Therapy

Dr. Hannah Roberts · April 18, 2024 ·

Nature Therapy

“Those who contemplate the beauty of the earth

find reserves of strength

that will endure as long as life lasts.”

— Rachel Carson

by Gavin Hannegan, Cal Poly, San Luis Obispo undergraduate intern, supervised by Dr. Hannah Roberts

In honor of Earth Day, we want to highlight one of the unique services we offer here at Thrive SLO: nature therapy. Is your home too distracting to hold a virtual therapy session? Do you feel most calm when you’re connecting with the trees and plants? Or maybe you haven’t gotten your steps in for the day. Nature therapy may be the perfect fit for you! Read on to learn more about the benefits of nature therapy and where to meet your therapist for your first outdoor session.

What is Nature Therapy?

If you’ve ever heard of the term “talk therapy,” nature therapy is essentially “walk and talk” therapy. Sometimes called eco-therapy or outdoor therapy, nature therapy allows you and your therapist to meet outside the walls of a typical office setting. You and your therapist will agree on a quiet, open space to meet, such as a park or a forest. Then, the two of you will spend the session working through any concerns you wish to discuss. Feel free to get up and stroll through the environment, or find a comfortable spot to take a breather. There are a number of ways to personalize your nature therapy experience to best suit your needs. Nature therapy can be used alongside a variety of evidence-based practices such as CBT and Gestalt therapy (Cooley et al., 2020). If you’re interested in being more involved with the environment, you may also want to look into horticultural therapy or wilderness therapy. Through nature therapy, you can work towards self-awareness while getting some fresh air and movement.

Why Nature Therapy?

Being in nature can help soothe the body and mind. One study found that undergraduate college students reported lower levels of stress and higher measures of well-being when they engaged in outdoor physical activity, including walking and hiking. By actively interacting with nature, college students can relieve themselves of the stress that they may experience as a result of their day-to-day responsibilities and commitments (Holt et al., 2019). Similarly, spending even just 30 minutes on “green” activities such as gardening or creating art from natural materials can help reduce symptoms of depression or anxiety and protect against future mental health concerns (Coventry et al., 2021). Nature provides a readily accessible form of self-care.

Nature therapy takes the calming effects of nature and combines it with the empowering qualities of therapy. Compared to a control group, those who participated in a walk and talk therapy intervention reported nearly twice as many positive outcomes, ranging from higher job satisfaction to lower rates of burnout (van den Berg & Beute, 2021). The natural environment can help separate yourself from the confines of your work environment. A distinct advantage of nature therapy is its ability to establish a more equitable relationship between therapists and clients. Rather than taking place in the therapist’s office, which may feel intimidating to new clients, both the therapist and the client work together to find an outdoor space for themselves (Cooley et al., 2020). Choosing a location not only fosters healthy communication between you and your therapist, but it’s also an opportunity to bond before you even meet in-person. The therapeutic relationship works best when both parties feel comfortable; spending time outdoors can help you better establish that comfort with your therapist.

Where Can I Meet My Therapist for a Nature Therapy Session?

San Luis Obispo is home to some beautiful outdoor areas that are ideal for a nature therapy session. Montaña de Oro has several great hiking trails to choose from, or you can sit right at the coastline and enjoy the sounds of the ocean. Morro Rock and Avila are some other notable locations to meet up for a beach walk. The Monarch Butterfly Grove in Pismo can feel lively when all of the monarch butterflies migrate to the tall trees during the winter season. The Bob Jones Trail and Meadow Park are great choices if you’re looking for a light walk on a paved trail, or if you want to ease your way into nature therapy. If your therapy sessions are virtual, remember that you can always sit outside for your therapy session or take your therapist along for a walk. Still not sure which place to visit? Reach out to one of our therapists for their recommendations. We can’t wait for you to enhance your therapy experience through the healing properties of nature.

Have more questions or feel like you need supportive therapy? Schedule a session with one of our therapists today! You can schedule online here!

We hope you enjoyed this blog post! Have more topics you’d like us to blog about? Contact us and we’ll be sure to include your topic in a future post!

