Therapeutic climbing as an adjunctive treatment for psychiatric inpatients: A qualitative study

Therapeutic climbing (TC) is increasingly used as a therapy form in psychosomatic settings. Recent studies have shown its effectiveness in terms of symptom severity and other psychological factors compared to other sports and even to group cognitive behavioural therapy. To gain a deeper understanding of TC, the present study aimed to qualitatively explore the patients' perspectives.

The qualitative study used semi-structured interviews to explore the experiences of inpatients at a psychosomatic clinic who participated in a standardised climbing therapy group. The main diagnoses of the participants were depression, anxiety, or obsessive-compulsive disorder (n = 17; 12 female, 5 male). Data were analysed using thematic content analysis.

Most patients described positive effects of TC. The following four factors emerged: Cognitive (e.g. concentration, focus), emotional (e.g. trust in oneself and others), social (e.g. mutual support), and physical (e.g. strength). Patients also reported positive perceived aspects in connection with their mental disorder and listed various transfer options, which indicates an effectiveness beyond TC.

From the patients' perspective, TC influences various factors, which also interact. Many of the identified effects could be assigned to the common factors of psychotherapy, which indicates that TC addresses similar factors as established psychotherapies. In addition to the researched aspects of self-efficacy and affective responses, new aspects were identified: Focus and concentration, social interaction, facing challenges, improved self-confidence, trust in others, and resource activation. Practical implications could be derived from this. Future studies should investigate the efficacy of TC in randomised, controlled clinical trials, considering the aspects identified.