How Does Walk and Talk Therapy Work?
Overview
Why movement and therapy?
Today, it is accepted that there is a powerful mind-body connection through which emotional, mental, social, spiritual, and behavioral factors can directly affect our health. Therapy is already known to develop a positive self-image and produce coping skills to treat a multitude of mental health conditions. What’s lesser known is physical activity’s effect on our mental well-being.
Movement, such as walking, releases brain chemicals that work to decrease feelings of depression, anxiety, and stress. Exercise has also been shown to be a powerful anti-depressant that releases mood-enhancing chemicals which improve self-esteem and decrease perceptions of physical and mental pain.
Furthermore, spending time outside in nature has a calming effect on the mind and body. Research repeatedly shows a number of positive effects that fresh air, nature, and the outdoors have on our well-being.
Our mental and physical health are inextricably connected—let’s work on them both together!
Incorporating walking with talk therapy has developed out of this theory that the mind and body are deeply connected and that mental health and physical health are closely linked. Movement and therapy with Off the Couch, LLC involves psychotherapy, talk therapy, or counseling that takes place while walking. This therapy, often coined “walk and talk therapy” is available in New York City and California and is spreading across the nation. It is actually not a new concept, however, as Freud himself carried out a number of walking analyses!
This type of therapy does include movement and may raise a person’s heart rate, however, it is not considered an exercise session. While the primary goal of movement therapy is not weight loss or improved fitness, these indeed may result for individuals who currently do not engage in any kind of physical activity. The focus of the sessions, as with any in-office therapy session, is for clients to bring their problems and concerns, and to work through them with his or her therapist while engaging in movement, rather than sitting.
It has been noted that the walk and talk therapy, or movement and therapy, approach may be a vehicle for getting some clients to talk more openly about their emotions and, for others, it may offer a less intimidating setting than an office. By including movement in the counseling session, therapy can be enriched and can stimulate creative, deeper ways of thinking which are often released by mood-improving physical activity. Walking therapy is also for those who want to try something new and different. No matter what your reason is, walking and talking is a great way to have a positive therapeutic experience!
The Specifics
◊ There will be an initial phone consultation to discuss your request for services and to answer any questions you may have about walking and talking therapy. If using insurance for services, please inform me of this during our initial phone consultation.
◊ If we determine that walk and talk therapy would be best for you, we will schedule an initial intake session. You will be provided with details about the locations offered for the walking sessions. Also included will be information about parking options and the specific place to meet. All walking sessions take place in park-like settings.
◊ You will receive an invitation to my patient portal via Patient Ally to register and complete all intake forms. You will also receive a request from IvyPay to handle your first appointment deposit.
◊ At you initial session, I will talk with you further about your reason(s) for seeking counseling and may ask for additional information, such as your basic health history. We will also review the forms and my policies. Any questions you have are welcome.
◊ We will then schedule your next session at the end of this initial meeting.
◊ All locations will be agreed upon prior to the walk and talk session. If at any time, you have any questions about where to meet or directions, please call or text me.
◊ Many times for therapy and walking sessions, clients need to text or call as they are parking or walking up to make sure they are in the right spot.
◊ Dress comfortably and wear comfortable shoes for walking. You may also wish to bring water with you if needed.
◊ Note that our sessions will be tracked on a live tracking phone app for our mutual safety.
◊ Please remember to bring payment (cash, check or Google Pay) with you as payment is due at time of service.
Why Walk and Talk Therapy?
“It’s never too late to be what you might have been.”
– George Eliot –
There are proven benefits of engaging in physical activity, including: reducing your risk for several diseases and health conditions, improving your overall quality of life, protection from health problems such as heart disease and stroke, high blood pressure, non-insulin-dependent diabetes, obesity, back pain, and osteoporosis (to name a few). There are also the psychological benefits of engaging in physical activity to consider, including: improving your mood and the way you feel about yourself, the likely reduction in depression and anxiety, and helping you to better manage stress. The combination of engaging in physical activity—with all its benefits—along with treatment to address your concerns, thoughts, feelings, and behaviors during talk therapy forms the unique, holistic approach that Off the Couch, LLC offers to you.
