It’s no secret that spending time in nature has mental health benefits. Getting out into the natural world, especially green spaces like parks and forests, can improve mood and focus, reduce stress and reduce the risk of psychiatric disorders.
A growing number of Seattle-area therapists are incorporating nature into their practices, meeting with clients outdoors in local parks and green spaces for psychotherapy sessions. They say the practice, commonly called “walk-talk therapy,” enhances traditional one-on-one sessions while giving clients the benefits of being outdoors.
Walk and talk therapy is just one form of ecotherapy, a category that can include different types of nature-based activities such as nature therapy, forest bathing and classes focused on plants and the natural world.
Even within walk and talk therapy, sessions look different depending on the therapists’ approach. For some, nature is primarily a setting for conversation; For others, plants, rocks, or water are integrated more directly to connect with what the client is discussing.
Research on walk-talk therapy is still limited, but it supports these experiences. Studies have found that outdoor sessions stimulate thinking, help the flow of conversation, and facilitate the mind-body connection.
“It’s a great gift as therapists to be able to do our sessions outside, but it’s also great for people who don’t want to be inside to be able to have these alternatives available,” said Seattle therapist Ari Bonagofski. “As more people become aware of ecotherapy and the different types of nature-based therapies available, I think it will continue to grow.”
A growing practice
Walk-and-talk therapy wasn’t as common in Seattle before the COVID-19 pandemic forced therapists to abruptly shift to holding sessions on Zoom or other video platforms.
Bothell therapist Becky Robbins was in an ecotherapy training program in 2020 when the pandemic hit. Clients began asking her if they could see her outside, particularly those who had just moved to the Seattle area and didn’t have a “bubble” of people to safely spend time with in person.
His office was next to a private beach in Edmonds, near the ferry terminal, giving him the opportunity to hold outdoor sessions.
“I almost instantly became a natural therapist because I wanted to see people in person and I didn’t want to be on Zoom all the time,” she said. “The pandemic really helped a lot with learning how to do all that, work with people and put it into practice.”
The Seattle Times spoke with eight therapists with experience in walk-talk therapy for this story. Most said that nature therapy was barely discussed in their formal education and that they learned more by doing their own research.
Robbins teaches classes that help other therapists understand the legal and ethical considerations involved in conducting a walk-and-talk session. She says interest in outdoor therapy is increasing, and other Washington therapists agree.
“When I started, I only knew one other therapist who did this work,” said Rachel Duthler, a Seattle therapist who conducts individual outdoor sessions and leads outdoor group therapy trips. “There is now a nature-based therapy Facebook group for providers, and several people are showing up and offering this. “I think it has been growing.”
What does the research say?
Academic research on walk-talk therapy has primarily focused on the therapists’ perspective. Denice Crowe Clark, an Atlanta-based therapist, focused her Ph.D. dissertation on three clients’ experiences with walk-talk therapy.
At first, some clients were hesitant to try walk-and-talk therapy, but they enjoyed the outdoor setting and told her it was equally if not more therapeutic than indoor therapy. Walk-and-talk therapy could also “normalize the therapy experience for some and reduce the stigma associated with seeking help for mental and emotional problems,” she said. he wrote in his 2019 dissertation. Clients told Clark that the natural environment made them feel more comfortable than walking into a therapist’s office; others in the park weren’t paying attention and didn’t realize they were in a therapy session.
“They felt like more things came to them when they walked side by side,” Clark said in an interview. “It was less intimidating. The content and conversation just flowed more easily.”
Professor Arie Greenleaf built on this work while teaching at Seattle University, interviewing clients after walk-and-talk sessions at Cal Anderson Park. Six of seven participants in a study 2023 They reported that the outdoor sessions stimulated creative thinking and helped them process thoughts and feelings more clearly.
“That’s exactly the state of mind you want a client to have: problem-solving, creativity, openness and mental clarity,” said Greenleaf, now a professor of counseling at Nova Southeastern University in Florida.
Outdoor therapy sessions also put the therapist and client on an equal footing, Greenleaf said. In a traditional session in a “counselor’s den,” the environment is outside the client’s control: the therapist has chosen the furniture and decorated the office, and his or her titles are often hanging on the wall.
“It evens out the power differential and calms people down,” Greenleaf said. “They’re more likely to open up that way.”
Some therapists use the natural environment directly, as an integral part of their conversation during sessions. Kaela Koepke, a Seattle therapist, focuses on the specific qualities of plants and trees and incorporates them into her work with clients, helping them examine their natural posture and movement.
“A cedar is really smooth and wavy. “Douglas fir is straight, stiff and tall,” Koepke said. “If you feel like your body is stiff, cedar can help soften it. If you feel like you are collapsing, Douglas fir or alder can help add more strength and structure.”
“We can do therapy in a more holistic way”
There are many things therapists should consider before deciding to hold sessions outdoors, starting with a mental map of the park or space they are using. Where are the bathrooms or water fountains? What does foot traffic look like at different times of the day?
“It’s as simple as having your therapy session outdoors, and yet it’s not,” Clark said. “There are many components to walk-talk therapy that therapists who haven’t done it before and clients don’t consider.”
Comfortable walking shoes are a must, and guests should be prepared to deal with allergies or other environmental issues. Rain in Western Washington is also a factor. Duthler, the Seattle therapist, said people are often prepared to dress for the weather year-round, but sometimes “it’s too much” and she will move a day of sessions to telehealth.
It is impossible to guarantee the privacy of a therapy session in a public park. Therapists said they discuss this directly with clients and run through different scenarios; some ask clients to sign an additional consent form before outdoor sessions.
“There’s always a chance that someone may recognize me as a therapist or recognize the client as a friend,” said Sam McCann, therapist and co-owner of Green Coast Counseling in SeaTac. “We talked about this beforehand and I say, if you’re talking about something difficult, someone might see you cry. How do you feel about that?”
But therapists interviewed said the benefits merit additional consideration, both for themselves and their clients.
“I’ve seen interest in it grow as people increasingly discover that we can do therapy in a more holistic way and that it doesn’t have to fit into the old idea of being face to face in a closed room. together,” McCann said. “If we can do therapy in a different way that makes (clients) feel more supported and comfortable, let’s try to make that happen.”
