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Adult Clients' Experience of Walk-And-Talk Therapy Denice Crowe Clark Walden University

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Adult Clients' Experience of Walk-And-Talk Therapy Denice Crowe Clark Walden University Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2019 Adult Clients' Experience of Walk-and-Talk Therapy Denice Crowe Clark Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Public Health Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Social and Behavioral Sciences This is to certify that the doctoral dissertation by Denice Crowe Clark has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Rebecca Stout, Committee Chairperson, Human Services Faculty Dr. Mary Bold, Committee Member, Human Services Faculty Dr. Randy Heinrich, University Reviewer, Human Services Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2019 Abstract Adult Clients’ Experience of Walk-and-Talk Therapy by Denice Crowe Clark MFT, Mercer University School of Medicine, 2008 BS, University of South Carolina, 1986 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Human Services Walden University May 2019 Abstract Standards of healthcare exist to promote beneficent treatment; however, treatment approaches are sometimes not supported by research, creating potential ethical issues for clinicians expected to use evidence-based practices. For example, walk-and-talk therapy, where therapy sessions incorporate physical activity in an outdoor setting, is being offered at increasing rates, but research regarding the practice is sparse and primarily reflects the therapists’ experiences. Thus, the purpose of this interpretative phenomenological analytic study was to explore the clients’ experience of the altered frame of walk-and-talk therapy through the conceptual lenses of therapeutic frame and the biopsychosocial model of well-being. Data were collected through in-depth, semistructured interviews with a sample of three former walk-and-talk therapy clients, and data were analyzed using the modified van Kaam method. Findings included that the clients’ experience of walk-and-talk therapy was shaped by prior therapy experiences with participants reporting concerns and benefits related to the altered frame. Clients found walk-and-talk equally or more therapeutic than traditional therapy and felt walk- and-talk could be a less stigmatizing therapeutic alternative for individuals who find traditional, indoor therapy unappealing . Implications for social change include shaping standard practices of walk-and-talk therapy, thus informing the future of training and supervision as well as providing an alternative therapeutic offering for individuals who find traditional, indoor therapy unappealing . Adult Clients’ Experience of Walk-and-Talk Therapy by Denice Crowe Clark MFT, Mercer University School of Medicine, 2008 BS, University of South Carolina, 1986 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Human Services Walden University May 2019 Dedication I would like to dedicate this dissertation to all those who have loved and supported me, and cheered me on throughout this process. First, thanks to my husband, Mark, who has put up with my stress and crazy for a lot of years, but particularly these last couple of years of dissertation writing. Thank you for the constant reminders to focus on what is most important and finish! Second, thanks to my youngest daughter, Hope, who lived at home long enough to experience the majority of the same stress and crazy. No wonder you moved out when you did. Thanks to my oldest daughter, Grace for cheering from afar, as well as your daily inquiry towards the end of the dissertation writing, “Are you done yet?” You were certainly brave to move back home while I was in those final stages of writing. Apologies to my son-in-law, Allan, for stressing you out with my writing deadlines, but, thanks for keeping the “pantry” stocked. I would also like to dedicate this to my grandson, Alex, and granddaughters on the way, Evelyn and Iris. Let this serve as an example that persistence pays off. Always follow your passions and live life with purpose. Thanks to my constant canine companion, Beau, who snuggled next to me from the very first course through the last iteration of this dissertation. Last, but certainly not least, this is dedicated to my biggest cheerleader, my Mommy, Annette. You always believed in me and pushed me to excel in whatever endeavors I engaged. I am proud to be a first generation college graduate, and now a first generation PhD! All of you share in my success and I could not have done it without you. I love you all. First round is on me! Acknowledgments Many thanks to everyone who held me accountable and guided me through this journey. Thank you to my committee chair, Dr. Rebecca Stout. Even though you were assigned as my chair without a prior conversation or introduction, I could not have selected a more appropriate fit. Thank you for fielding my e-mails and questions so quickly, and for responding to my discouragements along the way with positivity and affirmation. Thanks also, to my second committee member, Dr. Mary Bold, for reminding me to maintain a stance of curiosity, embody the role of researcher, and exercise brevity in my writing. Finally, thank you to my URR and third committee member, Dr. Randy Heinrich, particularly for your recommendation on data analysis method. I had the best dissertation committee in the history of dissertation committees! Many thanks, also, to my study participants. I would also like to acknowledge colleagues past and present who served as both friends and mentors: Alan Lyme, for constantly reminding me of the goal I was pursuing while also keeping my ego in check; Bonnie Cole Gifford, for your friendship and inspiring me to find and follow my passion, and to learn it inside-out; Annie Biers, for your ongoing friendship and affirmation. Thank you, Dr. Aaron Johnson, Dr. Paul Seale, and Dr. Sylvia Shellenberger, for all the professional opportunities you afforded me these past several years. And finally, thank you, Deborah Wight-Knight, for holding a safe space for me all those years ago, and helping me realize the path to finding my passion and purpose. Table of Contents List of Tables ..................................................................................................................... vi Chapter 1: Introduction to the Study ....................................................................................1 Background ....................................................................................................................2 Problem Statement .........................................................................................................4 Purpose ...........................................................................................................................5 Research Question .........................................................................................................6 Conceptual Framework ..................................................................................................6 Nature of the Study ........................................................................................................8 Operational Definitions ..................................................................................................8 Assumptions ...................................................................................................................9 Delimitations ................................................................................................................10 Limitations ...................................................................................................................11 Significance..................................................................................................................12 Summary ......................................................................................................................13 Chapter 2: Literature Review .............................................................................................14 Introduction ..................................................................................................................14 Literature Search Strategy............................................................................................16 Conceptual Framework ................................................................................................16 Physical Activity ..........................................................................................................19 Benefits of Physical Activity ................................................................................ 19 Mental/Emotional Benefits of Physical Activity .................................................. 23 i Other Benefits of Physical Activity ...................................................................... 24 Mediating Factors Related to Benefits of Physical Activity ................................. 25 Traditional Therapy .....................................................................................................27
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