Below is more support for this distinctive approach to the therapeutic process:
◊ “Walking is literally moving ahead. People feel like they are moving forward in their issues. They can tackle things better and faster.” – Clay Cockrell, LCSW
◊ “Drug ads are ‘all around us,’ but we overlook ‘this antidote for cancer, obesity, heart disease, depression’ [i.e., the outdoors], the efficacy of which has been explored in academic research.” – Jonathan Jarvis, National Park Service (Washington Post)
◊ Walking gets people to use their bodies which is a good start to incorporate movement in their lives. – Dr. Bridget McKinney, LPC
◊ Switching from seated meetings to walking meetings with colleagues “changed my life.” – Nilofer Merchant, TEDTalks
◊ Another benefit of physical activity is the ability to be more aware of how emotional problems manifest physically. –Dr. Bridget McKinney, LPC
◊ “When you are out walking, you’re working from a position of health. Lying on a couch is what people do when we’re sick.” – Psychotherapist Geri Dubé
◊ “In the same way that standing up is an oddity now, sitting down should be.” – Dr. James Levine, Mayo Clinic
◊ There are additional physical benefits of walk and talk therapy for clients: improvements in health, such as better sleep, lowered body fat, decreased cholesterol, and reduced risk of heart attack, as well as an increased awareness of physical symptoms. – Dr. Bridget McKinney, LPC
◊ “Your brain will gradually start to change if you get up each day and go for a walk.” – Dr. James A. Levine, Mayo Clinic
◊ “There are medical benefits to simply being outdoors.” – Robert Zarr, MD (Washington Post)
◊ Walking encourages clients to be more physically active for mental and physical reasons; it may help clients get “unstuck” when dealing with difficult problems; and it can encourage creative, deeper ways of thinking often released by mood-improving exercise. – Dr. Kate Hays
◊ “Numerous scientific studies have shown the positive effects of exercise on the brain, especially for people with depression.” – Clay Cockrell, LCSW
◊ Rhythmic exercise, such as walking, can be conducive to the process of self-discovery. – Dr. Kate Hays
Do You Offer In-Office Sessions?
If you prefer traditional therapy in an office setting, or if it is determined that walking during therapy is not the best approach for you at this time, you can engage in “regular” in-office therapy. I currently offer in-office sessions in Frederick, MD. Contact me today to discuss specifics about traditional therapy sessions.
Do You Offer Virtual Sessions?
I currently offer virtual sessions over video for clients located in Maryland and North Carolina. Please contact me today to discuss specifics about virtual therapy sessions.
How Do I Schedule an Appointment?
MARYLAND CLIENTS:
If you would like to schedule an appointment, please call me at 240-270-2640 or email at romayne@offthecouchllc.com.* When you call or email, please let me know if you plan on using insurance or if you will be a self-pay client.
You will register and complete all paperwork in Patient Ally. You will receive an invitation to register with the portal after our first phone consultation. The link to the portal is: https://www.patientally.com/welcome
In order to avoid insurance billing issues related to denied claims or deductibles, I require that you pay $100.00 up front prior to the first session. After we submit the claim for that session to the insurance company, if they accept the claim and pay for the session, you will be reimbursed whatever is left of your first session payment after your co-pay. If you will be self-paying for therapy, this $100.00 will be credited towards that fee.
NORTH CAROLINA CLIENTS:
If you would like to schedule an appointment, please visit my profile on the Headway website at My Headway Profile.
You will register, complete all paperwork and have your billing matters handled directly with Headway. If you have any questions about this process, please call me at 240-270-2640 or email me at romayne@offthecouchllc.com.*
CANCELLATION POLICY:
Your appointment time is reserved specifically for you. Please provide 48-hour cancelation notice if you are not able to attend a scheduled appointment. A full session fee will be charged for missed appointments or cancellations with less than 48-hour notice except where prohibited by law, regardless of failure of client to receive an appointment reminder and regardless of reason for late cancellation.
Should I See a Therapist?
Some Reasons Why You May Want to See a Therapist
You’re experiencing unexpected mood swings.
