Advertisement

Journal of Child & Adolescent Trauma

, Volume 12, Issue 1, pp 85–95 | Cite as

Family Enrichment Adventure Therapy: A Mixed Methods Study Examining the Impact of Trauma-Informed Adventure Therapy on Children and Families Affected by Abuse

  • Christine Lynn NortonEmail author
  • Anita Tucker
  • Mollie Farnham-Stratton
  • Federico Borroel
  • Annette Pelletier
ORIGINAL ARTICLE

Abstract

Child abuse is epidemic in the United States and has dire long-term consequences. Innovative interventions are needed to address the negative cognitive, affective and behavioral effects of child abuse. This mixed-method study examined if adventure therapy is 1) an effective mental health intervention for child and adolescent survivors of abuse and neglect, and 2) an effective intervention for families affected by abuse and neglect. The effectiveness of the adventure therapy intervention was measured by a reduction in child trauma symptoms and improved family functioning, as reported via the Trauma Symptom Checklist for Children (TSCC), the Family Assessment Device (FAD), as well as qualitative data gathered via family focus groups. Findings showed that trauma-informed adventure therapy with youth and families affected by abuse reduces trauma symptomology in youth and improves family functioning, particularly in the areas of communication, closeness and problem-solving skills.

Keywords

Adventure therapy Trauma-informed care Child abuse Multi-family groups 

Notes

Compliance with Ethical Standards

Disclosure Statement

This statement provides transparent information about who funded the study and any potential conflicts of interest related to the study.

Funding

This study was funded by a Hogg Foundation Mental Health Research Grant.

Conflict of Interest

Authors D & E have worked for ChildSafe’s FEAT program as providers of counseling and adventure therapy services.

