An Overview of Adventure Therapy

An Overview of Adventure Therapy
(Last Updated: 23 August 2012)
Adventure therapy is increasingly seen as a credible treatment approach for a range of clientele (Gass, Gillis, & Russell, 2012; Pryor, 2009). Internationally, adventure therapy programs take many forms and operate in a range of settings (Berman & Davis-Berman, 2000). In some cases adventure therapy is used as the primary method of treatment, whilst other times it is utilised as an adjunct to more mainstream therapeutic interventions (Newes, 2000). Treatment outcomes that are commonly sought in adventure therapy include the development of personal responsibility, cooperation and relationship building, intrapsychic outcomes (e.g., self-awareness, self-efficacy, self-confidence), social skill acquisition, and psychological resilience (Gass et al., 2012).

Adventure therapy has been referred to within the literature by an assortment of other terms, resulting in misunderstanding and lack of clarity surrounding the field. Such terms include wilderness therapy (Russell, Hendee, & Phillips-Miller, 2000), wilderness adventure therapy (Crisp, 2006), wilderness experience programs (Friese, Hendee, & Kinziger, 1998), bush adventure therapy (Pryor, Carpenter, & Townsend, 2005), adventure-based counselling (Fletcher & Hinkle, 2002), outdoor adventure intervention (Pryor, 2009), therapeutic camping (Brown, 2005), and outdoor behavioural healthcare (Russell, 2002). 

Although several definitions exist in the adventure therapy literature, a consistent and accepted definition is lacking. However, in exploring a variety of definitions and identifying common components, Gass et al. (2012) recently proposed that adventure therapy is “the prescriptive use of adventure experiences provided by mental health professionals, often conducted in natural settings that kinaesthetically engage clients on cognitive, affective, and behavioural levels” (p. 1). Alternatively, Neill (2004) defined adventure therapy as “the use of adventure-based activities and/or adventure-based theory to provide people with emotional and/or behavioural problems with experiences which lead to positive change in their lives."

For the purpose of my research, adventure therapy is conceptualised according to the three guiding elements recommended by Russell (2001): a) theoretical basis, b) practice, and c) expected outcomes. First, the design and theoretical basis of adventure therapy programs are purposefully therapeutic in nature, possibly focusing on the cognitive, affective, behavioural, physical, social, spiritual or environmental dimensions of the participants. Second, outdoor adventure pursuits and other activities (e.g., games, initiatives, reflection) are intentionally utilised by trained professionals in adventure therapy to kinaesthetically engage participants with the aim of enhancing personal and interpersonal growth. Third, the intended result from participating in an adventure therapy program is the development of the self, assisting participants to reach desired goals (e.g., responsibility, cooperation and relationship building, intrapsychic outcomes, social skill acquisition and resilience).

Classification of Major Purposes and Expected Outcomes of Outdoor Education*
 Purposes/Expected Outcomes Description
 Recreational, Physical Leisure (fun, relaxation, enjoyment), Physical fitness, Outdoor skills training
 Educational Direct (subject knowledge) and indirect (e.g., Academic self-concept)
 Developmental Personal and social development, life skills and functionality of behaviour
 Therapeutic, Redirectional Improve dysfunctional personal and group behaviour patterns
 Environmental Environmental attitude, knowledge, and behaviour
*Adapted from Neill (2008, p. 7)

Adventure therapy programs are typically designed and developed around several goals, targeting specific populations (e.g., substance abusers, psychiatric inpatients, disabled children, physical, emotional and sexual abuse victims, sexual perpetrators, at-risk teens; adjudicated youth, couples and families) (Cason & Gillis, 1994). Although adventure therapy predominantly takes place in the outdoors, it is recognised that it can also effectively operate indoors (Richards, Carpenter, &  Harper, 2011). Gillis and Gass (2003) indicate that adventure therapy typically occurs in three locations: a) on challenge/ropes courses and through games, trust activities and initiative experiences; b) in wilderness settings; and c) at residential camps.  

Key elements found in adventure therapy, that differentiate it from, or link it to other therapeutic approaches, include (Crisp, O'Donnell, Kingston, Poot, & Thomas, 2000; Gass et al., 2012):
  • The positive influence of nature 
  • The use of eustress or the positive use of stress
  • The active and direct use of client participation and responsibility 
  • Meaningful involvement in adventure experiences
  • The focus on positive change (present and future functional behaviour)
  • Holistic effects on client learning
  • The strong ethic of care and support

  • Dimensions that help distinguish adventure therapy approaches (Gass, Gillis & Russell, 2012, p. 5)
    Dimensions that help distinguish adventure therapy approaches (Gass, Gillis & Russell, 2012, p. 5)

    History of Adventure Therapy
    The deliberate application of outdoor- and adventure-based education principles to therapeutic populations has been taking place since at least the 1950s (Bandoroff & Newes, 2004). Although still in its formative stages, adventure therapy has been used in a wide range of therapeutic settings to treat a diversity of problems, both as an adjunct to more traditional interventions, and as a primary therapeutic modality in itself (Newes, 2000). As practice and interest in adventure therapy continues to grow internationally, an array of initiatives are being employed (e.g., associations, publications, conferences, and accreditation of programmes and practitioners) to solidify itself as its own profession (Aldridge, 2009; Priest & Gass, 2005). 

