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What is adventure therapy

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Abstract

The field of Adventure Therapy is experiencing substantial growth and is becoming more well-known. This increased popularity is leading more readers to the literature in search of information. Many of these readers have had little or no prior exposure to the field of Adventure Therapy. This paper is intended to provide an overview for those readers to help them bet-ter understand the principles and theories upon which Adventure Therapy is based. This will serve as a foundation for the chapters that follow in this text. At the same time, the authors believe that there is a need to under-stand Adventure Therapy in the context of broader mental health treat-ment. Toward that goal, this paper highlights the theoretical constructs that Adventure Therapy shares in common with other treatment approach-es, as well as those that are unique to the field. ■ ■ ■ Although the intentional application of adventure education princi-ples to therapeutic populations has been occurring for nearly forty years, many are unfamiliar with the field of Adventure Therapy (AT). It is not uncommon to encounter individuals who experienced great relief upon discovering the field of AT, having thought that they were going to have to create an entirely new discipline. This common experience speaks to both the natural fit between nature and therapy, as well as to the relative obscu-rity of the field. The numbers of readers of AT literature are growing as more students, traditional mental health practitioners and consumers of AT are attracted to the field. However, while there is an increase in attention focused on AT, it can be difficult for interested individuals to find an overview of the basic essential foundations of this field. In recognition of the fact that many of our readers have had little prior exposure to AT liter-ature, we are providing this overview as a means to introduce the chapters which follow.
COMING OF AGE: THE EVOLVING FIELD OF ADVENTURE THERAPY PP. 1–30
What is Adventure Therapy?
Sandra Newes and Scott Bandoroff
■ ■ ■
The field of Adventure Therapy is experiencing substantial growth and is
becoming more well-known. This increased popularity is leading more
readers to the literature in search of information. Many of these readers
have had little or no prior exposure to the field of Adventure Therapy. This
paper is intended to provide an overview for those readers to help them bet-
ter understand the principles and theories upon which Adventure Therapy
is based. This will serve as a foundation for the chapters that follow in this
text. At the same time, the authors believe that there is a need to under-
stand Adventure Therapy in the context of broader mental health treat-
ment. Toward that goal, this paper highlights the theoretical constructs
that Adventure Therapy shares in common with other treatment approach-
es, as well as those that are unique to the field.
■ ■ ■
Although the intentional application of adventure education princi-
ples to therapeutic populations has been occurring for nearly forty years,
many are unfamiliar with the field of Adventure Therapy (AT). It is not
uncommon to encounter individuals who experienced great relief upon
discovering the field of AT, having thought that they were going to have to
create an entirely new discipline. This common experience speaks to both
the natural fit between nature and therapy, as well as to the relative obscu-
rity of the field. The numbers of readers of AT literature are growing as more
students, traditional mental health practitioners and consumers of AT are
attracted to the field. However, while there is an increase in attention
focused on AT, it can be difficult for interested individuals to find an
overview of the basic essential foundations of this field. In recognition of
the fact that many of our readers have had little prior exposure to AT liter-
ature, we are providing this overview as a means to introduce the chapters
which follow.
2SECTION I: THEORETICAL CONSIDERATIONS
Another goal of this chapter is to highlight the commonalities of AT
with more traditional mental health treatments. Much of AT may not be
particularly unique and it is important to recognize this in developing a
thorough understanding of the discipline. Moreover, as AT struggles to gain
credibility in the mental health community, establishing commonalities
with widely accepted mental health treatments helps to support the growth
of AT as a viable mental health approach. It also may allow AT to borrow
from the extensive research literature of more widely recognized mental
health treatments as a means to provide support for its practices. Naturally,
despite commonalities to other approaches, AT has its unique aspects.
These will be highlighted as well.
Theoretical Background
Experiential Education
AT is rooted in the tradition of “experiential education” philosophies
(Kraft & Sakofs, 1985), defined as “learning by doing, with reflection”
(Gass, 1993). Early roots of experiential education can be traced to the edu-
cational writings of Dewey (Kraft & Sakofs, 1985). This experiential learn-
ing tradition is based on the belief that learning is a result of direct experi-
ence, and includes the premise that persons learn best when they have
multiple senses actively involved in learning. By increasing the intensity of
the mental and physical demands of learning, the participant “engages all
sensory systems in a learning and change process” (Crisp, 1998).
Psychological research on information processing provides some support of
this premise, indicating that multi-sensory processing accounts for a high-
er level of cognitive activity and increased memory. Applied specifically to
the context of AT, the multi-sensory level of the therapeutic experience
inherent in adventure activities may account for the high level of change
reported by practitioners (Crisp, 1998). This suggests that “integration of
experience may be more deeply anchored for the client because of this
broad [sensory] base” (Crisp, 1998, p. 67).
Experiential education theory also postulates that active learning is
often more valuable for the learner because the participant is directly
responsible for and involved in the process. In addition, experiential learn-
ing theory is based on the belief that learning is enhanced when individu-
als are placed outside of their comfort zones and into a state of dissonance.
Learning is then assumed to occur through the necessary changes required
to achieve personal equilibrium [(i.e., modern dissonance theory),
Festinger, 1957]. Kraft and Sakofs (1985) outline several elements inherent
to this experiential education process:
1. The learner is a participant rather than a spectator in learning.
2. The learning activities require personal motivation in the form of
WHAT IS ADVENTURE THERAPY?3
energy, involvement, and responsibility.
3. The learning activity is real and meaningful in terms of natural
consequences for the learner.
4. Reflection is a critical element in the learning process.
5. Learning must have present as well as future relevance for the
learner and the society in which he/she is a member.
In experiential classrooms, individuals are placed in “real life” situa-
tions in which it is necessary to employ problem-solving or otherwise cre-
ative methods of working with the environment or context at hand.
Therefore, effective experiential activities involve the participant in situa-
tions in which they must take some form of action to successfully cope
with their surroundings. Such activities may take the form of outdoor pur-
suits such as hiking, rock climbing, or kayaking, but also include team-
based initiative activities. Outward Bound is widely recognized as one of
the innovators in incorporating the philosophies of experiential learning
into adventure activity approaches (Bacon, 1983; Gillis & Ringer, 1999).
The Link to Therapy
In the late 1960’s Outward Bound expanded the application of their
adventure education model to therapeutic populations (Kelly & Baer,
1968). Gass (1993) has reworked the above experiential education princi-
ples and discusses how these principles can be applied to therapy.
1. The client becomes a participant rather than a spectator in therapy.
2. Therapeutic activities require client motivation in the form of ener-
gy, involvement, and responsibility.
3. Therapeutic activities are real and meaningful in terms of natural
consequences for the client.
4. Reflection is a critical element of the therapeutic process.
5. Functional change must have present as well as future relevance for
clients and their society (p. 5).
It is interesting that when examining the ideas stated above by Gass
(1993), it is evident to the critical reader that most of these principles are
not unique to AT. In actuality, one can see even from these basic statements
that the theory of AT builds on the foundations and well-established prem-
ises of accepted psychological theory, including cognitive and cognitive-
behavioral theory, humanistic theory, and elements of the interpersonal
aspects of object relations theory. Therefore, it appears from this definition
that what AT may offer is a potentially unique medium for the implemen-
tation of therapeutic processes assumed to be present in many therapeutic
orientations. Although this may be considered controversial, the remainder
4SECTION I: THEORETICAL CONSIDERATIONS
of the chapter will offer evidence to support this position.
Definition of Adventure-Based Therapy
Also referred to as “wilderness therapy,” “therapeutic adventure,”
“adventure therapy,” “wilderness-adventure therapy,” “adventure-based
therapy,” and “adventure-based counseling,” AT is a therapeutic modality
combining therapeutic benefits of the adventure experiences and activities
with those of more traditional modes of therapy. AT utilizes a therapeutic
focus and integrates group level processing and individual psychotherapy
sessions as part of an overall therapeutic milieu. While specific types of
facilitation occur directly related to the activities, this processing is not
associated exclusively with the activities alone. Rather, the activities can
also be conceptualized as a catalyst for the processing which occurs before,
during, and after activities; a catalyst which provides concrete examples of
the immediate consequences associated with individual and group actions
that can be referred to by both the client and the therapist. Therefore, ther-
apists may begin with processing exigencies around the activities them-
selves and branch into other areas related to the issues of the clients. This
approach tends to make such discussions more relevant for clients and
therefore, arguably, more engaging.
As such, AT lends itself well to multimodal treatment and can be uti-
lized as an intervention independent from other treatments or as an
adjunct to other well-established treatments. Importantly, therapists are
able to use any type of therapeutic orientation they adhere to in the pro-
cessing that occurs around the activities. This view contrasts with a com-
monly held assumption that the postulated change which may occur in AT
is singularly related to the activity participation.
Ringer (1994) defines AT as a generic term referring to a class of
change-oriented, group-based experiential learning processes that occur in
the context of a contractual, empowering, and empathic professional rela-
tionship. Notably, elements of this definition are not unique to AT and can
be assumed generally in many therapeutic traditions. However, the empha-
sis on “group-based experiential learning processes” in a typically outdoor
and active setting is clearly a combination differentiating AT from other
forms of therapy.
