Health and Disability A corrective emotional experience – or just a bit of exercise? The relevance of interpersonal learning in Exercise on prescription KIRSTEN KAYA ROESSLER Department of Psychology, Lund University, Sweden Roessler, K. K. (2011). A corrective emotional experience – or just a bit of exercise? The relevance of interpersonal learning in Exercise on prescription. Scandinavian Journal of Psychology 52, 354–360. The objective of the present study was to examine psychological aspects of intra- and interpersonal learning for patients with Type 2 diabetes, hypertension and dyslipidemia treated with Exercise on prescription. The research design consists of a qualitative investigation of 30 patients in Denmark undergoing a community-based exercise treatment at baseline, a post-intervention investigation after four months and a follow-up one year after the start of intervention. The results demonstrated that, for the majority of the participants, interaction under group conditions contributes to maintaining the commitment to exer- cise. For a corrective emotional experience – a correction of an emotional situation a person could not handle in the past – to occur requires two conditions: the group and the environment must be experienced as sufficiently safe, and there must be feedback to permit reality-testing. However, existential psycho- logical aspects such as fear of dying or the universality of suffering triggered, but could not sustain, a change in health behavior. The article concludes that behavioral change is strengthened by interaction with health personnel and with the training group. These new insights likewise demand an increased focus on the human resources of general practitioners or physiotherapists who handle the training. They should learn about their supportive role for the partici- pants, the regressive urges of the participants and the benefits of promoting group relations. Key words: Group processes, physical education and training, behavioral change, preventive treatment, interpersonal relations. Kirsten Kaya Roessler, Institute of Sport and Biomechanics, Faculty of Health Science, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark. Tel: +45 65503448; e-mail: kroessler@health.sdu.dk INTRODUCTION Evidence suggests that physical activity can lower blood pressure, reduce the risk of coronary heart disease and stroke (Cornellisen & Fagard, 2005; Pedersen & Saltin, 2006), help to achieve weight loss and manage diabetes (Tuomilehto, Lindstrom, Eriksson et al., 2001), reduce the risk of developing colon cancer (Thune & Fur- berg, 2001), and relieve moderate depression and anxiety (Bab- yak, Blumenthal, Herman et al., 2000; DiLorenzo, Bargman, Stucky-Ropp, Brassington, Frensch & LaFontaine, 1999). How- ever, interventions are often unable to promote long-term partici- pation in physical activity (Ingledew & Markland, 2008). In this paper, a psychological approach (Alexander & French, 1946; Streeck, 2007; Winnicott, 1965) attempts to look at the role of interpersonal relations in a health intervention. Our investiga- tion looks specifically at the motivating role of learning (Yalom & Leszcz, 2005) taking place in the interpersonal context of partici- pants, physiotherapists, general practitioners and their environ- ment. The term corrective emotional experience (Alexander & French, 1946) is introduced to designate learning or more pre- cisely behavioral change during an intervention. Originally it describes the crucial process that takes place during psychother- apy, whereby the therapeutic setting is seen as a context in which patients are re-exposed in a secure environment – made up, for example, by the empathy and awareness of the therapist (Streeck, 2007; Streeck & Leichsenring, 2009) – to emotional situations that they could not handle in the past. In order to be helped, the patient must undergo a corrective emotional experience that can repair the traumatic influence of previous experiences. In this the therapist adopts a holding attitude (Winnicott, 1964), which makes it possible for the patient first to undergo a therapeutic regression, then to have a corrective emotional experience, and afterwards to try out new behavior, initially in the secure environ- ment and later in daily life. The idea of a possible correction of emotions by using certain experiences has been adapted to health science, for example to affect a moderation of dental anxiety among adults (Eli, Uziel, Blumensohn & Baht, 2004) or to con- ceptualize responsiveness of the nursing staff in health services (Rafferty, 2000). The corrective emotional experience in the con- text of an exercise program is understood as a re-education of emotions that is linked to physical activity. Aims The first research aim question the role of existential aspects such as suffering and fear of death in order to understand personal motives for adopting an active and healthy life-style. The second research aim questions the role of a corrective emotional experi- ence for the change of exercise behavior. The third research aim, questioning whether the experience of other relevant individuals, such as the group or the physiotherapist in an Exercise on pre- scription program, will support behavioral change, receives partic- ular attention. Moreover, the aim is to gain insight into development within the groups in both short-term (4 months) and long-term (12 months) maintenance. Exercise on prescription – a community-based intervention Since April 2004 patients with life-style diseases in Copenhagen have received a prescription for exercise from their general practi- tioners. The program is based in primary health care and tries to Ó 2011 The Author. Scandinavian Journal of Psychology Ó 2011 The Scandinavian Psychological Associations. Published by Blackwell Publishing Ltd., 9600 Garsington Road, Oxford OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA. ISSN 0036-5564. Scandinavian Journal of Psychology, 2011, 52, 354–360 DOI: 10.1111/j.1467-9450.2010.00869.x