing in psychosomatic rehabilitation]. Rehabilitation. 2009;48(1):51–8. https://doi.org/10.1055/s-0028-1100408.CrossRefPubMed

19.

Veser S, Bady M, Wiesner M. Therapeutisches Klettern bei Kindern mit ADHS–Konzentriert durch Klettern. Ergopraxis. 2009;2(4):18–21. https://doi.org/10.1055/s-0030-1254350.CrossRef

20.

Lee H-S, Song C-S. Effects of therapeutic climbing activities wearing a weighted vest on a child with attention deficit hyperactivity disorder: a case study. J Phys Ther Sci. 2015;27(10):3337–9. https://doi.org/10.1589/jpts.27.3337.CrossRefPubMedPubMedCentral

21.

Mazzoni ER, Purves PL, Southward J, Rhodes RE, Temple VA. Effect of indoor wall climbing on self-efficacy and self-perceptions of children with special needs. Adapt Phys Activ Q. 2009;26(3):259–73.CrossRefPubMed

22.

Frühauf A, Niedermeier M, Sevecke K, Haid-Stecher N, Albertini C, Richter K, et al. Affective responses to climbing exercises in children and adolescents during in-patient treatment for mental health disorders a pilot study on acute effects of different exercise interventions. Psychiatry Res. 2020;291:113245.CrossRefPubMed

23.

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. https://doi.org/10.1186/s12888-019-2140-5.CrossRefPubMedPubMedCentral

24.

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. https://doi.org/10.1186/s12888-020-02518-y.CrossRefPubMedPubMedCentral

25.

Luttenberger K, Stelzer E-M, 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. https://doi.org/10.1186/s12888-015-0585-8.CrossRefPubMedPubMedCentral

26.

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. https://doi.org/10.1016/j.heliyon.2018.e00580.CrossRefPubMedPubMedCentral

27.

Schwarz L, Dorscht L, Book S, Stelzer E-M, 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); https://doi.org/10.1016/j.heliyon.2019.e02929.

28.

Luttenberger K, Karg-Hefner N, Berking M, Kind L, Weiss M, Kornhuber J, et al. Bouldering psychotherapy is not inferior to cognitive behavioural therapy in the group treatment of depression: a randomized controlled trial. Br J Clin Psychol. 2021;61(2):465–93. https://doi.org/10.1111/bjc.12347.CrossRefPubMed

29.

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;21(1):1162. https://doi.org/10.1186/s12913-021-07153-1.CrossRefPubMedPubMedCentral

30.

Kahneman D. A perspective on judgment and choice: mapping bounded rationality. Am Psychol. 2003;58(9):697–720. https://doi.org/10.1037/0003-066X.58.9.697.CrossRefPubMed

31.

Kahneman D, Tversky A. On the psychology of prediction. Psychol Rev. 1973;80(4):237.CrossRef

32.

Cuijpers P, de Wit L, Kleiboer A, Karyotaki E, Ebert DD. Problem-solving therapy for adult depression: an updated meta-analysis. Eur Psychiatry. 2018;48:27–37. https://doi.org/10.1016/j.eurpsy.2017.11.006.CrossRefPubMed

33.

Bowman D, Scogin F, Lyrene B. The efficacy of self-examination therapy and cognitive bibliotherapy in the treatment of mild to moderate depression. Psychother Res. 1995;5(2):131–40.CrossRef

34.

Kahneman D, Tversky A. Prospect theory: an analysis of decision under risk. In: MacLean A, Ziemba W, editors. Handbook of the Fundamentals of Financial Decision Making. Singapore: World Scientific Publishinh Co. Pte. Ltd; 2013. p. 99–127.

35.

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;9(1):126. https://doi.org/10.1186/s40359-021-00627-1.CrossRefPubMedPubMedCentral

36.

