The Use of Adventure Therapy in Community-Based Mental Health: Decreases in Problem Severity Among Youth Clients
- 2.6k Downloads
There is an increasing need to identify effective mental health treatment practices for children and adolescents in community-based settings, due to current mixed findings of existing interventions. This study looked at adventure therapy (AT) as a viable option to meet this need.
Using a sample of 1,135 youth from a community-based mental health center, this study addressed the following questions: (1) Is AT an effective treatment modality for youth compared to traditional counseling? (2) How do changes in problem severity associated with participation in AT-based interventions compare with those associated with traditional counseling across gender, age, primary diagnosis, and race? (3) What are the predictors of changes in problem severity in clients?
In this exploratory non-equivalent groups quasi-experimental design study, pre- and post- mean scores of problem severity as reported by youth’s primary clinician were compared by type of treatment and client characteristics. Treatment and client characteristics were used as predictors of changes in problem severity.
Participants in AT had significant reported mean decreases in problem severity larger than those of clients not involved in counseling with an adventure component with larger decreases in female and African American clients. AT and psychological counseling were found to be significant predictors of decreases in problem severity; however, length of counseling, not length of AT, was a significant predictor.
These findings suggest that community-based AT may be a viable treatment for youth in community settings; yet these findings should be interpreted with caution due to several study limitations.
KeywordsAdventure therapy Community-based mental health Problem behaviors Youth
- Alvarez, A. G., & Stauffer, G. A. (2001). Musings on adventure therapy. The Journal of Experiential Education, 24(2), 85–91.Google Scholar
- Ayers, C., & Shavel, D. (1997). Adventure programming & prevention of adolescent problem behaviors: Applying research and the public health model. In Deeply rooted, branching out, 1972–1997. Annual AEE international conference proceedings. (ERIC Document Reproduction Service No. ED 414125). Retrieved from ERIC Database.Google Scholar
- Berman, D. S., & Davis-Berman, J. (1995). Adventure as psychotherapy: A mental health perspective. Journal of Leisurability, 22(2), 21–28.Google Scholar
- Bernstein, B. E. (2012). Conduct disorder. Medscape reference: Drugs, diseases and procedures. Retrieved from http://emedicine.medscape.com/article/918213-overview.
- Caulkins, M. C., White, D. D., & Russell, K. D. (2006). The role of physical exercise in wilderness therapy for troubled adolescent women. The Journal of Experiential Education, 29(1), 18–37.Google Scholar
- Child Welfare Information Gateway (2007). Trauma-focused cognitive behavioral therapy: Addressing the mental health of sexually abused children. Washington, DC: US Department of Health and Human Services. Retrieved from http://www.childwelfare.gov/pubs/trauma/.
- Cohen, J. (1987). Statistical power of analysis for the behavioral sciences (2nd ed.). Hillsdale, NH: Erlbaum.Google Scholar
- Cooper, J. L. (2008). Towards better behavioral health for children, youth and their families: Financing that supports knowledge (Unclaimed Children Revisited, Working Paper No. 3). Retrieved from http://www.nccp.org/publications/pub_804.html.
