Walk-and-Talk Therapy for Depression and Anxiety
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Phase 2
Recruiting
Sponsor: Kansas State University
Disqualifiers: Active suicidal ideation, exercise risk, others
No Placebo Group
Prior Safety Data
Trial Summary
What is the purpose of this trial?This project will examine changes in depression and anxiety following a 10-week intervention promoting nature-based physical activity in mental health settings. We will recruit ten licensed therapists whose caseload includes adults with depression and anxiety. Following a training by our team, each participating therapist will recruit six clients, who will be randomly assigned to the intervention or control condition. Clients in the intervention condition will engage in walk-and-talk therapy outdoors during weekly sessions and discuss strategies for being active outdoors on their own. We will assess changes in depression, anxiety, and nature-based physical activity in both groups.
Do I need to stop taking my current medications for this trial?
The trial protocol does not specify whether you need to stop taking your current medications. It is best to discuss this with your therapist or the trial coordinators.
What data supports the effectiveness of the treatment Walk-and-talk therapy for depression and anxiety?
Research shows that cognitive-behavioral therapy (CBT), which is a part of walk-and-talk therapy, is effective in reducing symptoms of depression and anxiety. Studies also highlight the importance of a strong therapeutic alliance (the relationship between therapist and patient) in improving treatment outcomes, which is a key component of walk-and-talk therapy.
12345Is walk-and-talk therapy safe for treating depression and anxiety?
The research does not provide specific safety data for walk-and-talk therapy, but walking as part of therapy has been studied and generally considered safe for anxiety disorders.
678910How is walk-and-talk therapy different from other treatments for depression and anxiety?
Walk-and-talk therapy is unique because it combines physical activity with traditional talk therapy, allowing patients to engage in therapy sessions while walking. This approach may offer additional benefits from exercise, which has been shown to help reduce symptoms of depression and anxiety.
1112131415Eligibility Criteria
This trial is for adults with depression and anxiety who are currently seeing a therapist. Participants should be interested in nature-based physical activity. Therapists must have the appropriate caseload and agree to training. People with conditions that limit outdoor activity or those unable to commit to the full 10-week program cannot join.Inclusion Criteria
My therapist is part of the study and trained for it.
I have been diagnosed with depression or an anxiety disorder.
Willing to complete all study requirements
+1 more
Exclusion Criteria
I am currently having thoughts about harming myself.
Planning to discontinue therapy in less than 6 months
Does not pass exercise risk screener
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Training
Therapists receive a 3-hour in-person training covering project aims, procedures, and benefits of nature-based physical activity for mental health
1 day
Treatment
Participants engage in a 10-week intervention with walk-and-talk therapy outdoors during weekly sessions and set goals for nature-based physical activity
10 weeks
10 visits (in-person)
Follow-up
Participants are monitored for changes in depression, anxiety, and nature-based physical activity after the intervention
4 weeks
Participant Groups
The study tests walk-and-talk therapy, where clients engage in outdoor sessions focusing on active strategies while discussing mental health issues. Over 10 weeks, half of the participants will receive this intervention; the other half won't, allowing comparison of changes in mental health and physical activity levels.
2Treatment groups
Experimental Treatment
Active Control
Group I: Intervention (immediate start)Experimental Treatment1 Intervention
Participants will engage in walk-and-talk therapy during weekly sessions with their therapist and will set goals for engaging in nature-based physical activity on their own outside of therapy.
Group II: Waitlist controlActive Control1 Intervention
Participants will receive generic educational materials about nature-based physical activity and local parks.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Kansas State UniversityManhattan, KS
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Who Is Running the Clinical Trial?
