Adventure therapy

Adventure therapy is a type of experiential treatment for a range of psychological issues or traumas, including anxiety and depression, eating disorders, addiction, abuse, post-traumatic stress disorder, and behavioral problems. This type of therapy involves some sort of active "adventure," typically on a defined course, which may be outdoors or indoors. Adventure therapy most often functions as a type of group therapy, in which individuals work together on activities such as rock climbing, rafting, camping, problem-solving games, or ropes courses. The individuals participating in an adventure therapy group may be a family, or they may be unknown to each other prior to the group activity. There are many theories about the effectiveness of adventure therapy. The prevailing belief among practitioners of this type of therapy is that through the effective management of either real or perceived risk during the activity, and the required cooperation with the rest of the group, participants gain necessary life skills and behavioral management tools. The skills gained during the activity can assist participants in finding solutions to problems and managing their reactions when they return to their lives, while they also develop greater self-awareness and self-sufficiency.

Brief History

The use of the outdoors as a component of psychological treatment has existed since the early 1800s in the Friends Hospital in Philadelphia, where patients were permitted to spend time in nature during their time in treatment. However, it was not until the early twentieth century in Manhattan State Hospital East when doctors found that patients being treated for tuberculosis—who, at the time, were kept isolated outside in tents—were improving at better rates than those treated indoors. The same thing was found in San Francisco in 1906, when psychiatric patients were treated in tents outdoors following an earthquake and doctors noted marked improvement of their psychiatric symptoms. Soon after, in 1929, Camp Ahmek was founded for the express purpose of using camping as a therapeutic treatment. Other therapy camps continued to form in the United States throughout the twentieth century.

Around the mid-twentieth century, American psychologist and educational reformer John Dewey was developing the model of experiential education, which significantly affected the development of the adventure therapy model. Dewey's theory was based on the idea that students must engage in direct experiences in order to increase their knowledge and skills, and that learning happens more easily when all of the senses are stimulated. In 1941, German educator Kurt Hahn came to similar conclusions and founded Outward Bound at the Gordonstoun School in Scotland. Hahn's goal was to instill values, character, and leadership in his students through experiential learning, and his Outward Bound programs included outdoor challenges and adventures. Outward Bound came to the United States in 1962; in 1984, Colorado Outward Bound founded a treatment program. The growth of Outward Bound and its strategies also marked the expansion of nature-based therapy from its exclusive camping focus to a wide variety of activities incorporating outdoor adventure, and ultimately became what is known as adventure therapy.

Overview

Psychologists identify a number of key components for successful treatment through adventure therapy, recognizing that each individual is different and may respond differently in each situation. The most important aspects of this type of therapy are that the individual is engaging as a participant in the activity, is held accountable for his or her behavior, and cooperates with others in the group. In addition, the individual should feel both self-motivated and personally responsible to participate in the treatment. When used as a component of treatment for substance abuse, adventure therapy can also serve as an excellent tool to completely remove the person from the environment that was contributing to the substance abuse. For the treatment to be effective in any scenario, the activities in adventure therapy must have real consequences, and both the individual and the group should be held accountable for their actions during the activity. In addition, the participants must be able to see how the lessons learned on an adventure activity could be applied to their past or present experiences. Finally, participants should be given time to consider and reflect on their experiences, which assist in developing greater self-awareness. This self-reflection may be conducted independently, or with the help of the therapist.

Adventure therapy activities are often sequenced in order of difficulty, which is intended to facilitate trust among the group participants and promote feelings of mastery, thereby fostering healthy self-esteem. In some cases, other therapeutic techniques such as cognitive behavioral therapy are incorporated into adventure activities, in which participants may be feeling more comfortable and display a greater willingness to speak more openly. Adventure therapy often incorporates additional approaches, including psychodynamic and occupational therapies. Psychodynamic therapy is intended to reveal unconscious influences on behavior, while occupational therapy focuses on developing the patient's abilities to perform the daily activities of life.

Adventure therapy is often applied in the psychological treatment of children and adolescents, particularly at-risk youth who often do not respond as well to traditional talk therapy as do adults or other populations. In fact, many of the most common psychological treatment models, such as cognitive behavioral therapy, were originally developed for adults, and researchers have continued to examine and question their effects on children and adolescents. Teenagers in particular often struggle to engage in talk therapy treatment with a therapist. Conversely, research has shown that adventure therapy has demonstrated increased self-esteem among youth participants and has shown great benefit to young people with emotional and behavioral issues as it helps to build and enforce coping skills.

For those interested in pursuing a career in adventure therapy, a number of colleges and universities offer adventure therapy degrees for undergraduates and graduates that combine classes in counseling and psychology with wilderness and group-activity facilitation courses. It is likely that adventure therapy will continue to evolve along with other types of integrated mental health treatments such as art, music, dance, drama, and other types of recreational therapy that encourage movement and personal expression.

Bibliography

"Adventure Therapy." Dual Diagnosis, www.dualdiagnosis.org/treatment-therapies-for-dual-diagnosis-patients/adventure-therapy/. Accessed 28 Oct. 2017.

"Adventure Therapy Best Practices." Association for Experiential Education, www.aee.org/at-best-practices. Accessed 28 Oct. 2017.

Bowen, Daniel J., James T. Neill, and Simon J.R. Crisp. "Wilderness Adventure Therapy Effects on the Mental Health of Youth Participants." Evaluation and Program Planning, vol. 58, Oct. 2016, pp. 49–59.

Elliott, Ryan, and Larissa Pieper. "Adventure Therapy." Bradford Woods, www.bradwoods.org/wp-content/uploads/2012/03/Bradford-Woods-Adventure-Therapy-Overview.pdf. Accessed 28 Oct. 2017.

Gillis, H.L., et al. "Adventure Therapy with Groups." Handbook of Group Counseling and Psychotherapy, 2014, pp. 560–70.

Koperski, Haley, et al. "The Impact of Community Based Adventure Therapy on Stress and Coping Skills in Adults." The Practitioner Scholar: Journal of Counseling and Professional Psychology, vol. 4, no. 1, 2015, pp. 1–16.

Norton, Christine Lynn, et al. "Adventure Therapy with Youth." Journal of Experiential Education, vol. 31, no. 1, 2014, pp. 46–59.

Norton, Christine Lynn, et al. "Family Enrichment Adventure Therapy: A Mixed Methods Study Examining the Impact of Trauma-Informed Adventure Therapy on Children and Families Affected by Abuse." Journal of Child & Adolescent Trauma, 2017, pp. 1–11.

Tucker, Anita R., et al. "The Use of Adventure Therapy in Community-Based Mental Health: Decreases in Problem Severity among Youth Clients." Child & Youth Care Forum, vol. 42, no. 2, Apr. 2013, pp. 155–79.