- Davis, D., Ray, J., & Sayles, C. (1995). Ropes course training for youth in a rural setting: “At first I thought it was going to be boring…” Child and Adolescent Social Work Journal, 12(6), 445–463.Google Scholar
- de Arellano, M. A., Ko, S. J., Danielson, C. K., & Sprague, C. M. (2008). Trauma-informed interventions: Clinical and research evidence and culture-specific information project. Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress.Google Scholar
- Eagle, H., Gordon, J., & Lewis, L. (2000). The effects of a public school system’s one day adventure experience. Fifth Biennial Research Symposium Proceedings: Coalition for Education in the Outdoors. Google Scholar
- Forgan, J. W., & Jones, C. D. (2002). How experiential adventure activities can improve students’ social skills. Teaching Exceptional Children, 34(3), 52–58.Google Scholar
- Gass, M. A. (1993). Foundations of adventure therapy. In M. A. Gass (Ed.), Adventure therapy: Theoretical applications of adventure programming (pp. 3–10). Dubuque, IA: Kendall/Hunt Publishing Co.Google Scholar
- Gass, M. A., Gillis, L. H., & Russell, K. (2012). Adventure therapy: Theory, research and practice. New York: Routledge Press.Google Scholar
- Glass, J. S., & Myers, J. E. (2001). Combining the old and the new to help adolescents: Individual psychology and adventure-based counseling. Journal of Mental Health Counseling, 23(2), 104–114.Google Scholar
- Harper, N., & Russell, K. (2008). Family involvement and outcome in adolescent wilderness treatment: A mixed-methods evaluation. International Journal of Child and Family Welfare, 1, 19–36.Google Scholar
- 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 & Youth Care Forum, 36(2–3), 111–129. doi: 10.1007/s10566-007-9035-1.CrossRefGoogle Scholar
- Herbert, J. T. (1998). Therapeutic effects of participating in an adventure therapy program. Rehabilitation Counseling Bulletin, 41(3), 201–216.Google Scholar
- Hernandez, M., & Hodges, S. (2003). Crafting logic models for systems of care: Ideas into action making children’s mental health services successful (Vol. 1). Tampa, FL: University of South Florida, The Louis de la Parte Florida Mental Health Institute, Department of Child & Family Studies.Google Scholar
- Hunter, S. B., Ramchand, R., Griffin, B. A., Suttorp, M. J., McCaffrey, D., & Morral, A. (2011). The effectiveness of community-based delivery of an evidence-based treatment for adolescent substance use. Journal of Substance Abuse Treatment, 43(2), 211–220. doi: 10.1016/j.jsat.2011.11.003.PubMedCrossRefGoogle Scholar
- Kimball, R., & Bacon, S. (1993). The wilderness challenge model. In M. A. Gass (Ed.), Adventure therapy: Theoretical applications of adventure programming (pp. 11–41). Dubuque, IA: Kendall/Hunt Publishing Co.Google Scholar
- LeCroy, C. W. (2007). Problem solving and social skills training groups for children. In T. Ronen & A. Freeman (Eds.), Cognitive therapy in clinical social work practice (pp. 285–300). New York, NY: Springer Publishing.Google Scholar
- Marx, J. D. (1988). An outdoor adventure counseling program for adolescents. Social Work, 33(6), 517–520.Google Scholar
- Morral, A. R., McCaffrey, D. F., & Ridgeway, G. (2004). Effectiveness of community-based treatment for substance-abusing adolescents: 12-month outcomes of youths entering phoenix academy or alternative probation dispositions. Psychology of Addictive Behaviors, 18(3), 257–268. doi: 10.1037/0893-164x.18.3.257.PubMedCrossRefGoogle Scholar
- Newman, C. (2007). The effects of aerobic exercise on childhood PTSD, anxiety, and depression. Hofstra University. Dissertation Abstracts International, 67(10-B), 6070.Google Scholar
- Ogles, B. M., Melendez, G., Davis, D. C., & Lunnen, K. M. (1999). The Ohio youth problems, functioning, and satisfaction scales (short form): User manual. Athens: Ohio University. Retrieved from https://sites.google.com/site/ohioscales/the-manuals.
- Ogles, B. M., Melendez, G., Davis, D. C., & Lunnen, K. M. (2000). The Ohio youth problem, functioning, and satisfaction scales: Technical manual. Athens: Ohio University. Retrieved from https://sites.google.com/site/ohioscales/the-manuals.
- Parfitt, G., & Eston, R. G. (2005). The relationship between children’s habitual activity level and psychological well-being. Acta Pae-Diatr, 94, 1790–1796.Google Scholar
- Promising Practices Network on Children, Families and Communities. (2006). Incredible years. Retrieved from http://www.promisingpractices.net/program.asp?programid=134.