References

  1. Alvarez, A. G., & Stauffer, G. A. (2001). Musings on adventure therapy. Journal of Experiential Education, 24(2), 85–91. doi: 10.1177/105382590102400205.CrossRefGoogle Scholar
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.Google Scholar
  3. Anxiety and Depression Association of America (ADAA). (2014). Facts & statistics. Retrievedon 4/1/16 from: http://www.adaa.org/about-adaa/press-room/facts-statistics.
  4. Arias, I. (2004). The legacy of child maltreatment: The long-term consequences for women. Retrieved on 4/1/16 from: http://www.medscape.com/viewarticle/482931.
  5. Bettmann, J. E. (2005). Shifts in attachment relationships: A quantitative study of adolescents in brief residential treatment (Doctoral dissertation, Smith College School for Social Work, Northampton, Mass.).Google Scholar
  6. Bettmann, J., & Tucker, A. (2011). Shifts in attachment relationships: a study of adolescents in wilderness treatment. Child and Youth Care Forum, 40(6), 499–519. doi: 10.1007/s10566-011-9146-6.CrossRefGoogle Scholar
  7. Bettmann, J. E., Lundahl, B. W., Wright, R., Jasperson, R. A., & McRoberts, C. H. (2011). Who are they? A descriptive study of adolescents in wilderness and residential programs. Residential Treatment for Children & Youth, 28(3), 192–210. doi: 10.1080/0886571X.2011.596735.CrossRefGoogle Scholar
  8. Bettmann, J. E., Russell, K. C., & Parry, K. J. (2013). How substance abuse recovery skills, readiness to change and symptom reduction impact change processes in wilderness therapy participants. Journal of Child and Family Studies, 22(8), 1039–1050. doi: 10.1007/s10826-012-9665-2.CrossRefGoogle Scholar
  9. Child Welfare Information Gate. (2009). Supporting change in child welfare: An evaluation of training and technical assistance. Retrieved on 4/6/16 from: http://www.acf.hhs.gov/programs/cb/capacity/cross-center-evaluation.
  10. DeMille, S., & Montgomery, M. (2016). Integrating narrative family therapy in an outdoor behavioral healthcare program: a case study. Contemporary Family Therapy, 38(1), 3–13. doi: 10.1007/s10591-015-9362-6.CrossRefGoogle Scholar
  11. Deykin, E. Y., & Buka, S. L. (1997). Prevalence and risk factors for posttraumatic stress disorder among chemically dependent adolescents. American Journal of Psychiatry, 154(6), 752–7.CrossRefPubMedGoogle Scholar
  12. Epstein, N. B., Baldwin, L. M., & Bishop, D. S. (1983). The McMaster family assessment device. Journal of Marital and Family Therapy, 9(2), 171–180. doi: 10.1111/j.1752-0606.1983.tb01497.x.CrossRefGoogle Scholar
  13. Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. R., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences study. American Journal of Preventive Medicine, 14(4), 245–258. doi: 10.1016/S0749-3797(98)00017-8.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Finkelhor, D., Turner, H. A., Shattuck, A., & Hamby, S. L. (2013). Violence, crime, and abuse exposure in a national sample of children and youth: an update. JAMA Pediatrics, 167(7), 614–621. doi: 10.1001/jamapediatrics.2013.42.CrossRefPubMedGoogle Scholar
  15. Freeman, P. A., & Zabriskie, R. B. (2002). The role of outdoor recreation in family enrichment. Journal of Adventure Education & Outdoor Learning, 2(2), 131–145. doi: 10.1080/14729670285200241.CrossRefGoogle Scholar
  16. Funk, R. R., McDermeit, M., Godley, S. H., & Adams, L. (2003). Maltreatment issues by level of adolescent substance abuse treatment: the extent of the problem at intake and relationship to early outcomes. Child Maltreatment, 8(1), 36–45. doi: 10.1177/1077559502239607.CrossRefPubMedGoogle Scholar
  17. Gass, M. A., Gillis, H. L., & Russell, K. C. (2012). Adventure therapy: Theory, research, and practice. New York: Routledge.CrossRefGoogle Scholar
  18. Greenwald, R. (2009). Treating problem behaviors: A trauma-informed approach. New York: Taylor & Francis.CrossRefGoogle Scholar
  19. Harper, N., & Cooley, R. (2007). Parental reports of adolescent and family well-being following a wilderness therapy intervention: an exploratory look at systemic change. Journal of Experiential Education, 29(3), 393–396.CrossRefGoogle Scholar
  20. Harper, N. & Russell, K. C. (2008). Family involvement and outcome in adolescent wilderness treatment: a mixed-methods evaluation, 2008/1, 19-36.Google Scholar
  21. Harper, N. J., Russell, K. C., Cooley, R., & Cupples, J. (2007). Catherine Freer wilderness therapy expeditions: an exploratory case study of adolescent wilderness therapy, family functioning, and the maintenance of change. Child and Youth Care Forum, 36(2/3), 111–129. doi: 10.1007/s10566-007-9035-1.CrossRefGoogle Scholar
  22. Hodas, G.R. (2006). Responding to childhood trauma: The promise and practice of trauma informed care. Pennsylvania Office of Mental Health and Substance Abuse Services. Retrieved on 4/8/16 from: http://www.dhs.pa.gov/cs/groups/public/documents/manual/s_001585.pdf.
