Walk-and-Talk Therapy – An Interview with Clay Cockrell, LCSW

Clay Cockrell, LCSW practices Walk and Talk Therapy (“taking therapy off the couch”) in New York City.  He talked to WTCI via email about what he does and how he got started with it.

What’s your background?

I am a LCSW in New York state. My MSW is from the University of Kentucky and I received a BA in psychology from Asbury College. Raised in Kentucky, my first professional experiences included adolescent substance abuse treatment in Community Mental Health centers. Eventually I found myself in Cincinnati, OH working for several years in the Psychiatric Emergency Room of University of Cincinnati Hospital. 14 years ago, my wife and I moved to New York City where I began my private practice.

What do you do now?

I am the founder of Walk and Talk Therapy (www.walkandtalk.com).  The inspiration for Walk and Talk Therapy, as does all good things in my life, came from my beautiful wife. Years ago, I had a client who worked on Wall Street and was having a difficult time getting away in the middle of the day to come to his session. He simply didn’t have time to commute back and forth to my office. So my wife suggested that I meet him near his office and walk around the area during the session. My first response was: “Honey, that’s just not possible.”

But the more I thought about it, I really couldn’t come up with a good reason why it couldn’t be done. Confidentiality would not be broken if we walked where people could not hear us–and it’s not as if people who saw us walking would know that we were actually in a therapy session. So I proposed the idea to my client and he immediately thought it was a good idea. We met at Battery Park and had the session while walking along the waterfront. It was liberating. I had never seen him so animated and in touch with what he was saying. We continued the practice for the next two months and he made more progress in that time than in the entire previous year.

So with this kind of response, I began to offer it to my other clients and the results were the same. People who had been stuck in depression began to see their issues from a different perspective. Those that had struggled with anxiety began to incorporate a sense of calm into their lives and were much better able to reduce stress. And I loved it! I loved being outdoors and being active during the day. It completely transformed my practice and my approach to therapy.

I am also beginning to expand my practice to online–using Skype. I am in the process of launching www.counselingformen.com–focusing on the unique set of issues facing men in the 21st century.

What limitations have you encountered with Walk and Talk Therapy? Have there ever been confidentiality problems? What about affect–do clients ever cry in public?

As to date, I have never had any issues with confidentiality being compromised. Prior to taking on a new patient, I do explain the possible risks and I have yet to have anyone express a concern over this. I will say that New York City may be the best place to do this type of therapy. There is a certain anonymity that we take for granted here–and the city is so large, there is really very little risk in running into someone we may know. However, even if that were to happen, there is nothing to say that we are in a counseling session. As far tears, yes that can be an issue. I do most of my work within Central Park, and there are several secluded / private places within the park to process emotions. And my office is very near the park, so if a client would prefer to meet inside due to a particularly difficult issue–that is always an option.

How do you connect with clients? Do people seek you out for this type of therapy? If not, how do you introduce it?

About 90% of my clients come through the Internet. It is my belief that many people, when seeking therapy, don’t know where to turn–so they begin to Google. The choices can be overwhelming. But eventually they stumble upon my site and see something unique. It’s obvious from my website that I approach therapy differently and I think that is attractive to a certain segment of the population. I don’t really think anyone goes out to find a walking therapist – the approach is just not well known. I think people go in search of someone with whom they can connect and the modality is secondary. However, if someone finds me through a directory or some other means, I always direct them to my website and we discuss the options of indoor therapy vs. walking. I offer both.

Are there any clients you won’t see in walk-and-talk mode?  Does it seem contraindicated for some?

When I first started I really thought this would be contraindicated for the ADHD population. (Oh look, a squirrel!) But in actuality, the walking seems to calm and focus them. In my office, the ADHD clients seem to be bouncing off the wall and completely scattered, but I think the action and rhythm of walking allows them to gain control over their symptoms. I really haven’t found a population that is not helped by the process. I even have a few celebrity clients who walk with me. They just keep the sunglasses on and people don’t recognize them. Plus–it’s New York. The city has a leveling effect on everyone.

Are boundaries trickier with this type of therapy–does it seem more like friendship than therapist-client?
It is a more casual interaction–much less formal. So I work very hard at keeping professional boundaries. The therapist/client relationship is sacrosanct and I work to maintain the trust of my clients. Yes, the casualness allows inhibitions to be reduced, but I am always clear that I am with my clients in a professional capacity.

How would you recommend a therapist interested in trying Walk  and Talk Therapy get started?

I get calls about once a week from therapists across the country who would like to add this process to their practices. I have a list of things that I go over with them and I’m always open to coaching others as they begin to offer walking to their clients. To start, I always recommend a conversation with the client about the option of walking. If both therapist and client are on board and aware of what to expect, the only thing left to do is get out there and try it!

Find Clay Cockrell on the web at walkandtalk.com–more articles on Walk and Talk Therapy are posted there.