Step by Step Back — a psychologist‑guided physical activity program for stress‑related exhaustion

Step by Step Back - A Feasibility Study of a CBT-Based Physical Activity Intervention for Stress-Related Exhaustion

This program tests whether a psychologist‑led, CBT‑based physical activity program added to usual therapy can help adults with stress‑related exhaustion build gradual, lasting exercise habits.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 20 (estimated)
• Ages: 20 Years to 64 Years
• Sex: All
• Sponsor: The Swedish School of Sport and Health Sciences (other)
• Locations: 1 site (Stockholm)
• Trial ID: NCT07407829 on ClinicalTrials.gov

What this trial studies

Participants receive a CBT/ACT‑based physical activity program delivered by a psychologist or psychotherapist and integrated into routine outpatient psychological care. The program is individualized and gradual, with participants logging activity via a smartphone or computer and attending planned sessions alongside usual treatment. The study measures feasibility outcomes such as session attendance, acceptability to patients and clinicians, safety and any negative experiences, and practical barriers and facilitators to delivery. Descriptive pre‑to‑post changes in physical activity, exhaustion/fatigue, and everyday functioning are also recorded using standard questionnaires.

Who should consider this trial

Good fit: Adults aged 20–64 with stress‑related exhaustion who are past the acute phase, can attend outpatient psychological treatment, understand spoken and written Swedish, have internet access for activity logging, and have no medical contraindication to physical activity.

Not a fit: People in an acute phase of illness, those with medical conditions that make exercise unsafe, non‑Swedish speakers, those without internet/device access, or individuals receiving conflicting external psychological treatment may not benefit from this program.

Why it matters

Potential benefit: If successful, the program could help people with stress‑related exhaustion reintroduce safe, sustainable physical activity and reduce fatigue while improving daily functioning.

How similar studies have performed: Physical activity programs have established benefits for depression and anxiety, but targeted, psychologist‑delivered physical activity interventions for stress‑related exhaustion are less tested and specific evidence is limited.

Eligibility criteria

Inclusion Criteria

* Adult aged 20 to 64 years.
* Experiencing stress-related exhaustion, assessed in regular clinical care (for example, symptoms consistent with exhaustion disorder or a closely related stress-related condition).
* Symptoms are not in the acute phase (participant is able to engage in outpatient psychological treatment and gradual physical activity).
* Elevated fatigue/exhaustion at screening, indicated by scores on screening questionnaires (Karolinska Exhaustion Disorder Scale and Multidimensional Fatigue Inventory).
* Able to understand spoken and written Swedish.
* Has access to a smartphone, tablet, or computer with an internet connection to complete study questionnaires and activity logging.
* No medical condition that makes physical activity unsafe, based on clinical screening and participant self-report.

Exclusion Criteria

* Currently receiving psychological treatment outside the recruiting clinic that is expected to interfere with participation in the program or study assessments.
* Current or past diagnosis of a psychotic disorder.
* Current or past diagnosis of bipolar disorder.
* Severe mental health condition requiring another primary treatment approach at this time (for example, severe major depressive disorder, post-traumatic stress disorder, or an eating disorder).
* Ongoing substance use disorder.
* Medical condition or acute illness that makes physical activity inappropriate at this time (for example, recent blood clot, severe infection, or other serious condition).
* Severe musculoskeletal condition that substantially limits ability to perform physical activity.
* Started antidepressant medication within the past 4 weeks.

Additional notes (not eligibility criteria):

Participants may use psychotropic medication (for example, antidepressants, sleep medication, or anxiety medication) if the medication regimen is stable. Participants will be asked to report any medication changes during the study period. Mild to moderate comorbid anxiety or depression is allowed if stress-related exhaustion is the primary clinical problem.

Where this trial is running

Stockholm

• Avonova Occupational Health — Stockholm, Sweden (RECRUITING)

Study contacts

• Principal investigator: Victoria Blom, Professor — Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
• Study coordinator: Jenny Kling, MSc

Conditions: Exhaustion Disorder, Stress-Related Disorders, Stress-related exhaustion, Exhaustion disorder, Fatigue, Burnout, Physical activity intervention, Exercise therapy