Online Psychotherapy - Media information

online

psychotherapy

The Buzz

I've always been looking for ways to make therapy more innovative, effective, and ultimately convenient. This desire led to the creation of my New York based practice: Walk and Talk Therapy. As the only outdoor psychotherapy practice in New York, I have been fortunate to have been covered by Good Morning America, The Wall Street Journal and AM New York. The stories are pasted below.



		Is 'Zennis' the New Mental Health Therapy? Sept. 1, 2006 — Looking for some peace of mind that goes beyond the therapist's couch? The solution could be found in exercise. Now, counselors are providing a new kind of mental health treatment that combines talk therapy with physical exercise that includes everything from walking and hiking to tennis and golf. Clay Cockrell, a New York City licensed social worker, has taken his therapy off the couch and into the great outdoors. "I meet you. We do our session. It's just much more convenient," Cockrell said. Antidepressants are taking away business from talk therapy, according to some experts. A recent study found that less than 15 percent of patients had the suggested amount of follow-up care after starting medication. So therapists have to find new ways to keep people interested in talk therapy. Cockrell thinks combining talk therapy with physical exercise might increase the number of people considering talk therapy. "I think we're becoming a society looking for a quick fix. I go, I take my pill, and I'm better," he said. "It doesn't work that way." Bonus Benefits There's an added bonus in walk and talk therapy — the exercise. Research has shown that even a light workout helps diminish bad moods and relieve pain. "It's not for everyone, but for those that it works, it really, really works," Cockrell said. -CONT- Some critics, however, say the new type of therapy is unprofessional and doesn't protect clients' anonymity. Cockrell, however, disagrees. "I think that it's still a session. You're here for 50 minutes to an hour whether we're in an office or we're outside walking in the park," he said to "Good Morning America." For the clients, exercise therapy seems to hit a lot of birds with one stone: fitness, healing, and a little fun. For more information social worker Clay Cockrell, visit www. walkandtalk.com



	By Farnoosh Torabi July 2, 2007 Clay Cockrell rings up a new pair of sneakers each month. His job demands it. As the sole psychoanalyst running Walk and Talk, the 37-year- old conducts therapy sessions on the go in Central Park, Battery Park and throughout Manhattan. "We generally walk in isolated areas. It's not like people are listening in on our conversations," said Cockrell, who calls his alternative method "outdoor psychotherapy." Although if the trees could talk, it would probably be a different story, he admitted. The concept for Walk and Talk began three years ago after treating patients in his midtown office. "It was actually my wife's idea," said Cockrell. Since then, his client list has more than doubled from 15 to 40 a week. "We'll walk to their place of business or I'll meet them at their apartment… The convenience was a big selling point," he said, adding that appointments are sometimes scheduled in his old midtown office if the discussion is too serious. Sessions run $100 to $150 for 50 minutes, depending on the time of day. Lunch time and the evening hours after work are, expectedly, the highest in demand and are the most expensive. Clients range from Wall Streeters to those in film, theater and advertising. Most are referred by friends. Others find Cockrell on his Web site WalkandTalk.com. "I do really well with freelancers. They have that mentality of thinking outside the box," said Cockrell, a licensed social worker. Going forward, he'd like to see his business expand and be able to employ one more therapist who'd share his philosophy. Beyond the convenience factor, the benefits of the business, Cockrell said, are two-fold. First, the outdoor therapy sessions allow for more interaction that can support one's personal growth. "You can talk about how the weather affects your emotion. A lot of my clients don't get to be outside a lot." Take 30-something-year-old Diana Jones (who wished to have her name changed for this article). After a year visiting traditional therapists (couches and all), she now spends her lunch hour every other week with Cockrell in Central Park. In the past three months, she said Cockrell has helped her better cope with her anxiety issues related to running her own business and starting a family with her husband. "Distractions within the park are actually nice," she said. "Being [there] we see 40 billion kids … it almost helps [to think it through]." Then, there's the physical growth, said Cockrell, since being active is ultimately a healthy thing for the body. Personally speaking, Cockrell's blood pressure's gone down and he's shed about 15 pounds since starting the business. He said being outdoors also forces him to be more on his toes. "This is harder, I found [for me]," he said. "You really got to be on your game. It's a dynamic active session. I'm exhausted by the by the end of the day."

Wall Street Journal - Hannah Karp -
Our reporter on
practitioners who combine therapy
with physical activity.

