New course of treatment brings therapy to the great outdoors
Lara Andrews pulls into the Wilson Mountain Reservation parking lot in Dedham, where there’s still a lot of green among the gold and orange leaves. Abbie Hausermann is there to greet her. Both women are dressed in fall attire: hooded sweatshirt, down vest, windbreaker, boots or sneakers.
“How’s your week going?” Hausermann asks Andrews as they take off down a wooded trail.
They aren’t two friends going for a walk. Hausermann is a therapist, Andrews her client, and they are engaging in what’s known as “ecotherapy,” a growing practice that combines talk therapy with the well-documented benefits of being outside and exercising.
When Hausermann tells clients to take a hike, she means it. A licensed clinical social worker, she makes her office in the great outdoors: Wilson Mountain, or the Blue Hills Reservation in Milton, or Francis William Bird Park in Walpole, or some other trail or forest or park.
Her fledgling practice, which she opened in May, is named High Peaks Therapeutic Mentoring. She offers walk-and-talk therapy and daylong or overnight “wilderness quests” for students, and will also do traditional psychotherapy.
Though similar practices exist in other cities — “It seems it’s pretty widely accepted out west,” Hausermann says — she doesn’t know of other outdoor clinicians in Massachusetts.
Most talk therapy today happens in offices. But nature-based counseling is in some ways a throwback to an older model where the affluent often sought psychological treatment at “sanitariums” in beautiful natural spots.
A remnant of that earlier model remains in New England. At McLean Hospital in Belmont, one of the country’s top psychiatric facilities, it’s not unusual to see a therapist sitting outdoors or walking with a patient on the wooded campus. Though the hospital doesn’t officially list ecotherapy as a treatment model, some therapists integrate it into their work.
“I don’t know what the lasting effects of any single dose of ecotherapy is,” says Dr. Blaise Aguirre, medical director of McLean’s 3East unit for suicidal adolescents, who sometimes takes patients on “mindful” walks, paying attention to the greenery and the sounds of birds. “But research shows that being out in nature makes you happier. Outdoors, there are no side effects of a pill, and people often report an incredible sense of well-being.”
Hausermann, 30, provides that kind of help for clients outside a hospital setting, leading outdoor talk-therapy sessions for both individuals and groups. “It seems like common sense,” she says. “Being outside in general helps people relax. It’s less of a formal environment, people feel more comfortable. They’re not as stigmatized as going into an office to see someone.”
Then there’s the literal process of walking: moving forward. “It helps people to be active and feel they’re progressing and not so on-the-spot where someone is facing them in a chair asking questions.”
Andrews turned to Hausermann after seeing another therapist in an office setting for grief counseling in the wake of her boyfriend’s death last year in a car crash. “That wasn’t working for me, and a friend found Abbie for me,” says Andrews, 29, of Norfolk. The friend knew that Andrews loves hiking and the outdoors.
“I felt very connected the first session,” she says. “I just love the movement, being outside, and not being confined.”
From Monday through Thursday, Hausermann is a therapist in a family medicine clinic at Boston Medical Center. She concentrates on her High Peaks practice on late afternoons and weekends.
“I think it’s an innovative, great model,” says Cindy Gordon, her supervisor at BMC. “Natural sunlight and fresh air does a lot for one’s mental health. Some of the clinics are very sterile environments.”
Hausermann says her experience at BMC has made her realize that traditional therapy isn’t for everyone. One population she believes can particularly benefit from walk-and-talk sessions are adolescents — “especially kids who have hyperactivity and find it hard to sit still for an hour,” she says. “This is a much more active, engaging way to make progress.”
And with so many kids spending so much time online, the need for fresh air may be more important than ever. “There’s so much screen time, with people more reliant on their phone, their tablet, their computer,” says Hausermann. “It’s really sad that a lot of kids don’t get the chance to explore the outdoors like I did, or my parents did.”
Hausermann’s love of nature is in her DNA. A Boston native, she spent summers with her grandparents outside Syracuse, N.Y. “Both my grandfathers were farmers and I learned about growing things: planting, life, death, and regrowth. We walked through the woods a lot,” she says. In high school, Hausermann trekked the challenging Inca Trail to Machu Picchu, and two summers ago, she summited Mount Kilimanjaro, Africa’s highest peak, with a group of family and friends.
In Atlanta, therapist Denice Crowe Clark also takes her clients outdoors. Last May, she opened Sole to Soul Therapy and Consulting. She believes she is the only such practitioner in the city, where she holds sessions in Piedmont Park.
Both Clark and Hausermann note that even Freud, the father of psychoanalysis whose patients lay on a couch, would sometimes take them out on the streets of Vienna for a walk.
“There are benefits to outdoors and exercise,” says Clark. “In laymen’s terms, it helps enhance those pleasure centers of the brain, it helps with mood, with sleep.” She also believes that it levels the playing field between therapist and client. “There’s a power differential there, and when you take it out of the office, it’s more of an equalizer.”
Aren’t there distractions during the 50-minute sessions? Yes, and Hausermann welcomes them.
“It’s important to redirect our attention to what Mother Nature has to offer,” she says. “It helps foster communication. If we see a hawk flying overhead, one of my adolescents might talk about his interest in birds, and then about his general interests. Or a woman might observe the beauty of the fall foliage, and that might spark a conversation that can relate back to her personally.”
Both she and Clark hold their initial consults indoors, to screen patients. “I am a female walking outside. I want to make sure I feel safe, and that the client-therapist fit is a good one,” says Clark, who like Hausermann counsels during daylight hours and avoids secluded spots.
The days are getting shorter now, the air cooler. Come winter, Hausermann is ready to get out her skis and snowshoes. “Bad weather is a metaphor for life,” she says. “Sometimes things don’t work out the way you want them to, but it’s important to get outside.”
Would her client be willing to brave the cold? “I don’t snowshoe or cross-country ski,” Andrews says, as they take off down the path at Wilson Mountain. “But I’m open to it.”