Treatment - Other
Kristen H. Walter, Ph.D.
Clinical Research Psychologist
Naval Health Research Center
San Diego, California
Nicholas P. Otis, None
Research Scientist
Naval Health Research Center
San Diego, California
Travis N. Ray, M.S.
Data Analyst
Naval Health Research Center
Rochester, Michigan
Lisa Glassman, Ph.D.
Clinical and Research Psychologist
Naval Health Research Center
Calabasas, California
Jessica L. Beltran, B.S.
Research Associate
Naval Health Research Center
FPO, Armed Forces - AP
Kim T. Kobayashi Elliott, B.A.
Recreation Therapist
Naval Medical Center San Diego
San Diego, California
Betty Michalewicz-Kragh, M.S.
Exercise Physiologist
Naval Medical Center San Diego
San Diego, California
Background: Major depressive disorder (MDD) is prevalent, including among U.S. service members. In addition to evidence-based treatments, activity-based approaches have been shown to effectively treat depressive symptoms—particularly when occurring in the natural environment.
Methods: This study compared two activity-based interventions, Surf Therapy and Hike Therapy, on depression outcomes among 96 active duty service members with MDD. Participants were randomized to 6 weeks of Surf or Hike Therapy. Clinician-administered and self-report measures were completed at preprogram, postprogram, and 3-month follow-up. A brief depression/anxiety measure was completed before and after each activity session.
Results: Multilevel modeling results showed that continuous depression outcomes changed significantly over time (ps < .001). Although service members in Hike Therapy reported higher depression scores than those in Surf Therapy, the trajectory of symptom improvement did not significantly differ between groups. Regarding MDD diagnostic status, there were no significant differences between the groups at postprogram (p = .401), but at the 3-month follow-up, Surf Therapy participants were more likely to remit from MDD than those in Hike Therapy (p = .015). Limitations: The sample consisted of service members, so results may not generalize to other populations. Most participants received concurrent psychotherapy or pharmacotherapy, thus results should be interpreted in this context.
Conclusions: Both Surf and Hike Therapies appear to be effective adjunctive interventions for service members with MDD. Research is needed to examine the effectiveness of these therapies as standalone interventions.