If you’re noticing you’ve taken on a more negative mood or thought process ― and it’s persistent ― it might be worth talking to someone. This is typically a sign of a mental health issue. Therapy can help you get to the root of the problem. Therapy offers you the opportunity to open up about your thoughts, feelings, and circumstances in a confidential environment. Within the safety of this secure environment, you may feel more comfortable exploring areas of yourself or your life that you are struggling with or unhappy about.
You’re undergoing a big change.
This could be a new career, a new family or moving to a different city. New ventures are challenging and it’s normal to need assistance with that. With a therapist, you can work with someone with a neutral perspective—who does not have a vested interest in your choices—to identify goals and to develop a plan to achieve them. Therapy often involves the development of skills and strategies to reduce or manage life stressors.
You’re withdrawing from things that used to bring you joy.
A loss of motivation could signal that something is wrong. If you’re normally a very social person and you find that you are suddenly withdrawing from your usual clubs, groups, or community and family activities, you could be experiencing something deeper. A therapist is trained to help you uncover why this might occurring, and we can work together to help you find the source of your unhappiness. Therapy can help you sustain your mental health.
You’re feeling isolated or alone.
Many people who deal with mental health issues feel like they’re alone in dealing with their experience. Group therapy could help with this or even just having a medical professional recognizing the validity of your emotions. It has been noted that when you enter therapy, you can get the immediate sense of relief that you are not alone, that your problem is well understood and shared by others. This can bring about a sense of both comfort and hope.
You’re using a substance to cope with issues in your life.
If you find yourself turning to drugs or alcohol as a way to deal with what’s going on in your life, it might be time to reach out. Addiction and substance abuse are medical conditions ― not character flaws. Seeing a therapist can allow you to gain the knowledge needed to fully address the illness of addiction.
You suspect you might have a serious mental health condition.
Serious mental illness affects almost 10 million adults in America in a given year. If you’ve been feeling off for a long period of time, reach out. Psychiatric conditions like bipolar disorder or schizophrenia rarely develop out of nowhere and people display signs for a while. Symptoms ― particularly ones like severe nervousness, apathy or intrusive thoughts ― should not be ignored. They’re treatable. That being said, therapy alone will not address severe mood disorders or psychosis, and you will need to seek help from a psychiatrist or doctor who can prescribe appropriate medications to help you.
You feel like you’ve lost control.
This particular feeling arises when people are dealing with a substance abuse or addiction issue. This lack of control often keeps individuals in the in a repetitive circle of substance use. There is often a cycle of addiction which is difficult to break out of ― you may be using substances in order to avoid painful feelings, which can lead to guilt, and then you continue to use substances to mask these feelings. Going to therapy can help to lift this heavy burden.
Your relationships feel strained.
Relationships ― no matter what kind ― are hard work. You’re not expected to have all the answers. If you’re with a partner, therapy can help the two of you explore better ways to communicate and any other issues that seem to pop up. Couples therapy can even be beneficial if your partner is hesitant and doesn’t end up attending the session. A therapist can pinpoint how to help a spouse interpret misunderstandings and identify where the couple is most at odds.
Your sleeping patterns are off.
A key symptom of depression includes a disruption in sleep, whether it be too little or too much. If you’ve noticed any significant change, it might be time to investigate the underlying issue. Insomnia also includes therapy as a method of treatment.
You just feel like you need to talk to someone.
Bottom line: There’s nothing wrong with seeking professional help for any health issue, including mental health. If you have an inclination that you might need to speak with someone, do it. Therapy is a perfectly normal ― and valuable ― experience that works to many people’s benefit.
Credit: Lindsay Holmes, Senior Wellness Editor, HuffPost
What Forms of Payment and Insurance Do You Accept?
Current methods of payment and insurance that I work with in Maryland are listed below. For clients in North Carolina, visit my Headway profile here.
*Blue Cross
*Blue Shield
*CareFirst
*Cigna
*United Health Care
*UMR (United Medical Resources)
*Optum
*Self-pay
*Out-of-network insurance
*Insurance reimbursement
As a licensed therapist, my professional services qualify for reimbursement under most insurance plans. Pre-approved insurance or payment is expected at the time of each appointment.
Payment can be made in the form of cash, check, credit via IvyPay or Google Pay. If you are using your out-of-network benefits and wish to submit for reimbursement from your insurance company, I will provide you with the required information.