Interestingly, Ringer’s definition does not mention “adventure.” This
purposeful omission challenges one common misconception about AT:
namely, that in order to accomplish their goals, clients must necessarily
subject themselves to adrenaline-fueled feats of daring and technical skill.
The fact that “adventure” is not seen as an end unto itself distinguishes AT
from other types of outdoor programming devoid of therapeutic focus. In
line with this definition, adventure or outdoor experiences alone are not
assumed to be sufficient to facilitate deep-level therapeutic growth and
WHAT IS ADVENTURE THERAPY?5
change. Instead, it is the processing of the actual experience with the client
that promotes the therapeutic process. Therefore, the use of the word
“adventure” may in fact be misleading and terms such as “activity-based
psychotherapy” may be more appropriate (Gillis, 1992). However, this term
has not become one of common usage in the literature and adventure ther-
apy, with all of its connotations, is the name that has become standard.
In examining this discussion, it can be seen that there are problems
with delineating distinct and defining parameters of AT. To address this
problem, professionals within the field have been involved in an ongoing
debate as to how to best articulate a clear definition of what is unique to
AT as a treatment modality. Such a definition must necessarily incorporate
widely accepted therapeutic principles while also differentiating AT from
other therapies and from other types of outdoor adventure programs. In an
attempt to focus such definitions, Simon Crisp (personal communication,
August 24, 2004) offers the following:
1. Wilderness and/or adventure methods are utilized in the service of
therapeutic practice. Therapeutic practice involves:
a. the identification of a problem the client presents with,
b. application of a theoretical framework based on a theory of per-
sonality, behavioral and psychological problems and process of
change that explains the origin and nature of the problem;
c. selection of strategies of client management and method(s) of
intervention which logically and parsimoniously relate to b);
d. strategies and methods are routinely reviewed and modified
according to client need.
2. Professional relationship exists between therapist and client with
the following characteristics:
a. therapist brings to the relationship training and experience nec-
essary and appropriate to meet all foreseeable needs of the client,
including a capacity to assess and manage (a) life-threatening
and other crises, (b) psychological boundaries, and (c) any poten-
tially competing needs of the therapist,
b. a contract is formed between therapist and client about the aims,
limitations, methods, expected outcomes and risks of therapy,
c. therapist works towards the best interests of the client and holds
this at all times the overriding principle in determining the
actions of the therapist, and the therapist acts to protect the
client from harm—both physical and psychological.
Once again, the singularly unique aspect of this definition is the
emphasis on activities as a means of accomplishing the other common ther-
6SECTION I: THEORETICAL CONSIDERATIONS
apeutic goals. This appears to hold true as well for the definition put forth
by Alvarez and Stauffer (2001): “Adventure therapy is any intentional, facil-
itated use of adventure tools and techniques to guide personal change
toward desired therapeutic goals” (p. 87). Again, it is also this focus on the
use of activities to accomplish said goals which seems to differentiate AT
from most other therapeutic orientations. Based on this, perhaps AT can be
best be seen as an activity-based approach to treatment that attempts to
meet similar goals as do other treatments. Therefore, what must be parceled
out as theoretically unique to AT is the mechanism by which AT can accom-
plish these goals in ways that are more efficacious than other treatments for
particular clients. This is a question that remains as yet unanswered. Simply
put, it is essential that the field of AT begin holding itself accountable for
answering the questions posed to all other treatments: Is this treatment
effective? For whom, and under what circumstances?
Thought of in this way, AT can begin to be seen as more similar to
other types of treatments than different. The logical assumption should fol-
low then that AT is assumed to operate under the same scientific and clin-
ical umbrella as other mental health treatments, and therefore, practition-
ers of AT should be held accountable to the same standards as other prac-
ticing mental health professionals. However, in reality this is not always the
case. AT is often presented by its proponents as though it is a unique and
separate entity, an entity somehow not responsible for upholding such
standards. This presents a clear contradiction between established stan-
dards of mental health practice and AT.
This dilemma is reflected in the ongoing debate within the AT field
about the necessary qualifications for an adventure therapist. Let us return to
the definitions offered above in an effort to gain some clarity. While Ringer’s
reference to a “professional relationship” would not suggest that the facilita-
tor necessarily be credentialed, Gillis’ inclusion of the word “psychotherapy”
clearly indicates the involvement of an academically trained therapist. Crisp
attempts to elucidate the issue by defining “professional relationship” but
avoids delineating the training, so that uncredentialed professionals might
meet the criteria (note that the title of “therapist” is not restricted in many
jurisdictions). One can see that clarity is not easily achieved.
The debate surrounding this topic is extensive and heated. It has seri-
ous implications since the outcome would prescribe who is qualified to
conduct AT programs. Some in the field advocate for a required level of
competency as reflected by a specified level of training and accompanying
credential, while others advocate “training through experience.” This dis-
cussion may reflect a presently existing division one finds between those
AT practitioners who have followed the more established route of academ-
ic and clinical training and those who have learned their clinical skills
through direct experience. A related controversy involves the use of the
WHAT IS ADVENTURE THERAPY?7
term adventure therapy with some advocating that adventure therapy pro-
grams must involve clinically trained therapists, while those programs
working with clinical populations without clinically credentialed staff
should be referred to as therapeutic adventure. Further discussion of this
topic is beyond the scope of this paper. For more information the reader is
referred to chapters by Crisp and Williams in this edition.
From the standpoint of mental health practice, the eventual outcome
to this debate must involve holding AT to the same standards of care as are
other mental health treatments. This would necessarily include a thought-
ful examination of ethical practice in AT as well (Newes, 2000). However,
in order for this change to occur, there must be further efforts made to
establish a foundational knowledge that indicates that AT shares more sim-
ilarities with other mental health treatments than is commonly believed
within the field. It is only with the establishment of such a belief, as well
as a clear semantic and theoretical link, that AT will in actuality operate
under the aforementioned umbrella of scientific and clinical practice.
Goals of Adventure-Based Therapy
AT proponents have articulated a variety of goals that are recognized
as being associated with the modality. While recognizably unsupported by
solid empirical data, the following section will broadly summarize these
interconnected goals. First, clients are thought to generally increase in self-
awareness, leading to an increased recognition of behavioral consequences
and available choices; second, clients have a higher level of accountability
both to self and others; third, clients are thought to learn healthier coping
strategies leading to increased environmental control; fourth, through AT,
clients are thought to be provided tangible evidence of success, thereby cor-
recting negative self-conceptions and leading to a more positive self-con-
cept; fifth, clients are thought to learn creative problem-solving, commu-
nication, and cooperation skills; and sixth, AT is thought to facilitate real-
istic appraisal of individual strengths, weaknesses, and self-imposed limita-
tions. Ultimately, this increased awareness is thought to lead to better deci-
sion-making abilities.
Overall, AT programs have the overriding goal of an increasing self-
awareness in a variety of domains. In line with this, it is thought by AT the-
orists that connections between behavior and the results of such behavior
become more apparent. Therefore, clients can be provided with concrete
examples of dysfunctional behavior and shown that alternative behavioral
and interpersonal choices can lead to success. Relatedly, Bandoroff (1989)
argues that adventure activities, with the feedback and consequences avail-
able through such experiences, provide learning that enables participants
to begin regulating their own behavior. Amesberger (1998) expands on this
goal, noting that AT involves:
8SECTION I: THEORETICAL CONSIDERATIONS
...the reflection on internalized norms and values with the aim to sup-
port a person to find new and more suitable structures for his or her
life. Destructive and dysfunctional behaviors or emotions should be
recognized in their effects, as well as helpful and effective ones (p. 29).
Along with this increased insight and capacity for controlling their
behaviors comes a higher level of accountability. This goes well beyond the
elementary goal delineated in most programs of accepting responsibility for
behavior. What we are alluding to here speaks more to integrity. Clients
develop an understanding that they have a higher calling than what their
prior conduct would reflect. The AT treatment is designed to help them get
in touch with that potential and begin to live in alignment with the higher
standards dictated by this greater sense of self. Such a life implies an account-
ability to self that entails, but is more than, accountability to others.
Of note is the fact that the above noted tenets are clearly embedded
in the therapeutic process itself, as opposed to embedded within the activ-
ities. Taylor (1989) postulates that the exposure to uncertainty or ambigui-
ty accompanied by increases in levels of confidence and skill that can be
achieved through the AT process will facilitate a healthier coping response.
It is believed that as clients learn and use new modes of coping, they gain
greater control of their environment (Nadler & Luckner, 1992). It is hoped
that by coping with the treatment environment in new ways, clients can
learn to achieve increased personal and environmental control outside of
the treatment. This is an experience which may be novel for many clients.
According to Herbert (1996), through AT “persons challenge them-
selves, and in doing so, (re)learn something about themselves” (p. 5). To
accomplish this, mastery tasks, or initial successes, associated with the
activities counteract and disprove internally focused negative self-evalua-
tions, learned helplessness, and dependency (Kimball & Bacon, 1993) at a
time when such processes may be intensely activated. This heightened acti-
vation combined with concrete evidence of success may facilitate further
learning. Ultimately, feelings of success and control also associated with the
mastery tasks can then serve as additional reinforcers to support changed
behaviors. Thus, it is a circular process of interpersonal and intrapersonal
activation, success, and reinforcement.
