Why outdoor counselling may be the ideal post-lockdown solution

Counselling during the lockdown largely migrated to online or telephone sessions. But after weeks of social distancing, it may take time before people are ready to re-enter the confines of a small therapy room. Outdoor counselling might just be the ideal solution.
 
One feature of the health crisis lockdown has been visible across the country in our parks and outdoor spaces – as many people have rediscovered the art of ‘going for a walk.’ As a consequence, it feels as though we have all collectively given a great deal more attention to the arrival of spring this year, observing the day-to-day progress of buds, the nest-building habits of magpies in the park, and the sudden arrival of dozens of ducklings and goslings on a nearby pond.
 
There has been plenty written about how our interaction with the rhythms of nature can boost our mood. (This won’t work for everyone, I would imagine: if you were a farmer, for example, you might view the natural habitat in a local wood as a source of anxiety about the viability of re-wilding subsidies). But for many of us, nature and green spaces can bring a sense of calm. And numerous scientific studies have shown that combining light physical activity with the stimulus of the natural world will bring even more benefits to our wellbeing.
 
So if walking in a green space is good for both mind and body, it is not too surprising that some counsellors have chosen to combine counselling sessions with a walk outside. This is not such a new idea: more than a century ago, Sigmund Freud occasionally walked with his patients around the university in Vienna. However, that kind of freedom to experiment became the exception in subsequent decades, as therapy became confined within the four walls of a therapy room, offering a safe but unchanging environment – with no external distractions.
 
Over the last 20 years, things have somewhat loosened up, and therapists began to take their work outside. Those lucky to live on the doorstep of a national park or wilderness area began offering extended walking sessions, combining the benefits of exercise with the experience of nature and the therapy itself. The practice is becoming better known: a recent episode of Clare Balding’s ‘Ramblings’ series on BBC Radio 4 saw her meet up for a walk with psychotherapist Dr Ruth Allen, who provides outdoor counselling in Derbyshire. Meanwhile, outdoor therapy is also moving into more urban areas, with counsellors proposing walks along a riverside or in parks. So in the wake of the current health crisis – and the likelihood of prolonged social distancing well beyond the end of the lockdown – there is an opportunity for outdoor counselling that could drive it much closer to the mainstream.

A blueprint for outdoor therapy in urban parks

The lockdown taught us a great deal about communications technology that already existed, but which many of us were simply not using. I'm not just talking about Zoom. Take, for example, the way friends have used their phones while going out for a ‘socially distanced’ walk together. They are on the phone (usually with earbuds) while walking alongside each other, at the requisite distance. Their conversations are kept at a low volume (inaudible to a passer-by), but the pair can see each other (if they choose to look), so can be aware of each other’s expressions and of body language.
 
This looks to me like a blueprint for how outdoor therapy can be conducted in our urban parks and open spaces. You have the physical presence that is lacking in online counselling; the confidentiality of the spoken word via the simultaneous phone call; the stimulus of the immediate environment that can prompt new thoughts and reflections; and a range of choices over how far you as a client wish to engage directly (eye contact, walking, standing still) with your therapist.
 
So how does it work in practice? First off, we have to deal with the everyday worries that the format itself can bring up. The most common questions from outdoor therapy clients are listed below (in no particular order): “What if it’s raining on the day? What if we meet someone who comes up for a chat? What if there are people nearby who can hear us? When I meet you in the car park, does the therapy start immediately, or later? Will I need to walk faster than I am comfortable with? Can we sit down somewhere? Will we be able to concentrate, being outside? And can I bring my dog?”
 
All of these can be dealt with in a conversation before counselling begins, with the aim of creating a detailed counselling contract: there will be an agreed plan of action for the ‘what if…’ questions, clarity over when the therapy begins and ends, how long the walking part will be, and allowing for time over-runs if required.


 
Once these practicalities are sorted, the real advantages of the outdoor session can become apparent. Let’s not get too seduced up by the benefits of the physical act of walking and the mental benefits of being in a natural environment – because these are available to everyone free of charge, most of the time: we just need to go out for a walk. Instead, let’s consider what’s lost, and what’s gained, by taking the counselling itself outside.

Counselling outside the box

What outdoor therapy does not have is the sense of containment that can come from the four soundproof walls of the counselling room, the opportunity to think and reflect in absolute stillness and silence, to see the counsellor as something of a blank canvas, or to give undivided attention to a thought or feeling that may emerge in the course of a session. I won’t lie: these are key aspects of some types of psychotherapy that will work less effectively in an outdoor context.
 
But what do we gain instead? One thing people like about outdoor therapy is the avoidance of having to go into the four soundproofed walls of the counselling room we just spoke about: in other words, to sidestep the process of entering the counselling building, taking a seat in the waiting room, telling friends (or admitting to friends) that you are going to see a counsellor. Perhaps we could sum this up as making therapy less anxiety-provoking. It’s important to add here that even though outdoor counselling lacks the physical structure of a room, it is not totally lacking in boundaries and containment: rather, the counsellor maintains ‘invisible’ or ‘psychological’ boundaries, through managing the session, maintaining it as a counselling encounter (as opposed to a social encounter) and keeping as far as possible to a route and a timescale.
 
Beyond this, there are some important benefits that can outweigh the loss of the traditional enclosed space. The immediate environment during outdoor therapy is changing and unpredictable. It adds a new ingredient to the therapeutic pairing of patient and therapist, providing an external stimulus that will prompt new thinking and perhaps feelings: ‘My brother used to have a dog like that…’ or ‘That smell of grass reminds me of when I worked at…’ or even ‘I hate joggers…’ or ‘Those crows give me the creeps…’
 
Perhaps the ideal solution is to try to get the best of both worlds – the concentration of the therapy room experience coupled with the added freedom and spontaneity of the outdoors. Some patients seek to start counselling with a few outdoor sessions over a period of weeks, before continuing either in a therapy room or online. Others start counselling in a therapy room but opt for a shift outdoors from time to time. And for some people, the chance to simply take a walk with a professional counsellor on just one occasion can provide a catalyst for new ways of looking at an old problem.
 
One thing is certain: in the wake of the lockdown, and while social distancing persists, outdoor counselling will be the only way to get counselling in the same physical space as your counsellor. And in the more crowded urban green spaces, talking to your counsellor by phone across two metres of space as you walk together in the park – well, that may just become the new normal.