Oury F, Khrimian L, Denny CA, Gardin A, Chamouni A, Goeden N, et al. Maternal and offspring pools of osteocalcin influence brain development and functions. Cell. 2013;155(1):228–41. https://doi.org/10.1016/j.cell.2013.08.042.CrossRefPubMed

37.

Berger JM, Singh P, Khrimian L, Morgan DA, Chowdhury S, Arteaga-Solis E, et al. Mediation of the acute stress response by the skeleton. Cell Metab. 2019;30(5):890–902. https://doi.org/10.1016/j.cmet.2019.08.012.CrossRefPubMedPubMedCentral

38.

Kalinichenko LS, Mühle C, Jia T, Anderheiden F, Datz M, Eberle A-L, et al. Adult alcohol drinking and emotional tone are mediated by neutral sphingomyelinase during development in males. Cereb Cortex. 2022. https://doi.org/10.1093/cercor/bhac106.CrossRef

39.

Kalinichenko LS, Muhle C, Jia T, Anderheiden F, Datz M, Eberle A-L, et al. Neutral sphingomyelinase mediates the co-morbidity trias of alcohol abuse, major depression and bone defects. Mol Psychiatry. 2021;26(12):7403–16. https://doi.org/10.1038/s41380-021-01304-w.CrossRefPubMedPubMedCentral

40.

Chahla SE, Frohnert BI, Thomas W, Kelly AS, Nathan BM, Polgreen LE. Higher daily physical activity is associated with higher osteocalcin levels in adolescents. Prev Med Rep. 2015;2:568–71. https://doi.org/10.1016/j.pmedr.2015.06.017.CrossRefPubMedPubMedCentral

41.

Wagner CJ, Musenbichler C, Böhm L, Färber K, Fischer A-I, von Nippold F, et al. LDL cholesterol relates to depression, its severity, and the prospective course. Prog Neuropsychopharmacol Biol Psychiatry. 2019;92:405–11.CrossRefPubMed

42.

von Zimmermann C, Winkelmann M, Richter-Schmidinger T, Mühle C, Kornhuber J, Lenz B. Physical activity and body composition are associated with severity and risk of depression, and serum lipids. Front Psychiatry. 2020;11:494. https://doi.org/10.3389/fpsyt.2020.00494.CrossRef

43.

Schumacher F, Edwards MJ, Mühle C, Carpinteiro A, Wilson GC, Wilker B, et al. Ceramide levels in blood plasma correlate with major depressive disorder severity and its neutralization abrogates depressive behavior in mice. J Biol Chem. 2022;298(8):102185. https://doi.org/10.1016/j.jbc.2022.102185.CrossRefPubMedPubMedCentral

44.

Mühle C, Wagner CJ, Färber K, Richter-Schmidinger T, Gulbins E, Lenz B, et al. Secretory acid sphingomyelinase in the serum of medicated patients predicts the prospective course of depression. J Clin Med. 2019;8(6); https://doi.org/10.3390/jcm8060846.

45.

Rhein C, Reichel M, Kramer M, Rotter A, Lenz B, Mühle C, et al. Alternative splicing of SMPD1 coding for acid sphingomyelinase in major depression. J Affect Disord. 2017;209:10–5. https://doi.org/10.1016/j.jad.2016.09.019.CrossRefPubMed

46.

Rhein C, Zoicas I, Marx LM, Zeitler S, Hepp T, von Zimmermann C, et al. mRNA expression of SMPD1 encoding acid sphingomyelinase decreases upon antidepressant treatment. Int J Mol Sci. 2021;22(11):5700.CrossRefPubMedPubMedCentral

47.

von Zimmermann C, Böhm L, Richter-Schmidinger T, Kornhuber J, Lenz B, Mühle C. Ex vivo glucocorticoid receptor-mediated IL-10 response predicts the course of depression severity. J Neural Transm (Vienna). 2021;128(1):95–104. https://doi.org/10.1007/s00702-020-02288-7.CrossRef

48.

