In a quiet corner of a clinic in Germany, a group of patients is scaling rock walls, but they’re not just pushing their muscles to the limit. As their hands grip the cold, solid holds, something else is happening—something even more profound. They’re also tackling anxiety, depression, and the crippling thoughts that so often accompany mental health disorders. This isn’t a typical therapy session. It’s therapeutic climbing, and for these psychiatric inpatients, it’s becoming a lifeline.
The story behind this unconventional treatment begins with the work of a group of researchers at the University of Innsbruck and Schoen Clinic Roseneck, who have uncovered how structured climbing sessions are helping those with depression, anxiety, and obsessive-compulsive disorder (OCD) find emotional relief, mental focus, and a new sense of connection to others. Their research, published in The Journal of Behavior Therapy and Experimental Psychiatry, sheds light on why physical challenges like climbing may be just what some patients need when traditional treatments fall short.
The Challenge of Untreated Mental Health Disorders
In Germany, where the study took place, mental health struggles are more common than many realize. Nearly one in three people in the country meet the criteria for a mental disorder, a statistic that far exceeds the global average. Yet, only 19% of those affected seek help, and many of those who do face long waitlists—up to six months—before they can begin treatment. This prolonged delay leaves many people living with untreated symptoms for extended periods.
While psychotherapy is the standard route to recovery, the gap in treatment availability is a pressing concern. In the meantime, patients continue to suffer. Exercise has long been shown to help alleviate symptoms of depression and anxiety, reducing mortality risk and improving emotional well-being. But exercise as a therapeutic intervention has historically been an underutilized tool in psychiatric care. That’s where therapeutic climbing comes in.
From the Rock Wall to the Therapy Room
Therapeutic climbing isn’t your typical workout. It started as a passion project among clinicians who loved rock climbing and decided to bring it into psychiatric care. What makes it different from traditional physical exercise is its unique ability to blend mental, emotional, and social engagement with physical effort. Rope climbing and bouldering, for instance, require concentration, coordination, and—depending on the height—can trigger intense emotions. The structured environment of a climbing wall, however, provides a safe space for individuals to confront and work through these feelings.
In the therapeutic climbing sessions at the clinic, patients face challenges on the wall that mirror the obstacles they grapple with in their daily lives. Whether it’s fear of failure, self-doubt, or the anxiety that comes with stepping out of one’s comfort zone, climbing serves as a testing ground for overcoming these mental barriers.
In a series of interviews conducted with 17 patients, the research team found that participants experienced a wide range of emotional responses. Initially, many struggled with anxiety—fear of heights, fear of making mistakes, fear of being judged. But over the course of several sessions, these patients started to report more positive feelings. There was joy, relief, and a sense of accomplishment when they reached the top of a climb. One participant even described feeling “proud” of attempting tasks that previously felt impossible.
Trust, Focus, and Cognitive Shifts
What surprised many participants was the trust they learned to place not only in the climbing equipment and their therapists, but in their own abilities and in the people around them. As patients belayed each other or took turns climbing, they had to communicate clearly and support one another, which led to a sense of trust and connection.
Climbing also forced patients to focus on the task at hand. One of the most consistent themes across interviews was the feeling of mental clarity that came from being fully engaged in the climb. Several participants noted that, during sessions, they experienced a rare break from the endless cycle of rumination, compulsions, and worries that so often plague those with mental health disorders.
“I focused completely on the movement, on where to place my hands and feet,” one patient explained. “For once, I wasn’t thinking about everything else—just the climb. It was a relief.”
This kind of cognitive shift is something that traditional therapies often aim to achieve. It’s a break from negative thought patterns, a chance to reconnect with the present moment. The experience of focusing on the climb allowed participants to push through fears and doubts, reinforcing a sense of control and competence.
A Social Web of Support
For many participants, the group dynamic was a key component of the experience. Climbing is an inherently social activity, and while some patients initially struggled with social anxiety or the discomfort of being watched, these barriers slowly dissolved as the group supported one another. The shared experience of overcoming physical challenges brought people closer, with some describing a sense of camaraderie and mutual encouragement.
“I was surprised at how much trust I felt for the others,” one participant shared. “We were all in this together, and it felt good to rely on each other. It was like we were a team, not just patients.”
The act of helping and being helped on the climbing wall mirrored the emotional support that patients began to offer one another in other areas of their lives. Some even noted that relationships within the group deepened, extending beyond the wall into shared conversations during breaks or meals.
Physiological Reactions and Body Awareness
Climbing is also a physical challenge. For most, it was demanding, and patients reported signs of physical anxiety—sweating, trembling, rapid heartbeats. But as the sessions progressed, many noticed these reactions subsided. As patients became more familiar with the climbing process, their bodies began to respond less intensely, and climbing, though still physically challenging, became a source of positive physical exertion rather than stress.
Interestingly, several patients also reported improvements in other aspects of their physical health. One person even noted better sleep following their climbing sessions, while others reported feeling stronger or more coordinated. This suggests that physical activity isn’t just good for the mind; it’s good for the body, too.
Shifting Perspectives on Mental Health
The impact of therapeutic climbing extended far beyond the clinic. Many patients expressed a desire to continue climbing after their discharge, describing it as a resource for managing their mental health. They spoke about how the experience helped them confront fears, improve frustration tolerance, and even connect more deeply with others.
For patients with depression, the sessions helped break through cycles of rumination. For those with anxiety, climbing offered a structured form of graded exposure that eased their discomfort. Those with OCD found that their compulsive behaviors weakened during the focused activity of climbing, and individuals with trauma histories discovered new ways to assert control.
Participants also spoke about carrying the lessons they learned on the wall into their daily lives. The confidence, focus, and trust they developed in the climbing sessions were resources they hoped to use as they navigated challenges outside the clinic.
Why This Research Matters
This study marks a significant step toward understanding the potential of non-traditional therapies for psychiatric care. Therapeutic climbing offers a powerful, multi-dimensional approach to mental health—one that addresses emotional, cognitive, social, and physical well-being all at once. The results are promising: patients reported emotional relief, enhanced self-confidence, and improved coping strategies that they could apply in their daily lives.
What makes this study particularly important is the growing recognition that mental health treatment cannot be one-size-fits-all. While therapy and medication are essential, alternative methods, like therapeutic climbing, are opening new avenues for helping patients take control of their mental health. By blending physical activity with therapeutic goals, climbing provides a way to confront and reframe difficult emotions, build trust, and foster social connections—tools that traditional therapies often struggle to address in a single setting.
The researchers call for further clinical trials to test the effectiveness of therapeutic climbing in treating various psychiatric conditions, and we can only hope that this approach will become a more widely accessible treatment option in the future. After all, when it comes to mental health, sometimes the most powerful steps forward are the ones taken on the rock wall.
More information: Lisa Zöbl et al, Therapeutic climbing as an adjunctive treatment for psychiatric inpatients: A qualitative study, Journal of Behavior Therapy and Experimental Psychiatry (2025). DOI: 10.1016/j.jbtep.2025.102058
