The outside counselling experience
I am a BACP registered counsellor and psychotherapist who offers therapy outside. Contact me through my main page or here Contact
Outside therapy is available. This involves meeting at an arranged location, normally the Countryside or Beach. Maintaining social distancing and following the current guidelines. This method of working has some extra considerations to take into account and they are highlighted on this page.
Existing in the World
Look at the picture below and ask the question ‘what would my experience be like standing in the middle of this beach?’.
Everybody will have a different answer. Do you love the beach? Some will and some will not. Possibly the sea is something you like? Maybe you would prefer the forest or a meadow? You can choose. The point is this, places influence how we feel.
Now add a therapist to the picture with you. How would that be for you?
Biology Psychology and Sociology
I offer therapy outside in open spaces, a fresh intervention with good science to back it up! The Biopsychosocial model (Engel, 1977) posits that the environment (environment social component) affects the whole person, the mind, and biology. The environment can change your behaviour. And in turn, new behaviour can change your social environment.
I seek to work with people on the changes that they want to make in their life experience.
The environment becomes the therapy room and that adds to the process of change. We all exist in this environment, we all have existential anxieties.
‘The earth is what we all have in common’ – Wendell Berry
Whilst Wendell speaks from an environmentalist point of view the simple fact is that the environment shapes who we are. Psychologists have studied this for a very long time now.
A Room Full of Reality
Two of the most important elements of a therapy room are Safety and Confidentiality. However, there are other challenges in open space therapy! For example, the weather is just one of many.
Important considerations
If you have read this far and you are considering this option of therapy outside, lets look at important issues.
- Safety
- Confidentiality
- Weather
- Unexpected events
- Time
- Boundaries
- Tissues
- Sitting, standing, or walking in the environment
- Current Safety Statement to be observed
- Lastly, if you would like to add anything to this list let me know.
Safety
How can we create a sense of safety outside? Contracting how we would like the meeting to be is a good start.
Consider carefully the places where you would like to meet and maybe make a list. What is your experience of being in this place? And your thoughts about the place? How would you feel in this location? What are your bodily sensations in this place? Does the space hold past memories? Would you like this space to hold a memory of therapy? Do you feel safe? Many of the points that now follow all contribute to a sense of safety.
Please read each point and consider them carefully.
Confidentiality
Two people meeting in open space is a natural occurrence, park, field, beach, gardens, woods, forests, and many many other possible areas. In the therapy situation confidentiality is important.
One instance could be proximity to other people’s hearing and vision. Consider the possibilities of been seen speaking to, a man, a stranger, and a therapist. Now imagine all the ‘by chance’ possibilities of people who could observe this interaction.
Lastly, consider it all and remember two people meeting outside observed by some is just normal. Just remember confidentiality now becomes a shared responsibility in your choice of location.
Weather
Consider possibilities. A storm arrives and how should we deal with this? Would you like me to bring an umbrella for you? What other things could happen? A gale, snow, thunder and lightning?
Consider the possibilities and what you would like to do in the event of the weather changing?
Unexpected events
A loose dog approaches, a Police officer approaches, Friend approaches, Stranger approaches, what would you like to do if any of these things happened? Who should speak or act and what should be said or done, if anything? Currently, psychological support is considered as keyworker work and is allowed one to one.
Time
How do we manage our time together? Your phone clock? My phone clock? Alarm timer?
Boundaries
Proximity is a boundary. Note, under current guidelines, we can not be closer than 2 metres apart.
How would you like to leave the meeting? Who leaves first? Does the therapist leave the space? Do you leave the space? Or both people exit the space in different directions?
It is important to think about how you feel about this.
Tissues
In this environmental approach you are responsible for these items. Please remember not to touch your face directly if you have tears and do not touch your mouth.
Sitting, Standing or Walking
What would you like to do? Again, we need to consider how this may alter some of the things I have already spoken about.
If we sit, folding chairs are an easy option in some cases. Do you have a folding chair? Additionally, existing natural environment objects such as park bench, tree stumps, rocks, beach, and ground are other possibilities.
Current safety statement
I would advise in coming to an appointment that you follow government guidelines.
You are not currently self-isolating, you are not currently living with a family or other people who are self-isolating, you have not been recently diagnosed with COVID19. Additionally, you are not currently showing any symptoms relating to this disease. If you are in a vulnerable group you have a duty of self-care to yourself and it is solely your decision regarding being in the environment. This section is part of the therapy safety section and specified separately for clarity.
Your additions
Let me know if you would like to add anything to the guidance for your outside therapy session.
Understanding the Science
‘Our environment influences our genome through the so-called epigenetic modifications.‘
Drouet Emmanuel – Doctor of Pharmacy, Professor at the Université Grenoble-Alpes
‘At the end of the 20th century the BPS approach inferred some important advantages, e.g., in changing the way of conceptualizing “illness,” opportunities existed for practitioners of medicine and psychiatry to be more holistic and integrative in their approach to illness and humanistic in the delivery of health care. Individuals with health challenges were now acknowledged to be active participants in the healing process and good health, rather than mere passive victims of deviations in physiologic functioning.‘
Babalola E, Noel P, White R. The biopsychosocial approach and global mental health: Synergies and opportunities. Indian J Soc Psychiatry 2017;33:291-6
Finally, before I leave you to your thoughts, let’s look at an example. Some aspects of this example are challenged by different schools of thought.
A person can carry a genetic predisposition to depression and lives a life without ever experiencing depression.
How can this be?
The answer in some cases is epigenetics. The environment never caused the predisposition to be expressed. Environments have been shown to turn genes on and off (DNA Mythelation). Stimulus rich environments have been shown to be therapeutic.
If you would like a therapy appointment outside then contact me to discuss the possibilities. CONTACT