References

Cooley, S. J., Jones, C. R., Kurtz, A., & Robertson, N. (2020). ‘Into the Wild’: A meta-synthesis of talking therapy in natural outdoor spaces. Clinical Psychology Review, 77, 1-14. https://doi.org/10.1016/j.cpr.2020.101841

Coventry, P. A., Brown, J. V. E., Pervin, J., Brabyn, S., Pateman, R., Breedvelt, J., Gilbody, S., Stancliffe, R., McEachan, R., & White, P. C. L. (2021). Nature-based outdoor activities for mental and physical health: Systematic review and meta-analysis. SSM – Population Health, 16, 1-14. https://doi.org/10.1016/j.ssmph.2021.100934

Holt, E. W., Lombard, Q. K., Best, N., Smiley-Smith, S., & Quinn, J. E. (2019). Active and passive use of green space, health, and well-being amongst university students. International Journal of Environmental Research and Public Health, 16(3). https://doi.org/10.3390/ijerph16030424

van den Berg, A. E. & Beute, F. (2021). Walk it off! The effectiveness of walk and talk coaching in nature for individuals with burnout- and stress-related complaints. Journal of Environmental Psychology, 76, 1-11. https://doi.org/10.1016/j.jenvp.2021.101641

Dr. Hannah Roberts · April 11, 2024 ·

Think You Want to Become a Therapist?

Go to Therapy!

“Understanding why people suffer,

how they change, and how to help them live satisfying lives

is a fascinating and important undertaking.”

~John & Rita Sommers-Flanagan

by Gavin Hannegan, Cal Poly, San Luis Obispo undergraduate intern, supervised by Dr. Hannah Roberts

How can you tell if being a therapist is the right career path for you? Maybe you know that you want to help others through therapy. You might want to work with a specific population, or specialize in certain topics. Or maybe you’re interested in learning more about the vast diversity of mental health. Although these interests are great, they may not provide a full picture of all that therapists do. And Google searching may only give you half the story. If you’re thinking about becoming a therapist, one of the best resources to help you decide is to experience therapy for yourself. Therapy for future therapists can be a guiding force–even for your career! Here are some ways that therapy can equip you for your future endeavors into this helping profession.

The Skills You Learn Will Be Shared With Your Own Clients

Consider your own personal development throughout therapy. If you feel like you have made powerful strides towards becoming your better self, that is a good indicator that you can leave a positive impact on your future clients. Because each client has their own unique background, your clients may not respond to your self-care strategies in exactly the same ways. But there are some core components of personal development that both therapists and clients can help foster.

Take empathy, for instance. Empathy is a skill that can be strengthened in people over time just by having practice with identifying and responding to the emotions of others (van Berkhout & Malouff, 2015). Therapy for future therapists is an ideal place to develop these skills, whether you’re the client or the therapist. In this safe space, clients can talk about their relationship problems and learn where the emotions of a friend, partner, or family member may be coming from. Throughout their practice, therapists gain multicultural competence and learn how to connect with clients that may seem completely different from them. By practicing empathy yourself, you can become a model of empathy for others.

Another valuable skill is self-reflection. A quick check-in with yourself can go a long way. In one study, CBT trainees reported that engaging in self-reflective practices, such as writing about one’s experiences, improved their ability to function not only in their personal lives, but also in their clinical programs (Chigwedere et al., 2021). Self-reflective questions may look something like this:

“How has this new self-care strategy been working for me?”
“What are some ways I can help this client feel more comfortable during our sessions?”
“How can I hold more empathy towards this person in my life?”

Self-reflection allows you to be more present towards the people that you care about, including yourself. And like with empathy, this is a skill that is important for both clients and therapists. Set some time throughout your day to complete some of these check-ins and gain experience with self-reflection. If you do decide to become a therapist, you can use your own experiences to help develop self-reflective practices with your clients. We are constantly learning from others, so there’s no need to keep these skills a secret.

You Gain Direct Insight Into the Day-to-Day Life of a Therapist

Beyond just working with clients, consider what the working environment is like for a therapist. For those who attend therapy through a private practice, ask yourself if this is a setting that you would feel comfortable working at full- or part-time. Do you also feel comfortable meeting in-person or online? Also, think about the types of therapy techniques that you’ve been exposed to (CBT, mindfulness-based interventions, etc.) and whether there’s any particular one that you would feel confident practicing with clients. All of these questions may seem overwhelming at first, but the more therapy sessions you have, the more experience you’ll have to help you address these questions. Even if you’ve never worked in the field of mental health, you’ll still gain some familiarity with the environment. You may also need to consider aspects of the job that you may not directly see, such as taking session notes or promoting your practice. Additionally, you may be used to only one hour a week with your therapist, but keep in mind that therapists have to meet with multiple clients throughout the week.

If you still have questions about what being a therapist is like, you could ask your therapist, but do so sparingly. Although the focus of your therapy is on you, it’s common to want to know more about your therapist. Some clients feel more comfortable in the therapeutic relationship when their therapists allow their clients to feel curious or ask questions about them (González et al., 2022). Your therapist is a resource, and they want to support you. Just be aware that your therapist may not answer every question you have, or answer them as directly as someone like a career counselor would. Another option is to ask your therapist to connect you with someone who would be more willing to answer questions about the field.

Yes, Even Therapists Go to Therapy!