Kansas State UniversityLead Sponsor
REI Cooperative Action FundCollaborator
References
Forecasting success: patients' expectations for improvement and their relations to baseline, process and outcome variables in group cognitive-behavioural therapy for depression. [2022]There is growing evidence for the important role of patients' outcome expectations to the process and outcome of psychotherapy, yet its relevance to group cognitive-behavioural therapy (CBT) for depression has not been examined. In an effort to fill this void, the present study investigated expectations for improvement among 80 psychiatric outpatients attending a group CBT program for depression. The study addressed the following four questions: (1) Which baseline patient characteristics might be associated with patients' expectations for improvement? (2) Does providing a rationale and outline for treatment affect patients' expectations? (3) Are patients' expectations related to the quality of therapeutic alliance? and (4) Are patients' expectations associated with the outcome of treatment? The main findings of the study are as follows: (a) baseline symptoms of depression, quality of life and current suicidal ideations were consistently associated with outcome expectancies; (b) outcome expectancies were unrelated to treatment completion status; (c) although expectancy ratings did not change significantly for the group as a whole, there was some variability in how individual patient's expectancy ratings changed; (d) baseline expectancies were related to early-treatment alliance quality, but not to mid-treatment alliance, whereas early-treatment expectancies were significantly associated with mid-treatment alliance; and (e) baseline expectations of favourable outcome had a negative association with improvement in anxiety symptoms, yet expectancy ratings from session 3 had a positive association with improvement in quality of life and interpersonal problems. Increases in expectancy ratings were significantly related to improvement in anxiety, quality of life and interpersonal problems.
Naturalistic outcome of case formulation-driven cognitive-behavior therapy for anxious depressed outpatients. [2022]This article describes a case formulation-driven approach to the treatment of anxious depressed outpatients and presents naturalistic outcome data evaluating its effectiveness. Fifty-eight patients who received case formulation-driven cognitive-behavior therapy (CBT) in a private practice setting were studied. All received individual CBT guided by a case formulation and weekly outcome monitoring; in addition, 40 patients received adjunct therapies, including pharmacotherapy, which were added as indicated by the case formulation and the results of weekly outcome monitoring. Patients treated with case formulation-driven CBT showed statistically and clinically significant changes in anxiety and depression that were generally comparable to those reported in published randomized controlled trials of empirically supported therapies (ESTs) for single mood and anxiety disorders. Findings support the proposal that anxious depressed patients who have multiple comorbidities and require multiple therapies can benefit from empirically supported treatments guided by a case formulation and weekly outcome monitoring.
Quality of life in depression and anxiety disorders: an exploratory follow-up study after intensive inpatient cognitive behaviour therapy. [2018]Thirty-seven patients with depression and anxiety disorder, who participated in an intensive inpatient cognitive behaviour therapy program for 6 weeks, were interviewed before treatment and 6 weeks after the end of treatment; in addition to other measures, quality of life was assessed with the Berlin Quality of Life Profile. Substantial reduction in subjective quality of life, objective functioning and environmental assets was found at baseline. At follow-up, according to clinical global impression, 13.5% of the patients were very much improved, 45.9% much improved; in 26.3% only slight improvement and in 16.2% no improvement was reported. Quality of life changed for the better in areas like work and education, leisure, housing, social relations, psychological well-being and a global rating of satisfaction with life, but not in marital relations, health in general and in finances.
Do comorbid social and other anxiety disorders predict outcomes during and after cognitive therapy for depression? [2020]Cognitive therapy (CT) improves symptoms in adults with major depressive disorder (MDD) plus comorbid anxiety disorder, but the specific type of anxiety may influence outcomes. This study compared CT outcomes among adults with MDD plus social, other, or no comorbid anxiety disorders.
The role of the therapeutic alliance in psychotherapy and pharmacotherapy outcome: findings in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. [2022]The relationship between therapeutic alliance and treatment outcome was examined for depressed outpatients who received interpersonal psychotherapy, cognitive-behavior therapy, imipramine with clinical management, or placebo with clinical management. Clinical raters scored videotapes of early, middle, and late therapy sessions for 225 cases (619 sessions). Outcome was assessed from patients' and clinical evaluators' perspectives and from depressive symptomatology. Therapeutic alliance was found to have a significant effect on clinical outcome for both psychotherapies and for active and placebo pharmacotherapy. Ratings of patient contribution to the alliance were significantly related to treatment outcome; ratings of therapist contribution to the alliance and outcome were not significantly linked. These results indicate that the therapeutic alliance is a common factor with significant influence on outcome.
