Intervention: Treatment Outcomes *DRAFT*
Treatment interventions in adventure therapy typically combine facilitation and activity components. This section describes a number of intended treatment outcomes.
The use of adventure activities as an intervention allows for great flexibility in how each activity is utilized in treatment. The combination of the activity with varying facilitation choices can allow one activity to be employed for several different intended treatment outcomes. For example, rock climbing can be used to address trust, creating options, moving beyond self-imposed limits, or exploring relationships.
There are a variety of reasons a practitioner may decide to use certain adventure activities or facilitation approaches within a therapeutic intervention. These reasons are as diverse as the populations served in treatment, and will vary in response to the practitioner's assessment. It is important to remember that the intervention includes both the activity and the appropriate facilitation of that activity with the client. For information about research on treatment outcomes, refer to the Research section.
Well-constructed adventure therapy interventions are designed to assist clients in progressing in their change process in order to reach desired goals (Newes, 2000; Russell & Hendee, 2000; Lung, Stauffer & Alvarez, 2008; Alvarez & Stauffer, 2001; Bacon, 1983, 1988, 1989; Itin, 1994, 1998, 2003; Gass, 1985). The following text describes treatment outcomes that are often sought in adventure therapy, regardless of the type of activity selected. The identified outcomes are not intended to be an exhaustive list, but to highlight those most common to adventure therapy. Most of these potential treatment outcomes exist in all environmental and social contexts of treatment to some degree. Some outcomes may not apply to some contexts; for example, if a practitioner is operating in an individual therapy context, then group cohesion is not likely to be an intended outcome of the intervention.
Responsibility
Adventure activities create situations that encourage clients to be responsible to other people. Interventions are structured to allow clients to experience the natural consequences of their choices, which provides a feedback loop that informs clients about the positive and negative aspects of these choices. Clients are able to develop a sense of contributing to something larger than themselves and have the opportunity to be motivated and encouraged by others. (Copland Arnold, 1994; Eisenbeis, 2003; Levine, 1994; Mitten, 1994; Newes, 2000)
Cooperation and Relationship Building
Adventure interventions can be used to support clients in developing willingness to work together and an ability to do so effectively. Many times, adventure activities encourage clients to build positive, healthy interactions with others. Clients can achieve a sense of balance between cooperating with group or societal expectations and attending to individual needs and boundaries. Clients have the opportunity to learn and practice managing social, emotional and physical risk. Clients can develop trustworthy behaviors and the ability to trust others. Adventure interventions allow opportunities to model healthy relationships, begin building trust in the group, and explore positive risk-taking in social settings. Interventions can be designed to create group or family cohesion and to develop belonging, which can be critical to the developmental stage of clients (Corsini & Wedding, 2004; Newes, 2000; Lung, Stauffer & Alvarez, 2008; Nadler, 1993).
Intrapsychic Outcomes
Clients are able to increase their self-awareness regarding their level of functioning through practitioner and peer feedback. Adventure activities challenge client’s pre-conceived notions about themselves, others and practitioners in a way that allows clients to change prior negative cognitions. Clients can develop self-efficacy and self-confidence through gaining experience working through obstacles successfully. (Gillen, 2003; Hart & Silka, 1994; Levine, 1994; Mitten, 1994; Newes, 2000)
Social Skill Acquisition
There are a variety of opportunities with adventure activities for social skill acquisition. Clients are also given an opportunity to learn and to practice appropriate social skills, and to utilize skills they already possess, such as communication, following directions or conflict resolution. This can improve the client's ability to interact effectively with others. Clients can experience effective social interactions and practice the skills needed to maintain them (Russell, 2000).
Resiliency
Developing a client's ability to cope with challenges and be resilient is frequently a sought after outcome of adventure therapy. Practitioners often work with clients on skills related to problem solving, emotional management, coping skills, and the development of some self-confidence and reasonable persistence. Practitioners often work to increase client's feelings of self-efficacy or belief in their ability to manage issues. Clients are able to identify their strengths and learn to enhance their ability to use their strengths to achieve positive outcomes (Newes, 2000; Russell & Hendee, 2000).
