What is Outdoor Adventure Therapy?

What is Outdoor Adventure Therapy?

Outdoor adventure therapy is an experiential therapy often used as a complementary treatment in addiction rehab programs. When it’s used alongside traditional “talk” therapies, outdoor adventure therapy has numerous benefits for people in recovery.

Outdoor adventure therapy is just as it sounds: It’s therapy that takes place in nature and involves a wide range of activities and experiences, such as climbing, hiking and playing outdoor games. Here, we take a closer look at adventure therapy, including the concepts behind it, how it works, and why it’s so beneficial to many as part of a comprehensive treatment plan.

The Goals of Outdoor Adventure Therapy

Outdoor adventure therapy draws heavily on principles of cognitive-behavioral therapy, which focuses on changing faulty patterns of thinking that influence unhealthy behaviors. Adventure therapy helps people examine their thoughts, feelings, attitudes and beliefs, but instead of engaging in a one-on-one dialogue with the therapist, participants in adventure therapy take part in a variety of hands-on experiences facilitated by the adventure therapist. The experiences and activities lead to the development of essential social and coping skills and a higher level of self-awareness.

Benefits of Outdoor Adventure Therapy

According to the Institute for Outdoor Learning, adventure therapy provides many benefits to participants, depending on the types of activities and experiences they engage in.1 In general, the benefits of outdoor adventure therapy include:

  • Recovery from mental fatigue that can occur in early recovery
  • Improved concentration and cognitive functioning
  • Better physical and mental health
  • Whole-person healing
  • A more positive outlook on life
  • Improved coping skills for stress, fear, negative emotions and other relapse triggers

A meta analysis of over 150 studies on adventure therapy found that the short-term effects of this therapy were significant for seven out of eight of the outcome categories. The strongest effects were for self-concept measures, while the weakest effects were for spirituality.2 The University of Indiana’s Bradford Woods Outdoor and Leadership Center cites a range of studies showing that adventure therapy programs improve self-esteem, leadership and interpersonal relationships.

Who Benefits the Most from Adventure Therapy?

Adventure therapy can have far-reaching benefits for anyone in treatment. It’s especially effective for women, adolescents, young adults and people who reside in an urban environment. The University of Kentucky stresses that adventure therapy works best for participants who:3

  • Have an open mind about participating in new experiences despite any fears or biases they may have
  • Have the ability to reflect on a new experience from a variety of perspectives
  • Are willing to rework old ideas and beliefs and create new ones based on their reflections and observations during adventure therapy
  • Have the capacity to apply new concepts learned to other life domains

Adventure Therapy for Trauma

Adventure therapy is particularly helpful for addressing trauma. It focuses heavily on building resilience and developing coping skills, which can help individuals reduce the effects of trauma both in the short-term and the long-term. An estimated 70 percent of American adults have experienced a traumatic event in their lifetime. A study published in the American Journal of Psychiatry found that 24.3 percent of males and 45.3 percent of females in treatment for a substance use disorder had a lifetime history of post-traumatic stress disorder.4 Another study in the journal Psychiatric Services found that up to 80 percent of women in treatment for a substance use disorder have a history of trauma, including physical or sexual abuse.

Four-Stage Foundation of Outdoor Adventure Therapy

Educational theorist David Kolb identifies a four-stage cycle that draws on the idea that learning is the process of gaining knowledge through transformative experience. New experiences, he proposes, are the catalyst for developing new skills and concepts. Kolb’s four-stage cycle is the foundation of outdoor adventure therapy.

    Stage One

    Engaging in a new hands-on experience or situation, such as climbing.

    Stage Two

    Involves actively observing thoughts, emotions, and behaviors during the experience and reflecting about it afterwards in a group setting facilitated by the therapist.

    Stage Three

    Abstranct conceptualization, wherein the active observation and reflection result in a new idea or a revision of an old idea. A climber who was reluctant and fearful about limbing but did it anyway realizes that she can be afraid and still master the climbing wall. This leads her to revise her old idea that fear is insurmountable.

    Stage Four

    Active experimentation. Learners apply the new or reworked ideas to other areas of their lives. The climber applies newfound confidence to other areas of her life.

    Outdoor adventure therapy only works when all four stages are present. The experiences and activities alone aren’t enough to elicit meaningful change. They must be intentionally observed, reflected upon, conceptualized and synthesized.

      The Main Concepts Behind Outdoor Adventure Therapy

      Adventure therapy programs are generally goal-oriented and focused on solutions. They emphasize a humanist approach to healing and the idea of innate goodness in everyone.

