Trueform Therapy

Tag: nature-therapy

  • Walking Side by Side: What Happens When Therapy Leaves the Room

    Therapy doesn’t have to happen in a beige room with a box of tissues on the table.

    I’ve known for a long time that walking is where my own real thinking happens. Not at a desk, not when I’m trying hard to think, but on a path somewhere, moving, with my eyes on the trees rather than on a screen. Things that felt knotted untangle. Words arrive that wouldn’t come when I was sitting still.

    For a while I assumed this was just a personal quirk. It turns out it isn’t. And it raises a question I find myself asking more and more: if many of us think more freely when we’re moving and outside, why do we assume that the hardest conversations of our lives have to happen sitting down, indoors, facing each other?

    Walk-and-talk counselling session in a park – therapist and client walking side by side, outdoor therapy for anxiety, stress, and burnout, promoting mental health through movement and nature.

    Why the Words Come More Easily

    There’s a moment I think many people recognise. Some of the most honest conversations happen in the car, or on a long walk, or while washing up side by side. Not across a table. Not eye to eye.

    There’s research that helps explain this. Psychologists studying gaze have found that looking at a face takes up a surprising amount of mental effort. In one study, Gwyneth Doherty-Sneddon and her colleagues taught young children to look away when they were thinking through a hard question, and those children answered challenging questions noticeably better than children who hadn’t been taught to do this. Studies with adults point the same way: looking away from a face seems to free up space for remembering and thinking.

    I find this striking when I think about therapy. We often treat looking away as avoidance, a sign that someone isn’t really engaging. But it may be the opposite. Looking away can be how we make room to think.

    Walking adds something else. In a well-known set of experiments at Stanford, Marily Oppezzo and Daniel Schwartz found that people came up with noticeably more creative ideas while walking than while sitting, and the effect carried on for a while after they sat back down. That research was about generating ideas, not about therapy. But anyone who has ever solved a problem halfway round the park will recognise it.

    Put the two together and you get something interesting. Walking side by side, you’re not managing eye contact. Your body is moving. Your attention can drift to the path and back again. For many people, that combination makes it easier to say the thing they’ve been circling for weeks.

    This matters especially for people who find the traditional therapy room demanding in itself: the eye contact, the stillness, the feeling of being watched while you try to find the right words. For a lot of people, including many autistic people and people with ADHD, a face-to-face hour can feel like a performance. Moving through an open space can take some of that pressure off. I want to be honest that this is an area where therapists’ experience is ahead of the published research. But it’s something I take seriously.

    Photo by Janusz Walczak on Pexels.com

    What the Evidence Actually Says

    Nature and mental health is a field where enthusiasm often runs ahead of the evidence, so it’s worth being careful.

    The strongest overview I know of is a 2021 review led by Peter Coventry at the University of York, which pooled fifty studies of nature-based activities, from walking groups to gardening. In the randomised trials, people who took part showed meaningful improvements in mood and anxiety, and a clear increase in positive feelings, compared with people who didn’t. The most effective programmes ran for eight to twelve weeks, with sessions of between twenty and ninety minutes, which fits neatly with how counselling is usually offered.

    There are caveats. Many of the studies were small, and some had weaknesses in how they were designed, so the size of the benefit may be less than the headline numbers suggest. It’s also worth noticing that most of this research is about time in nature, not therapy in nature. It tells us green space is good for us. It doesn’t tell us that walking therapy beats sitting therapy.

    The research on walk-and-talk therapy itself is much thinner. A small pilot study at the University of Newcastle in Australia compared walk-and-talk with indoor therapy for 37 men with low mood. The walking group showed a bigger drop in overall distress, and both groups improved equally on standard measures of depression. But, interestingly, the indoor group did better on a measure of what researchers call “masculine-type” depression, the kind that shows up as irritability, anger or withdrawal. It’s an early, small study, and a larger trial is now under way. For now, the honest summary is: promising, not proven.

    There’s also research that listens to people’s own experiences. A 2026 review from the University of Manchester gathered studies in which people described what nature-based therapy had meant to them. Many said that being outdoors helped them work through painful emotions, accept difficult changes and reconnect with a sense of purpose. Some described simple moments, like watching trees grow, decay and renew, as giving them permission to accept change in their own lives. That’s not the kind of evidence that proves something works. But it tells us something about how it might help.

    The UK government has also trialled green social prescribing across seven sites in England, where people were referred to things like community gardening and nature walks. In the first area to publish results, Humber and North Yorkshire, people’s wellbeing, mood and anxiety improved, especially among those who took part for nine to twelve weeks. There was no comparison group, though, so we can’t be sure how much of that change came from the activities themselves.

