Table Of ContentExercise for Mood and Anxiety Disorders
EDITOR-IN-CHIEF
DavidH.Barlow,PhD
SCIENTIFIC
ADVISORY BOARD
AnneMarieAlbano,PhD
GillianButler,PhD
DavidM.Clark,PhD
EdnaB.Foa,PhD
PaulJ.Frick,PhD
JackM.Gorman,MD
KirkHeilbrun,PhD
RobertJ.McMahon,PhD
PeterE.Nathan,PhD
ChristineMaguthNezu,PhD
MatthewK.Nock,PhD
PaulSalkovskis,PhD
BonnieSpring,PhD
GailSteketee,PhD
JohnR.Weisz,PhD
G.TerenceWilson,PhD
Exercise for Mood
and Anxiety
Disorders
T h e r a p i s t G u i d e
Jasper A. J. Smits • Michael W. Otto
1
2009
1
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Allrightsreserved.Nopartofthispublicationmaybereproduced,
storedinaretrievalsystem,ortransmitted,inanyformorbyanymeans,
electronic,mechanical,photocopying,recording,orotherwise,
withoutthepriorpermissionofOxfordUniversityPress.
LibraryofCongressCataloging-in-PublicationData
Smits,JasperA.J.
Exerciseformoodandanxietydisorders:therapistguide/JasperA.J.Smits,MichaelW.Otto.
p. cm.—(TreatmentsThatWork)
Includesbibliographicalreferencesandindex.
ISBN978-0-19-538225-9
1.Mood(Psychology) 2.Exercisetherapy. 3.Exercise—Psychologicalaspects.
I.Otto,MichaelW. II.Title.
BF521.S652009
616.89(cid:2)0642—dc22
2009000271
9 8 7 6 5 4 3 2 1
PrintedintheUnitedStatesofAmerica
onacid-freepaper
About TreatmentsThatWorkTM
Stunning developments in healthcare have taken place over the last
severalyears,butmanyofourwidelyacceptedinterventionsandstrate-
gies in mental health and behavioral medicine have been brought into
questionbyresearchevidenceasnotonlylackingbenefit,butperhaps,
inducing harm. Other strategies have been proven effective using the
bestcurrentstandardsofevidence,resultinginbroad-basedrecommen-
dations to make these practices more available to the public. Several
recent developments are behind this revolution. First, we have arrived
at a much deeper understanding of pathology, both psychological and
physical, which has led to the development of new, more precisely tar-
getedinterventions.Second,ourresearchmethodologieshaveimproved
substantially, such that we have reduced threats to internal and exter-
nal validity, making the outcomes more directly applicable to clinical
situations.Third,governmentsaroundtheworldandhealthcaresystems
andpolicymakershavedecidedthatthequalityofcareshouldimprove,
thatitshouldbeevidencebased,andthatitisinthepublic’sinterestto
ensurethatthishappens(Barlow,2004;InstituteofMedicine,2001).
Of course, the major stumbling block for clinicians everywhere is the
accessibility of newly developed evidence-based psychological inter-
ventions. Workshops and books can go only so far in acquainting
responsible and conscientious practitioners with the latest behavioral
healthcare practices and their applicability to individual patients. This
newseries,TreatmentsThatWork™,isdevotedtocommunicatingthese
excitingnewinterventionstocliniciansonthefrontlinesofpractice.
Themanualsandworkbooksinthisseriescontainstep-by-stepdetailed
procedures for assessing and treating specific problems and diagnoses.
But this series also goes beyond the books and manuals by providing
ancillary materials that will approximate the supervisory process in
v
assistingpractitionersintheimplementationoftheseproceduresintheir
practice.
In our emerging healthcare system, the growing consensus is that
evidence-based practice offers the most responsible course of action
for the mental health professional. All behavioral healthcare clinicians
deeplydesiretoprovidethebestpossiblecarefortheirpatients.Inthis
series, our aim is to close the dissemination and information gap and
makethatpossible.
Oneofthebestkeptsecretsinthetreatmentofmoodandanxietydis-
orders is the proven efficacy of a program of exercise, which has many
benefits on mood, but has yet to be widely adopted as a therapeutic
technique. This therapist guide provides guidance for care providers
who want to apply exercise-based interventions to the treatment of
moodandanxietydisorders.
Theinterventionsdescribedcanbeappliedinavarietyofsettingsrang-
ingfromprimarycaretospecialtycareinthecontextofpsychological,
psychiatric, nursing, or social work settings. Treatment is organized
around a weekly prescribed activity program, with an emphasis on
teachingclientsstrategiesforstayingmotivatedandorganizedinorder
toensureadherencetotheprogram.Theintroductorychaptersdescribe
the intervention and how to initiate it with clients, while later chap-
tersfocusspecificallyonusingexercisetocombatdepression,aswellas
stress,worry,andpanic.Thisguideprovidesanintegratedapproachto
establish exercise programs targeting mood and anxiety disorders, and
also provides useful cognitive and behavioral interventions designed to
supporttheseprograms.
DavidH.Barlow,Editor-in-Chief,
TreatmentsThatWork™
Boston,MA
References
Barlow, D. H. (2004). Psychological treatments. American Psychologist, 59,
869–878.
InstituteofMedicine.(2001).Crossingthequalitychasm:Anewhealthsystem
forthe21stcentury.Washington,DC:NationalAcademyPress.
vi
Dedications
JAJS:ToJillandStella,formanyhappyexercisesessions
MWO:ToJenni,forthelaughterandjoyshebrings
vii
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Acknowledgments
Our writing of the therapist guide and workbook for Exercise for
Mood and Anxiety Disorders was motivated by research showing the
tremendous benefits of exercise for mental health and well-being.
We want to acknowledge the valuable evidence provided by inter-
national teams of researchers who documented these benefits in
population-based studies, experimental investigations, clinical studies,
meta-analytical comparisons, and review articles. We would also like
to thank our collaborators on our own investigations in this area. In
particular, our collaborators on research and review articles included
Evi Behar, Angie Berry, Tim Church, Lynette Craft, Daniel Galper,
Dina Gordon, Tracy Greer, Pamela Handelsman, Bridget Hearon,
Kristin Julian, Kate McHugh, Alicia Meuret, Heather Murray, Mark
Powers, Katherine Presnell, David Rosenfield, Anke Seidel, Georgia
Stathopoulou,CandyceTart,MadhukarTrivedi,andMichaelZvolensky.
Alloftheseindividualshelpedexpandwhatisknownaboutthebenefits
ofexerciseformoodandanxietydisorders.
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