Adventure Therapy as an Addiction Treatment Therapy
According to the American Public Health Association (APHA), there is growing evidence to suggest that access to nature can alleviate some of the most damaging public health issues facing our society. These issues include obesity, stress, isolation, injury, and violence. APHA states that access to nature significantly reduces illness and increases the participant’s sense of well-being.
Modern Adventure Therapy is a specific form of psychotherapy that incorporates various physical and mental challenges designed to treat the participant’s emotional health while providing beneficial physical activity. This therapy often involves outdoor activities that are physically demanding or require problem solving skills. Adventure therapy is commonly confused with Wilderness Therapy. While both usually take place outdoors, Wilderness Therapy’s focus is on the client’s ability to adapt to unfamiliar surroundings. However, Adventure Therapy is focuses on challenging activities and exercises that allow patients to overcome obstacles or perform a common task while enjoying the outdoors. Adventure Therapy is not an individualized therapy process and is conducted in process groups. These personal exploration groups allow our clients to participate in trust-building exercises, work on communication, and bond with their peers, and learn to work as a team. Adventure Therapy commonly includes physically demanding activities such as kayaking, zip-lining, and tug-of-war matches.
A History of Adventure Therapy
Before 1800, the Friends Hospital opened in Philadelphia and incorporated the use of the natural environment as a major component of treatment for the mentally ill. Then, in 1901, Manhattan State Hospital East introduced “tent therapy” to isolate TB patients from other patients and found unexpected health benefits for patients related to being outside. This was the first documented case of utilizing the outdoors as a healing factor in the United States. In 1906, the San Francisco Psychiatric Hospital moved patients into tents after an earthquake and again noted dramatic improvements, indicating that the patients demonstrated improved social interactions. These events mark historic beginnings of the idea that there is a mental health benefit to being in natural environments. (Davis-Berman & Berman, 1994; leegillis.com).
The camping movement identified the use of camping as a therapeutic milieu, making initial attempts at integrating outdoor experience with therapeutic intent. This form of intervention was first seen through Camp Ahmek in 1929. This program identified socialization of the camper’s behaviors as one of its primary goals, indicating the beginning of a therapeutic approach to camping (Davis-Berman & Berman, 1994; Russell & Hendee, 2000). The second program emerged in 1946, created by Campbell Loughmiller, as part of the Salesmanship Club of Dallas. This program represents the beginning of the therapeutic camping movement. (Loughmiller, 1965; Russell, 2005; Davis-Berman & Berman, 2008; Russell & Hendee, 2000; Davis-Berman & Berman, 1994; Schoel & Maizell, 2002).
Progressive Education Movement
The Progressive Education Movement also had significant impact on the development of AT. This movement was largely championed by John Dewey, considered to be one of the founders of experiential education. This philosophy holds that experience is a central means to broaden a student’s knowledge and, thus, experience must form the basis of a student’s curriculum (Mitten & ?, 2008). In the view of the Progressive Education Movement, the learner is also a participant and more can be learned by struggling with a problem than by being provided with a solution. Experiential learning is active and may encourage the learner to become intrinsically motivated. The learner has the freedom to make choices and take responsibility. The philosophy of experiential education highlights the use of natural and logical consequences to provide feedback to the learner and incorporates reflection on the experience as a critical component of the learning process. (Gass, ; Stanchfield, ).
The catalyst for the development of the adventure education movement was the development of Outward Bound by Kurt Hahn. The Hahnian approach to education included concepts such as journey, expedition, and challenge. This approach was not only experience-centered but also value-centered. Learning through doing was not developed to facilitate the mastery of academic content alone but was oriented toward development of character and maturity (Russell & Hendee, 2000). Bacon (1983) published The Conscious Use of Metaphor in Outward Bound integrating outdoor expeditions, personal change, and the conscious use of metaphor, which advanced the concept of intentional use of outdoor experience to foster personal growth and change.
Kurt Hahn opened the first Outward Bound program in 1941 in Aberdovey, Wales with Lawrence Holt and Jim Hogan (Miles & Priest, 1999). In 1950, the second Outward Bound school opened in England. In 1962, the first American Outward Bound school opened in Colorado. By 1984, Colorado Outward Bound had opened a treatment program. The influence of Outward Bound can be seen in the practices of the National Outdoor Leadership School, the Teton Science School, and Project Adventure.
