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Is walk and talk therapy right for your practice?

Discover how walk and talk therapy benefits both therapists and clients. Learn strategies, considerations, and when you could use this approach in your practice.

Walk and talk therapy, sometimes referred to as hiking therapy, is a type of eco-psychotherapy that incorporates the benefits of nature and physical exercise to help clients meet their mental health goals. In walk and talk therapy, you could walk with your client through a local park, hiking trail, or even a beach. While it primarily involves walking, you may take short breaks to rest, take in scenery, or practice mindfulness or meditation. You can also do walk and talk sessions over the phone or via telehealth.

While walk and talk therapy can be beneficial for many clients — and therapists, too — it’s not for everyone. Taking time to understand how it works, along with its benefits and limitations, can help you determine whether walk and talk therapy is right for you and your clients.

Below, learn more about walk and talk therapy, and how you can decide if it’s a good fit for your therapy practice.

Identifying suitable clients for walk and talk therapy

Not everyone is a good fit for walk and talk therapy. Considerations include: 

  • Physical ability: Consider a client’s physical abilities, including whether someone is able to walk safely on outdoor terrain while having an active discussion. 
  • Mental health history: Clients who have a hard time sitting down for long periods of time or maintaining eye contact may be a good fit for walk and talk therapy. 
  • Therapeutic goals: Walk and talk therapy isn’t a fit for every client’s therapy goals. If your client will be discussing very emotional or vulnerable topics, such as trauma, then it may be best to prioritize privacy. Similarly, if you plan to incorporate a modality that’s best done in an office — like EMDR or art therapy — then a traditional setting is probably a better fit.
  • Personal preferences: Some clients, whether they’re interested in exercise or nature, may simply prefer getting outside for a walk to sitting on a therapist’s couch. 

Practical implementation: Getting started with walk and talk therapy

  1. Choose a route: Pick a conveniently located outdoor location with access to benches and restrooms. You may want to discuss with your client whether they prefer a location that’s not close to their home or work, so they don’t bump into people they know. Consider a location that won’t have loud noises like trains or buses driving by, and make sure to both start and end the therapy session in the office if you are physically present with the client.
  2. Time your sessions well: Walk-and-talk therapy doesn’t allow you the same control over privacy in your sessions. You may prefer to schedule the sessions when locations are less crowded to promote the most privacy possible.
  3. Plan for weather: Create a back-up plan for inclement weather, including whether and where you will conduct the session and how you’ll communicate about changes.
  4. Communicate with clients: Along with providing directions to the location, tell your client exactly where and when you’ll meet.

Evidence-based benefits of walk and talk therapy

Walk and talk therapy, for the right client, can benefit both physical and mental well-being. Some possible benefits of walk and talk therapy include: 

Improved well-being

Psychological science is clear that being outside can promote positive mental health outcomes. For example, the natural world is a great grounding tool, which can help people feel more connected to their mind and body. And taking in beautiful views and fresh air can be relaxing, which can help clients manage stress and anxiety symptoms. 

Enhanced emotional regulation

You’ll likely include evidence-based therapy modalities like cognitive-behavioral therapy or dialectical behavioral therapy in your walk-and-talk sessions. But walking and being outdoors on their own can help promote mood regulation skills that help people manage their stress and mental health symptoms outside of therapy sessions. 

Stronger therapeutic relationship

Studies show the therapeutic relationship is one of the most important predictors of therapeutic success. Doing an activity together — including walking outdoors — can be a great way to build rapport that can contribute to your therapeutic relationship. Walking side-by-side may also help build trust for some clients who may struggle to open up in traditional settings, because it levels the playing field and promotes a feeling of equality.

Reduced therapy stigma and resistance

Going outside for a walk may make it easier for clients to talk about their mental health, because it doesn’t include the stigma of sitting in a therapist’s office. Studies show this may be particularly helpful for populations who may be more resistant to therapy. Plus, people may be more likely to make and keep appointments if they include an enjoyable activity. 

Less stress for you as a therapist 

Given the known benefits of exercise and outdoor activities for well-being, walk and talk therapy could be a great way to reduce stress and burnout in your practice. A change of scenery can be helpful in introducing new insights and perspectives that can support your clients’ mental health. 

Considerations to keep in mind for walk and talk therapy sessions

Ethical considerations and best practices

Walk and talk therapy happens in public, which means other people may see or hear the session — including someone your client knows. Before you start walk and talk therapy with someone, be sure your client is aware of confidentiality concerns and comfortable discussing personal topics in a public setting. It may also help to create a plan for how to respond if your client sees someone they know during the session. 

Insurance considerations specific to walk and talk therapy 

No matter what type of therapy you plan to provide, it’s always a good idea to verify your client’s insurance coverage and plan details. Check that their insurance plan will cover walk and talk therapy, and how often to avoid potential billing surprises that could interrupt your payments and cause unnecessary stress to your client. Many insurance companies require that a session begin and end in the office for in-person appointment POS codes. Also make a plan for when you will complete documentation, as taking notes during the session may not be possible. Learn more about behavioral health billing with Headway’s billing and coding resources.

How Headway supports innovative therapy approaches

For therapists interested in walk and talk therapy, Headway makes it easy to step outside the office. Flexible scheduling tools allow clinicians to plan sessions around weather, client preferences, or location, while secure documentation features make it simple to take notes on the go. Headway also takes care of insurance — handling verification, billing, and claims — so providers can focus more on their clients and less on paperwork.

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