Our therapists are sometimes made out to be all-knowing beings that have the answers to every question. Or that they’re free from any sort of mental health concern because they are a therapist. But therapists, just like everyone else, can grow and develop into better versions of themselves. Hearing from your therapist directly that they also benefit from therapy can help you feel more comfortable with your therapist and may even reduce your own mental health symptoms (Levitt et al., 2015). Therapy needs to be demystified, and this transparency is one of the key ways that this can be achieved. This can be incredibly validating for clients and, over time, it reduces the stigma against mental health treatment.

Along with their personal lives, therapists also strive to become better at their jobs. Outside of a session, therapists may use “deliberate practice” to develop personalized strategies to hone their interpersonal skills. One study described the various forms that deliberate practice can take, which included:

Basic skill development such as listening and challenging clients
Relationship-based work such as establishing authenticity, and
Self-care exercises such as learning how to say no (McLeod, 2021).

It is unrealistic (and too stressful!) to aim for perfection while attending therapy. The same goes for therapists: you don’t need to be perfect to be a strong support system for your clients.

Each session you have with a therapist gives you more insight into what therapy is like and how to be an effective therapist. Your growth throughout your own therapy sessions can inspire your current and future clients, whether you’re just beginning your career or have been a therapist for decades. By healing yourself, you can heal those around you. Best of luck as you explore this rewarding field!

Have more questions or feel like you need supportive therapy? Schedule a session with one of our therapists today! You can schedule online here!

We hope you enjoyed this blog post! Have more topics you’d like us to blog about? Contact us and we’ll be sure to include your topic in a future post!

References

Chigwedere, C., Bennett-Levy, J., Fitzmaurice, B., & Donohoe, G. (2020). Personal practice in counselling and CBT trainees: The self-perceived impact of personal therapy and self-practice/self-reflection on personal and professional development. Cognitive Behaviour Therapy, 50(5), 422-438. https://doi.org/10.1080/16506073.2020.1846608

González, J. M., Pérez-Rojas, A. E., Darby, M. E., & Marks, E. C. (2022). “Where have you been in this world?” A qualitative study of clients’ curiosity about their psychotherapists. Psychotherapy, 59(4), 572-583. https://doi.org/10.1037/pst0000451

Levitt, H. M., Minami, T., Greenspan, S. B., Puckett, J. A., Henretty, J. R., Reich, C. M., & Berman, J. S. (2015). How therapist self-disclosure relates to alliance and outcomes: A naturalistic study. Counseling Psychology Quarterly, 29(1), 7-28. https://doi.org/10.1080/09515070.2015.1090396

McLeod, J. (2021). How students use deliberate practice during the first stage of counsellor training. Counselling and Psychotherapy Research, 22(1), 207-218. https://doi.org/10.1002/capr.12397

van Berkhout, E. T. & Malouff, J. M. (2015). The efficacy of empathy training: A meta-analysis of randomized controlled trials. Journal of Counseling Psychology, 63(1), 32-41. https://doi.org/10.1037/cou0000093

Dr. Hannah Roberts · April 4, 2024 ·

Accessing Therapy Beyond Crisis Situations

“When we are no longer able to change a situation,

we are challenged to change ourselves.”

~Viktor E. Frankl

by Gavin Hannegan, Cal Poly, San Luis Obispo undergraduate intern, supervised by Dr. Hannah Roberts

There’s a misconception that therapy should be complete once you start “feeling better.” It’s important to recognize your progress, but there shouldn’t be a deadline to feel your best. Mental health is complex, and oftentimes, your progress doesn’t follow a linear fashion. One week, you might feel stable and secure, and then the next week, you might feel like you fell a few steps back. Don’t worry, these ups and downs are perfectly normal. But what if you’ve been “feeling better” for months, or even years? Or, what if you’ve never had a mental health crisis? Therapy can still be a valuable resource! No matter your background or previous experiences, you are deserving of this kind of care.

Here are 3 reasons for considering therapy beyond the context of a crisis:

#1: The Brain Doesn’t Function Properly While Under Distress

Chronic stress can make your body feel like it is in a never-ending fight-or-flight state. This is because of how chronic stress delays two important parts of the brain: the prefrontal cortex and the neurotransmitter GABA. The prefrontal cortex is responsible for processes such as cognitive planning and self-regulation, while GABA produces a calming effect meant to counteract stress. Because of these delays, traumas or other ongoing adversities can impair daily functioning. For example, those who experience such stressors have significant declines in working memory, a component of short-term memory that allows you to actively process information. As we age, our working memory skills decrease naturally, but chronic stress accelerates this process (Gandy et al., 2024). COVID-19 has contributed to global increases in chronic stress, which has subsequently produced similar accelerated aging effects in adolescents (Gotlib et al., 2022). Our bodies are not equipped to handle such extreme amounts of stress in small amounts of time, which can increase the risk of cognitive and health-related deficits.

