Outdoor Therapy: Another novel therapy option during the COVID-19 pandemic (and beyond…?), by Dr. Jennifer Andersen

Like many other people, I was happy to move past 2020 and welcome in a new year. My new calendar arrived with this bold quote (above; photo credit) for the month of January. It certainly reframes how we might think about winter. As a figure skating coach whose family comes from Norway, I’d like to be able to summon my inner “Elsa” and say that “the cold never bothered me anyway.” But for those of us without Disney magic, cold weather is often unpleasant, to say the least.

Last January, if anyone asked me whether I was conducting outdoor therapy sessions, I would definitely have assumed they were joking and/or I would have looked for some hidden cameras. Of course, that was before the COVID-19 pandemic. The pandemic has led to many modifications in our routines to reduce the spread of infection, the most prominent being a major increase in virtual interaction—Zoom calls for work, Zoom for remote school, Zoom calls for Thanksgiving family gatherings, etc.  Needless to say, our collective screen time has gone up exponentially. And although this method has helped keep infection rates lower, many people have been making efforts to minimize screen time when possible. Which brings us to another pandemic-prompted change—increased time spent outdoors.

The benefits of being outdoors have been widely documented (see here, for example). The fresh air, the change of scenery, the increased vitamin D, are all alluring reasons to head outside. In fact, some schools (see here, for example) have successfully implemented 100% outdoor education. Thus, Dr. Lauren, Dr. Jaime, and I have recommended outdoor psychotherapy sessions for many of our clients, including for children whose developmental or regulatory needs make it very difficult to successfully engage in teletherapy (psychotherapy via video). We have been excited to engage in therapy sessions with children and families in parks, backyards, and courtyards, while maintaining safety guidelines and wearing masks during the past several months. Thinking outside the frame, and adjusting our expectations of what therapy “should” look like, has led to unique learning opportunities for ourselves and our clients.

Together with our clients, we have learned many important new things through outdoor psychotherapy sessions, including:

  • How slowly we need to walk if we want to get a closer look at some winter birds (great real-life practice for modulating our movements)
  • How far we can walk in the park and still get back to the bench where a parent is waiting by the end time of the session (time management)
  • How our bodies feel (increasing body awareness) and what kind of movement we can do in order to stay warm (promoting motor planning; coping skills)
  • How much distance we should keep from others in the park (social awareness; health and safety)
  • How much louder our voices need to be in larger, noisier spaces (voice modulation)
  • How the sun sets a little later each day in January than it did in December (science; safety awareness).
  • Outdoor psychotherapy sessions also provide more space to move around, which is essential for children with diagnoses of ADHD, autism spectrum disorder, and related challenges, as well as for all children.

In the past, I typically spent a lot less time outdoors once the cold weather arrived. Outdoor therapy in January was a totally bizarre concept to me. But this winter, I’ve found myself thinking more flexibly about the kinds of activities that I can do outside. I’ve been taking walks to the grocery store, for example. I went on a 2-mile jog last week. And I haven’t  been the only one out there! I’ve seen several friends’ posts on social media from hikes they’ve taken with their children this month. As long as I am wearing “suitable clothing,” that is, my gloves, head warmer, sunglasses, and mask, the cold temperature is manageable. So, I encourage clinicians and caregivers alike to bundle up and head outside to discover all that winter has to offer!

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