      The foundational concepts that underlie adventure therapy are rooted in the principles of experiential education and a belief in the value of action and engagement to facilitate real and meaningful change. According to the Association for Experiential Education, the foundational concepts of outdoor adventure therapy include:5

      Involvement of Risk and Stress

      Risk is inherent in outdoor adventure therapy as participants try new activities and develop new skills. It’s understood that engaging in the adventures and activities carries some risk and creates some stress for participants. However, studies show that the average injury rate for adventure therapy programs is just 1.12 per 1,000 participants.

      It’s not simply the risk alone that is foundational to adventure therapy, but rather the assessment and use of the risk by the therapist to support the process of change for the client. The therapist adjusts levels of risk and stress as needed based on real-time assessments of the environment and the client’s perception of the risk. The goal is to provide opportunities for participants to work through challenges, develop and use coping skills, increase their resilience, and improve their ability to manage stress effectively.

      Natural and Logical Consequences

      Adventure therapy is all about logical and natural consequences of participants’ choices. Natural consequences naturally occur as the result of a choice or behavior, such as getting wet after not putting on a rain coat. Logical consequences are meted out by the therapist, such as not allowing a participant to climb if the participant refuses to wear a helmet. Natural and logical consequences provide participants with real-time feedback and help shape the experience and the lessons learned.

      The Healing Power of Nature

      The healing power of nature is well-documented, and it’s an important foundational concept for outdoor adventure therapy. Nature reduces stress, improves mood, promotes recovery, increases energy and improves sleep. It provides immediate and non-judgmental feedback to participants, facilitated by the therapist who utilizes the dynamics in nature to promote change.

      The Shared Experience of the Practitioner

      The outdoor adventure therapist has a major role in adventure therapy. The relationship between the therapist and the participants is based on shared experience, and this shared experience allows several dynamics to emerge:

      • Speedy development of a strong therapeutic relationship between therapist and client
      • Enhanced reflection during in-the-moment events and multiple points for reflection
      • Opportunities for the therapist to determine whether or not gains have been made
      • A leveling of the power dynamic that minimizes hierarchy
      • Opportunities for the client to give and receive help, which promotes empathy and altruism
      • A better chance of participants transferring lessons learned to their daily lives

      The Actively Engaged Client

      When participants in outdoor adventure therapy are fully engaged, they reveal who they are authentically as they move through an activity. This gives the therapist insight into how clients make decisions and solve problems in their “real” lives and how they might integrate the skills and strategies learned in adventure therapy. One of the most important concepts of adventure therapy is the idea that clients are responsible for choosing what they want to learn and what type of change they want to make in their lives. Outdoor adventure therapy embraces client empowerment, freedom and responsibility.

      The Active Process as the Vehicle for Change

      Real-life, concrete experiences are at the heart of outdoor adventure therapy, and these are the vehicles for change. The therapist chooses the activities based on clients’ issues and needs, and the activities are designed to explore those issues. The activities are the impetus for change, but the treatment goal is the overarching focus of outdoor adventure therapy. Activities are typically designed to be fun and challenging, mimicking play. Researchers believe that individuals become less resistant to change and less fearful through this type of play.

      Types of Activities Used in Outdoor Adventure Therapy

      Outdoor adventure therapy typically involves activities that carry some risk and which are physically and emotionally challenging. Activities are highly structured and designed to promote growth and development while improving participants’ social, psychological and physical wellbeing. Different types of activities in outdoor adventure therapy produce different results, and each has its own benefits.

      Cooperative Activities

      Activities that require cooperation with others are used in adventure therapy to create positive interactions and deepen the relationships between participants and the therapist. These cooperative activities include games and ice breakers, and they’re meant to be enjoyable and relaxing.

      The benefits of cooperative activities include:

      • Enabling the therapist to assess clients’ comfort levels, social functioning level and willingness to engage
      • Building trust within the group
      • Acquiring social skills through increased self-awareness and by examining preconceived ideas about oneself and others

      Initiative Activities

      Initiative activities usually involve groups working together to reach a certain outcome. They require participants to take the initiative to communicate effectively with one another to solve problems and make decisions together.

      Benefits of initiative activities include:

      • Improving cooperation and communication skills
      • Building trust
      • Promoting healthy problem-solving and social skills
      • Developing coping skills
      • Developing strategies for managing emotions
      • Increased self-awareness

      Trust and Support Activities

      Trust and support activities involve creating a situation where participants must rely on others to complete a task, such as being led blindfolded through an obstacle course. These activities enable the therapist to evaluate clients’ comfort levels and see how they cope with situations where they’re not in full control. They reveal whether a participant is willing to take risks, maintain healthy boundaries and trust others. They give participants some control over others’ wellbeing and offer the opportunity to help others.