  23. Kilpatrick, D. G., Ruggiero, K. J., Acierno, R., Saunders, B. E., Resnick, H. S., & Best, C. L. (2003). Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: results from the National Survey of Adolescents. Journal of Consulting and Clinical Psychology, 71(4), 692. doi: 10.1037/0022-006X.71.4.692.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Kiser, L. J., Donohue, A., Hodgkinson, S., Medoff, D., & Black, M. M. (2010). Strengthening family coping resources: the feasibility of a multifamily group intervention for families exposed to trauma. Journal of Traumatic Stress, 23(6), 802–806. doi: 10.1002/jts.20587.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Liermann, K., & Norton, C. L. (2016). Enhancing family communication: examining the impact of a therapeutic wilderness program for struggling teens and parents. Contemporary Family Therapy, 38(1), 14–22. doi: 10.1007/s10591-015-9371-5.CrossRefGoogle Scholar
  26. National Alliance on Mental Illness. (2013). President’s New Freedom Commission on Mental Health. Retrieved on 1/4/2016 from: http://www.nami.org/Template.cfm?Section=New_Freedom_Commission&Template=/ContentManagement/ContentDisplay.cfm&ContentID=28338.
  27. National Child Traumatic Stress Network. (2008). Child welfare trauma training toolkit: Comprehensive guide (2nd ed.). Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress.Google Scholar
  28. Newes, S., & Bandoroff, S. (2004). What is adventure therapy. Coming of age: The evolving field of adventure therapy, 1–30. Boulder: The Association for Experiential Education.Google Scholar
  29. Norton, C. L. (2009). Exploring the process of a therapeutic wilderness experience: key components in the treatment of adolescent depression and psychosocial development. Journal of Therapeutic Schools and Programs, 4(1), 24–46.Google Scholar
  30. Norton, C. L. (2010). Into the wilderness - a case study: the psychodynamics of adolescent depression and the need for a holistic intervention. Clinical Social Work Journal, 38(2), 226–235. doi: 10.1007/s10615-009-0205-5.CrossRefGoogle Scholar
  31. Norton, C. L., & Watt, T. T. (2013). Exploring the impact of a wilderness-based positive youth development program for urban youth. Journal of Experiential Education, 37(4), 335- 350. DOI: 1053825913503113.Google Scholar
  32. Norton, C.L., Beale, B., Magle-Haberek, N., Borroel, F. & Tucker, A. (2014). Trauma-informed adventure therapy: Practice considerations. A Professional Development Intensive presented at the Association for Experiential Education International Conference, Chattanooga, TN, October 24, 2014.Google Scholar
  33. Norton, C. L., Tucker, A., Russell, K. C., Bettmann, J. E., Gass, M. A., & Behrens, E. (2014b). Adventure therapy with youth. Journal of Experiential Education, 37(1), 46–59. doi: 10.1177/1053825913518895.CrossRefGoogle Scholar
  34. Office of Juvenile Justice and Delinquency Prevention. (2013). U.S. Department of Health and Human Services encourages states to adopt trauma-informed practices. Retrieved on4/5/16 from: http://www.ojjdp.gov/newsletter/242652/sf_3.html.
  35. Pernicano, P. (2010). Family focused trauma intervention: Using metaphor and play with victims of abuse and neglect. Lanham: Jason Aronson.Google Scholar
  36. Perry, B. D. (2009). Examining child maltreatment through a neurodevelopmental lens: clinical applications of the neurosequential model of therapeutics. Journal of Loss and Trauma, 14(4), 240–255. doi: 10.1080/15325020903004350.CrossRefGoogle Scholar
  37. Snell-Johns, J., Mendez, J. L., & Smith, B. H. (2004). Evidence-based solutions for overcoming access barriers, decreasing attrition, and promoting change with underserved families. Journal of Family Psychology, 18(1), 19. doi: 10.1037/0893-3200.18.1.19.CrossRefPubMedGoogle Scholar
  38. Substance Abuse and Mental Health Services Administration. (2013). The National Center for Trauma Informed Care. Retrieved on 1/4/2013 from: http://www.samhsa.gov/nctic/trauma.asp.
  39. Swank, J. M., & Daire, A. P. (2010). Multiple family adventure–based therapy groups: an innovative integration of two approaches. The Family Journal: Counseling and Therapy for Couples and Families, 18(3), 241–247. doi: 10.1177/1066480710372123.CrossRefGoogle Scholar
  40. Tucker, A. R. (2009). Adventure-based group therapy to promote social skills in adolescents. Social Work with Groups, 32(4), 315–329. doi: 10.1080/01609510902874594.CrossRefGoogle Scholar
  41. Tucker, A. R., & Norton, C. L. (2013). The use of adventure therapy techniques by clinical social workers: implications for practice and training. Clinical Social Work Journal, 41(4), 333–343. doi: 10.1007/s10615-012-0411-4.CrossRefGoogle Scholar
  42. Tucker, A., Widmer, M. A., Faddis, T., Randolph, B., & Gass, M. (2016). Family therapy in outdoor behavioral healthcare: current practices and future possibilities. Contemporary Family Therapy, 38(1), 32–42. doi: 10.1007/s10591-015-9370-6.CrossRefGoogle Scholar
  43. Zelov, R., Tucker, A. R., & Javorksi, S. (2013). A new phase for the NATSAP PRN: post discharge reporting and transition to the network wide utilization of the Y-OQ 2.0. Journal of Therapeutic Schools & Programs, 6(1), 7–19. http://natsap.org/pdf_files/journals/JTSP_VOL6.1.pdf.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing 2017

Authors and Affiliations

  • Christine Lynn Norton
    • 1
    Email author
  • Anita Tucker
    • 2
  • Mollie Farnham-Stratton
    • 3
  • Federico Borroel
    • 4
  • Annette Pelletier
    • 5
    • 6
  1. 1.Texas State University School of Social WorkSan MarcosUSA
  2. 2.University of New Hampshire, Social WorkDurhamUSA
  3. 3.Camp KiniyaColchesterUSA
  4. 4.ChildSafeSan AntonioUSA
  5. 5.Austin Women and Children’s ShelterAustinUSA
  6. 6.Discovery Ranch for GirlsCedar CityUSA

Personalised recommendations