What You Should Know About Walk and Talk Therapy and Other Non-Traditional Counseling Settings

What You Should Know About Walk and Talk Therapy and Other Non-Traditional Counseling Settings

Curt and Katie chat about non-traditional therapy settings like outdoor walk and talk therapy as well as home-based counseling. In the first of a two-part, continuing education podcourse series, we look at the basics, including why therapists should consider these settings (and may not), clinical and cultural considerations, and best practices.

In this continuing education podcast episode, we look at non-traditional therapy settings

For our third CE-worthy podcourse, we’re looking at the basics of bringing therapy into non-traditional settings, including walk and talk therapy and home visits. We cover a lot of topics in this episode:

What are non-traditional therapy settings?

• The focus of this episode is walk and talk and home-based therapy
• Client’s locations like home, school, or work; community-based settings
• Anything beyond the typical therapy office or telehealth settings are worthy of consideration
• Creativity and collaboration in creating the space
• How different the therapy can be when opening up more settings as possibilities

Why should therapists consider these non-traditional therapy settings?

• Logistical considerations that can lead to these settings being the ideal choice (or only choice)
• Clinical indications that walk and talk or home-based therapy is a better choice
• The impact on changing settings on the therapeutic relationship and the therapeutic work
• Specific modalities that are best served by client-centered spaces
• Assessment, treatment teaming
• How access, attendance, and attrition are impacted
• The therapeutic impact of the settings and movement

What are the hesitations therapists have in considering alternative settings for therapy?

• The challenges in creating systems and managing the logistics
• Lack of alignment with the medical model
• Lack of training and guidance
• Legal and Ethical considerations (that will be talked about in next week’s episode)

What are the clinical and cultural considerations when doing therapy outside or in someone’s home?

• Navigating the shifting relationship and boundaries
• Cultural differences between therapist and client, and assumptions made about the relationship
• The importance of leading the conversation about these relationships
• Hospitality and others who may be present at a client’s home
• The unusual space, the level of confidentiality, and emotional containment and depth of conversation
• Treatment planning based on where you meet and how the client interacts with the space
• The importance of the clinician holding the therapeutic space and attention
• Creating the space and the contract for how therapy will happen
• Cultural norms for the activities and for the client and family – more complexity to discuss

Clinical How-To for Non-traditional Settings

• Assessment considerations
• Client and clinician characteristics
• Alignment with treatment goals and presenting concerns
• Presenting issues can vary and assessment can be important
• Initial assessment appointments and making the decision early in treatment
• Treatment Formulation related to active versus passive interaction with the space
• The importance of true informed consent and the dynamic nature of process contracting
• Introducing predictability
• Risk assessment
• Knowing your scope and what types of professionals you might consider consulting