Adventure therapy is a distinct form of psychotherapy that is based on principles from a number of different psychological therapy paradigms.
This article will discuss the benefits of adventure therapy with regards to its utility in the treatment of substance use disorders.
What Is Adventure Therapy?
According to the book Handbook of Group Counseling and Psychotherapy, adventure therapy is an approach that is an active and experiential (focuses on experiencing events, emotions, etc.) type of individual, group, or family therapy. Adventure therapy uses an activity-based approach, such as cooperative games, rope or zip line courses, wilderness or other outdoor expeditions, and other outdoor pursuits that employ certain types of real and perceived risks as a clinical tool to help individuals change. Obviously, this type of therapy is appropriate for individuals who can handle the physical activity involved. These therapies are more often used with children, teens, and younger adults; however, older adults and families can also get involved.
- Trust activities: This category includes a number of different activities that are designed to develop trust, teamwork, and support among group members or family members.
- Problem-solving initiatives: These are games that are cooperative, challenging, and fun, and that involve confronting a group with a specific problem or type of problem to solve. The group works together.
- Outdoor pursuits: These are a number of different recreational activities designed to provide clients with environmental awareness, experiential learning, recreation, and the development of leadership and cooperation.
- Wilderness expeditions: These include a number of different wilderness activities, such as survival expeditions, discovery expeditions, and so forth. These activities develop specific skills as a result of the type of challenge involved and also foster communication skills and self-esteem.
- High adventure: This category include such things as rope courses, zip lines, rock climbing/rappelling, and peak ascents designed to give individuals the experience of overcoming a situation that is associated with some risk.
All of these approaches involve risk, problem-solving, and the development of a number of coping skills as well as self-esteem. Individuals learn to share control, give control to others when necessary, and assume aspects of control and responsibility for themselves.
- How Does Adventure Therapy Work?
It is important to remember that adventure therapy is more suited to families with younger children or adolescents, teens, young adults, and, in some cases, middle-aged and older adults. The effectiveness of adventure therapy interventions with individuals in treatment for substance use disorders is that it offers these individuals:
- Structure and concrete goals as well as the means to attain these goals
- The process of self-discovery
- A number of different methods of experience and self-expression, including typical verbal experience and expression, visual experiences and expression, and tactile/kinesthetic modes of expression and experience
It is important to understand that adventure therapy is an adjunct, or additional, series of therapeutic techniques that can enhance traditional treatment for substance use disorders. Individuals who engage in adventure therapy will also need to follow the standard protocols used in substance use disorder treatment. Adventure therapy can enhance the effects of these standard treatments, but is not designed to be a substitute for them.
Research indicates that adventure therapy does have some positive effects. For instance, a 2000 meta-analysis comparing adventure therapy to standard treatments used for delinquent adolescents (some with substance use issues) indicated a slight advantage for the use of adventure therapy in preventing recidivism in delinquent youth. Adventure therapy programs that were incorporated with traditional therapy programs fared the best compared to adventure therapy alone or to traditional approaches alone.
A 2013 quasi-experimental study (a type of research design that uses natural settings as the “laboratory”) with over 1,000 participants found components of adventure therapy to be advantageous over therapies without an adventure therapy component regarding decreases in problem severity. However, it is important to note that the best predictor in the study was the length of the therapy.
A number of studies have found adventure therapy to be better than no therapy at all; however, this type of research is limited in its ability to determine the actual therapeutic utility of a specific procedure.
- When Is Adventure Therapy Not Appropriate?
Adventure therapies may have some utility in the treatment of substance abuse as discussed above; however, there are a number of limiting factors that suggest that certain types of participants with certain types of co-occurring psychological disorders are not appropriate for adventure therapy. These groups include:
- Individuals with eating disorders and co-occurring substance use disorders
- Individuals with specific phobias, social anxiety disorder, or generalized anxiety disorders and co-occurring substance use disorders
- Individuals with post-traumatic stress disorder and a co-occurring substance use disorder
- Individuals with co-occurring diagnoses of obsessive-compulsive disorder and substance use disorder
- People who have co-occurring bipolar disorder or major clinical depression as well as people who are actively suicidal
- Individuals with ADHD or conduct disorders and co-occurring substance use disorders
- People with psychotic disorders, such as schizophrenia
- People with certain physical limitations, cognitive issues, and perceptual issues (e.g. individuals who are deaf or blind)
Adventure therapy is an option that can be used as an adjunctive form of treatment for certain individuals with substance use disorders. The focus of adventure therapy is to provide individuals with a challenge, a perceived risk, and an opportunity to overcome the challenges despite the risk. This can develop self-esteem, a sense of control over oneself, the experience of acceptance, the experience of working toward the specific goal, and the facilitation of communication skills, social skills, and problem-solving skills.
There are a number of contraindications for using adventure therapy, and adventure therapy is not a standalone treatment for substance use disorders. Adventure therapy can be incorporated into standard treatment protocols for substance use disorders in the treatment programs of some individuals.