Promoting walking as an adjunct intervention to group cognitive behavioral therapy for anxiety disorders--a pilot group randomized trial. [2022]A group randomized trial of adding a home-based walking program to a standard group cognitive behavioral therapy (GCBT+EX) was compared with groups receiving GCBT and educational sessions (GCBT+ED). The study was implemented in an outpatient clinic providing GCBT for clients diagnosed with panic disorder, generalized anxiety disorder or social phobia. Pre- and post-treatment measures included the self-report depression, anxiety, and stress scale (DASS-21) and measures of physical activity. From January 2004 to May 2005, six groups were allocated to GCBT+EX (n=38) and five to GCBT+ED (n=36). Analysis of covariance for completed cases (GCBT+EX, n=21; GCBT+ED, n=20), adjusting for the group design, baseline DASS-21 scores, and anxiety diagnosis showed significant effect for GCBT+EX on depression, anxiety, and stress (regression coefficients=-6.21, -3.41, and -5.14, respectively, p
Drugs vs. talk therapy: 3,079 readers rate their care for depression and anxiety. [2022]With or without drugs, most people who sought care for depression or anxiety gained relief. A survey of thousands of CR subscribers who recently received treatment for those conditions found that: (1) a combination of talk therapy and drugs often worked best. But "mostly talk" therapy was almost as effective if it lasted for 13 or more visits. (2) "Mostly drug" therapy was also effective for many people. Drugs had a quicker impact on symptoms than talk therapy, but it often took trial and error to find a drug that worked without unacceptable side effects. (3) Forty percent of people who took antidepressants complained of adverse sexual side effects. (4) Care from primary-care doctors was effective for people with mild problems, but less so for people with severe ones.
Combining Dance/Movement Therapy with Cognitive Behavioral Therapy in Treatment of Children with Anxiety Disorders: Factors Explaining Therapists' Attitudes. [2022]Anxiety disorders (ADs) are among the most common psychiatric disorders and they may appear as early on as in childhood. The current study addressed the combination of two treatments approaches for ADs: Dance/movement therapy (DMT) and cognitive behavioral therapy (CBT), focusing on factors that explain the therapists' attitudes towards actually combining the two therapies. The study utilized a quantitative design, with a perceptions survey administered via an online questionnaire. Ninety-nine therapists participated in the study (DMT-only n = 35, CBT-only n = 42, and DMT + CBT, n = 22). Following preliminary analysis (comparison between the groups, correlations and factor analysis), the structural equation model (SEM, confirmatory factor analysis) revealed a good fit between the theoretical model and the empirical data. First, it was found that the reported actual use of the combined approaches (DMT + CBT) in treatment of children with ADs, was significantly explained by therapists who had experience practicing DMT but not CBT perceiving this combination as efficient. Second, the therapists' use of the combined therapy (DMT + CBT) approaches was not related to their sense of efficacy as therapists of children with ADs. The model represents concordance between the components of the therapists' attitudes: Affective-belief that it is efficient, cognitive-perception of it as effective, and behavioral-their actual use.
Depression does not affect the treatment outcome of CBT for panic and agoraphobia: results from a multicenter randomized trial. [2018]Controversy surrounds the questions whether co-occurring depression has negative effects on cognitive-behavioral therapy (CBT) outcomes in patients with panic disorder (PD) and agoraphobia (AG) and whether treatment for PD and AG (PD/AG) also reduces depressive symptomatology.
Cognitive behavioral therapy for depression. [2022]CBT is a valuable treatment for mild, moderate, and severe forms of major depression. It is equally effective and more durable than medication alone, and the combination of medication and CBT may increase the response rate and extend durability when CBT is employed after pharmacotherapy is successful. Therapist competence has been shown to influence outcomes in CBT for depression. Practitioners who wish to learn more about CBT may access a wide variety of educational materials: basic texts, course offerings at major scientific meetings, and local and national training centers are available. The Academy of Cognitive Therapy website (www.academyofct.org) provides detailed information about obtaining training and certification in CBT.