    Photo by Farhaan Mushtaq Parimoo on Pexels.com

    What a Session Looks Like

    At Trueform Therapy, I offer walk-and-talk sessions in Cardiff. It isn’t the main way I work, but it draws on the same things I already do in the therapy room: paying attention to what the body is doing, using pace and pauses, and making a space where you don’t have to perform being okay.

    A session lasts about fifty minutes, the same as a standard counselling hour. Before we start, we’ll talk about the route, what you’ll need to wear and any mobility or sensory needs you have. I choose paths with privacy in mind, where we’re unlikely to be overheard, with places to stop. Some sessions involve walking the whole time. Others include pauses on a bench, when a conversation needs to slow down.

    We’ll also agree what happens if we meet someone you know, and what we’ll do if the weather turns. In Wales, rain isn’t a reason to cancel, but there’s always an alternative if being outside becomes impractical or unsafe. The session still has a shape — a beginning, a middle and an ending — even when the scenery keeps changing.

    You can read more about how I work here: Counselling Sessions

    When the Room Is the Better Choice

    Walking isn’t right for everyone, or for every moment.

    If someone is in acute crisis, or needs the steadiness and containment of a familiar, private room, indoors is usually the better place to start. The same is true for people with agoraphobia, or for some kinds of trauma work where feeling physically held and safe in one place matters a great deal. Significant mobility barriers need careful thought too, although good practitioners can adapt a lot, from step-free routes to quieter paths and regular places to rest.

    None of this is a permanent “no”. It’s a reason to be honest about where you are now. Outdoor work can be something you build towards, or something you mix with sessions indoors.

    And the Newcastle study is a useful reminder that indoor therapy has its own strengths. For some people and some kinds of struggle, sitting still in a room may be exactly what’s needed.

    Photo by Csenteri Arthur on Pexels.com

    Safety, Privacy and the Weather

    Taking therapy outside raises practical and ethical questions, and professional bodies have taken them seriously. The BACP highlights confidentiality, contracting, risk assessment and weather plans as the key issues to think through. The Institute for Outdoor Learning publishes good-practice guidance on what to look for in an outdoor therapist, and the British Psychological Society produced guidance on taking therapy outdoors in 2021.

    In practice, a good outdoor therapist will talk you through how outdoor sessions differ from indoor ones before you start. They’ll have thought about the route, including privacy and what happens if you meet someone you know. They’ll have a clear plan for bad weather and cancellations, and they’ll be willing to adapt to your physical and sensory needs.

    If a therapist can’t answer questions about these things, that’s worth noticing.

    If You’re Thinking About Trying It

    It can help to ask yourself a few honest questions first. Are you comfortable with a bit of weather and uneven ground? Do you have mobility or sensory needs that would need planning for? Do you feel steady enough, right now, to work without the containment of a room?

    When you speak to a therapist, it’s reasonable to ask what training they have for outdoor work, how they plan routes and assess risk, and what happens when the weather makes it impractical. In the UK, outdoor sessions usually cost about the same as indoor ones. Directories such as the BACP’s Therapist Directory or Counselling Directory let you search for therapists who offer outdoor work, and if cost is a barrier, your GP or local Mind may know of lower-cost options nearby.

    Small Doses

    If getting outside for therapy isn’t possible right now, some of what makes it helpful can still find its way into your day. A short walk before a difficult conversation. Sitting near a window during a phone call. A few minutes in a garden or a park at the end of the day.

    One small study found that just twenty to thirty minutes in a natural space was enough to lower levels of the stress hormone cortisol. That’s not therapy, and it’s not a cure. But it’s a reminder that our bodies respond to where we put them.

    Where the Words Come More Easily

    If you’ve sat in a therapy room and found the words wouldn’t come, it may not be because you weren’t ready, or weren’t trying hard enough. It may simply be that the room wasn’t the right place for you to think.

    Trueform Therapy offers one-to-one support in person in Cardiff, including walk-and-talk sessions, and online across the UK and EU. Whether you’re burned out, overwhelmed, or struggling beneath an exterior that seems to be coping, you don’t have to be in crisis to deserve support. You can read more about counselling sessions and get in touch to see whether this feels like the right fit for where you are now.

    If You Want to Explore These Ideas Further

    If the link between walking and thinking interests you, Shane O’Mara’s In Praise of Walking (2019) is a lively, readable account by a neuroscientist of what walking does for the brain.

    For a therapist’s perspective on taking sessions outside, William Pullen’s Run for Your Life (2017) describes his own approach to combining movement and talking therapy.

    And if you’d like to look at the research directly: