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Walk & Talk Therapy - Things to Consider

Walk & talk therapy is gaining popularity among clients and therapists. While there are potential benefits to walk & talk therapy, there are some specific considerations to be aware of as well. This is not an exhaustive list but several things to think about if preparing to offer walk & talk therapy for your clients. 

While we are providing tips and considerations for Walk & Talk therapy, it's important to note that ultimately, the decision to offer this type of therapy should be based on your own clinical judgment. Assessing its appropriateness should be conducted on a case-by-case basis for individual clients, as well as more broadly for your overall practice. Layla does not endorse or prohibit this therapy modality as it is case specific.
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Confidentiality:

  • Make sure to discuss and plan for potential confidentiality issues with your client before engaging in walk & talk therapy. Examples could be:
    • Running into someone you or your client knows
    • People overhearing pieces of your conversation
    • Your client becoming visibly upset while in a public place

Consent:

  • There are additional things to discuss with your client(s) and for them to sign off on before beginning walk & talk therapy. You should have a consent that includes these topics. We have a sample consent addendum you can use and/or modify for use in your practice.

Insurance/liability:

  • Contact your insurer to make sure you are covered for walk & talk therapy - you may need to pay an additional premium for coverage
  • You may want your client to sign a consent saying they are aware of the extra risks (including physical and confidentiality risks) that come with walk & talk therapy and won’t hold you liable if there is an issue during a session (you can see our sample walk & talk consent addendum for one way to word it)

Last minute issues/changes:

  • Have a plan for how you will deal with last minute issues that could affect the session. For example:
    • Client is running late - now the route is too long for the time you have left in the session
    • You or client get injured earlier that day
    • Your normal route is closed or blocked for some reason
  • Ensure you have a reliable way to get in touch with your client and for them to reach you for last minute issues/changes
  • Ensure you have a plan for when these things arise

Other clients:

  • Be mindful of leaving enough time between clients to ensure privacy/confidentiality and to take care of any of your needs between sessions (e.g., recording session notes)

Preparation

  • Your first session with your client should be either virtual or in office (not walk & talk). During that session, you should discuss your walk & talk consent and any other details from this tip sheet, your consent, or other subjects you feel are important to review beforehand
  • Ensure your client reviews and signs any additional consent you may have before your first walk & talk session
  • Ensure your client has the chance to ask you any questions they may have before your first walk & talk session
  • Inform your client what type of clothing/footwear is appropriate for the terrain/your route

Route:

  • Choose a route that you know. Important things to think about and know beforehand:
    • The route needs to take the time of the session, ensure you can be back by the end of your session
    • Walking conditions should be relatively flat and hazard-free
    • A natural environment generally has the benefit of not being too crowded with people and also of combining time in nature with the therapy session which can improve the healing experience of walk & talk therapy
  • Make it very clear at what point and how you would cancel a walk & talk session and what the alternative would be (e.g., switch to virtual or switch to in-office, how much notice, how you would notify the client)

Safety

  • Bring a backpack! It is recommended to carry 2 water bottles, one for you and one for your client and a basic first aid kit on your walk & talk sessions
  • It is recommended that your client bring any medication they may need for any walk & talk sessions (e.g., epi pen, inhaler, or allergy medication)
  • It is recommended that you ask your clients if they have any health conditions that may impact their ability to participate in a walk & talk session and if so, that they get medical clearance before participating in any walk & talk sessions
  • Make sure your phone is fully charged and bring an extra battery pack/charger if possible
  • It is recommended that you bring your wallet, cash, and a map in case of emergency

Weather

  • Discuss and agree upon beforehand with the client what weather conditions are acceptable or would result in cancelling a session. Things to consider:
    • Temperature
    • Precipitation
    • Chance of precipitation
    • Wind or other weather warnings
    • Air quality (e.g., smoke from forest fires, smog warnings)
  • Make it very clear at what point and how you would cancel a walk & talk session and what the alternative would be (e.g., switch to virtual or switch to in-office, how much notice, how you would notify the client)

Offering Walk & Talk to Layla Clients

Walk & talk therapy is gaining popularity among clients and therapists. While there are potential benefits to walk & talk therapy, there are some specific considerations to be aware of as well. This is not an exhaustive list but several things to think about if preparing to offer walk & talk therapy for your clients. 

While we are providing tips and considerations for Walk & Talk therapy, it's important to note that ultimately, the decision to offer this type of therapy should be based on your own clinical judgment. Assessing its appropriateness should be conducted on a case-by-case basis for individual clients, as well as more broadly for your overall practice. Layla does not endorse or prohibit this therapy modality as it is case specific.
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Sources:
‍1.         DeAngelis, T. (2013). A natural fit. Monitor on Psychology, 44(8). https://www.apa.org/monitor/2013/09/natural-fit
‍2.         McKinney, B. (2011). Therapist’s Perceptions of Walk and Talk Therapy: A Grounded Study. Retrieved from https://scholarworks.uno.edu/cgi/viewcontent.cgi?article=2381&context=td
‍3.         Just, L. (25 September, 2020). What is Walk and Talk Therapy? Retrieved from https://welldoing.org/article/what-is-walk-and-talk-therapy
‍4.         Wise, E. (2020). The Benefits of Walking and Talking Therapy. Retrieved from https://www.counselling-directory.org.uk/memberarticles/the-benefits-of-walking-and-talking-therapy
‍5.         Seif, M., & Winston, S. (2018). Unwanted Intrusive Thoughts. Retrieved from https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/unwanted-intrusive-thoughts
‍6.         Crowe Clark. (2019). Adult Clients’ Experience of Walk-and-Talk Therapy. Retrieved from https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=8058&context=dissertations
‍7.         Dockett, L. (2019). Walk and Talk, Psychotherapy Takes a Stroll. Retrieved from https://www.psychotherapynetworker.org/magazine/article/2407/walk-and-talk
‍8. Cooley, S.J. et al. (2020). ‘Into the Wild’: A meta-synthesis of talking therapy in natural outdoor spaces. Retrieved from https://www.sciencedirect.com/science/article/pii/S0272735820300295?ref=pdf_download&fr=RR-2&rr=7fb4790afdee36fb