He is one in a tiny pocket of
mental-health practitioners who
are combining physical activity and
talk therapy. The methods
range from strolls to more rigorous
"Adventure Therapy"
programs, which involve wilderness
experiences like
rock-climbing and camping. Atlanta
psychiatrist Sheldon B.
Cohen runs with his patients, while
licensed counselor Geri
Dube takes her clients on walks
around Seattle.

But some prominent doctors are
critical of the approach,
saying that it can violate professional
guidelines meant to
establish boundaries and maintain
confidentiality. Therapists
have also found some real-world
risks: Clay Cockrell, a New
York social worker who walks with his
clients, has witnessed a
mugging in Central Park and an
explosion during his
sessions. Psychotherapist Terri
Hengesh, who hikes with her
patients in Northern California, has
run into snakes on the
trail. (If you encounter a snake while
walking with your
therapist, is it really just a snake?)

The alternative treatments come as
mainstream therapists
are under pressure, in part because of
the success of drugs
in treating mental illness. Patients are
increasingly opting for
medication over talk therapy. Nearly
15% of adults used an
antidepressant at least once last year,
according to pharmacy
benefit manager Medco Health
Solutions, up from 12% of
adults in 2001. And while drugs are
often meant to be used in
conjunction with talk therapy,
medication is serving as a
substitute. A study published this
month in the American
Journal of Managed Care found that
less than 15% of
patients received the suggested level
of follow-up care after
starting antidepressant medication --
the U.S. Food and Drug
Administration recommends weekly
face-to-face visits in the
first four weeks. Health insurers often
cover just half of the
cost of mental-health treatments,
leading patients to drop out.

Scientific Benefits

A number of studies have
documented the psychological
benefits of exercise. While scientists
have long known that a
workout can temporarily boost
serotonin levels and improve
mood, the latest research shows that
exercise can have a
deeper and more lasting effect. One
article in the American
Journal of Preventive Medicine last
year found a correlation
between the intensity of exercise and
a reduction in
depression. A 2005 study published in
the Journal of
Neuroscience found that exercise
increases the growth of
neuronal brain cells, possibly elevating
mood permanently.
Advocates of the combined approach
say that being active
during the session helps patients to
relax and open up, and
some patients say they find it easier
to talk while looking
forward and walking, rather than
staring the therapist in the
eye.

Combining therapy with nature and
activity isn't new. In the
late 1800s, Sigmund Freud walked
with some of his patients
through the streets of Vienna and
even brought a few of them
along on his vacations, says Jacques
Barber, associate
director of the Center for
Psychotherapy Research at the
University of Pennsylvania School of
Medicine. In later years,
Freud moved to an enclosed space to
eliminate distractions.
Still, up until the 1960s, when
antidepressant medications
became more common, people with
symptoms of depression
were often sent to rural retreats were
they would garden,
chop wood or stroll with doctors.
Even today, therapy isn't
limited to offices. A behavioral
therapist might take an
obsessive-compulsive patient into a
dirty train station to
confront their worst fears, while
others take clients outside, to
a park bench or garden.

A Dangerous Combination

However, some warn that combining
sports and therapy can
be dangerous. Dr. Barber says that
engaging in sports could
lead to "multiple relationships"
between therapist and patient.
"To maintain boundaries, people have
to be very cautious,"
he says. "If you play tennis with them,
where do you stop?"

Peter Kramer, a clinical professor of
psychiatry and human
behavior at Brown University and
author of "Listening to
Prozac," believes that an activity like
tennis can add an
unwanted element of competition. If a
therapist takes too
much pleasure in the sport, it can be
a problem, he says,
"since many patients have had
parents who were very
competitive, or who were more
interested in themselves than
in their children."

Many of the practitioners say it was
an intuitive decision. Keith
Johnsgard, professor of psychology
at San Jose State
University and author of "Conquering
Anxiety and Depression
Through Exercise," started walking
with his patients when he
realized that he was less anxious after
working out with
colleagues at lunch.

Mr. Cockrell in New York hoped to
expand his practice by
meeting busy patients at the office for
a stroll at lunch or on
the way home. Now he walks with five
clients a day, at $150
for 50 minutes. He recalls "a great
session" when a manhole
exploded in front of him and a client,
forcing them to realize
that "you could be zapped at any
time." Another time, Mr.
Cockrell and a patient who wanted to
be more assertive
encountered a woman being mugged.
"It was an opportunity
to put this into action," he says. "We
both started yelling and
the thief ran off."