Schaller G, Sperling W, Richter-Schmidinger T, Mühle C, Heberlein A, Maihöfner C, et al. Serial repetitive transcranial magnetic stimulation (rTMS) decreases BDNF serum levels in healthy male volunteers. J Neural Transm (Vienna). 2014;121(3):307–13. https://doi.org/10.1007/s00702-013-1102-1.CrossRefPubMed

49.

Swoboda C, Deloch L, von Zimmermann C, Richter-Schmidinger T, Lenz B, Kornhuber J, et al. Macrophage migration inhibitory factor in major depressive disorder: a multilevel pilot study. Int J Mol Sci. 2022;23(24); https://doi.org/10.3390/ijms232415460.

50.

Grawe K. Psychological therapy. Seattle: Hogrefe & Huber; 2004.

51.

Chan AW, Tetzlaff JM, Gotzsche PC, Altman DG, Mann H, Berlin JA, et al. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013;346:e7586. https://doi.org/10.1136/bmj.e7586.CrossRefPubMedPubMedCentral

52.

Neue Wege aus der Depression. https://www.psychiatrie.uk-erlangen.de/index.php?id=1023975. Accessed 9 May 2023.

53.

Fassbinder E, Klein JP, Sipos V, Schweiger U. Therapie-Tools Depression: Mit E-Book inside und Arbeitsmaterial. Beltz; 2015.

54.

Altman DG, Bland JM. Treatment allocation by minimisation. BMJ. 2005;330(7495):843. https://doi.org/10.1136/bmj.330.7495.843.CrossRefPubMedPubMedCentral

55.

R Core Team. R: a language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2022.

56.

Boulderpsychotherapie. https://www.psychiatrie.uk-erlangen.de/med-psychologie-soziologie/forschung/app-boulderpsychotherapie/. Accessed 9 May 2023.

57.

Grossmann I, Kross E. Exploring Solomon’s paradox: self-distancing eliminates the self-other asymmetry in wise reasoning about close relationships in younger and older adults. Psychol Sci. 2014;25(8):1571–80. https://doi.org/10.1177/0956797614535400.CrossRefPubMed

58.

Klayman J. Varieties of Confirmation Bias. In: Busemeyer J, Hastie R, Medin DL, editors. Decision making from a cognitive perspective. 32. San Diego: Academic Press, Inc., A Division of Harcourt Brace & Company; 1995. p. 385–418.

59.

Arkes HR, Blumer C. The psychology of sunk cost. Organ Behav Hum Decis Processes. 1985;35(1):124–40. https://doi.org/10.1016/0749-5978(85)90049-4.CrossRef

60.

Roese NJ, Vohs KD. Hindsight bias. Perspect Psychol Sci. 2012;7(5):411–26. https://doi.org/10.1177/1745691612454303.CrossRefPubMed

61.

Robins CJ, Schmidt H, Linehan MM. Dialectical Behavior Therapy: Synthesizing Radical Acceptance with Skillful Means. In: Hayes SC, Follette VM, Linehan MM, editors. Mindfulness and acceptance: expanding the cognitive-behavioral tradition. New York: The Guilford Press; 2004. p. 30–44.

62.

Jefferys WH, Berger JO. Ockham’s razor and Bayesian analysis. Am Sci. 1992;80(1):64–72.

63.

Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979;134(4):382–9. https://doi.org/10.1192/bjp.134.4.382.CrossRefPubMed

64.

Williams JBW, Kobak KA. Development and reliability of a structured interview guide for the Montgomery-Åsberg Depression Rating Scale (SIGMA). Br J Psychiatry. 2008;192(1):52–8. https://doi.org/10.1192/bjp.bp.106.032532.CrossRefPubMed

65.

Hawley CJ, Gale TM, Sivakumaran T, group HNR. Defining remission by cut off score on the MADRS: selecting the optimal value. J Affect Disord. 2002;72(2):177–84.CrossRefPubMed

66.

