Physical activity is well known to have multiple beneficial effects for everyone. This is particularly the case for people with mental illness where inactivity has been linked to poor mental and physical health outcomes and a dramatic reduction in life expectancy. This engaging book brings together leading experts in the field to provide a comprehensive review of the evidence for exercise interventions across multiple mental health disorders, highlighting the consistent benefits of physical activity on psychiatric symptoms, wellbeing and physical health. Exercise interventions are shown to be low risk, low stigma, and highly acceptable and compare favourably with other treatments.

Of the seventeen chapters, six focus on the evidence for exercise interventions with specific populations including depression, anxiety, bipolar, schizophrenia, alcohol use disorders and eating disorders. Although this is a useful framework, the authors also identify exercise as a transdiagnostic intervention. This is an important consideration when arguing for the provision of training for new or existing workforces. Chapter 6 focuses on the crucial area of sedentary behaviour, which is linked to poor health outcomes independently of exercise behaviour. This is an enormously important area for the whole population, given our tendency towards more sedentary lifestyles and is particularly relevant for people with serious mental illness. Chapter 12 usefully sets out how technology and mobile health may be harnessed to increase activity, making interventions more accessible and stigma light. Chapter 14 gives a physician’s perspective and serves as a useful way for non-exercise professionals to consider what they might do to increase activity amongst their patients. For those interested in furthering the evidence base, chapter 16 is particularly helpful in considering exercise-specific research and evaluation issues. Chapter 17 demonstrates, through illustrative case studies, how research can be translated into practice. Of particular relevance for clinical psychologists and cognitive behavioural therapists, chapter 10 addresses behavioural and psychological approaches to exercise interventions and usefully sets out the theoretical underpinnings of these interventions. The role of psychological interventions in promoting physical activity is often neglected in this field and further research addressing the psychological barriers to activating behaviour and maintaining it beyond the end of an intervention would be beneficial.

Although the book makes a strong argument for the integration of exercise professionals into multi-disciplinary teams, it also highlights that it is the duty of every mental health professional to routinely ask about physical activity. Having worked as a clinical psychologist in adult mental health for many years, I can identify that we too often dismiss exercise goals as not our domain. Yet clinical psychologists and cognitive behavioural therapists have many applicable skills to help people meet their exercise goals and we should make improving physical activity a priority for our clients. Individualized formulation to understand the factors maintaining physical inactivity will be especially helpful, identifying ways to help clients overcome their personal barriers and live a healthier lifestyle. Behavioural experiments involving leaving the therapy room for sessions or indeed, conducting a whole session out and about, could have the dual effect of promoting and modelling physical activity whilst also achieving another therapeutic goal. Targeting physical activity early on in therapy may also provide an ‘easy win’, having a positive effect on symptoms whilst improving a client’s confidence to work on more challenging therapeutic goals. For those wondering how to implement exercise interventions into their psychological work, this book does not provide practical answers. However, it provides a helpful overview for clinicians interested in the evidence base for exercise interventions for mental illness, and gives a clear rationale for the need for further training in physical activity and collaboration with exercise professionals.