Priest and Baillie (1987) discuss additional possibilities for client
change, stating that “The aim of adventure education is to create astute
adventurers: people who are correct in their perceptions of individual com-
petence and situational risk” (p. 18). Relatedly, through AT, clients can
learn skills related to problem-solving, cooperation, communication, and
facing challenge (Herbert, 1996). It is thought that through this process,
clients learn to more realistically appraise their own personal strengths and
weaknesses, both on a personal and an interpersonal level.
WHAT IS ADVENTURE THERAPY?9
Through this process, clients begin to recognize their own self-
imposed limitations and increase in their awareness of available choices,
thus becoming better able to accept responsibility for their level of success
or failure. As clients increase in this self-knowledge and self-awareness, it is
believed that they are ultimately able to make more realistic and healthy
decisions. These are important skills many clients lack. Moreover, Taylor
(1989) notes that the increased levels of confidence, skill, and self-aware-
ness that participants may gain through AT encourages clients to see uncer-
tainty as a challenge and not a threat, a change with potentially far-reach-
ing positive consequences for clients.
Ultimately, these proposed changes can perhaps be summarized in
this inherent underlying assumption embedded within the adventure-
based therapy literature: the assumption that by becoming aware of avail-
able choices, and by experimenting with different behaviors in a novel
environment where one is receiving immediate and realistic feedback,
clients can learn to actively influence their probability of success.
Furthermore, through AT clients learn to demonstrate personal competen-
cies, build upon skills, accept personal responsibility, more accurately assess
themselves, and maintain a higher degree of control over their environ-
ment. It is also believed that having an increased capacity to regulate one’s
own behavior will facilitate further increases in levels of self-awareness,
competence and a more internal sense of control of one’s own world.
Again, it is important to be aware that these assumptions and goals
are common to many other treatment approaches. In fact, statements such
as those above with their emphasis on self-awareness and the interpreta-
tions of challenge vs. threat carry clear elements of humanistic theory, and
the focus on self-knowledge and the increased awareness of available choic-
es directly parallels the humanistic tradition (Csikszentmihaly, 1990;
Raskin, & Rogers, 1989; Maslow, 1971). In addition, one can see elements
of cognitive, behavioral, and object relations theory embedded in this dis-
cussion of the goals of AT.
Characteristics of Adventure Therapy
Having discussed the theoretical background, definition, and the
goals of AT, a discussion of the specific characteristics of AT is warranted.
Fourteen characteristics, including those delineated by Kimball and Bacon
(1993), will be discussed in turn: (1) multiple treatment formats, (2) group
focus, (3) processing, (4) applicability to multimodal treatment, (5)
sequencing of activities, (6) perceived risk, (7) unfamiliar environment, (8)
challenge by choice, (9) provision of concrete consequences, (10) goal-set-
ting, (11) trust-building, (12) enjoyment, (13) peak experience, and (14)
therapeutic relationship.
10 SECTION I: THEORETICAL CONSIDERATIONS
Multiple Treatment Formats
First, adventure programs range in scope from those which incorpo-
rate adventure-based techniques with more traditional modes of therapy to
those that utilize full-scale extended expeditioning as their therapeutic
medium. These types of programs are differentiated based on where the
therapy is taking place, for what length of time the clients involved, and
what types of programming are being utilized (Gillis, 1995). As Gass (1993)
suggests, three main areas exist within the adventure-based therapy field:
(a) activity-based psychotherapy, (b) wilderness therapy, and (c) long-term
residential camping.
Given the diversity of programs, it is important to be clear as to what
type of program is being referred to under this broad rubric of “adventure
therapy” when considering AT from a scientific perspective. Unfortunately,
this distinction is not always clearly noted and can be difficult to determine
when examining the literature.
Activity-based psychotherapy.
Activity-based psychotherapy (Gillis, 1992) utilizes adventure activi-
ties as one type of intervention in the client’s overall treatment plan. This
type of therapy can occur at the therapeutic facility of the client, at anoth-
er nearby facility designed for such interventions (e.g., ropes course), or
simply in a park or open space using mobile elements. The AT intervention
may range from a regularly scheduled one hour group to a full day in dura-
tion, which is typical for a ropes course experience.
This type of format is often used in inpatient or residential settings, but
can also be used in combination with outpatient psychotherapy. The experi-
ences tend to be contrived (i.e. the facility and initiatives are developed specif-
ically for such an intervention), and focus on teambuilding, trust and prob-
lem-solving (Banaka & Young, 1985; Witman, 1987; Witman & Preskanis,
1996). As the group builds upon previous skills and successes to overcome
each successive challenge, they increase group cohesion and confidence.
Crisp (1997) more fully defines this type of adventure-based therapy by
its “emphasis on the contrived nature of the task, the artificiality of the envi-
ronment and the structure and parameters of the activity being determined
by the therapist” (p. 58). In addition, he notes that the goals of the particu-
lar activities are often a specific outcome. These outcomes are typically
planned for, and influence the selection of the activities by the therapist.
As previously discussed, it is the activities that make AT unique.
However, it is equally important to recognize that the conscious use of ther-
apeutic technique designed to work toward a specific outcome is something
that AT has in common with all mental health treatments. In addition, it
can be noted that potentially all therapeutic situations can be thought of
as contrived, although AT clearly takes this to another level.
WHAT IS ADVENTURE THERAPY?11
Wilderness therapy.
The second format discussed by Gass (1993) is wilderness therapy.
This type of program is what most associate with the general term “adven-
ture therapy.” Such programs are frequently utilized as an independent
treatment and are commonly explored in the efficacy literature for AT.
Wilderness therapy interventions have been employed with a wide variety
of clients, ranging from military veterans to survivors of domestic violence.
However, the vast majority of programs serve adolescents, with diagnoses
covering the gamut from developmental disorders to mood disorders.
In wilderness therapy, programs utilize an expedition-oriented format
in remote settings and treatment lasts anywhere from 7 to 60 days,
although programs may be longer. Some programs employ a basecamp
model where clients may spend up to a month in a permanent camp devel-
oping skills and participating in clinical assessment before embarking on
an expedition. The wilderness therapy intervention is known for its inten-
sive treatment and its capacity to generate dramatic change in a short peri-
od of time. These programs typically follow either an Outward Bound or
primitive living skills model, and the teaching and practicing of wilderness
skills is an important aspect of the intervention. Not only is the learning of
these skills necessary for the client’s survival and comfort, but it is also
believed that this learning provides an opportunity for clients to increase
their skill base and thus, their own individual level of perceived compe-
tence [(i.e., self-efficacy theory) Bandura, 1977].
The wilderness model allows the development of individual strength
within a cooperative framework. Operating as a small, self-sufficient team
in a wilderness environment requires mutual decision making which
demands trust, cooperation, effective communication and good problem-
solving. The members of the group are dependent upon each other for their
success as well as their survival. This promotes empathy, sharing, support,
and patience and fosters a strong sense of community. This interdepend-
ence makes it likely that individual strengths will be maximized and weak-
nesses minimized. However, the stressful nature of the experience ensures
conflict, and the interdependence of the group demands that participants
learn conflict resolution (Bandoroff, 1992).
A new term, “outdoor behavioral healthcare,” has been coined to
describe wilderness treatment programs that are dedicated to upholding
standards common to mental health practice (Russell, 2003). This consor-
tium of programs in the U.S. (Outdoor Behavioral Healthcare Industry
Council) incorporates a clinical model which includes client assessment,
development of an individual treatment plan, the use of established psy-
chotherapeutic practice, and the development of aftercare plans. OBHIC is
committed to research as well and launched the most impressive outcome
study to date which included 1600 participants from eight programs
12 SECTION I: THEORETICAL CONSIDERATIONS
(Russell, 2003). These benchmark findings provided support for outdoor
behavioral healthcare as an effective treatment intervention for youth. A
review of this research along with the results of a two year follow-up study
can be found in the chapter by Russell in this edition.
One problem with wilderness therapy programs is that follow-up
tends to be limited. Since clients typically come from a wide geographic
area, programs generally pass the responsibility for aftercare onto local
resources. Thus, aftercare services are provided by professionals who are
likely unfamiliar with the client’s experience and therefore, less able to
build on the treatment gains experienced by the client. From both a
research and a clinical standpoint, this lack of follow-up provides signifi-
cant problems when evaluating long-term treatment gains associated with
this type of program (Newes, 2000; Wichman, 1991).
Long-term residential camping.
The third type of therapeutic adventure program is long-term resi-
dential camping, also known as therapeutic camping. This format has tend-
ed to be used primarily with youth-at-risk and adjudicated adolescents.
Program length varies, ranging from several months to as long as two years.
Such programs are characterized by Buie (1996) as utilizing considerable
acreage, having a permanent base camp, and temporary campsites built by
campers (typically tent-covered wood platforms). Clients are responsible
for providing for their own survival needs and, according to Gass (1993)
“the client change is seen to be associated with the development of a pos-
itive peer culture, confronting the problems associated with day-to day liv-
ing, and dealing with existing natural consequences” (p. 10). The focus on
group living as a major component of treatment is similar to other types of
treatment programs, as is the reliance on structure. Education in tradition-
al school subjects is also provided during such programs.
