With all my love of therapy, one of my biggest struggles is the sedentary lifestyle of being in an office doing talk therapy in an enclosed space for 8 hours. Coming from a hospital background on the unit and a PHP/IOP program at an alternative school, I was very used to movement. So, when I converted to outpatient therapy, I didnt realize how much residual adrenaline I still carried with me from that environment. This would make focus difficult at times and my tailbone very, very, sore.
I laugh, but I truly had difficulty coming home and sitting through dinner, with how much I was sitting all day. I was sore. My muscles were cramped. I was very tired. Then, I put myself in my client's shoes. A 10 year old with ASD, who has been focusing at keeping his behaviors in check all day or a 13 year old with ADHD who has been ruminating all day, hyperfixated and tasked to sit on my couch for the next hour. Even my adult clients, who were dealing with depression and anxiety- coming to me sit in my room enclosed with no sunlight for another hour.
There is a place for good ol' talk therapy and is there also room for movement?
According to the following peer review:
Cooley, S. J., Jones, C. R., Moss, D., & Robertson, N. (2022, March). Organizational perspectives on outdoor talking therapy: Towards a position of “environmental safe uncertainty.” The British journal of clinical psychology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9291048/
There has been evidence based research on what constitues a ‘healing environment' (Huisman, Morales, van Hoof, & Kort, 2012; Sadek & Willis, 2020) The healing environment can be affected by aesthetics, lighting, music, sounds, textures, seating arrangements- you name it (Gaminiesfahani, Lozanovska, & Tucker, 2020; Huisman et al., 2012; Ulrich et al., 2008). Because how the room is set up is so vital to talk therapy (we want a calming inviting space that fits our client's needs), this then begs the question, well, what if we weren't confined by the four walls of an office space?
Research has since been done on how outdoor environments can be beneficial to the therapeutic process especially since the pandemic. In another study, it was reported that there is great benefit to connecting with nature, which enhances mindfulness grounding practices a long with supporting an increase in positive affect. The top areas that were noted to improve were physical health, better stress responses, mood, focus, social connection, and an even better connection to life's purpose (Cipriani et al., 2017; Twohig‐Bennett & Jones, 2018; Zhang, Mavoa, Zhao, Raphael, & Smith, 2020).
The highlight of being able to be outside during sessions is the opportunity for movement. There have been several studies that have supported the benefits of movement in terms of improving mood, focus, and even problem solving, memory, and creativity. (Miller & Krizan, 2016 & Mualem et al., 2018; Oppezzo & Schwartz, 2014), which are all essential when engaging in talk therapy.
I have often asked clients what they do if they feel anxious. Do they notice if they pace? Do they feel the need to move? And if they do engage in movement- how do they feel after? Most of the time there is a direct correlation to a reduction in anxiety the minute they move even if its light walking. Though I love everything with couch therapy, I also see a big need for us to connect outdoors and move our bodies. We have pent up stuff that is just aching for us to release it and find others ways to cope. So if you are so inclined, I definitely encourage anyone who wants to practice therapy while walking or in a non traditional sphere- definitely ask your therapist and see how you feel after a session of walking and talking. Or just being in nature while you guys talk to see what benefits come or what changes you notice while changing up the environment.
As always- take what you need and leave what you don't and make the best decision for you.
Sincerely,
L-A