Prior to combining psychotherapy with walking:
- Therapists should receive training from medical professionals on safe walking practice 
- Clients should be screened using the Physical Activity Readiness Questionnaire (PARQ) or another assessment to assess health risk and eligibility

Grand Valley State University

Potential solutions include:
- Using nearby or building indoor tracks 
- Organizing walking groups sessions for safety and support
- Using appropriate approaches like exposure therapy to address apprehension about public sessions (depending on individual needs)

Solutions for Implementing Walking in Therapy

Koziel, N., Vigod, S., Price, J., Leung, J., & Hensel, J. (2021). Walking psychotherapy as a health promotion strategy to improve mental and physical health for patients and therapists: Clinical open-label feasibility trial. The Canadian Journal of Psychiatry, 67(2), 153–155. https://doi.org/10.1177/07067437211039194

 Walking psychotherapy as a health promotion strategy to improve mental and physical health for patients and therapists: Clinical open-label feasibility trial

Recommendations for Incorporating Walking into Therapeutic Practices

Different types of psychotherapy, like CBT or DBT, have yet to be tested in combination walk therapy. Therapeautic interventions combining walking with psychotherapy have not been manualized, but a general relational therapy approach was shown to improve symptoms.

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