These long-term camping programs are less intensive than the short-
term wilderness therapy programs described above. They are often more
similar to other types of residential programs, such as boarding schools,
than wilderness therapy programs. The primary difference between a long-
term residential camping program and a therapeutic boarding school is the
use of a natural setting and the emphasis on self-sufficiency. Therapeutic
camping programs generally utilize wilderness expeditions as well,
although they are typically less intense than a wilderness therapy expedi-
tion. Moreover, the basecamp phase employed by some wilderness therapy
programs resembles the therapeutic camping model. This overlap of pro-
gramming blurs the distinction between treatment models and makes
research comparing these modalities challenging.
Group Focus
The second characteristic of AT is group focus. While some AT pro-
WHAT IS ADVENTURE THERAPY?13
grams utilize individual psychotherapy as well, overall AT is considered to
be primarily a group process. As in many therapeutic settings, groups typi-
cally range from 6 to 14 people (Kimball & Bacon, 1993) and the clients
tend to be somewhat heterogeneous in terms of therapeutic issue or diag-
nostic category. Although the target group could be a family or a multi-
family group, this is not the average AT client group. Since the most typi-
cal AT client is adolescents, the group focus is especially valuable due to its
developmental appropriateness for this population.
As with any group psychotherapy, this group component is a vital
part of the overall therapeutic aspect of the intervention. Similar to any
therapy group, the group in AT provides support, feedback, and a potent
interpersonal context. Uniquely, however, in AT, specific activities are pre-
sented to the group as challenges to be overcome, and success depends on
each individual member participating in completion (e.g., by standing on
a platform, scaling a rock face, or negotiating unmarked terrain to a speci-
fied destination). In order to master any of the challenges, the group must
cooperate, apply skills, creatively problem-solve, and rely upon each other.
Herbert (1996) discusses more completely the issue of creative prob-
lem-solving as it relates to AT. What is expressly different about AT and
other problem-solving formats is that in order for the tasks to be complet-
ed, all participants must play a role in order for the group to succeed (i.e.,
utilization of superordinate goals). Therefore, activities require the group to
discuss and decide on different strategies, implement such strategies, mod-
ify those that are unsuccessful, or implement new strategies: all potentially
important skills for clients to practice. Not only does this process involve
the successful completion of the task, but group dynamics involved in the
decision-making process are closely monitored, and the interpersonal
aspects of the activity are then processed by the therapist in a similar fash-
ion as any other type of group therapy.
Drawing from the theory of interpersonal group psychotherapy
(Yalom, 1995), it is further thought that group focus leads to the intensive
activation of a client’s interpersonal patterns, which, in conjunction with
appropriate therapeutic processing, facilitates therapeutic change. This
assumption also echoes Yalom’s “social microcosm” theory of group func-
tioning in which it is assumed that “patients will, over time, automatically
and inevitably begin to display their maladaptive behavior in the therapy
group” (Yalom, 1995, p. 28). Therefore, this group context provides an
environment for the enactment of individual pathology, and the problem-
solving associated with the group process may lead to further concrete rep-
resentations of this, as well as provide an opportunity for the practice of
new behaviors.
Also similar to interpersonal group psychotherapy, it is not just what
happens during this problem-solving process but how it happens in the
14 SECTION I: THEORETICAL CONSIDERATIONS
group that is of interest. For example, how did the group decide on which
strategy to use? Who was the leader? Did some clients participate in the
decision-making process more fully than others? Is this a common
response for them or a new behavior? What was it like to work through this
problem? How did it feel? Each of these components, along with others
that can lead into deeper level therapeutic processing, provides a rich
opportunity to observe and process a client’s relational processes.
It is also thought that the more active and concrete nature of the
“task” in AT may lead to greater involvement for all clients than does tra-
ditional group psychotherapy. Importantly, such higher levels of involve-
ment have been shown to be a significant predictor of psychotherapy out-
come (Gomes-Schwartz, 1978). In a traditional therapy group, certain
members can achieve “success” regardless of the level of participation of
others. While it can recognizably be argued that a skilled group therapist in
any therapy setting can involve the entire group, or in fact involve the
entire group around any individuals client’s lack of participation, it may be
that this type of “non-participation,” with its impact on the group, is less
likely to occur in an AT setting. Simply put, it is thought to be more diffi-
cult for a client to remain unengaged, as the activities themselves necessi-
tate participation by all members in order for the group to achieve success.
In addition, one can speculate that clients who process experience in a less
verbally oriented manner may participate more fully in this type of inter-
vention. If this were the case, it would perhaps allow for greater growth
among those clients for whom traditional psychotherapy feels too threat-
ening or invasive. In fact, it could be argued that traditional “talk therapy”
is ill-suited for adolescents in general, and an action-oriented approach is
more developmentally appropriate.
Finally, the power of modeling (Bandura, 1986) is an important
aspect of the group experience. Naturally, the opportunity to observe and
imitate other clients is available in any form of group treatment. In AT the
involvement in the activities could provide a tremendous opportunity for
modeling of appropriate communication, cooperation, feedback, and help-
seeking, again, in what is speculated to be a less threatening format to
defensive clients. Thus, such clients may be better able to attend to and uti-
lize such modeling.
Processing
Another descriptor of AT programs is that a great deal of time is spent
processing the experience with clients and facilitating the transfer of learn-
ing into a client’s daily life. It must be noted again that this processing is
not necessarily associated exclusively with the activities alone. The activi-
ties can be conceptualized as a catalyst for the processing which occurs
before, during, and after activities: a catalyst which also provides concrete
WHAT IS ADVENTURE THERAPY?15
examples of the consequences associated with individual and group
actions. Despite the fact that some of the activities being processed are con-
trived, the interactions that they create are real and in present time. The
opportunity to deal with issues in the here and now provides relevance that
is often difficult to obtain in conventional therapy.
To engage in this processing, tools such as individual psychotherapy,
group psychotherapy, journal writing, individual time for reflection, mod-
eling, self-disclosure, and metaphoric processing (Gass, 1993) may be uti-
lized throughout the course of an AT program. While the techniques listed
above may be familiar to clinicians, the extensive use of metaphoric pro-
cessing is an aspect of AT which may be fairly unique in its application and
thus, warrants further discussion
“The use of metaphors in adventure programming often serves as the
key factor in producing lasting functional change to clients” (Gass, 1995,
p. 235). Metaphors are vital for linking the learning and growth achieved
through the adventure-based experience to situations found in the client’s
“real life,” thereby providing the generalization so necessary for maintain-
ing these gains. It is important to recognize that this perceived lack of rel-
evance to realistic situations that the client may encounter is one of the
most commonly voiced criticisms of AT. Clearly, the AT intervention is not
about climbing over walls or surviving in the wilderness but about access-
ing the resources that will allow clients to surmount the walls in their lives
and survive the challenges that they face at home.
While the setting and activities utilized by AT programs, whether it
be the wilderness or a ropes course, are replete with powerful metaphors,
the most effective metaphors are believed to be client-generated. When
using metaphor in AT, the therapist takes on the role of conduit, actively
helping the client to build such metaphors. Adventure-based practitioners
postulate that the use of metaphor helps the client to continue utilizing the
learning and growth provided through the adventure experience in ongo-
ing and productive ways. Although the use of nature makes AT a natural fit
for metaphoric work, the development of the use of metaphors in adven-
ture programming is associated with the work of Milton Erickson (Bacon,
1983; Itin, 1998). Popularized by Ericksonian psychotherapy, the use of
metaphor is common to many therapeutic disciplines.
Applicability to Multimodal Treatment
Another characteristic of AT is its applicability to multimodal treat-
ment. As aforementioned, AT can be used either as an independent inter-
vention or as an adjunct treatment. A wilderness therapy program is the
most typical example of AT as an independent treatment, whereas an activ-
ity-based group session at an inpatient treatment facility would be consid-
ered adjunctive. Importantly, the focus on group level processing in com-
16 SECTION I: THEORETICAL CONSIDERATIONS
bination with the individual psychotherapy which takes place around the
activities provides a therapist with the opportunity to utilize standard and
accepted treatment orientations and practices.
Sequencing of Activities
Fourth, in order to allow for the group to develop the skills and the
level of cohesion necessary to achieve success in the activities, such activi-
ties are incrementally sequenced in difficulty. This sequencing also pro-
vides initial successes, or “mastery tasks,” fostering feelings of capability
while counteracting internal negative self-evaluations, learned helpless-
ness, and dependency (Kimball & Bacon, 1993). This provision of a mastery
task (success) concurrent with the activation of negative self-evaluations in
the face of challenge is an important component for the therapeutic
change thought to be associated with AT. The mastery task provides an
opportunity to confront and tangibly disprove such evaluations. It is the
therapist’s role to facilitate such a transfer as such connections are not pre-
sumed to be an automatic reaction to the activities.
