General information about the project

Since February 2018, the Department of Clinical Psychology and Psychotherapy of the University of Tuebingen is implementing a group therapeutic exercise program called ImPuls in cooperation with the Institute of Sports Science (Prof. Dr. Gorden Sudeck) and the Academy for Behavioral Therapy Tuebingen (TAVT) and the Psychotherapy outpatient clinic: A strong mind through motivation and exercise. A cognitive behavioral therapeutic exercise for patients who are waiting for psychotherapy. ImPuls addresses people with different mental illnesses (anxiety disorder, depression, ADHD, sleep disorder) who are waiting for psychotherapy (e.g., cognitive behavior therapy, psychoanalysis etc.). Within four weeks, ImPuls aims at building up knowledge about the positive effects of physical activity, to gain motivation and enjoyment from being physically active, to deal with possible psychological exercise-related obstacles as well as to develop exercise-related health skills. All this will enable the participants to integrate physical activity into their everyday lives.

Scientific findings about the effects of physical activity on mental health

The number of mental illnesses are increasing in Germany. They represent one of the three most common causes of disability to work in Germany (Bundespsychotherapeutenkammer, 2015). At the same time, people have to wait at least three months until they get psychotherapy (Bundespsychotherapeutenkammer, 2011, Zeit, 2014). Only 2.5% of people with a mental disorder receive psychotherapy (Nubling & Nick, 2014). Additionally, the adherence to treatment recommendations in psychotherapy shows a very high discontinuation rate of 20-60% (Jacobi, 2011, Salmoiraghi & Sambhi, 2010, Swift & Greenberg, 2012). These care gaps may be closed by exercise therapy approaches referring to the convincing empirical evidence about the effects of physical activity on mental health. Thus, the therapeutic effect of physical activity on patients suffering from depression is comparable to the effects of cognitive behavioral therapy and classical antidepressants (Cooney et al., 2013, Schuch et al., 2016, Wolf & Hautzinger, 2012). Positive effects are also seen in patients with anxiety disorders (Jayakody, Gunadasa, & Hosker, 2014, Stonerock, Hoffman, Smith, & Blumenthal, 2015), ADHD (Archer & Kostrzewa, 2012, Memarmoghaddam, Torbati, Sohrabi, Mashhadi, & Kashi, 2016) and sleep disorders (Morita, Sasai-Sakuma & Inoue, 2017, Reid et al., 2010). Nevertheless, there are no therapeutic exercise programs for the outpatient psychotherapeutic context across different mental illnesses.

Have we gathered your interest and would you like to help us to develop and evaluate a new form of treatment for patients will mental illnesses?

Procedure and detailed information

The following criteria should be fulfilled for participation:

• You are on a waiting list for a psychotherapy place and have to wait at least 4 months until you get a psychotherapy
• You are currently not engaging in physical activity (endurance training) more than once a week
• You are aged between 18 and 65 years
• You are not taking any medication or have not changed your medication (e.g, Elavil) for at least two months
• You do not take benzodiazepines (e.g., Lorazepam)

If you were to participate, you would go through the following steps:

• Two diagnostic examinations of maximum 2 hours each
• Random assignment to the control group (only psychotherapy at the end of the program) or to the ImPuls group (ImPuls exercise program and psychotherapy at the end of the program)
• After the program: two further diagnostic examinations of 2 hours each
• Guaranteed psychotherapy after the termination of the study *

If you are assigned to the ImPuls group, you will go through a three-month exercise program: In the first four weeks, small group sessions (4-5 people) take place three times a week, combining endurance exercise and psycho-educational elements, which is supervised by two therapists. The training is individually adapted to your fitness. After that, participants are engaging in physical activity independently twice per week for eight weeks at various local sport clubs.

* If you are on the waiting list for psychotherapy of a practice or an outpatient clinic and you will not get psychotherapy one year after the start of the study, you will receive psychotherapy at the psychotherapeutic university ambulance preferentially (provided that there is an indication).