Adventure Therapy: Definition, Types, Techniques, and Effectiveness

What Is Adventure Therapy?

The use of adventure experiences provided by mental health professionals, usually in natural settings, is the practice of adventure therapy. The encounters are meant to engage individuals, families and groups on physical, cognitive, emotional, and behavioral levels.

It draws from learnings from the Outward Bound Process Model, which helps its participants overcome their self-limiting beliefs.

A study of Outward Bound participants who had participated in a 21-day course found better outcomes for recidivism (refers to the likelihood that a person who committed a crime will do so again) than those teens who did an intensive outpatient therapy program instead.

Types of Adventure Therapy

There are three major types of adventure therapy: wilderness therapy, adventure-based therapy, and long-term residential camping. The structure of these three different types may vary wildly but the goals are the same:

1.Wilderness therapy: This typically takes place in remote wilderness settings and in a small-group, multi-day format. The group remains the same throughout the process unless someone drops out. These programs are often modeled after Outward Bound.

2.Adventure-based therapy: These programs are often hosted at or near where the person is being treated—usually for people who are in multi-day programs like an intensive outpatient program or residential treatment. The groups change as people come in and out of the facility, and sometimes the activities are more contrived (i.e., rock climbing walls at a treatment facility built specifically for therapeutic purposes rather than out in the “true” wild.)

3.Long-term residential camping: This places people in outdoor camps or “mobile training units” (such as learning to sail on clipper ships) for a very long time, often a year, to teach them how to develop a positive peer culture, confronting problems inherent in day-to-day living and dealing with natural consequences of their actions.

Techniques

Adventure therapy is based on seven core tenets:

1.Action centered therapy: Traditional therapy occurs somewhat in a vacuum, with one other individual in a room. Adventure therapy takes people outside and puts them in a more “holistic” environment, where body language can also be observed.

2.Unfamiliar environment: Many people come into therapy resistant to change. This takes them out of familiar environments where it may be easier to—literally—take a different perspective.

3.Climate of change: One of the purposes of adventure therapy is to introduce “eustress” (good stress) into people’s lives to show them evidence that they are capable of changing their behaviors and attitudes.

4.Assessment capabilities: Seeing someone in a natural habitat, outside of a therapy room, helps the therapist get a full picture of someone they might not otherwise get in a therapy room—and be able to observe patterns that apply globally in someone’s lives manifesting in this way.

5.Small group development: This helps people develop a community and take into account others’ needs and show proof of success.

6.Focus of successful behaviors rather than dysfunctional behaviors/deficits: Often therapy may focus on someone’s weaknesses/dysfunction rather than their strengths or what they’re doing well.

7.Altered role of the therapist: Often, this type of therapy makes people feel like the playing field has been leveled a bit since the therapist is participating in the same kind of challenges.

What Adventure Therapy Can Help With

Adventure therapy can help with a wide range of conditions, including:

•Anxiety

•Depression

•Trauma

•PTSD

•Grief

•Loss

•Eating disorders

•Substance use disorders

•Schizophrenia

Benefits of Adventure Therapy

•Reduce feelings of suicidality

•A decrease in feelings and symptoms of depression

•Fading sense of hopelessness

•Promotes feelings of self-efficacy

Effectiveness

A meta-analysis (study of studies) of 197 studies about adventure therapy (with nearly 3,000 participants) showed that adventure groups showed greater change than those who either received alternate treatment or no treatment.

Studies have shown an improvement in symptoms for at-risk youth and those with combat-related PTSD, body image issues, and more.

Things to Consider

Unfortunately, adventure or wilderness therapy is not often covered by insurance, and it can be very costly—an average of $500 per day but up to $1,000 per day for some programs. Because of this, it is inaccessible to many, though there are some grant programs available.

Additionally, most of them are a major time commitment that not everyone may be able to make.

Additionally, the private treatment program industry has had some reports of ethical issues,so it is important to really do your research.

Some questions you might want to ask include:

•Do they treat the problem/issue/concern you’re looking for?

•How do they measure "success" for individuals?

•Are skills being taught that can be used in the “real world”?

•Are they members of the Outdoor Behavioral Healthcare Council, an accrediting body?

Also, many of these programs are part of residential treatment or intensive outpatient programs—longer programs at a higher level of care—so this is a modality often not available for regular outpatient therapy.

How to Get Started

For starters, wilderness therapy is a very intensive type of therapy. Be sure you (or your child) have talked it through with your current therapist and have talked through the pros and cons, including if the rigors of this type of therapy are appropriate for you physically.

If you have picked a program, you can expect to do an intake session where you both will be making sure this is the correct fit for you or your child. Be prepared to discuss your (or your child’s) mental health history, including other programs or therapies or medications that you have tried in the past.

The Bottom Line

Adventure therapy can be a very costly and time-intensive endeavor, so don't be afraid to advocate for yourself to make sure you get what you want out of a program. That said, it is also a one-of-a-kind opportunity, so also take time to be present in the experience.

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