Conversely, activities presented with inappropriate sequencing can
be counterproductive and reinforce negative self-conceptions for individual
participants. The activation of such negative internal processes for a client
without the opportunity to counteract such feelings with success can fur-
ther reinforce existing beliefs in personal ineffectiveness. In addition, such
negative conceptions can also permeate the development of a group iden-
tity. Therefore, it is vital that the therapist avoid creating a situation in
which the group repeatedly experiences failure as it can be recognized that
this dynamic can carry the highest potential for emotional harm and
would be likely to limit therapeutic potential. By the same token, exclusive
success is not desirable either, as failure is useful for the group process and
helps to teach frustration tolerance. As with other types of therapy groups,
it is recognized that effectiveness is often dependent upon the facilitator
remaining aware of where the group is in its development (Yalom, 1995)
and taking this into consideration when planning.
Perceived Risk
On the surface, challenges are often structured so as to appear to be
impossible or dangerous to the group. In reality, the challenges are in fact
low in actual risk but high in perceived risk, with the term “risk” referring
to not only physical risk, but also intra- and interpersonal risk as well. A
classic example is rappelling, where a participant must descend down the
face of a rock wall. As anyone who has ever rappelled can attest, the per-
ceived risk to life and limb is extreme as one steps back off of the cliff edge.
However, risk management considerations dictate that all AT activities
remain low in actual physical risk. On the other hand, high levels of emo-
WHAT IS ADVENTURE THERAPY?17
tional risk are encouraged. Since emotional risk is more subjective and
more difficult to control, it is critical that therapists constantly monitor the
emotional risk for each client, as well as for the group, throughout the
intervention. This is precisely one of the central arguments for having clin-
ically trained staff involved. The complex interaction between physical and
emotional risk is illustrated in the following example. Standing on a plat-
form and falling backwards into the arms of group members (i.e., trust fall)
requires more trust than utilizing another person’s support to cross a log.
However, at earlier points in a group’s development, this need to be sup-
ported (i.e., depend or rely on someone else) while crossing a log, could be
perceived as carrying as high a level of interpersonal risk, along with the
associated intrapersonal risk, as any physical activity for some clients.
Conceptually, perceived risk is thought to create tension and disequi-
librium within the individual, ultimately leading the client to a position of
choice [(i.e., dissonance theory), Festinger, 1957]. With regard to this con-
viction, Herbert (1996) notes that “In order for a person to achieve equi-
librium, persons are challenged to make necessary adaptations” (1996, p.
5). He goes on to state: “Adventure-based work recognizes that it is the
effort to overcome obstacles and, in effect, overcoming one’s own fears that
is critical.” (p. 5). Through this combined process of relieving dissonance
and overcoming fears, it is commonly believed in AT that clients are shown
that old patterns are destructive and new choices can lead to more success-
ful behaviors.
This perception of risk is so central to AT that Amesberger (1998)
notes: “The most striking difference between adventure-based therapy and
traditional psychotherapy is the client’s strong involvement in a reality
that is neither harmless nor perfectly safe” (p. 29). Although emotional risk
clearly permeates traditional psychotherapy as well, it is the perceived
physical risk that is a cornerstone of AT and distinguishes it from other
forms of therapy.
Unfamiliar Environment
Another core characteristic of AT is that it is usually conducted in an
environment unfamiliar to the client. This use of an unfamiliar and novel
environment is thought to unbalance (Minuchin & Fishman, 1981) the
client, further activating their underlying inter- and intrapersonal process-
es. It is hypothesized that the client has no familiar template from which
to draw their reactions to the new situation, and thus it is the conviction
of AT practitioners that the client must eventually rely on potentially new
and ideally, healthier ways of behaving in order to achieve success (Gass,
1993) and equilibrium. In a sense, this can perhaps be conceptualized as
providing an opportunity for clients to be free of past determinism. Gass
(1990) postulates that this allows clients to explore problems rather than
18 SECTION I: THEORETICAL CONSIDERATIONS
being overwhelmed by them.
The assumption underlying the unfamiliar environment in AT theo-
ry is that by taking a person out of their normal context, the client is
exposed to new situations where old patterns of coping probably will not
work. As social microcosm theory (Yalom, 1995) maintains, it is typical for
clients to revert to earlier learned and more dysfunctional ways of behav-
ing in such stressful situations. However, through the AT activities, the
client may be provided with more tangible evidence of the consequences
of dysfunctional behavior than is typically provided in group psychothera-
py. These concrete consequences of dysfunctional behavior in combination
with a novel environment, an environment that invites and may even
necessitate new ways of behaving, could provide an impetus for change. In
addition, the group can also provide reinforcement for new behaviors.
This environmental unfamiliarity in AT is also thought to allow for
the client to experience the therapy without drawing from their typical
expectations and defenses. Therefore, it is thought that this unfamiliarity
may allow for a client to approach the therapeutic experience with less of a
defensive posture. The engaging nature of the activities (i.e., fun or chal-
lenging), and the surreal environment (i.e., ropes course or wilderness) also
help to make AT less threatening. Golins (1978) contrasts AT to traditional
therapy methods on this issue of defensive posturing, noting that “tradi-
tional individual or group therapy methods may be particularly threatening
for persons who have difficulty expressing themselves and/or establishing
new relationships” (p. 27). To compare this with traditional psychotherapy
research, Orlinsky and Howard (1986) have found “the dimension of the
patients openness vs. defensiveness to be related to outcome” (p. 219). If in
fact AT does work to lower defenses, this finding suggests that lowered
defensiveness may contribute to a more positive outcome for clients.
As with dysfunctional behaviors, it is thought in AT theory that when
a client’s defenses do inevitably become activated, the therapist and the
client may be provided with tangible examples through the activities and
the interpersonal interactions during the activities, of the ways in which
defenses operate in a client’s life. In addition, the unfamiliar and novel AT
setting may then provide a situation that is less threatening for some
clients to experiment with new and less defensive behavioral and relation-
al patterns. Again, the gamelike or surreal environment may also make it
more inviting for clients to “try on” new behaviors (Golins, 1980).
Relationship Between Perceived Risk and Environmental Unfamiliarity
Herbert (1996) discusses how the unfamiliarity of the environment
and the high level of perceived risk interact and how this combination is
presumed to affect the client. He refers to this interaction as
“challenge/stress,” and reviews how it is believed by AT proponents that
WHAT IS ADVENTURE THERAPY?19
the dissonance created by the unfamiliar environment, in combination
with a high level of perceived risk, results in an increased intensity of the
activation of interpersonal and intrapersonal processes. Herbert goes on to
discuss this interaction and subsequent activation as a potential change
mechanism, noting: “Stressful experiences that are likely to occur through-
out an adventure-based program serve as impetus for individual change”
(p. 5). Gass (1993) also discusses this phenomena in terms of positive stress,
or eustress.
It is this belief in client dissonance and the associated intensive acti-
vation of intra- and interpersonal processes, the unbalancing based on the
lack of familiar “templates,” the opportunity for new behavioral choices,
the reinforcement provided by the activities, and the associated processing
that moves AT most completely away from outdoor adventure programs
and into the realm of therapy. While intensity (Minuchin, 1974) is
employed in many treatment approaches, it is uniquely inherent in AT.
The AT literature purports that clients who make new behavioral
choices in order to complete a novel challenge perceived as high in risk,
particularly one they had previously thought themselves incapable of, con-
sequently see themselves in a new light. The ultimate goal of such a trans-
action is for clients to recognize their own self-imposed limitations. This
awareness is believed to increase clients’ self- esteem, and such gains have
been linked in the psychotherapy literature to decreases in anxiety and
depression (Gilbert, 1992). Again, as noted above the AT intervention offers
clients the opportunity to confront negative self conceptions and tangibly
disprove them. Moreover, Priest (1993) has suggested that participants will
be able to influence their probability of success in an adventure experience
if they have realistic perceptions of risk involved in the choices they make,
as well as a realistic sense of their own competence.
Challenge by Choice
Related to the discussion of perceived risk is the recognition that
clients are given the option of “challenge by choice” (Schoel, Prouty, &
Radcliffe, 1988). This allows for a client to choose to not participate in an
activity for whatever reason. It is important to recognize that the choice to
not participate in an activity is not necessarily negative and may have as
many therapeutic implications as participation (i.e., choosing to not par-
ticipate is still a choice). Such an instance may potentially reflect positive
steps toward clients asserting their personal boundaries by recognizing and
acting on personal discomfort, a potentially important issue for many
clients. In such a situation, the therapist makes every effort to include the
client in some way, such as “spotting” or observing. According to Royce
(1987), “The key to growth in any situation is that the participants should
choose to confront their fear rather than being forced to engage in fearful
20 SECTION I: THEORETICAL CONSIDERATIONS
activities. This allows for the individual to take control of one’s life instead
of being other-directed.” (p. 28). It should be noted that while the client
ultimately always has the choice to not participate, that option is often not
presented as a viable one in wilderness therapy and therapeutic camping
programs, where compliance is a primary goal.