If you have any questions or concerns about fees and insurance, please feel free to discuss these with me. Please also check with your insurance carrier regarding any questions.
What is your Privacy Policy?
NOTICE OF PRIVACY PRACTICES
Your health record contains personal information about you and your health. This information about you that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services is referred to as Protected Health Information (“PHI”). This Notice of Privacy Practices describes how I may use and disclose your PHI in accordance with applicable law, including the Health Insurance Portability and Accountability Act (“HIPAA”), regulations promulgated under HIPAA including the HIPAA Privacy and Security Rules, and the ACA Code of Ethics. It also describes your rights regarding how you may gain access to and control your PHI.
I am required by law to maintain the privacy of PHI and to provide you with notice of our legal duties and privacy practices with respect to PHI. We are required to abide by the terms of this Notice of Privacy Practices. I reserve the right to change the terms of our Notice of Privacy Practices at any time. Any new Notice of Privacy Practices will be effective for all PHI that I maintain at that time. I will provide you with a copy of the revised Notice of Privacy Practices by posting a copy on my website, sending a copy to you in the mail upon request or providing one to you at your next appointment.
HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
For Treatment. Your PHI may be used and disclosed by those who are involved in your care for the purpose of providing, coordinating, or managing your health care treatment and related services. This includes consultation with clinical supervisors or other treatment team members. I may disclose PHI to another party only with your written authorization.
For Payment. I may use and disclose PHI so that I can receive payment for the treatment services provided to you. Examples of payment-related activities are: making a determination of eligibility or coverage for insurance benefits, processing claims with your insurance company, reviewing services provided to you to determine medical necessity, or undertaking utilization review activities. If it becomes necessary to use collection processes due to lack of payment for services, I will only disclose the minimum amount of PHI necessary for purposes of collection.
For Health Care Operations. I may use or disclose, as needed, your PHI in order to support our business activities including, but not limited to, quality assessment activities, employee review activities, licensing, and conducting or arranging for other business activities. For example, I may share your PHI with third parties that perform various business activities (e.g., billing or typing services) provided I have a written contract with the business that requires it to safeguard the privacy of your PHI. For training or teaching purposes PHI will be disclosed only with your authorization.
Required by Law. Under the law, I must disclose your PHI to you upon your request. In addition, I must make disclosures to the Secretary of the Department of Health and Human Services for the purpose of investigating or determining our compliance with the requirements of the Privacy Rule.
Without Authorization. Following is a list of the categories of uses and disclosures permitted by HIPAA without an authorization. Applicable law and ethical standards permit us to disclose information about you without your authorization only in a limited number of situations. As a professional counselor licensed in this state and as a member of the American Counseling Association, it is our practice to adhere to more stringent privacy requirements for disclosures without an authorization. The following language addresses these categories to the extent consistent with the ACA Code of Ethics and HIPAA.
Child Abuse or Neglect. I may disclose your PHI to a state or local agency that is authorized by law to receive reports of child abuse or neglect.
Judicial and Administrative Proceedings. I may disclose your PHI pursuant to a subpoena (with your written consent), court order, administrative order or similar process.
Deceased Patients. I may disclose PHI regarding deceased patients as mandated by state law, or to a family member or friend that was involved in your care or payment for care prior to death, based on your prior consent. A release of information regarding deceased patients may be limited to an executor or administrator of a deceased person’s estate or the person identified as next-of-kin. PHI of persons that have been deceased for more than fifty (50) years is not protected under HIPAA.
Medical Emergencies. I may use or disclose your PHI in a medical emergency situation to medical personnel only in order to prevent serious harm. I will try to provide you a copy of this notice as soon as reasonably practicable after the resolution of the emergency.
Family Involvement in Care. I may disclose information to close family members or friends directly involved in your treatment based on your consent or as necessary to prevent serious harm.
Health Oversight. If required, I may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies and organizations that provide financial assistance to the program (such as third-party payers based on your prior consent) and peer review organizations performing utilization and quality control.
Law Enforcement. I may disclose PHI to a law enforcement official as required by law, in compliance with a subpoena (with your written consent), court order, administrative order or similar document, for the purpose of identifying a suspect, material witness or missing person, in connection with the victim of a crime, in connection with a deceased person, in connection with the reporting of a crime in an emergency, or in connection with a crime on the premises.
