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Walk and Talk Therapy: Out of the Office, Into the Park

The next time you have a medical check-up, don’t be surprised if your doctor hands you a prescription to walk.” (Harvard Medical School 2017)

It’s not just alternative health doctors who now tell people to go for a walk if they are stressed. You can’t get much more mainstream than Harvard Medical School, which sent a health newsletter to my inbox with the bold statement above.

A Prescription to Walk?

Here is a practical example.  “Walk and Talk” therapist Jennifer Blough told me about her patient Jake, “a man in his early 40’s who was struggling with PTSD and extreme social anxiety.” He was reluctant to see a professional for help, but something about the idea of “walk and talk” therapy in the park made him comfortable enough to reach out to Jennifer.

Jennifer describes the process they went through together: “He told me during our first session that he appreciated the fact that he could bring his dog for support and didn’t feel “cornered” by having me staring at him in an enclosed office. In fact, Jake had been unable to leave the house without his dog…period – and often had panic attacks when in small spaces or crowds. Jake, his dog, and I met weekly at the park for a month.”


 “On his fifth visit, it was snowing and Jake arrived solo, claiming that he didn’t want his dog to get cold and told me of how he no longer had to take his dog with him. We spent the session talking about all of the recent places he was able to visit, from the grocery store to visiting friends, without having to take the dog and sans any panic attacks. Jake also started walking daily (with and without his dog) and told me of how he started to actually enjoy exploring different parks in the area.  Jake’s confidence began to rise, and his symptoms of PTSD and social anxiety began to decrease.” (Note: Jake’s name and some personal details were changed to preserve privacy.)

The Pioneer

We’re talking real therapy here, not just a stroll with friends around the local mall.

In the early 1980’s, psychiatrist Dr. Thaddeus Kostrubala shifted his practice from sitting together in an office to running or walking together with the patient outdoors.  He called his new practice “running therapy.”

“During those years from 1980 to 1983 I treated patients while walking, jogging, or running with them. Due to the patient volume, sometimes I would take 10 showers a day.” (Kostrubala 2009)

Kostrubala was a pioneer who recognized the benefits of combining walking – or running – with mental health therapy long before Reader’s Digest and Time Magazine were extolling the benefits of walking.

Because he originally ran with most of his clients, his “10 showers a day” was a bit extreme!  That is likely one reason you hear more today about “walk and talk” therapy than “run and talk” therapy.

Why “Walk and Talk” Therapy?

Why would “walk and talk” therapy provide benefits beyond the normal counseling session?

Some people are put off by their image (or their experience) of the psychiatric office: an old couch to sit or lie on, tacky art on the walls, feeling boxed in while the doctor asks questions and stares at you.

In contrast, with “walk and talk therapy” the patient and therapist look at the world side by side, which can help patients relax and open up.  Walk/run therapist Sepideh Saremi, LCSW says on her website: “In my observation, being side-by-side seems to reduce patients’ shame and self-judgment….”

In addition, the two are moving together.  Harvard Medical School Psychology instructor Sarah Gray, Psy.D. has found that for “those who may have symptoms of ADHD or who may process things in a more body-based way, conducting therapy while moving outdoors can often feel easier than sitting indoors on the couch for 50 minutes.”

“Walk and talk” therapists have found that the movement of walking during therapy can also be especially helpful for teenagers, people dealing with anxiety or grief, and survivors of trauma.

An added benefit is that “walk and talk” therapy usually takes place in a park or natural environment, which adds the healing benefits of nature to the mental health benefits of walking.

The Science of Walking and Health

The science is now overwhelming that walking helps the body, the mind and the emotions.

Not only does walking improve physical and cardiovascular health.

Not only does walking reduce stress.

Not only does walking increase brain health.

To the point of this article about therapy, walking also reduces the negative self-talk that so often sabotages our best intentions.

Walking Reduces Depression

Walking can even help your mood. A number of studies have found that it’s as effective as drugs for decreasing depression. It can help relieve everyday stresses, too.”  (Harvard Medical School 2017)

According to Johns Hopkins neuroscience researcher and therapist Katie Davis, Psy.D., “Research shows that people who exercise regularly were 25% less likely than those who didn’t to develop depression or anxiety.”

If a drug achieved results like that, it would be hailed as a blockbuster breakthrough.  The former head of the Centers for Disease Control, Dr. Thomas Frieden, put it well.

Photo - Dr. Thomas Frieden Walking, Wonder Drug.jpg

How much walking is necessary? “Research suggests that 30 minutes of daily walking is the equivalent of taking an antidepressant,” says licensed professional counselor Blough.  Then she added: “Of course, unlike medication, walking doesn’t have negative side effects, such as decreasing your sex drive or causing you to gain weight!”


Maybe we should add “a walk a day” to “an apple a day” as the non-drug prescription for life-long health.    But if you ever decide to consider therapy, consider whether you have a personality that will thrive with the “Walk and Talk” style of therapy.

I will leave the last, simple and soothing words to neuropsychologist and neuroscience researcher Dr. Davis.

 All of my patients seem to do better when they are active: attention and concentration are better, sleep is better, stress is reduced. Exercise doesn’t need to be particularly rigorous to produce anxiety-reducing benefits. Walking, even for just a few minutes, can reduce anxiety for a few hours.” 


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