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Walk and Talk Therapy

Exercise is good for the body and the mind. It may improve psychotherapy sessions, too.
By Suzanne Wright
WebMD Feature
Reviewed by Louise Chang, MD

Work is a walk in the park for Clay Cockrell. Instead of seeing patients in a traditional office setting, the Manhattan-based licensed clinical social worker practices therapy that combines exercise with psychotherapy -- mostly in Central Park and Battery Park.

"It's very similar to traditional psychotherapy," he tells WebMD, "except you are walking while you are talking about issues. I have found that bringing a little bit of movement enriches the counseling session. My clients are intrigued by the idea and are naturally drawn to being outside."

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Kate Hays, PhD, is the author of Working It Out: Using Exercise in Psychotherapy and has incorporated sports psychology into her clinical practice for more than two decades. Now located in Toronto, Hays continues to explore the mind-body connection in her consulting practice, The Performing Edge, and is past president of the American Psychological Association's division of exercise and sport psychology.

Hays says she first encountered the concept of movement and therapy in the early 1980s -- reading such books as Thaddeus Kostrubala's The Joy of Running. The hypothesis is that rhythmic exercise, such as walking, can be conducive to the process of self-discovery.

Hays cites three key reasons for combining exercise and therapy:  

  • It encourages a patient to be more physically active for mental and physical reasons.
  • It helps a patient get "unstuck" when confronting difficult issues.
  • It spurs creative, deeper ways of thinking often released by mood-improving physical activity.

"Some patients may become anxious when confronting something difficult in a traditional seated, face-to-face interaction," she says. "Walking in parallel with visual distractions may allow for easier engagement."

Walk and Talk Therapy: Tapping Into Nature's Healing Power

Cathy Brooks-Fincher, a Brentwood, Tenn.-based licensed clinical social worker with 20 years of experience, has also found this to be true. An avid runner and athlete, she has observed that patients at all levels of fitness can benefit from fresh air and exercise when it comes to processing their feelings. She initially began using walk and talk therapy with teenagers who were having a hard time opening up. 

"When I took them into an adjacent park, I found that patients were much more relaxed and the sessions were much more productive," she tells WebMD. "Patients have verified that looking forward rather than directly at a therapist can help them open up."

Brooks-Fincher also praises the "healing power of nature." She says many patients consider the association of being outdoors with recreation and vacation, two very positive things that most people want to experience more.  

"We have a beautiful setting in which to do this, a public park with a paved path that runs along a small river," she says. "There are turtles, deer, birds, and a horse farm; restrooms and water fountains are nice assets. Clients who try walk-and-talk often have very dramatic shifts in their thinking about relationships in their lives."

Licensed clinical social worker Carlton Kendrick, EdM, who is based in Cambridge, Mass., agrees. He got his start using exercise and therapy when working with institutionalized and incarcerated patients in the early 1970s.

"When I got people walking on the grounds, listening to cows mooing and birds singing, having to avoid a rock in the road, engaged in a multi-sensory experience, the result was the patients were much more talkative and relaxed."

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