Specialized Government Functions. I may receive requests from U.S. military command authorities if you have served as a member of the armed forces, authorized officials for national security and intelligence reasons and to the Department of State for medical suitability determinations, and disclose your PHI based on your written consent, mandatory disclosure laws and the need to prevent serious harm.
Public Health. If required, I may use or disclose your PHI for mandatory public health activities to a public health authority authorized by law to collect or receive such information for the purpose of preventing or controlling disease, injury, or disability, or if directed by a public health authority, to a government agency that is collaborating with that public health authority.
Public Safety. I may disclose your PHI if necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. If information is disclosed to prevent or lessen a serious threat it will be disclosed to a person or persons reasonably able to prevent or lessen the threat, including the target of the threat.
Research. PHI may only be disclosed after a special approval process or with your authorization.
Verbal Permission. I may also use or disclose your information to family members that are directly involved in your treatment with your verbal permission.
With Authorization. Uses and disclosures not specifically permitted by applicable law will be made only with your written authorization, which may be revoked at any time, except to the extent that I have already made a use or disclosure based upon your authorization. The following uses and disclosures will be made only with your written authorization: (i) most uses and disclosures of psychotherapy notes which are separated from the rest of your medical record; (ii) most uses and disclosures of PHI for marketing purposes, including subsidized treatment communications; (iii) disclosures that constitute a sale of PHI; and (iv) other uses and disclosures not described in this Notice of Privacy Practices.
YOUR RIGHTS REGARDING YOUR PHI
You have the following rights regarding PHI I maintain about you. To exercise any of these rights, please submit your request in writing to me at Off the Couch, LLC, 18026 Maugans Avenue # 6 • Hagerstown, MD 21740.
Right of Access to Inspect and Copy. You have the right, which may be restricted only in exceptional circumstances, to inspect and copy PHI that is maintained in a “designated record set”. A designated record set contains mental health/medical and billing records and any other records that are used to make decisions about your care. Your right to inspect and copy PHI will be restricted only in those situations where there is compelling evidence that access would cause serious harm to you or if the information is contained in separately maintained psychotherapy notes. I may charge a reasonable, cost-based fee for copies. If your records are maintained electronically, you may also request an electronic copy of your PHI. You may also request that a copy of your PHI be provided to another person.
Right to Amend. If you feel that the PHI I have about you is incorrect or incomplete, you may ask me to amend the information although I am not required to agree to the amendment. If I deny your request for amendment, you have the right to file a statement of disagreement with us. I may prepare a rebuttal to your statement and will provide you with a copy. Please contact me if you have any questions.
Right to an Accounting of Disclosures. You have the right to request an accounting of certain of the disclosures that I make of your PHI. I may charge you a reasonable fee if you request more than one accounting in any 12-month period.
Right to Request Restrictions. You have the right to request a restriction or limitation on the use or disclosure of your PHI for treatment, payment, or health care operations. I am not required to agree to your request unless the request is to restrict disclosure of PHI to a health plan for purposes of carrying out payment or health care operations, and the PHI pertains to a health care item or service that you paid for out of pocket. In that case, I am required to honor your request for a restriction.
Right to Request Confidential Communication. You have the right to request that I communicate with you about health matters in a certain way or at a certain location. I will accommodate reasonable requests. I may require information regarding how payment will be handled or specification of an alternative address or other method of contact as a condition for accommodating your request. I will not ask you for an explanation of why you are making the request.
Breach Notification. If there is a breach of unsecured PHI concerning you, I may be required to notify you of this breach, including what happened and what you can do to protect yourself.
Right to a Copy of this Notice. You have the right to a copy of this notice.
COMPLAINTS
If you believe I have violated your privacy rights, you have the right to file a complaint in writing with me at Off the Couch, LLC, 18026 Maugans Avenue • #6 • Hagerstown, MD 21740 or romayne@offthecouchllc.com or with the Secretary of Health and Human Services at 200 Independence Avenue, S.W. Washington, D.C. 20201 or by calling (202) 619-0257. I will not retaliate against you for filing a complaint.
The effective date of this Notice is September 2021.