- Roberts, B., Horwood, S., Aunger, N., & Wong, M. (1998). Adventure with adults living with psychiatric disabilities. In C. Itin (Ed.). Exploring the boundaries of adventure therapy: International perspectives. Proceedings of the 1st international adventure therapy conference: Perth, Australia (pp. 368–375). Boulder, CO: The Association for Experiential Education.Google Scholar
- Ross, S. (2003). The therapeutic effects of an adventure challenge program on the personal empowerment of women survivors of sexual trauma. Journal of Experiential Education, 25(3), 350.Google Scholar
- Russell, K. (2007). Adolescent substance-use treatment: Service delivery, research on effectiveness, and emerging treatment alternatives. Journal of Groups in Addiction & Recovery, 2(2–4), 68–96.Google Scholar
- Schoel, J., & Maizell, R. (2002). Exploring islands of healing: New perspectives on adventure based counseling. Beverly, MA: Project Adventure, Inc.Google Scholar
- Substance Abuse and Mental Health Services Administration (SAMHSA). (2007). The comprehensive community mental health services for children and their families program, evaluation findings: Annual report to congress 2002–2003. Retrieved from http://download.ncadi.samhsa.gov/ken/pdf/SMA03-CBE2002/CongReport20022003FINALPUBLICATION.pdf.
- Substance Abuse and Mental Health Services Administration (SAMHSA). (2008). Assertive community treatment: The evidence. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration.Google Scholar
- Substance Abuse and Mental Health Services Administration (SAMHSA). (2011). Justification of estimates for appropriations committees. Rockville, MD.Google Scholar
- Substance Abuse and Mental Health Services Administration (SAMHSA), National registry of evidence-based programs and practices (NREPP). (2006). Dialectic behavior therapy. Retrieved from http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=36.
- Substance Abuse and Mental Health Services Administration (SAMHSA), National Registry of Evidence-Based Programs and Practices (NREPP). (2007a). Multisystemic therapy (MST) for juvenile offenders. Retrieved from http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=26.
- Substance Abuse and Mental Health Services Administration (SAMHSA), National registry of evidence-based programs and practices (NREPP). (2007b). Motivational interviewing. Retrieved from http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=130.
- Substance Abuse and Mental Health Services Administration (SAMHSA), National registry of evidence-based programs and practices (NREPP). (2008). Multisystemic therapy with psychiatric supports (MST-Psychiatric). Retrieved from http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=17.
- Substance Abuse and Mental Health Services Administration (SAMHSA), National registry of evidence-based programs and practices (NREPP). (2009). Multisystemic therapy for youth with problem sexual behaviors (MST-PSB). Retrieved from http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=46.
- Tucker, A.R., & Norton, C. L. (2012). The use of adventure therapy techniques by clinical social workers: Implications for practice and training. Clinical Social Work Journal. doi: 10.1007/s10615-012-0411-4.
- Tucker, A., Zelov, R., & Young, M. (2011). Four years along: Emerging traits of programs in the NATSAP practice research network (PRN). Journal of Therapeutic Schools and Programs, 5(1), 10–28.Google Scholar
- Van Dorn, R., Kosterman, R., Williams, J. H., Chandler, K., Young, M. S., Catalano, R., et al. (2010). The relationship between outpatient mental health treatment and subsequent mental health symptoms and disorders in young adults. Administration and Policy in Mental Health and Mental Health Services Research, 37(6), 484–496. doi: 10.1007/s10488-010-0291-2.PubMedCrossRefGoogle Scholar
- Voruganti, L. N. P., Whatham, J., Bard, E., Parker, G., Babbey, C., Ryan, J., et al. (2006). Going beyond: An adventure- and recreation-based group intervention promotes well-being and weight loss in schizophrenia. Canadian Journal of Psychiatry, 51, 575–580.Google Scholar
- Warren, J. S., Nelson, P. L., Mondragon, S. A., Baldwin, S. A., & Burlingame, G. M. (2010). Youth psychotherapy change trajectories and outcomes in usual care: Community mental health versus managed care settings. Journal of Consulting and Clinical Psychology, 78(2), 144–155. doi: 10.1037/a0018544.PubMedCrossRefGoogle Scholar
- Zisser, A., & Eyberg, S. M. (2010). Treating oppositional behavior in children using parent-child interaction therapy. In A. E. Kazdin & J. R. Weisz (Eds.), Evidence-based psychotherapies for children and adolescents (2nd ed., pp. 179–193). New York: Guilford.Google Scholar