    Important influences and significant events in the development of adventure therapy include (Gass et al., 2012):
    1901: The use of ‘tent therapy’ to isolate tuberculosis patients from other patients 
    1907: The founding of Scouts by Baden Powell
    1930s: The Progressive Education Movement, to a large extent pioneered by John Dewey
    1941: The founding of the first Outward Bound program by Kurt Hahn
    1946: The establishment of therapeutic camping, with programs like the Dallas Salesmanship Club
    1971: The founding of Project Adventure
    1972: The founding of the Association for Experiential Education
    1988: The publication of Adventure Based Counselling
    1992: The first Australian wilderness adventure therapy program commences in a clinical service (Crisp et al., 2000)
    1993: The publication of Adventure Therapy: Therapeutic Applications of Adventure Programming
    1997: The first International Adventure Therapy Conference was held in Perth, Western Australia
    2009: Formation of the Australian Association of Bush Adventure Therapy (AABAT, 2012b)

    Within Australia, adventure therapy is a diverse and widespread field of practice. Having conducted a critical literature review, interviews and focus groups, Pryor (2009) documented the emergence and evolution of outdoor adventure interventions in Australia. Prior to colonisation, evidence suggests that Indigenous communities utilised traditional ‘bush adventure’ practices for both prevention and treatment of health needs. It was not until the 1950’s, in response to identified needs and service gaps, that modern Western use of bush adventure therapy emerged. For example, Outward Bound Australia was founded in 1956. Initially used in educational settings, adventure therapy evolved to be used within community, health, justice, drug treatment, mental health and employment sectors over time. In 1996, Crisp suggested principles of best practice in wilderness and adventure therapy and in 2002 he developed the Wilderness Adventure Therapy accreditation scheme. Another recent development was the incorporation of the Australian Association for Bush Adventure Therapy (AABAT) in 2009. AABAT is a professional association for practitioners and organisations who use adventure and the outdoors to achieve therapeutic outcomes (AABAT, 2012a).

    Although adventure therapy is yet to adopt a unifying theory which considers all dimensions, the integration of theory and practice is fundamental to the field (Richards et al., 2011). As a multi-disciplinary, multi-theoretical intervention, adventure therapy integrates components of theories from a diversity of perspectives (Association for Experiential Education [AEE], 2012). Literature addressing how adventure therapy works draws on such fields as psychology, education, sociology, and outdoor education (Bandoroff & Newes, 2004).
    The following five core perspectives are posed by AEE (2012) as theories which underpin adventure therapy:
  • Experiential Learning Theory/Experiential Education Philosophy
  • Systems Theory 
  • Existential Theory
  • Behavioural/Cognitive Behavioural Theory
  • Psychodynamic Theory

  • systems framework for understanding the interactive relationship between an individuals’ phenomenological reality (Ii) and domains of influence in outdoor education and adventure therapy (adapted from Neill, 2008, p. 43). What occurs during an outdoor education and adventure therapy program can be understood as a complex interaction between elements within each of these domains. These elements interact with one another and with elements in other domains.

    A Systems Framework for Adventure Therapy (Adapted from Neill, 2008, p. 43)

    Meta-Analytic Research on the Outcomes of Adventure Therapy
    There are currently no published meta-analyses directly concerned with adventure therapy. However, there are a number of existing outdoor education, psychological and educational meta-analyses (e.g., Cason & Gillis, 1994; Gillis & Speelman, 2008; Hans, 2000; Hattie, Marsh, Neill & Richards, 1997; Wilson & Lipsey, 2000) which, in some cases, report outcomes for therapeutic clientele or groups. There are also a number of unpublished thesis adventure therapy meta-analysis work by Staunton (2003), Baker (2011) and George (2011). The first study of my PhD will conduct a meta-analysis of studies that empirically report on participant outcomes for adventure therapy programs and examine variation in these outcomes across different types of participants and programs. 

    Click here for a list of previous outdoor education, camping, wilderness and adventure therapy meta-analyses, including abstracts, overall effects sizes and included studies.

    Overall, these meta-analyses indicate that outdoor education programs have small to moderate effects on participants, in areas such as self-concept, locus of control, and teamwork (Neill, 2003). Further, these meta-analyses revealed that the  programs which demonstrated the greatest effect were delivered by organisations, comprised adult participants and were longer in program length (Neill, 2002). Of note, these meta-analyses suggest that program participants experience further growth when returning home, and that the effects from these programs appear to be retained over time (Neill, 2002). However, there is considerable variability of effect sizes between different types of adventure programs (Hattie et al., 1997). Findings therefore highlight the potential of specific types of adventure-based programming, rather than purporting the effectiveness of outdoor education and adventure therapy programs (Neill, 2003).