Adventure Therapy: Treatment Effectiveness and Applications with Australian Youth

PhD Thesis

Bowen, D. J. (2016). Adventure therapy: Treatment effectiveness and applications with Australian youth. Doctor of Philosophy in Clinical Psychology, University of Canberra, Canberra, Australia.  

Abstract

        Adventure therapy involves use of small groups, nature-contact, adventure activities, and therapeutic processes to create opportunities for psychological change in participants, usually with the purpose of supporting an individual (or family) to move towards greater health and well-being. Adventure therapy programs involve diverse target groups, settings, program models and aims; yet too little is understood about their characteristics and efficacy. This thesis including published works assists in improving the health and well-being of Australian youth by providing up-to-date information, consolidating and advancing understanding of the therapeutic uses and treatment effectiveness of adventure therapy. Further, by evaluating two specific therapeutic adventure-based interventions for youth, this thesis provides valuable insight about the current utility and therapeutic outcomes of adventure therapy programs in Australia.
        This thesis includes four studies reported in four papers, each of which contributes to its overall aims. Study 1 examines the efficacy of adventure therapy programs internationally through a meta-analysis of outcomes and moderators. Study 2 provides an up-to-date description of outdoor adventure interventions for youth in Australia based on a national survey of program managers and leaders. Study 3 examines the efficacy of the Wilderness Adventure Therapy®  (WAT) model of clinical treatment for Australian youth, while Study 4 examines the efficacy of the Queensland Police-Citizens Youth Welfare Association Bornhoffen Catalyst program for Australian youth-at-risk (Study 4).
        Meta-analytic results from Study 1 confirmed that adventure therapy programs are moderately effective (.47) in facilitating positive short-term change in psychological, behavioural, emotional, and interpersonal domains and that these changes appear to be maintained in the longer-term. Such magnitude of benefit is comparable to the majority of efficacious treatments for patients across the age span reported in the literature. As the most comprehensive and robust meta-analysis of adventure therapy studies to date, the findings from Study 1 can be recommended for use in benchmarking and monitoring program effectiveness. Results from Study 2 indicated considerable breadth, depth, diversity and differences in the organisation, program, staff, and participant characteristics of outdoor adventure interventions in Australia. The main outcomes of outdoor adventure interventions, as perceived by staff, were recreation, and personal and social development. Surveyed staff believed that the majority of participants obtained significant long-lasting benefits. Findings from Studies 3 and 4 suggest some cautious promise that two Australian adventure therapy programs (WAT and the Catalyst program) each offer a viable alternative to traditional psychotherapeutic approaches through prevention and intervention programs for youth at-risk.
        Overall, the findings of this thesis confirm that adventure therapy has the potential to play important roles in improving the health and well-being of Australian youth. While adventure therapy is not a panacea, these findings indicate that it is useful in a wide range of settings and for a broad spectrum of clients. Thus, findings from this thesis strongly support the assertion that adventure therapy should be in the suite of therapeutic interventions that operate in diverse service settings across Australia.
        Future research could build on Study 2 by conducting a dedicated survey of adventure therapy programs in Australia. In addition, research utilising a comparison or wait-list control group, multiple sources of data, and a larger sample, could help to qualify and extend findings of Studies 3 and 4. Overall, despite the promising findings, more rigorous research evaluations of adventure therapy programs (e.g., quasi/experimental, case study, observational, mixed method, and longitudinal design) are needed to strengthen the reliability, validity, and usability of adventure therapy research.


The thesis resulting from this project included four published works:  
  1. The first study conducted a meta-analysis of studies that empirically reported on participant outcomes for adventure therapy programs and examined variation in these outcomes across different types of participants and programs. 

  2. The second study conducted secondary data analysis of data from the Outdoor Youth Programs Research Alliance (OYPRA) National Survey in order to describe the nature of Australian outdoor adventure intervention programs currently delivered in Australia, including the characteristics of organisations, staff, programs, participants, and the perceived benefits and outcomes.

  3. The third study conducted secondary data analysis of a longitudinal dataset to examine the efficacy of the Wilderness Adventure Therapy® model, a therapeutic adventure-based intervention for adolescents at risk of developing serious psychological and behavioural problems. 

  4. The fourth study conducted primary data analysis using a mixed methods design to investigate the treatment effectiveness and clinical significance of the PCYC Bornhoffen Catalyst program.