Challenge by choice is thought to be based not only on the recogni-
tion of risk involved in activities and related boundary issues, but also to an
extent on the construct of learned helplessness (Seligman, 1975). Groff and
Datillo (1998) discuss learned helplessness theory as it relates to AT, noting
that past experiences leading to attributions which result in feelings of help-
lessness can generalize to other areas of a person’s life, potentially resulting
in a decreased motivation to engage in activities where one is unsure of the
outcome. It is believed that challenge by choice can help lead to the recog-
nition of the power of individual choice that can perhaps begin mitigating
learned helplessness (Groff & Dattilo, 1998), thus contributing to the devel-
opment of a greater sense of control for the client and more realistic cogni-
tive attributions for events. As learned helplessness has also been espoused
as a causal element in depression, this may be an important link to explore
regarding AT’s potential for therapeutic change (Gilbert, 1992).
Schoel et al. (1988) share this example to illustrate the power of chal-
lenge by choice:
A short-term patient [from the Institute of Pennsylvania Hospital], a
lawyer, was very depressed, denying his problems, not involved in
anything, complaining of a bad back, etc., reluctant to do anything.
He eventually tried some of the activities, and on the last day got up
on a high element [ropes course] and completed it. According to the
therapist, “he felt he never would have attempted the Incline Log at
all if we had pushed him. The important thing is that we gave him
the decision-making power.” (p. 132).
Provision of Concrete Consequences
An additional descriptor of the AT approach is that the activities pro-
vide an opportunity for concrete consequences, positive and negative, of a
client’s behavior to be readily apparent. Beyond those aspects mentioned
previously, another important element of this characteristic is that individ-
ual actions have consequences for both the group as a whole and the indi-
vidual in relation to the group. A client who is unable to, or chooses not to,
work successfully with the group is impacting the entire group’s function-
ing. Therefore, the client may find his or her place within the group altered,
may miss out on the group accomplishment, or even more concretely, may
WHAT IS ADVENTURE THERAPY?21
have a wet sleeping bag due to not setting up a tent correctly. Conversely,
clients also experience the impact of positive behavior as well within the
group. Such consequences at the group level may provide an opportunity
for important developmental learning for individual clients. While these
consequences are common to all group treatment modalities, the abun-
dance of natural consequences in AT is a hallmark of the intervention.
Natural consequences are particularly effective because they do not rely on
an authority figure for enforcement, and in AT they tend to be particularly
impactful, as the following example illustrates.
As a hypothetical example, at the start of a week-long wilderness expe-
dition, the group leader tells participants to pack rain gear on the top of the
pack. The group leader is aware that there is potential for a rainstorm dur-
ing the course of the day and hopes to help the participants learn to be pre-
pared. Jeff refuses to listen and acts in defiance of the leader, packing all of
his rain gear on the bottom of the pack. Later in the pouring rain, Jeff is
forced to remove all of the other items from his pack in order to reach his
rain gear. The other gear, and Jeff himself, becomes soaked in the process.
This gear included some of the dry food that was planned for the group’s
meal that evening. Justifiably, group members become angry with Jeff and
he becomes temporarily ostracized, leading to conflict in the group and con-
sequences for Jeff as a group member. The rainstorm also provided a natural
individual consequence to Jeff for not heeding the advice of the group
leader. Of course, had the weather not been warm, the leader would have
intervened for safety reasons to prevent Jeff from becoming soaking wet.
Goal Setting
Goal setting in AT involves identifying for each client the objectives
of program participation, with the ultimate goal being to tie the interven-
tion to specific treatment outcomes for clients. Such goals are not related
to the activities, rather, as with any psychotherapeutic treatment, goals are
focused on specific problem areas for individual clients. As with any thera-
peutic intervention, these goals are developed after consultation with the
client and/or the referral source and must be held in the therapist’s aware-
ness throughout the scope of the intervention. In addition, group goals are
also established and often a “full value contract” is agreed upon, specifying
the parameters of acceptable behavior within the group. This type of con-
tracting maintains that all participants work together as a group to achieve
both individual and group goals, adhere to necessary safety guidelines, and
give and receive feedback when appropriate (Schoel et al., 1988). These
guidelines are also established to promote physical and psychological safe-
ty for all participants.
22 SECTION I: THEORETICAL CONSIDERATIONS
Trust-Building
As in any therapeutic process, trust-building is a crucial characteristic
of AT. Clients must learn not only to trust their therapist, but also to trust
and depend on other members of the group, allowing for the closer exam-
ination of interpersonal processes related to trust as an ongoing therapeu-
tic issue. This again is not unique to AT but rather mirrors the theory of
interpersonally oriented group psychotherapy, and most specifically relates
to the stages of therapeutic group development (Yalom, 1995).
The process of building trust is accomplished through the aforemen-
tioned sequencing of activities involving an increasing level of cooperation
and group interaction. Most adventure-based therapy begins this gradual
trust-building process by learning basic level information about each par-
ticipant, allowing for the trust building process to begin in a way that may
feel more natural for clients than does traditional group psychotherapy. As
the activities progress, a higher level of self-disclosure is required and par-
ticipants share deeper level experiences and emotions. As previously men-
tioned in the discussion of defenses, the activity focus of the group may
allow an alternate medium for individuals to gradually share parts of them-
selves without the fear of being ridiculed or laughed at (Rohnke, 1995).
Thereby it is speculated that the activities could provide a vehicle for emo-
tional sharing and closeness for those to whom the more direct approach
found in traditional psychotherapy may be overly threatening.
Physical trust is also incorporated and is conceptualized as a gateway
to interpersonal trust (Schoel et al., 1988), with the assumption being that
as clients increasingly entrust other group members with their physical
safety, they will gradually begin to entrust the group with their emotional
safety as well. As overall trust increases, the group becomes more
autonomous and self-reliant, as well as more willing to openly communi-
cate. As with a traditional therapy group, it is felt that when the group
reaches this level of autonomy, that it is the most powerful vehicle for last-
ing change (Yalom, 1995). Compared to more traditional forms of therapy,
AT would be considered unique in its use of physical trust.
Enjoyment
Enjoyment is also a component thought to be inherent in AT, and
this is another aspect of AT that may be considered unique. Therapy is not
often characterized as fun. Simply put, it is felt by supporters of AT that
people are more invested in their treatment when it has positive reinforce-
ment, and allowing for elements of therapy simply to be fun may be one
way to provide an opportunity for such reinforcement. An increased level
of enjoyment may also help in increasing attention levels and is believed,
to take some of the seriousness out of threatening topics. This does not sug-
gest treating such topics lightly, but rather, taking a less direct approach
WHAT IS ADVENTURE THERAPY?23
might reduce a client’s reluctance to discuss such areas and ultimately lead
to more open discussion of frequently avoided issues. This can be seen in
some ways as similar to systematic desensitization, where aversive stimuli
are paired with relaxation in order to decrease anxiety levels. It seems plau-
sible that in AT this type of enjoyable interaction may function similarly to
relaxation in facilitating therapeutic change.
To create such an atmosphere, many activities in the early phases of
an adventure-based intervention are designed to increase group cohesion
through sharing laughter. These activities “break the ice” and are thought
to move the group more quickly and efficiently into the “working phases”
of a group’s development.
Peak Experience
The final characteristic of adventure-based therapy is peak experi-
ence. Herbert (1996) states: “the purpose of the peak experience is to pro-
vide an opportunity to practice all of the learning that has occurred and
apply it to this one intensive challenge” (p. 6). These experiences can con-
sist of an actual peak ascent or similar climactic wilderness experience, or
can take the form of a group activity requiring a high degree of cooperation
and trust. In both types of situations, clients perceive the challenge as more
intense and complex than prior activities, and these types of experiences
are often employed to provide the culmination of the group experience. Of
all the characteristics described above, this is the one which may vary the
most based upon which type of programming format is utilized.
While the actual therapy setting where the peak experience occurs is
certainly unique to AT, this search for a peak experience is clearly some-
thing that is shared with other therapies. The emphasis on peak experience
as a part of self-actualization is a crucial underlying assumption of human-
istic theory (Csikszentmihaly, 1990; Maslow, 1971). Maslow discusses the
power for growth embedded in such peak experiences at length, noting
that “in a fair number of peak experiences, there ensues what I have called
the “cognition of being” (p. 173), noting that this refers to “a technology
of happiness” and the avenue to “pure joy” (p. 174).
Therapeutic Relationship
A description of the characteristics that define AT, as well as the change
mechanisms that may be operating in AT, would not be complete without a
discussion of the therapeutic relationship. Given that the strongest predictor
of outcome in psychotherapy research has been shown to be the therapeutic
relationship (Orlinsky, Grawe, & Parks, 1994), it is worthwhile to consider
the implications of the extended and intensive relationship that is found
uniquely in the AT experience. This is particularly true in wilderness therapy
programs that last for at least one week and beyond, where the therapists
24 SECTION I: THEORETICAL CONSIDERATIONS
sometimes live together with the clients in the wilderness. Specifically, it is
interesting to consider the potential effects for the client of continuous
involvement with the therapist, as well as the group, that lasts for an extend-
ed period of time on an around-the clock basis.
It can be speculated that for some clients this may be immensely threat-
ening. For such clients this may result in their being unable to form positive
relationships as their defensive reactions may become intensely activated and
further entrenched, essentially making it impossible for them to engage in
therapy. However, it may be that just the opposite is true— that such inten-
sive relationships developed on an ongoing basis with no opportunity for
withdrawal may in fact facilitate the creation of more positive internal repre-
sentations based on this all-encompassing level of relationship. Advocates for
AT offer much anecdotal evidence to support the latter argument.
