Walk-and-Talk Therapy

Is this legitimate? Yes! There are trainings and books about walk-and-talk therapy as well as related modalities (eco- and nature-based therapy). Many cultures include concepts related to well-being achieved through interaction with nature, as well. (Norwegian culture includes exposure to wind and in Japan there is forest bathing.)

How long is a session? Sessions are a “therapist’s hour” or about 50 minutes, the same as a tele-health or in office/in person appointment.

Who sets the pace? You do! We walk at whatever pace is comfortable for you. That said, we typically walk slower than you might if you were purposefully walking for exercise as you want to be able to talk easily without getting out of breath. There may be times when we stop at a particular spot as part of the work of therapy. For example, seeing a bird, flower, or other animal may be a bonus of this kind of outdoor therapy, and we might decide to toss rocks into a river, lake, or the ocean, or “draw” in the soil with a stick.

How far do we walk? This will vary based on the pace and whether and how long we stop. I typically choose places where I am aware of a reasonable distance such as using a loop or for an “out and back” we rely on a timer to help regulate distance and account for time to return to the starting point.

Does this count as exercise and can you help me get in shape or lose weight? Walk-and-talk therapy’s point is the therapy, and the walk is not only a bonus to the therapy. Rather, people often find that movement facilitates thinking and processing and that nature and natural environments provide ready metaphors for the work of therapy. We are not setting a pace for fitness, nor am I a fitness professional or licensed or certified in any way to judge what is safe or would be sufficient exercise for you. That said, any increase in movement might result in better overall health and weight loss, yet that is not the point or purpose to a walk-and-talk session.

Where is this done? I live in Rhode Island and am familiar with several area parks and walking trails in Rhode Island and Southeast Massachusetts. I am also licensed in both states, so it is ok for us to have a session in either state! We will walk where at least one of us is familiar and I am willing to research trails near you to make sure I make myself familiar prior to meeting you where you are already comfortable. The point is not exercise or reaching a summit or specific destination or distance, so we will determine a final “end point” or turn around if walking for an out-and-back or determine a loop that will be suitable for the therapy hour.

Will you come to my house/neighborhood or to my work? Depending on where you live or work and its access to a trail or park, I might meet you near where you live or work, yet we need to talk about this a bit more before we do this. Below, I talk about running into people either of us knows, and I will get more into detail at those specific questions. One thing we must consider is whether you are more likely to run into people you know who may ask you who I am if we are near where you live or work. Keep in mind this might happen after our session, when you may not otherwise expect such a question as “who was that you were walking with the other day?” Consider whether you would want to have to answer a supervisor or coworker, as well, about who I am if we are seen out walking together. I also like to maintain good boundaries and the nearer we are to your home or work, the more likely it is that our relationship could be misconstrued in some way. All of that said, if you live near a major park or trail area, I am not opposed to meeting you there, we should discuss this ahead of time is all.

What about weather and seasons? There are times when we will need to make an alternative plan if there is weather predicted or happening that is dangerous for outdoor activities (think hurricane, tornado warning, or active driving rain with lightning or serious risk of flooding where we plan to be). I am willing to change to a tele-health session or in person session if you do not want to walk in the rain. I am also willing to get rained on as long as it is safe to walk where we plan to go if this is ok with you.

May I bring my baby/child? Babies under the age of one may be accommodated yet we should discuss this prior to the session. Children are not welcome as they should not be in the therapy appointment for an individual for a variety of reasons. We will determine whether where we will meet is appropriate for a stroller or back or front pack. You will be entirely responsible for your baby the same as if you were walking solo. Babies may increase the likelihood that strangers interact with us and interrupt the session. Babies may also require care that interrupts the session. I am also not responsible in any way for the well-being and safety of your baby, and you may want to consider health conditions, allergies, or other needs your baby may have.

What do you wear or need to bring? Dress how you would if you were to take a walk in your own neighborhood. Athletic or hiking shoes are most appropriate rather than sandals or other kinds of shoes. That said, if we meet at a park where there are paved paths, wear whatever you wish. Again, the pace will be set by you. I encourage people to dress and wear comfortable shoes and clothing that is most comfortable for being outdoors. Proper clothing and shoes decrease the risk of injury, and I will ask you to sign a waiver to participate in walk-and-talk therapy anyway. Consider bringing any medication for asthma, allergies, or your health that you carry normally. A water bottle may also help you enjoy the session more especially if the weather is hot and/or humid. A rain jacket or other rainwear may be helpful yet are not necessary depending on our choices related to weather. While I will carry a minimal first aid kit (I am not a wilderness first aid provider and I am not an emergency medical professional), feel free to bring bandages and ointment that you might take with you on a hike yourself or with family or friends. I will bring my cell phone for safety purposes (it will be on silent) and you are welcome to do the same. If we use trail areas where hunting is allowed, we will follow all recommendations and rules and you are responsible for having a regulation orange vest and hat.