Bibliography
Alvarez, T. & Stauffer, G. (2001). Musings on Adventure Therapy. Journal of Experiential Education, 24(2), -91.
Bacon, S. B. (1983). The Conscious Use of Metaphor in Outward Bound, Denver, CO: Colorado Outward Bound School.
Bacon, S. (1988). Paradox and double binds in adventure-based education. ERIC Document Reproduction Service No. 296832, Grennwich, CT: Outward Bound, USA, 4-30.
Bacon, S. (1989).
Copland Arnold, S. (1994). Transforming body image through women's wilderness experiences. In E. Cole, E. Erdman and E. Rothblum (Eds.) Wilderness Therapy for Women: The power of adventure. New York: The Hawthorn Press.
Eisenbeis, S. (2003). Psychotherapy on the steep wall: Adventure therapy and the psychiatric treatment of children and adolescents. In K. Richards & B. Smith (Eds.) Therapy Within Adventure: PRoceedings of the second annual adventure therapy conference. University of Ausburg, Germany: ZEIL Publications.
Gass, M. (1985).
Gerstein, J. R. (1992). The Group Counseling Skills of Adventure Based Counselors: A Survey Examining Relevant Group Counseling Skills, Perceived Group Counseling Skill Competency Levels and Group Counseling Training Experiences. (Doctoral dissertation: Northern Illinois University. 53/06-a Of Dissertation Abstracts International Abstract from: DIALOG(R)File 35: Dissertation Abstracts Online, (University Microfilms Order No:AAD92-30712).
Gillen, M. (2003). Pathway to efficacy: Recognizing cognitive behavioral therapy as an underlying theory of adventure therapy. Journal of adventure education and outdoor learning, 3, 93-102.
Hart, L. & Silka, L. (1994) Building self-efficacy through women-centered ropes course experiences. In K. Richards and B. Smith (Eds.) The therapy Within Adventure: Proceedings of the 2nd International Adventure Therapy Conference. Germany: Zeil Verlag.
Itin, C. (1994). Ericksonian Approach to Experiential Education Part 1. Developing the Stance of the Practitioner; 2. Developing Interventions; Part 3. Applying Specific Ericksonian Techniques. ERIC No. ED37009).
Itin, C. (1998). Many Pathways to becoming an adventure therapist. In Insight. 6, 1,1-6.
Itin, C. (2003). Adventure therapy vs. therapeutic adventure: Critical differences and appropriate training (pp. 175-183). In K. Richards and B. Smith (eds.) The therapy Within Adventure: Proceedings of the 2nd International Adventure Therapy Conference. Germany: Zeil Verlag.
Lung, M., Stauffer, G. & Alvarez, T. (2008). Power of One: Using Adventure and Experiential Activities Within One-on-One Counseling Sessions. Oklahoma City, OK: Wood ‘N' Barnes Publishing.
Mitten, D. (1994). Ethical considerations in adventure therapy: A feminist critique. In E. Cole, E. Erdman and E. Rothblum (Eds.) Wilderness Therapy for Women: The power of adventure. New York: The Hawthorn Press.
Nadler, R. S. (1993). Therapeutic Process of Change. In M. Gass (Ed.), Adventure Therapy: Therapeutic Applications of Adventure Programming, 57-69. Dubuque, IA: Kendall/Hunt Publishing Co.
Newes, S. (2000). Adventure-Based Therapy: Theory, Characteristics, Ethics, and Research. A paper written to fulfill the comprehensive examination requirement. Areas: Psychotherapy, Ethics, Methodology. Pennsylvania State University.
Priest, S. & Gass, M. (1999). Effective Leadership in Adventure Programming. Human Kinetics Publishing.
Ringer, M. (1994). Leadership Competencies for Outdoor Adventure: from Recreation to Therapy. (ERIC Document Reproduction Service No. ED378018)
Russell, K.C. & Hendee, J.C. (2000). Outdoor Behavioral Healthcare: Definitions, common practice, expected outcomes and a nationwide survey of programs. Technical Report 27, Idaho Forest Wildlife and Range Experiemnt Station, Mascow, ID. 87pp.