Consider the fact that if client and therapist are together for twenty-
one days on a twenty-four hour basis, this translates into 504 hours of ther-
apeutic contact, an approximate time equivalent of ten years of weekly psy-
chotherapy. Excluding the hours spent sleeping, that still is roughly 330
hours of contact, an equivalent of approximately six and one-half years of
weekly psychotherapy. Obviously a 21-day experience with no follow-up is
not the equivalent of 6 or 10 years of weekly psychotherapy. Such a com-
parison of the numbers is provided merely to illustrate the potential poten-
cy of this amount of time between therapist and client spent continuously.
The opportunity for the development of therapeutic relationships in
the different, more time intensive, and more multidimensional way pro-
vided by the AT experience may facilitate growth in clients based in this
relational bond. It also possible that there may be an effect based on this
twenty-four hour contact that is simply not available in traditional forms
of psychotherapy. Clearly, the access alone is an important factor.
Therapists in the field are available to capitalize on teachable moments.
The level of support that the therapist can offer with continual presence
and during such an intensive experience is another valuable consideration.
From an object relations (psychodynamic) framework, the develop-
ment of such a potentially unique relationship in AT may provide greater
opportunity for corrective emotional experience to occur. That is, the expe-
rience helps to heal a prior traumatic event. For example, a caring and sup-
portive relationship experienced with the therapist may help the client to
work through abandonment by a parent. If so, such occurrences may
become more firmly anchored for the client based on the fact that the rela-
tionship becomes a part of their daily existence for a period of time and
thus, is grounded in “real experience.”
Related to this is the potential power of modeling (Bandura, 1986)
that could occur in such a situation. The therapist is living in the same
conditions and is required to perform the same tasks as the client.
WHAT IS ADVENTURE THERAPY?25
Opportunities for modeling abound as the therapist faces many of the same
daily stressors and must cope with the same hardships as the client.
Moreover, the therapist’s willingness to expose him or herself voluntarily to
these difficult conditions inspires a degree of intimacy, trust, and mutual
respect that goes beyond that found in traditional therapeutic settings
(Greenwood, Lipson, Abrahamse, Zimring, 1983). Such high regard for the
therapist is likely to help the client to be more open to imitating the ther-
apist’s behaviors.
It is important to acknowledge that not all wilderness therapy pro-
grams maintain a therapist in the field throughout the expedition. In fact,
it may be more common for the therapists to visit the field for one or two
days per week. Nevertheless, the therapist’s willingness to meet the clients
in those conditions is very meaningful to many clients and may break
down barriers that exist when a client visits a therapist’s office. Perhaps
more importantly, the AT therapist understands the process that the client
is going through and that may be enough to forge a strong relationship
when a client is in the midst of such an intensive experience. Of course,
with or without the ongoing presence of a therapist, all programs have field
staff who are available on a continual basis. For many of the same reasons
described above, these staff members are able to develop close relationships
with clients and are responsible for much of the therapeutic change that
occurs in wilderness therapy programs.
The unconventional therapeutic relationship described above also
extends to activity-based psychotherapy and therapeutic camping.
Although these formats may not offer the intensity of an expedition-based
relationship, therapists are still working outside of an office setting. This
alone makes them more accessible for many clients who feel distrusting or
defensive in a traditional psychotherapy setting. Moreover, the relationship
is activity-based and as mentioned, this is less threatening for many clients.
Illustrative Example
To illustrate, Jane is a hypothetical 32-year-old woman who typically
blames others for her problems and often uses threats to get her way. Jane
has come to therapy because she “has trouble in relationships” and her ulti-
mate goal in therapy is to both understand and change this problem.
Imagine Jane, 30-feet up in the air on a high ropes course element. Her heart
is pumping, her fears and anxieties are increasing, and she is beginning to
become frustrated because she believes that she cannot proceed. It is likely
that if Jane approaches the situation in her “standard way,” by yelling at
others and blaming them for her inability to complete the task, she will
remain where she is and only become more entrenched in her spiraling neg-
ativity. This behavior will inevitably alienate members of the group, making
it unlikely that they will come to her aid and support her in succeeding.
26 SECTION I: THEORETICAL CONSIDERATIONS
The level of risk which Jane perceives in the situation has led to an
experience of disequilibrium, or feeling unbalanced, leading to Jane’s reen-
actment of previously dysfunctional interpersonal patterns. In this
instance, with no further therapeutic intervention, Jane remains stuck on
the ropes course and there is tangible evidence of the consequences for her
continued maintenance of old ways of behaving. Should she manage to
simply get down off the course, she may have learned something, but it is
unlikely that the learning will provide lasting characterological change. In
fact, an equally likely scenario is that the intervention may be harmful for
Jane by reinforcing her negative self-conceptions.
However, if the therapist processes this experience with Jane and the
group in a way that helps her to recognize her dysfunctional ways of behav-
ing, as well as assisting her to achieve some level of control and an
increased willingness to work with others, she is much more likely to com-
plete the activity successfully. This processing may take place later in indi-
vidual sessions as well. On the group level, other members also provide
Jane feedback as to the consequences of her actions, both while such
actions are occurring and afterwards in a group session.
Should Jane succeed, such a success will ideally reinforce for Jane the
new and more positive ways of behaving, as well as illustrate for her the
negative aspects of behaving in her old patterns. If the therapist were to
expand this processing to an exploration of where these dysfunctional pat-
terns originated (using a psychodynamic orientation), Jane could poten-
tially gain insight into these origins and perhaps begin establishing more
functional ways of relating to both herself and to others on a level beyond
that provided by the activity alone. Should the therapist continue his or
her relationship with Jane upon her completion of the AT intervention,
such concrete examples provided by the activities could perhaps be referred
to as points of reference by both Jane and the therapist. In such an
instance, the process of change that began for Jane during the course of her
AT treatment component, could potentially be continued and deepened
through this ongoing relationship.
What can be seen here is a direct parallel to traditional psychothera-
py, with the activity itself simply providing both the catalyst and a concrete
external representation of pre-existing issues for Jane. Jane’s behavior can
be explored, as well as her cognitions, affect, and interpersonal function-
ing. Repetitions of the activity or participation in new activities can give
Jane an opportunity to practice different ways of behaving, thinking, feel-
ing and relating, again, with tangible and easily seen results. Over time, the
illustrations provided by the activity can be referenced by both Jane and
her therapist. Ideally, a skilled therapist builds upon this learning process,
allowing for the activities themselves and the processing associated with
them to become an inextricably linked and circular process. This type of
WHAT IS ADVENTURE THERAPY?27
model can be used in any of the aforementioned settings when the activi-
ties are processed in a therapeutic manner.
Conclusion
As AT becomes more widely recognized as a credible treatment
approach, it is important that the literature be able to clearly represent
what exactly adventure therapy is. It is also vital that those within the field
have a thorough understanding of the theoretical principles that underlie
this approach. It has been the experience of the authors that many practi-
tioners, caught up in their enthusiasm for their work, believe that AT is a
totally unique treatment approach. This misconception is not helpful in
advocating for AT’s acceptance in the mental health field. On the contrary,
AT shares many commonalities with well-established treatment approach-
es. In fact, as this paper has attempted to demonstrate, AT is more similar
to other types of treatments than different. This is not a liability but rather,
an asset that can assist AT in gaining wider recognition among the mental
health treatment community and help AT to demonstrate its viability as a
treatment approach.
At the same time, there are aspects of AT which are unique and help
to make it an effective intervention. Most notably, the activity base which
serves as a foundation for AT clearly distinguishes it from other forms of
treatment. There is substantial theoretical evidence to suggest that the
activities inherent to AT, and more specifically the theoretical process that
surrounds the activities, contribute largely to its effectiveness. The research
evidence, however, is not as convincing. More process evaluations are
needed to substantiate this claim, and future research must address this
shortcoming. The field of AT must begin to hold itself accountable for
answering the questions posed to all other treatments: Is this treatment
effective? For whom, and under what circumstances? To its proponents, AT
has long been seen as a powerful treatment intervention; as we “come of
age,” it is time to garner the evidence to convince the broader mental
health establishment.
28 SECTION I: THEORETICAL CONSIDERATIONS
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Authors’ Biographies
Dr. Sandra Newes obtained her doctorate in clinical psychology from Penn State
University. She is involved in writing about clinical theory and research methodol-
ogy in adventure therapy, as well as in more conventional settings. She is an active
member of AEE and is the past chair of the Therapeutic Adventure Professional
Group. She currently maintains a consulting practice in Asheville, North Carolina.
Dr. Scott Bandoroff is a psychologist with 20 years of experience working with
challenging adolescents and their families in wilderness and outpatient settings.
He has worked as a clinician, supervisor, internship director, consultant, and
trainer. He founded Peak Experience to provide training and consultation in
Adventure Therapy and works with mental health agencies, schools, residential
treatment centers, and wilderness programs.
