Adventure Therapy and Routine Outcome Monitoring of Treatment: The Time Is Now (original) (raw)
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As an intervention for adolescents, adventure therapy has evolved considerably over the last three decades with support from multiple meta-analyses and research input from both residential and outpatient services. Tainted by a history of unethical practice and issues of accountability, this article explores the question of how adventure therapy can meet a standard of evidence preferred by policymakers and funding bodies on the international stage. In this case, feedback-informed treatment (FIT) is presented as a means for routine outcome management, creating a framework for adventure therapy which aims to improve the quality of participant engagement while maintaining and operationalizing today's definitions for evidence-based practice. A case vignette illustrates the use of FIT with an adolescent participant engaged on a 14-day adventure therapy program.
A Meta-Analysis of Adventure Therapy Outcomes and Moderators
The Open Psychology Journal, 2013
This study reports on a meta-analytic review of 197 studies of adventure therapy participant outcomes (2,908 effect sizes, 206 unique samples). The short-term effect size for adventure therapy was moderate (g = .47) and larger than for alternative (.14) and no treatment (.08) comparison groups. There was little change during the lead-up (.09) and follow-up periods (.03) for adventure therapy, indicating long-term maintenance of the short-term gains. The short-term adventure therapy outcomes were significant for seven out of the eight outcome categories, with the strongest effects for clinical and self-concept measures, and the smallest effects for spirituality/morality. The only significant moderator of outcomes was a positive relationship with participant age. There was also evidence that adventure therapy studies have reported larger effects over time since the 1960s. Publication bias analyses indicated that the study may slightly underestimate true effects. Overall, the findings provide the most robust meta-analysis of the effects of adventure therapy to date. Thus, an effect size of approximately .5 is suggested as a benchmark for adventure therapy programs, although this should be adjusted according to the age group.
Clinical Supervision in Adventure Therapy: Enhancing the Field Through an Active Experiential Model
Journal of Experiential Education, 2010
Supervision of therapeutic practice is one of the central professional elements of mental health practitioners. Supervision provides growth for therapists in their respective professional fields, more effective therapy for clients, and some measure of ethical protection for the welfare of clients and the public at large. However, therapists who utilize adventure therapy are often at a loss for experiential supervision models that value the active approach they use with their clients. The ENHANCES supervision model was developed to provide ...
Adventure as Therapy: A Map of the Field. Workshop Report
1994
This paper defines the field of adventure therapy and relates itto other types of adventure activities. Outdoor adventure may have recreational, educational, or enrichment goals that focus on having fun, increasing participant knowledge, or building skills such as communication in a target group. Adventure therapy, on the other hand, ha's the clear goal of engendering lasting personal change in participants. Characteristics of adventure therapy include assessment of participants before the adventure experience, preactivity discussion to predispose participants to personal c.hange, activities chosen specifically for their potential to engender personal change, and postgro/T reflection to help participants transfer changes to everyday life. Adventure therapy programs vary widely in the areas of professional context, underpinning therapeutic framework and epistemology, range of therapeutic techniques, client base and presenting problems, funding sources, types of activities, interrelationship with other programs, and program design. A chart outlines the basic principles, underlying assumptions, role of therapi.t, and role of insight in five types of therapies: insight-based therapies, "black box" therapies and other behaviorist models, systems-based therapies, experiential therapies, and psychodynamic therapies. (SV)
Looking at the landscape of adventure therapy: making links to theory and practice
Journal of Adventure Education & Outdoor Learning, 2011
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The Ecology of Adventure Therapy: An Integral Systems Approach to Therapeutic Change
Ecopsychology, 2010
Currently, a fragmentation in ideas exists regarding understanding psychological wellness and preferred routes to healing. This is evident in current adventure therapy (AT) literature, where unique combinations of experiential learning, challenge activities, novel experiences, group work, and other psychological theories are often used to account for positive outcomes and to explain mechanisms for change. Rarely is contact with wilderness environments included as an important variable associated with positive outcomes and change. AT has been rightly criticized for not recognizing the ecological paradigm of therapy conducted in wild nature. By including principles from integral systems theory, we offer adventure therapists a map, allowing for these seemingly disparate parts to fit together into a coherent whole. In addition, we propose that wilderness is a crucial cofacilitator in the change process. If seriously considered, these ideas pose a number of important questions for AT theory and practice.
A critical evaluation of the state-of-the-art in psychotherapy outcome research
Psychotherapy: Theory, Research, Practice, Training, 1996
Results from recent large-scale psychotherapy outcome studies have prompted efforts to manualize clinical practice. To many, the use of empirically validated manualized treatments for clients with specific DSM disorders represents the current state-of-the-art in the field. Despite these efforts, we argue that attempts to manualize clinical practice are premature. In this article, we review the current state-of-the-art and critique the manualization movement with a consideration of current clinical practices and recent findings from the field of psychotherapy process research.