For Mind & Body

Therapy + Movement

Online psychotherapy sessions that include a guided workout. You use whatever equipment you already have, and we talk while you move.

Read this first: what this is, and what it is not

The session is psychotherapy, provided by Leanne Wiese, Registered Psychotherapist with the College of Registered Psychotherapists of Ontario (CRPO #15522).

The movement guidance alongside it is a separate service. It is not psychotherapy and it is not a regulated health service. Leanne is also a certified fitness instructor with more than ten years of experience, and that is the basis for the movement part. She is not a physiotherapist, a kinesiologist or a physician, and she does not diagnose, assess or rehabilitate injuries.

The movement is optional. You can decline it at any point, including halfway through a session. It does not affect your access to therapy or change how we work together.

Sessions are online only, 50 or 80 minutes. You need to be physically in Ontario for every session. Start with a free 15-minute consultation.

What a session looks like

You join from home. We agree at the start what you feel like doing, based on what is actually in your house and how you have slept. Then you move, at an easy-to-moderate pace, and we talk. It is a therapy session; the movement runs underneath it rather than interrupting it.

  • Walking, outside with headphones or on a treadmill
  • Spin bike, if you have one
  • Yoga and stretching
  • Calisthenics, using your own body weight and the floor
  • Light dumbbells, kettlebells or bands

The intensity stays in the band where you can still hold a conversation. That is a deliberate choice, and worth being straight about: it is the band that lets the therapy happen, not the band with the strongest research behind it. Some people move the whole hour. Some weeks people sit down after ten minutes and talk instead. Both are fine.

What the evidence actually shows

The best available evidence is a 2024 review in The BMJ that pooled 218 randomised trials covering 14,170 people who met clinical criteria for depression. Compared with active controls such as usual care, it found moderate improvements across several kinds of exercise.1

Effect on depression compared with active controls, with the review authors' own confidence rating:

  • Walking or jogging: g = −0.62 (95% CrI −0.80 to −0.45), from 51 study arms. Confidence: low, which is the highest rating they gave anything.
  • Yoga: g = −0.55 (−0.73 to −0.36), 33 arms. Confidence: very low.
  • Strength training: g = −0.49 (−0.69 to −0.29), 22 arms. Confidence: very low.
  • Mixed aerobic: g = −0.43 (−0.61 to −0.25), 51 arms. Confidence: very low.
  • Cycling: g = −0.30 (−0.60 to 0.01), 11 arms. The interval crosses zero, so this one has not been shown to help.

The authors are explicit that only one of the 218 studies met the criteria for low risk of bias, and they conclude exercise could be considered alongside therapy and medication, not instead of them.1

We publish the weak row on purpose. If you have a spin bike and that is what you want to use, use it: it is still movement and you may well feel better for it. But the trial evidence for cycling specifically has not separated from no effect, and you should know that rather than be sold it.

One session a week is not the dose

This matters more than the effect sizes. A Bayesian dose analysis of 46 trials covering 3,164 adults estimated the minimum effective dose at around 320 METs-minutes per week, which is roughly 90 to 100 minutes of brisk walking, with the relationship U-shaped rather than more-is-always-better.2 CANMAT's 2023 guidance recommends supervised exercise at low to moderate intensity, 30 to 40 minutes, three to four times a week.3

A single 50 or 80-minute session does not reach that on its own. What it can do is anchor the week, give the movement a fixed appointment that someone else also shows up for, and be the session you do not skip. That is the honest claim.

There is some support for the anchoring idea. In the same BMJ review, studies that left participants to choose their own frequency and intensity tended to show weaker effects than studies that did not, though the intervals overlap and one crosses zero, so treat it as a pattern rather than a rule.1 And a Dutch trial that added 12 weeks of prescribed exercise to standard care found no significant overall benefit, with only 22 per cent of the exercise group completing what was prescribed; it looked worthwhile only among those who actually attended six or more supervised sessions.4 Turning up is most of it.

Screening, and who this is not for

Before any movement happens you complete the CSEP Get Active Questionnaire, a short standard health screen. Some answers mean seeing a doctor or a qualified exercise professional first, and we ask for written confirmation that you did. The triggers include blood pressure at or above 160/90, new chest pain or pressure, fainting, shortness of breath at rest, a recent concussion, dizziness during activity, and new pain or swelling.5

When the movement part has to wait

An active eating disorder, or a compulsive relationship with exercise. This is the one we are strictest about. Monitoring for that situation is physical: heart rate, blood pressure, electrolytes, things that cannot be seen over a video call. An at-home, unsupervised, online format cannot provide it. This is not a refusal to work with you, and it is not a judgement. It means this particular format is the wrong container, and therapy without the movement component is still available here.

