As any private practitioner can attest, there’s no one-size-fits-all when it comes to therapy. Finding the best course of treatment for each client means testing out different methods and forms before finding the most effective solution—and even then you have to be ready to adjust and pivot as they progress.
Flexibility and creativity with your treatment methods are essential to achieving that breakthrough and getting your clients where they want to be. Some therapists, like Dr. Lori Roberto, use the therapeutic qualities of nature and movement to enrich their clients’ experience. This method is known as walk-and-talk therapy, which has become an increasingly popular alternative to in-office sessions and even telehealth visits—especially as many practitioners are cautiously considering a return to the office.
What’s walk-and-talk therapy?
Walk-and-talk therapy, sometimes referred to as hiking therapy, takes your sessions outdoors. It can happen in a public park or on nearby trails. This alternative provides a new approach by infusing the benefits of fresh air and exercise into the therapy sessions.
Movement, whether it’s a leisurely walk or a brisk hike, can make it easier for some people to discuss their feelings. Clients may prefer to move or walk as opposed to sitting across from their therapist in an office or looking through a screen.
Some practitioners are finding walk-and-talk therapy particularly helpful in teenagers and younger clients. Other professionals have also found that some of their clients are more at ease in nature, which improves their ability to open up. Sitting down for a one-on-one conversation in close quarters can be uncomfortable for some clients, so taking the conversation outside can help relieve some of that pressure.
Is walk-and-talk therapy the right solution for my clients?
As with all new modes of treatment, consider your individual clients and their specific needs before suggesting walk-and-talk—or hiking—therapy. It may be a great option for people who exhibit a lot of excess energy during sessions or for those who feel uneasy with maintaining direct eye contact and sitting still. Some therapists have noted that physical movement encourages psychological movement, and can even accelerate client breakthroughs.
The endorphins that exercise produces has a known positive impact on mental health. Dr. Lori Roberto has noticed clients to be more energized at the end of outdoor sessions than after traditional visits. For generally healthy and able-bodied clients, outdoor sessions can enhance their ability to navigate particularly difficult issues. It can also leave them feeling refreshed in body and mind.
All that said, you’ll need to take the physical as well as the mental health of your client into consideration before suggesting walk-and-talk sessions. Consider your local terrain, weather, accessibility to benches and water fountains on your route, and any underlying health concerns your client may have before making the leap.
If you do decide to introduce this mode of therapy to your practice, have an open discussion with each client about what they’re comfortable with and capable of. This will help you decide if walk-and-talk therapy will meet your client’s needs.
Are there any ethical concerns about walk-and-talk therapy?
Aside from any potential physical concerns, there are some ethical questions to consider before you start your first walk. Once you venture out of the office or the living room, you have less control over the privacy of your session.
There’s the possibility that you and your client will see someone your client knows, or you may come across someone who recognizes you as a mental health professional. Depending on how busy the park or the trail is, there’s also a chance your conversation may be overheard.
These concerns may not bother some clients and won’t change their preference—but for others, giving up the privacy and confidentiality of their sessions may not be worth the sunshine and fresh air. Discuss any concerns prior to your first walk-and-talk, so you can make an informed decision together.
Set up boundaries with your clients beforehand, like how they want to proceed if they do see someone they know, or how often they want to stop to rest and drink water. That way, when you’re out on the trail, you can use the walk to focus on your conversation—not distractions.
What are the insurance or legal concerns and limitations?
No matter how carefully groomed the trails are or how well kept your public park is, there are always more risks associated when you’re not in a more controlled environment like your physical or virtual office. When and if you decide that walk-and-talk therapy is the right choice, you’ll need to make your client aware of the risks, and make sure you and your practice are legally covered in case something happens.
Use this informed consent form to make sure your clients acknowledge that you will only be acting under the scope of your license. Make sure your clients are aware of the risks before you go on your first walk, and consult your regulatory board or your insurance carrier if you have concerns.