Müller MJ, Himmerich H, Kienzle B, Szegedi A. Differentiating moderate and severe depression using the Montgomery-Åsberg depression rating scale (MADRS). J Affect Disord. 2003;77(3):255–60. https://doi.org/10.1016/S0165-0327(02)00120-9.CrossRefPubMed

67.

Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Internal Med. 2006;166(10):1092–7. https://doi.org/10.1001/archinte.166.10.1092.CrossRef

68.

Jerusalem M, Schwarzer R. SWE - Skala zur Allgemeinen Selbstwirksamkeitserwartung. Trier: Leibniz-Zentrum für Psychologische Information und Dokumentation (ZPID); 2003.

69.

Hinz A, Schumacher J, Albani C, Schmid G, Brähler E. Bevölkerungsrepräsentative Normierung der Skala zur allgemeinen Selbstwirksamkeit. Diagnostica. 2006;52:26–32.CrossRef

70.

Schumacher J, Wilz G, Gunzelmann T, Brähler E. Die sense of coherence scale von Antonovsky. Psychother Psychosom Med Psychol. 2000;50(12):472–82. https://doi.org/10.1055/s-2000-9207.CrossRefPubMed

71.

Bachem R, Maercker A. Development and psychometric evaluation of a revised sense of coherence scale. Eur J Psychol Assess. 2018;34(3):206–15. https://doi.org/10.1027/1015-5759/a000323.CrossRef

72.

Kovaleva A, Beierlein C, Kemper C, Rammstedt B. Eine Kurzskala zur Messung von Kontrollüberzeugung: Die Skala Internale-Externale Kontrollüberzeugung-4 (IE-4). Köln: GESIS-Leibniz-Institut für Sozialwissenschaften; 2012.

73.

Tanay G, Bernstein A. State Mindfulness Scale (SMS): development and initial validation. Psychol Assess. 2013;25(4):1286.CrossRefPubMed

74.

Ullrich-French S, Hernández JG, Montesinos MDH. Validity evidence for the adaptation of the State Mindfulness Scale for Physical Activity (SMS-PA) in Spanish youth. Psicothema. 2017;29(1):119–25. https://doi.org/10.7334/psicothema2016.204.CrossRefPubMed

75.

Blanke ES, Brose A. Mindfulness in daily life: a multidimensional approach. Mindfulness. 2017;8(3):737–50. https://doi.org/10.1007/s12671-016-0651-4.CrossRef

76.

Fuchs R, Klaperski S, Gerber M, Seelig H. Messung der Bewegungs-und Sportaktivität mit dem BSA-Fragebogen. Zeitschrift für Gesundheitspsychologie. 2015;23(2):60–76. https://doi.org/10.1026/0943-8149/a000137.CrossRef

77.

Vogel E, Blanck P, Bents H, Mander J. Wirkfaktoren in der Gruppentherapie: Entwicklung und Validierung eines Fragebogens [Change Factors in Group Therapy: Development and Validation of a Questionnaire]. Psychother Psychosom Med Psychol. 2016;66(5):170–9. https://doi.org/10.1055/s-0042-104495.CrossRefPubMed

78.

HPMS Inc. The Therapy Connection. Baseline® Hydraulic Hand Dynamometers: HPMS; 2023. https://www.hpms.com/Baseline-Hydraulic-Hand-Dynamometers-p/fab-dynamometer.htm. Accessed 9 May 2023.

79.

Roberts HC, Denison HJ, Martin HJ, Patel HP, Syddall H, Cooper C, et al. A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age Ageing. 2011;40(4):423–9. https://doi.org/10.1093/ageing/afr051.CrossRefPubMed

80.

Steiber N. Strong or weak handgrip? Normative reference values for the German population across the life course stratified by sex, age, and body height. PLoS One. 2016;11(10); https://doi.org/10.1371/journal.pone.0163917.

81.

Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S. Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil. 1985;66(2):69–74.PubMed

82.

McGill SM. McGill’s torsomuscular endurance test battery. 2015. https://www.acefitness.org/cmes-resources/pdfs/02-10-CMES-McGillsTorsoEnduracneTest.pdf . Accessed 9 May 2023 .

83.

Mühle C, Kornhuber J. Assay to measure sphingomyelinase and ceramidase activities efficiently and safely. J Chromatogr A. 2017;1481:137–44. https://doi.org/10.1016/j.chroma.2016.12.033.CrossRefPubMed

84.

Frederick S. Cognitive reflection and decision making. J Econ Perspect. 2005;19(4):25–42.CrossRef

85.

Toplak ME, West RF, Stanovich KE. Assessing miserly information processing: an expansion of the Cognitive Reflection Test. Think Reason. 2014;20(2):147–68. https://doi.org/10.1080/13546783.2013.844729.CrossRef

86.

Grawe K, Donati R, Bernauer F, Donati R. Psychotherapie im Wandel: von der Konfession zur Profession. Verlag für Psychologie Göttingen: Hogrefe; 1994.

87.

Mayring P, Fenzl T. Qualitative Inhaltsanalyse. In: Baur N, Blasius J, editors. Handbuch Methoden der empirischen Sozialforschung. Wiesbaden: Springer; 2022. p. 691–706.CrossRef

88.

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101. https://doi.org/10.1191/1478088706qp063oa.CrossRef

89.

Ali MW, Siddiqui O. Multiple imputation compared with some informative dropout procedures in the estimation and comparison of rates of change in longitudinal clinical trials with dropouts. J Biopharm Stat. 2000;10(2):165–81.CrossRefPubMed

90.

Neuhof A, Hennig FF, Schoffl I, Schoffl V. Injury risk evaluation in sport climbing. Int J Sports Med. 2011;32(10):794–800. https://doi.org/10.1055/s-0031-1279723.CrossRefPubMed

Title: New ways to cope with depression—study protocol for a randomized controlled mixed methods trial of bouldering psychotherapy (BPT) and mental model therapy (MMT)
Authors: Leona Kind
Katharina Luttenberger
Vivien Leßmann
Lisa Dorscht
Christiane Mühle
Christian P. Müller
Eva-Maria Siegmann
Sophia Schneider
Johannes Kornhuber
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Psychotherapy
Mood Disorders
Affective Disorder
Psychotherapy
Mindfulness
Published in: Trials / Issue 1/2023
Electronic ISSN: 1745-6215
DOI: https://doi.org/10.1186/s13063-023-07629-x

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

New ways to cope with depression—study protocol for a randomized controlled mixed methods trial of bouldering psychotherapy (BPT) and mental model therapy (MMT)

Abstract

Background

Methods

Discussion

Trial registration

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Abstract

Background

Methods

Discussion

Trial registration

Please log in to get access to this content

Other articles of this Issue 1/2023

Randomized phase III trial evaluating motivational interviewing and text interventions to optimize adherence to breast cancer endocrine therapy (Alliance A191901): the GETSET protocol

Further considerations for placebo controls in surgical trials

Effectiveness of full Pulpotomy compared with Root canal treatment in managing teeth with signs and symptOms indicative of irreversible pulpitis: a protocol for prospectiVE meta-analysis of individual participant data of linked randomised clinical trials (PROVE)

Study protocol for The GOAL Trial: comprehensive geriatric assessment for frail older people with chronic kidney disease to increase attainment of patient-identified goals—a cluster randomised controlled trial

Evaluation of the efficacy and safety of amustaline/glutathione pathogen-reduced RBCs in complex cardiac surgery: the Red Cell Pathogen Inactivation (ReCePI) study—protocol for a phase 3, randomized, controlled trial

PHaLIR: prevent hernia after loop ileostomy reversal—a study protocol for a randomized controlled multicenter study