What happens if there is an emergency, illness, or injury? I will carry my cell phone and a basic first aid kit on all our walk-and-talk sessions. I will not carry medications since I am not qualified to offer allergy, headache, or other over-the-counter medications to you for any reason. Feel free to bring any prescribed or over-the-counter medication you believe you may need or would carry on your own walk or hike. I am not a wilderness first aid expert, and I am not a medical professional for physical health needs. I cannot administer your medication to you or otherwise intervene in treating you for any injury or illness sustained during a walk or hike. I will seek emergency medical attention if you become unconscious or sustain an injury or appear to have a life-threatening emergency the same as I would in an in person or tele-health session.

What happens if we see someone you know? Many people who know me know that I am a therapist. I also have a wide network of colleagues and friends. When I have run into a therapy client while out with my family or run into a friend while in a walk-and-talk session with a client, I will typically just keep moving and offer a brief wave, nod, or simple “hello” possibly followed by a “we can catch up soon! Take care!” since the session is your time. Just like I would not answer the phone during our sessions, I will not waste your time interacting with friends, family, colleagues, or other clients. In rare instances when I run into a client in the grocery store when I am with my family, and the client recognizes and initiates the interaction, I will merely introduce you as “someone I work with.” My family knows that I will not later say more or share whether we “work” together as therapist and client or whether you are a colleague. They are used to this kind of thing, and respect privacy and my legal obligation to privacy laws.

What happens if we see someone I know? We will talk about what you want to do in this situation and make a plan prior to our first session. You are welcome to introduce me by name or as any way you feel most comfortable. I encourage you to avoid use of parks or trails or other areas where you are more likely to run into people you know. You can also follow the same polite moving along greeting I described in how I will be if we run into someone I know: keep moving and keep the greeting to a minimum. Be prepared that friends or family may inquire after the fact and have a plan for what you will or will not share to avoid being caught off guard. While it is ok with me if you introduce me as “a friend,” keep in mind that this language can skew your feelings and clarity around our professional relationship. It may help to use my same description of you as “someone you work with” or “someone I go to school with” or some other status. It is also likely fine to introduce me just by my first name and move along as quickly as possible. This is partly why a “neutral” place versus one near your home or work is advisable, as well.

What is the cost? The cost is the same as a regular session fee. If I drive over ten miles from my origin point of my business location, we may discuss travel fees or an additional fee for the session. This will be known ahead of time when we make an appointment and plan a location. There will never be additional fees added after an agreed upon fee for the session.

Can we meet at night? Since we will most likely use paths, walkways, and trails in public parks and forest areas, we must follow guidelines of use. Most parks and trail access areas are open dawn to dusk. I also keep the same hours of business for walk-and-talk therapy as for tele-health or in person sessions.

I love the idea of being outdoors! Can we ride bikes, run, or have lunch? While there is a “running therapy” modality, this is not something I offer currently. Without any personal training or other health background, I am not qualified to advise anyone about safety with running. I do not own a bike, so that might make a bike ride quite difficult! Therapy sessions are the work of therapy wherever it takes place. It is not for exercise or a social event. Biking and running are likely to increase heart rate and breathing and would likely interrupt the flow of conversation. Where lunch is concerned, our sessions are not social events and sharing meals may create confusion about boundaries in our professional relationship. While it is ok with me if you choose to eat something during a session, keep in mind that movement and eating anything substantial can increase the risk of choking. Water bottles or coffee or tea are fine to bring – we carry out what we carry in and use trash/recycling bins to protect the places we walk. If you have a health condition that requires you to consume foods, please do what you would normally do when walking solo. If we meet during your lunch hour, it is ok with me if you eat. I will refrain from eating and yet would sit with you while you ate with my water bottle and conduct the session. I do not want to pay attention to my own food rather than our session. Additionally, I want to avoid bringing anything you may be allergic to with me, just as I would avoid eating in an in person or tele-health session.

Wow! Did you make it this far?

I’m still interested! How do I set up an appointment for walk-and-talk therapy? Walk-and-talk therapy requires that you sign specific disclosures and waivers of liability. All paperwork must be completed prior to the first session or be brought to the first session. We should discuss all the questions referenced here, answer whatever other questions you have, and create a plan to manage situations outlined in this information ahead of meeting. An initial intake session is where I gather a lot of information to help me decide the best course of treatment, and this may be done in person or by tele-health and thus our first session cannot be walk-and-talk. If we decide your dog is a potential companion, we may also need to set up a meet and greet for your dog that is in person even if the intake session is by tele-health. Click here to contact me about walk-and-talk therapy!