Pregnancy with an absolute contraindication under the Canadian pregnancy activity guideline, including ruptured membranes, premature labour, persistent unexplained bleeding, placenta previa after 28 weeks, preeclampsia, incompetent cervix, or uncontrolled cardiovascular, respiratory or thyroid conditions.

Postpartum pelvic floor symptoms: leaking with exertion, a feeling of heaviness or bulge, or the abdomen doming under effort. Pelvic floor technique is a pelvic floor physiotherapist's job, not a fitness instructor's. We pause the movement and refer.

No safe, private space to move in, or no emergency contact and session address on file. If something goes wrong we need to be able to send help to a real address.

If you are in crisis right now, call 911, or call or text 9-8-8, the Suicide Crisis Helpline. In Waterloo Region, Here 24/7 is on 1-844-437-3247, 24 hours a day. This is a scheduled private service, not a crisis service.

You are on your own in the room

Worth stating plainly, because it changes what you should agree to. You exercise at home by yourself. You are responsible for your space, your footwear, your floor surface and your equipment. Leanne cannot see your whole body on video, cannot correct your form by touch, and cannot physically help you if something goes wrong.

Stop straight away if you get chest pain or pressure, unusual breathlessness, dizziness or faintness, new pain, or loss of balance, or if you start to feel panicky or disconnected from yourself. Leanne will stop the movement too if she sees any of that. Stopping is never a problem and never needs explaining.

What it costs, and what is covered

Current rates are listed on the booking page and shown before you confirm anything. See current rates.

The psychotherapy and the movement guidance are billed and receipted separately, and the movement guidance is never receipted as psychotherapy. That matters for your insurer: extended health plans that reimburse a Registered Psychotherapist will consider the therapy portion, and will not consider the movement portion. OHIP does not cover private psychotherapy at all. There is no HST on the psychotherapy.

How to start

  1. Book a free 15-minute consultation, or email leanne@kwtherapy.ca. Mention that you are interested in the movement option.
  2. If it looks like a fit, you complete the Get Active Questionnaire and we go through the consent, the stop rules and your emergency details before any movement happens.
  3. First session, we start easy and find out what your body actually feels like doing on a normal Wednesday.

Common questions

Do I need to be fit already?

No. The movement stays in a light-to-moderate band, which is the band you can hold a conversation in. That band is chosen so the therapy can happen, not because it is the hardest work you could do. If walking slowly on the spot is where you are, that is where we start.

What equipment do I need?

Whatever you already have, including nothing. A treadmill, a spin bike, a mat, light dumbbells, kettlebells or bands, or just the floor. Because sessions are online you provide your own equipment, and we plan around what is actually in your house.

Is the movement part compulsory?

No. It is optional and you can decline at any point, including partway through a session. It does not affect your access to therapy and does not change how we work together.

Does exercise actually help with mood?

The evidence is genuinely promising and genuinely limited, and you deserve both halves. The 2024 BMJ review of 218 trials and 14,170 people found moderate improvements for walking, yoga and strength training. The same authors note only one of those 218 studies was at low risk of bias, and rate their confidence low to very low. Worth doing, not a cure, and not a replacement for anything else you are doing.

Is this physiotherapy or personal training?

Neither. The session is psychotherapy provided by a Registered Psychotherapist. The movement guidance alongside it is a separate, non-regulated service. Leanne is not a physiotherapist, a kinesiologist or a physician, and does not diagnose, assess or rehabilitate injuries.

Who should not do the movement part?

Anyone with an active eating disorder or compulsive exercise, because the monitoring that needs cannot be done over video. Anyone whose screening flags something not yet cleared by a doctor. Anyone pregnant with a listed absolute contraindication. Anyone without a private space to move in. In every case the therapy itself is still available.

Where these numbers come from

  1. Noetel M, Sanders T, Gallardo-Gómez D, et al. Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials. BMJ. 2024;384:e075847. 218 trials, 14,170 participants.
  2. Bayesian dose-response analysis of exercise for depression, 46 randomised trials, 3,164 adults, 2024.
  3. CANMAT 2023 clinical guidelines, exercise recommendation for depression.
  4. Pragmatic randomised trial of exercise added to guideline care for depression, 112 outpatients across four specialist centres.
  5. Canadian Society for Exercise Physiology, Get Active Questionnaire, the current Canadian pre-exercise screening tool.

This page describes psychotherapy provided by KW Therapy in Ontario, together with an optional non-regulated movement component. It is general information, not clinical advice. Leanne Wiese is a Registered Psychotherapist with the College of Registered Psychotherapists of Ontario, registration #15522, confirmable on the CRPO public register. Her fitness instructor certification is a separate credential and is not a regulated health profession. Page last reviewed 27 July 2026.

Related: Individual therapy · Sport performance therapy · Pregnancy and postpartum · All services

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