Correspondence
Contact Sandra Newes
(814) 935-2135 or slnewes@yahoo.com
Contact Scott Bandoroff
(541) 951-4329 or scott@peakexperience.org
or on the web at: www.peakexperience.org
... It started to gain recognition in the 1990s along with the idea of using the nature's healing power in therapeutic context. In literature, it is also referred to as "therapeutic adventure", "wilderness therapy", "adventure-based therapy" and "adventure-based counseling" (Newes and Bandoroff 2004). There are no studies indicating use of adventure therapy in our country whereas it is a commonly seen practice in international literature. ...
... Therefore, it is also defined as "use of traditional therapy methods in nature environments for therapeutic purposes" (Davis-Berman and Berman 1994;Russell 2001). According to Newes and Bandoroff (2004), it is a therapeutic method based on a combination of benefits of adventure-based events and activities with benefits of more traditional types of therapy. According to Ringer (1994), adventure therapy is a group-based experimental learning with a focus on change, in which the client and the counselor enter into a professional contract and which is conducted as an empowering and empathic professional relationship. ...
... This process takes place as clients question themselves during the adventure therapy and get to know themselves better while doing that (Herbert 1996). In addition, adventure therapy increases selfawareness of clients, increases their responsibilities towards both themselves and the others, promote healthier coping mechanisms, help clients develop a more positive sense of self by allowing them to obtain concrete results for success and correcting negative senses of self, help with improving creative problem-solving, communication and cooperation skills of clients, help clients see their weaknesses, strengths and limitations more realistically, and finally, help them develop more realistic and healthier decision-making skills (Herbert 1996, Newes andBandoroff 2004;). Furthermore, adventure therapy help clients develop different coping skills, allowing them to control their environments (Nadler and Luckner 1992). ...
... Both adventure activities of the day reflected the uncertainty and challenges of R & O." Three months after the intervention, the participants were able to affirm how these experiences benefited them on a personal level and equipped them for their roles as peer helpers-making the sustainability of the learning experience apparent. Gass (1991) report that the transfer of learning to other areas of the participants' lives is one of the distinguishing characteristics of ABEL, while Newes and Bandoroff (2004) add that the use of metaphors aids in the process of change and facilitates the transfer of learning. Importantly, as illustrated by the following quote, the participants seemed to continue this process of selfdiscovery after the program had reached its conclusion: ...
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... ELT is based on experience that all genuine learning comes about through the construction of knowledge from experience (Dewey, 1964). It includes beliefs that people learn best from experience if there are multiple senses involved in the activity and if the experience has direct real-life consequences (Newes & Bandoroff, 2004). The author utilizes the principles of ELT to bridge the gap between the existing literature regarding the potential of VR and putting the evidence into OT practice through widespread adoption. ...
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... Activities are carried out in nature and range from experiences of contemplation to higher-pressure challenges (Gabrielsen et al., 2018). Programs vary from intensive outdoor group adventures (8-15 persons) over several days (7-60 days), to the integration of adventure experiences to the usual treatment modality of the person, with variable durations (ranging from 1 hour to 1 or a few days combined) (Newes & Bandoroff, 2004). ...
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... Although the populations are different, the underlying value of facilitating these experiences have commonalities in philosophy and practice. Planned outcomes include facilitation of personal growth, development of intra-personal and inter-personal skills, increase in self-esteem, resilience and confidence and a stronger sense of self identity (Newes & Bandoroff 2004;Itin,1998). ...
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Whilst there is no one definition of adventure therapy, it commonly utilises adventure based activities, experiential learning theory and outdoor environments to facilitate a therapeutic effect. Adventure therapy is an emerging intervention utilised by mental health clinicians, often within services for youth. This qualitative descriptive study explored the fit between occupational therapy and adventure therapy. Semi-structured interviews were conducted to examine the practice and use of theory with seven New Zealand occupational therapists who use adventure therapy. There are practice and philosophical elements of adventure therapy that are compatible with occupational therapy, including therapeutic use of activity. Differences occur in that adventure therapy purposefully utilises novel activities and environments, and that these activities are often prescribed. This paper presents the findings with a particular emphasis on the value of activity as therapy. Whilst not the whole of occupational therapy, adventure therapy can be utilised as an approach to practice. Adventure based activities are not usual everyday activities for most clients, or usual occupational therapy practice. However as an intervention it is attractive to youth. It is argued that adventure therapy is a powerful example of the use of activity as a means to an end. Occupational therapists are well positioned to use adventure therapy as a component of their overall occupational therapy practice.
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Doğal ortamın insan psikolojisi üzerindeki etkileri, sosyal bilimlerin genelinde ama özellikle çevre psikolojisi odaklı çalışmalarda öne çıkmaktadır. Çevrenin insan psikolojisini hem pozitif hem de negatif yönde etkilediğine ilişkin birçok olgusal bağıntılar örnek verilebilir. Afet bölgelerindeki afetzedelerin çaresizliğini ya da sahil kasabasının müdavimi sayılan martıları seyrederken aldığı ilhamla güfteler sıralayan bir edebiyatçının hissettiği duygular da çevrenin psikolojik yansımalarına örnektir. Bu bağlamda insanların ruhen olumsuz etkilendikleri yerlerin yanı sıra, olumlu etkilendikleri yerlerde ise huzur ve rahatlama hissiyle büyülendikleri yerler de gündelik yaşamın olağan örneklerindendir. Nitekim çevrenin etkileriyle ilgili olarak, tarih boyunca insan psikolojisi ve fiziksel sağlığı üzerinde olumlu etkileri olduğu değişik kaynaklarda ifade edilmektedir.
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Adventure-based counseling programs offer unique opportunities to promote positive growth and change for persons with disabilities. A review of the literature is described which explains this intervention, a rationale for using adventurebased programs, research to support its efficacy, and resources to help rehabilitation clients and professionals to obtain further information concerning these programs.
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This book first appeared in 1970 and has gone into two further editions, one in 1975 and this one in 1985. Yalom is also the author of Existential Psychotherapy (1980), In-patient Group Psychotherapy (1983), the co-author with Lieberman of Encounter Groups: First Facts (1973) and with Elkin of Every Day Gets a Little Closer: A Twice-Told Therapy (1974) (which recounts the course of therapy from the patient's and the therapist's viewpoint). The present book is the central work of the set and seems to me the most substantial. It is also one of the most readable of his works because of its straightforward style and the liberal use of clinical examples.
Book
Depression: The Evolution of Powerlessness offers a fresh perspective on research, theory and conceptualisations of the depressive disorders, derived from evolution theory and arguing for the adoption of the biopsychosocial model. The book is split into three parts. Part I explores the major distinctions between all types of depression and Part II offers an overview of evolution theory and its application to depression. Part III covers the major theories of depression; theories are compared and contrasted, highlighting controversies, weaknesses and strengths, and where cross fertilisation of ideas may be beneficial. The final chapter outlines why simple theories of aetiology are inadequate and explores the role of culture and social relationships as elicitors of many forms of depression. This Classic Edition, with a new introduction from the author, brings Paul Gilbert’s early work to a new audience, and will be of interest to clinicians, researchers and historians in the field of psychology.
Article
Presents an integrative theoretical framework to explain and to predict psychological changes achieved by different modes of treatment. This theory states that psychological procedures, whatever their form, alter the level and strength of self-efficacy. It is hypothesized that expectations of personal efficacy determine whether coping behavior will be initiated, how much effort will be expended, and how long it will be sustained in the face of obstacles and aversive experiences. Persistence in activities that are subjectively threatening but in fact relatively safe produces, through experiences of mastery, further enhancement of self-efficacy and corresponding reductions in defensive behavior. In the proposed model, expectations of personal efficacy are derived from 4 principal sources of information: performance accomplishments, vicarious experience, verbal persuasion, and physiological states. Factors influencing the cognitive processing of efficacy information arise from enactive, vicarious, exhortative, and emotive sources. The differential power of diverse therapeutic procedures is analyzed in terms of the postulated cognitive mechanism of operation. Findings are reported from microanalyses of enactive, vicarious, and emotive modes of treatment that support the hypothesized relationship between perceived self-efficacy and behavioral changes. (21/2 p ref)
Article
Given the particular characteristics of delinquents, wilderness education offers a unique opportunity for holistic change.
Article
A study was conducted to determine whether a program of severe physical challenge can be more effective than a traditional training school experience in reducing further delinquency by adolescent boys adjudicated delinquent. Effectiveness was meas ured by comparing the recidivism rates between two matched groups. An experimental group (N=60) attended Outward Bound schools while a comparison group (N=60) was treated in a routine manner by the Massachusetts Division of Youth Serv ice. One year after parole, the recidivism rates for the two groups were compared. Only 20 per cent of the experimental group recidivated, as opposed to 42 per cent of the comparison group. Background variables such as age of first court appearance, pres ence of both parents in the home, first institutionalization, and type of offense were important conditions affecting recidivism. The results suggest that for some delinquents a program such as Outward Bound, which presents a severe physical challenge, is a desirable alternative to traditional institutional care and should be considered as a model for improving current correc tional programs. It appears that those delinquents who are re sponding to an adolescent crisis rather than to a character defect would profit most from such a program.