Non-randomised feasibility study of training workshops for Talking Therapies service high-intensity therapists to optimise depression and anxiety outcomes for individuals with co-morbid personality difficulties: a study protocol. [2023]The NHS Talking Therapies for Anxiety and Depression programme ('TTad'; formerly Improving Access to Psychological Therapies 'IAPT') delivers high-intensity cognitive behavioural therapy (CBT) to over 200,000 individuals each year for common mental health problems like depression and anxiety. More than half of these individuals experience comorbid personality difficulties, who show poorer treatment outcomes. TTad therapists report feeling unskilled to work with clients with personality difficulties, and enhancing the training of TTad therapists may lead to improved treatment outcomes for individuals presenting with secondary personality difficulties alongside depression and anxiety.
Tailored vs. standardized internet-based cognitive behavior therapy for depression and comorbid symptoms: a randomized controlled trial. [2023]Major depression can be treated by means of cognitive behavior therapy, delivered via the Internet as guided self-help. Individually tailored guided self-help treatments have shown promising results in the treatment of anxiety disorders. This randomized controlled trial tested the efficacy of an Internet-based individually tailored guided self-help treatment which specifically targeted depression with comorbid symptoms. The treatment was compared both to standardized (non-tailored) Internet-based treatment and to an active control group in the form of a monitored online discussion group. Both guided self-help treatments were based on cognitive behavior therapy and lasted for 10 weeks. The discussion group consisted of weekly discussion themes related to depression and the treatment of depression.
Effects of Exercise on Depression and Anxiety. A Comparison to Transdiagnostic Cognitive Behavioral Therapy. [2019]The aims of this study were (i) to know the effects of an exercise program on a group of people with depression and anxiety and (ii) to compare theses effects with a transdiagnostic cognitive behavioral group therapy (TCBGT). The participants were 15 people with depression and/or anxiety symptoms. The participants followed an exercise program. Depression and anxiety symptoms were assessed with validated questionnaires. An exercise program can be used as a treatment option for people with depression and/or anxiety with good results in comparison with TCBGT.
Editorial: Optimizing Depression Prevention: The Way Forward? [2021]Since the advent of cognitive-behavioral therapy (CBT) and interpersonal therapy in the 1960s and 1970s, the progress on "talking therapies" has been slow. An extensive review of prevention and treatment studies over the past 50 years has shown that, although the therapies are effective, for depression the effect size is moderate, even for treatment, and has not changed in 50 years,1 with some indication that efficacy may have decreased.2 The approaches used in treatment have also been the mainstay of depression prevention approaches,3,4 with evidence of a small-to-moderate reduction in depressive symptoms but with no convincing evidence of reduction in the incidence of depressive disorder in meta-analyses.3,4.
Disorder-specific versus transdiagnostic and clinician-guided versus self-guided treatment for major depressive disorder and comorbid anxiety disorders: A randomized controlled trial. [2022]Disorder-specific cognitive behavior therapy (DS-CBT) is effective at treating major depressive disorder (MDD) while transdiagnostic CBT (TD-CBT) addresses both principal and comorbid disorders by targeting underlying and common symptoms. The relative benefits of these two models of therapy have not been determined. Participants with MDD (n=290) were randomly allocated to receive an internet delivered TD-CBT or DS-CBT intervention delivered in either clinician-guided (CG-CBT) or self-guided (SG-CBT) formats. Large reductions in symptoms of MDD (Cohen's d≥1.44; avg. reduction≥45%) and moderate-to-large reductions in symptoms of comorbid generalised anxiety disorder (Cohen's d≥1.08; avg. reduction≥43%), social anxiety disorder (Cohen's d≥0.65; avg. reduction≥29%) and panic disorder (Cohen's d≥0.45; avg. reduction≥31%) were found. No marked or consistent differences were observed across the four conditions, highlighting the efficacy of different forms of CBT at treating MDD and comorbid disorders.