Several theoretical perspectives influenced Outward Bound in the development of their mental health curriculum. These include humanism, T-group movements, structural therapy, and strategic therapy. This was an important point in the history of AT because it was the first concrete shift from the camping movement to adventure therapy. These theories were applied alongside the adventure education movement’s philosophies related to challenge and stress. Early approaches to AT viewed risk and stress as a pre-requisite for growth and held to the idea that people grow by getting out of their “comfort zone.” These concepts are controversial today, as there is a movement away from the use of intentional risk and stress by many practitioners who prefer an approach based on individual assessment of client needs rather than assumptions regarding the value of stress.
The adventure movement was also influenced by individuals previously serving in the British and American military. While these perspectives aided in the evolution of adventure work, they have also led to the development of coercive models that utilize a philosophy of “breaking someone down to build them back up.” This approach is not consistent with current ethical guidelines or best practice in AT.
Project Adventure, begun in 1971, had a significant impact in developing the use of experiential programs to effect positive growth and change for clients. Key constructs in the adventure movement were promoted by PA including challenge by choice and the use of full value contracts.
Benefits of Adventure Therapy
A study conducted in 2013, found that adventure therapy has the capacity to yield physical, emotional, moral, and spiritual benefits. In this study, there were proposed benefits to academic performance, family and social development, and overall behavior as well. In addition, it indicated that adventure therapy has the capacity to increase the patient’s self-perception, self-control, and self-efficacy.
Adventure therapy can help to decrease anxiety. Since there is a small level of risk inherently involved in the activities the client is asked to partake in, it is not uncommon that participants will have to face their fears for this therapy to be successful.
Anxiety is a major co-occurring disorder within people suffering from drug and alcohol addiction. Treatments help a client confront that anxiety and face their fears helps in a therapeutic way. Addicts who engage in adventure therapy learn cooperation skills and build trust with their peers while engaging in activities that might cause them to feel self-conscious under normal circumstances. A person with low self-esteem might easily become anxious when engaging in physical activities within a group, because they are inclined to feel at risk of looking inferior. Adventure therapy takes these anxiety triggers and substitutes them with fond memories of having fun and making friends.
Types of Adventure Therapy
While most commonly performed outdoors, Adventure Therapy does not have to take place outdoors to be effective. Indoor activities are known to provide many of the same benefits. Camping is considered the original form of Adventure Therapy, but overnight stays outdoors are not possible in the recovery environment. The activities offered in our program change often and vary according to the skillsets possessed by our clients at the time of service. Most of our activities are expeditionary, which is common among many types of Adventure Therapy. Since we are in Florida, we take advantage of our warm climate year-round to provide outdoor activities related to the water, beach, and tropical environment. Many of our Adventure Therapy sessions take place in, on, or around the ocean or intercoastal waters. Activities include fishing, wakeboarding, and kayaking. Other sessions include group exercises and activities on the beach. Performing physical tasks on the beach can demand a lot more from the client’s body, presenting unique challenges to overcome. When they overcome these obstacles, a new sense of accomplishment is formed providing therapeutic relief from anxiety and trauma.
While exposure to “green exercise” can provide multiple mental health benefits, we are not in proximity to mountains or forests. Because of this, we commonly take advantage of indoor alternatives like rock wall climbing, and gym activities. While the scenery is not as compelling as a true outdoor experience, the clients still enjoy the physical and mental health benefits of fun and exercise.
Adventure Therapy Goals
The goal of adventure therapy is to give participants the coping skills needed to deal with difficult situations. The desire to abuse drugs or alcohol are met with the coping strategies learned through these challenges, team-building activities, and the knowledge of how choices affect other people. Adventure Therapy gives our clients the confidence necessary to manage their addiction and help to live a sober lifestyle. The ability to measure success in a tangible way is what allows Adventure Therapy to help its participants rebuild lost self-esteem, build useful communication skills, bond with their peers, and face their fears. Like all other treatment methods, Adventure Therapy begins with an assessment of the client’s needs. This allows therapists to group patients with others who have similar issues making the therapy as effective as possible.