Therapy can help us navigate these stressors by providing coping strategies. However, deficits in working memory impair the learning of these strategies, and delays in the prefrontal cortex and the firing of GABA impair the proper use of these strategies. This is not to say that therapy wouldn’t be helpful to someone actively experiencing a crisis. Rather, you don’t need a crisis to justify therapy. In fact, you might be more receptive to these strategies if they are learned before a crisis emerges.

#2: Therapy Can Be a Protective Measure Against Future Mental Health Crises

It’s never too early to consider therapy. We may not be able to predict when we will encounter another crisis, but we can take action to better prepare ourselves for one. This doesn’t mean that you need to be in therapy for the rest of your life. But attending therapy even when you feel stable can help you maintain that stability over time. One way that therapy operates as a maintenance tool is by teaching skills such as mindfulness, which can help reduce symptoms of anxiety and depression (Eilert et al., 2021). Your therapist can work with you to develop mindfulness strategies that fit best for you. These can include daily affirmations, breathing exercises, or meditations. Additionally, compared to brief forms of therapy (~6 months), long-term therapy, which we often prefer at Thrive SLO (~3 years), is slightly more effective in reducing depressive symptoms and improving daily functioning (Knekt et al., 2016). For some individuals, short-term therapy may not be enough time to implement maintenance strategies and measure their effects, especially for those who are only focused on overcoming a chronic stressor. There isn’t necessarily an ideal length of therapy; it depends on the goals that you set with your therapist. You might have multiple short-term goals (e.g., wanting to be social at an upcoming party) or one overarching goal (e.g., adjusting to daily life after an unexpected loss). Each step you take towards reaching these goals can have a strong positive impact on your well-being, and the lessons you learn can be applied to new goals or concerns.

#3: Long-term Therapy Gives You More Time to Build an Alliance With Your Therapist

Another valuable aspect of therapy is that you have someone to talk to who knows you well. Someone who is unbiased, who recognizes your potential, and who encourages your personal growth. In one meta-analysis that reviewed over 30,000 therapy clients, the relationships those clients had with their therapists were consistently associated with positive outcomes such as symptom reduction (Flückiger et al., 2018). Your therapist can be a consistent form of support. Even having one such person in your life can make a difference.

As with many other kinds of relationships, though, it can take some time for you and your therapist to form a close bond. You may be hesitant to be vulnerable to a new person in your life, while your therapist has to adapt to your level of comfort with certain topics or situations. If you’re experiencing a crisis, then your typical responses to these topics may be exaggerated or distorted. You could be more on edge, less willing to disclose personal information, or you could be more likely to think irrationally. As a result, there could be misinterpretations between the two of you that can threaten the therapeutic alliance. By spending more time with your therapist, they will have more opportunities to learn about who you are outside the context of a crisis situation. Remember that crises are temporary, and the skills you develop with your therapist can help protect you not just against the crisis you’re currently facing, but also against many other future challenges. There is no concern too small for therapy.

Have more questions or feel like you need supportive therapy? Schedule a session with one of our therapists today! You can schedule online here!

We hope you enjoyed this blog post! Have more topics you’d like us to blog about? Contact us and we’ll be sure to include your topic in a future post!

References

Eilert, N., Wogan, R., Adegoke, A., Earley, C., Duffy, D., Enrique, A., Palacios, J., Timulak, L., & Richards, D. (2023). The relationship between posttherapeutic cognitive behavior therapy skills usage and follow-up outcomes of internet-delivered cognitive behavior therapy. Journal of Clinical Psychology, 79(1), 55-67. https://doi.org/10.1002/jclp.23403

Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316-340. https://doi.org/10.1037/pst0000172

Gandy, H. M., Holis, F., Hernandez, C. M., & McQuail, J. (2024). Aging or chronic stress impairs working memory and modules GABA and glutamate gene expression in prelimbic cortex. Frontiers in Aging Neuroscience, 15. https://doi.org/10.3389/fnagi.2023.1306496

Gotlib, I. H., Miller, J. G., Borchers, L. R., Coury, S. M., Costello, L. A., Garcia, J. M., & Ho, T. C. (2023). Effects of the COVID-19 pandemic on mental health and brain maturation in adolescents: Implications for analyzing longitudinal data. Biological Psychiatry Global Open Science, 3(4), 912-918. https://doi.org/10.1016/j.bpsgos.2022.11.002

Knekt, P., Virtala, E., Härkänen, T., Vaarama, M., Lehtonen, J., & Lindfors, O. (2016). The outcome of short- and long-term psychotherapy 10 years after start of treatment. Psychological Medicine, 46(6), 1175-1188. https://doi.org/10.1017/S0033291715002718