      The benefits of trust and support activities include:

      • Building and experiencing the positive effects of trust in others
      • Creating a stronger therapeutic alliance
      • Promoting healthy boundaries
      • Increasing confidence in one’s ability to help other people

      High-Constructed Elements

      Activities that take place at some height are known as high constructed elements, and these activities create a greater perception of personal risk. They simulate the emotional and behavioral responses that help the therapist move the client closer to personal treatment goals.

      The benefits of high constructed elements include:

      • Setting realistic goals
      • Providing emotional support to others
      • Promoting group cohesion
      • Developing emotional management and coping skills
      • Developing self-confidence
      • Reinforcing trust in others
      • Managing impulsive behaviors

      High-Adventure and Low-Adventure Activities

      High adventure activities are typically daylong excursions or even overnight trips involving activities like rock climbing, canyoneering, caving or rappelling. These activities are riskier than others, and they promote the mastery of a variety of skills and strategies.

      Low adventure activities are less risky than high adventure activities, and while they require less physical exertion, they provide intense and dynamic experiences. Low adventure activities include hiking, fishing and kayaking.

      Benefits of high- and low-adventure activities include:

      • Promoting personal responsibility and greater self-awareness
      • Understanding the impact one’s behavior and choices have on others
      • Enhanced and emotional management skills
      • Promoting healthy relationships and cooperation
      • Fostering a deep and meaningful connection to nature

      Expeditionary Activities

      Expeditionary activities are those that involve spending anywhere from seven to 90 day in nature, experiencing the natural world and engaging in therapeutic adventures. Expeditionary activities remove participants from their “real” lives and from society for an extended period of time and promote excellent opportunities for deep reflection and contemplation.

      Benefits of expeditionary activities include:

      • Relying and drawing on nature
      • Promoting personal responsibility
      • Building healthy relationships
      • Building trust
      • Developing self-confidence
      • Developing essential coping skills
      • Increasing self-awareness
      • Promoting healthy personal choices

      How to Evaluate an Adventure Therapy Program

      Adventure therapy became popular in the 1970s, but they were largely unsupervised and unregulated, and many were little more than a boot camp for people–particularly youth–with mental problems or a substance use disorder. That changed in the 1990s, when a young participant in an adventure therapy wilderness expedition died of abuse and neglect. 

      Before committing to an adventure therapy program, it’s important to make sure it’s reputable. In 2013, the Association for Experiential Education and the Outdoor Behavioral Healthcare Council at the University of New Hampshire developed and expanded adventure therapy standards and created a set of current best practices. Any outdoor adventure therapy program should meet these standards and adhere to the best practices. To ensure you pick a quality program, look for an accreditation from the Outdoor Behavioral Healthcare Council, which evaluates programs to ensure they meet or exceed the industry standards.

      Outdoor Adventure Therapy: Part of A Holistic Approach to Treatment

      A high-quality addiction treatment program will utilize a range of therapies, services and interventions to address an individual’s multiple needs and attend to issues of body, mind and spirit. This holistic approach is one of the Principles of Effective Treatment, according to the National Institute on Drug Abuse.6 Holistic treatment has been shown to improve the chances of successful long-term recovery and involves a variety of both traditional and complementary therapies that help individuals change self-destructive habits and develop the coping skills they need to enjoy long-term sobriety.

      Traditional therapies are evidence-based psychotherapies, such as cognitive-behavioral therapy, family therapy, and motivational interviewing, that have been shown to successfully treat substance use disorders. Complementary therapies are experiential, hands-on, therapies, such as adventure therapy, art therapy, and restorative yoga. Complementary therapies have been shown through research to be effective for treating addiction when they’re used along with traditional therapies.

      Adventure therapy is a widely used complementary therapy that’s fun and engaging. Participants gain personal insights, increase self-awareness and develop coping skills that help them stay in recovery. Adventure therapy can help round out your treatment plan and improve your wellbeing and quality of life for the long-haul.


      Resources:

      1. http://www.outdoor-learning.org/Portals/0/IOL%20Documents/Horizons%20Documents/Horizons%20pdf%20archive/H56.OutdoorAndAdventureTherapy.pdf
      2. https://psycnet.apa.org/record/2014-26269-001
      3. http://www.uky.edu/UGE/sites/www.uky.edu.UGE/files/pres-u/21st%20Century%20Learner%20and%20Learning%20Cycle%20for%20FF%20kickoff%202015.pptx
      4. https://www.ncbi.nlm.nih.gov/pubmed/9167501
      5. http://www.aee.org/tapg-best-p-foundational-concepts
      6. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment