Walking and Nordic walking programmes

Domain X · Body, movement, breath & physical

What it is

This is a family of programmes and formats, not a single therapy. The psychotherapist can deliver strands 1 and 2 directly within their existing competence and contract. Strand 3 is delivered by trained volunteer walk leaders, and strand 4 by INWA-certified instructors. For those two, the therapist…

Format

• Phase A: suitability assessment (before any outdoor session). Davies used a telephone assessment of about an hour. It covered presenting issues and goals, expectations and what working outdoors would mean, health conditions affecting the client's ability to move through the space, familiarity with…
• Phase B: contracting. Agree a written or verbal outdoor contract before the first outdoor session, covering the limits of confidentiality in public and the weather policy. The client agrees to say if they feel uncomfortable, and the contract is reviewed as sessions progress.

Who practises it, and how they are trained or regulated

• The Ramblers runs Walking for Health with Sport England funding; local organisations such as councils, charities, leisure providers or NHS bodies lead each scheme. The first scheme was set up by Dr William Bird in 1996. The programme's standards, stated as facts and not as targets for clients: walks are regular, easy, free and led by trained volunteers; each lasts 90 minutes or less, and at least one walk a week is…
• INWA was founded in Finland in 2000 and describes itself as the sport's global governing body. Its flagship course is the Nordic Walking Instructor Course built on the INWA 10 Step Method, supported by the online INWA Academy. The roles are National Trainer (trains instructors and leaders in a country), Nordic Walking Instructor (teaches technique and runs groups) and Activity Guide (leads group walks but does not…
• This is a family of programmes and formats, not a single therapy. The psychotherapist can deliver strands 1 and 2 directly within their existing competence and contract. Strand 3 is delivered by trained volunteer walk leaders, and strand 4 by INWA-certified instructors. For those two, the therapist signposts, prepares and integrates, unless they hold the relevant training themselves.

Evidence status, as the guide reports it

• Aerobic exercise for depression. Morres et al. (2019) pooled 11 RCTs (455 adults recruited through mental health services) and found a moderate-to-large reduction in depression scores (SMD −0.79). Walking was grouped with other aerobic exercise rather than reported separately. About a third of…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• strong material surfacing during the walk back. Allow extra settling time on a bench rather than parting mid-flow.
• all-or-nothing relapse beliefs. It is working when the client can describe the plan and has used it at least once.
• clients pushing on in unsafe conditions to avoid cancelling. It is working when switching format happens without a rupture.
• blank or perfectionist diaries. Accept a partial one. It is working when patterns linking activity and mood become visible.
• walking reports replacing harder therapeutic work. It is working when walking experiences feed insight and behaviour change.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.