56 MONITOR ON PSYCHOLOGY • SEPTEMBER 2013
As a practicing psychologist with training in sport psychology, Michelle Joshua, PhD, knew she was in the right field to pursue her passion: helping people face
challenges and grow from them.
Less appealing about the field was working in an office all day.
“I’m an athletic person and I wanted to work primarily with
athletes and people who could benefit from being more active,”
says Joshua, who earned her PhD in counseling psychology
from the University of North Texas in 2002.
So, Joshua founded Work it Out LLC, a clinic with offices
in Raleigh and Carrboro, N.C., that helps athletes address
performance and personal issues, and provides health and
behavior interventions to people with conditions including
diabetes and obesity. Part of that work involves walking on trails
near her offices.
“I thought that incorporating exercise into my clinical or
performance work might allow clients to address issues in a way
that felt more comfortable for them than talking face to face, or
would give them the opportunity to literally get off the couch as
opposed to talking about it,” she says.
Joshua is one of a growing number of clinicians who have
figured out how to bring exercise and the outdoors into their
practices in a way that’s both ethical and effective for clients.
Research is scarce on how many psychologists fit that bill, but a
2010 sample of 204 psychology practitioners interested in exercise
and psychotherapy found that 86 percent exercised regularly,
most recommended exercise to clients, and 18 percent exercised
with clients during therapy, according to consulting psychologist
Kate Hays, PhD, of The Performing Edge in Toronto.
Besides exercise’s proven ability to combat depression,
anxiety, insomnia, weight gain and other health and mental
health conditions, combining it with therapy has benefits of its
For one, it can model good exercise behavior for clients,
Hays says. It can also provide a bridge to help people actualize
their exercise resolutions and ease rapport with certain types of
clients, she and others say.
“There are some people who become blocked or
overwhelmed by the intimacy of therapy in an office setting,”
says Jennifer Lager, PsyD, who walks with clients on trails
natural fit A
Therapy and exercise needn’t be mutually exclusive. Here’s how to
incorporate the outdoors, walking and other exercise into therapy
in a way that’s good for clients and for you.
BY TORI DEANGELIS