Volume 22 Number 2
Adventure Therapy and the Addictive Process
Case Example (1)
The group is made up of 11 other people from the treatment program. As a warm up to the adventure experiences, the facilitator engages the group in several ice-breakers and warm-up games. During an initial game, John is unwilling to fully participate. He expresses concern that these activities are childish and have no relevance to his treatment. As the games continue, John is encouraged by other participants to participate. The group takes responsibility for inviting him to be a part of the activity. John's participation changes from marginal involvement to active engagement. As John participates, he begins to laugh and allow others to be involved with him.
As the adventure therapy continues, the group is engaged in problem-solving initiatives. During the first initiative, John attempts to control the activity and order his peers around. He is confronted by other group members about this behavior. John acknowledges his tendency to dominate and take charge. The group expresses concern that John does this to remain isolated from the group. During subsequent activities, he explores various ways to act within the group.
Further in the adventure therapy process, John is provided the opportunity to participate in a trust walk  with a peer. During the walk John is blindfolded and is being led by his peer. He initially attempts to lead his guide or go in his own way. Both John and his guide are frustrated and becoming increasingly angry. The activity is stopped and both participants are asked to explore what is happening. John tells the group that he has trouble trusting other people, especially men. John's guide shares how difficult it is to provide support and guidance when John won't let his guard down. John and his partner choose to engage in the trust walk again. The second time John allows his partner to lead him.
After the trust walk, the group proceeds to the ropes course . John asks for the support of the person who led him on the trust walk. On a challenging activity, John is gripped with fear. With support from his peers, he is able to work with this fear and to continue on with the activity. John is willing to allow himself to be supported and helped by his peers.
The program ends with an overnight solo  experience. After the solo, John shares with the group that he is sorry for some of his actions during the program. He acknowledges a need to work on issues of trust and intimacy and sees how he tends to take control when he feels powerless, rather than asking for support. He talks about how support helped him during the trust walk and on the ropes course.
The Addictive Process
The addictive process is a deathoriented process, one that prevents people from living life fully. An addiction for this article will be considered the use of any substance, activity or behavior that one has become powerless over and that has made one's life unmanageable. The person is negatively affected by the repetitive abuse of a substance, activity or behavior to such a degree that the person no longer has control. Furthermore, the addiction becomes increasingly central to the person's life, taking more and more of the person's energy. The addictive process, as previously stated, are those activities, behaviors and themes that go along with addictions. The addictive process goes beyond the simple activity of the addiction and speaks to how the person begins to live his or her life. The behaviors of an addictive process focus around 6 primary areas (Itin & Gault, 1989):
To maintain the elements of control, separation of feelings, and denial the person dealing with the addictive process must develop ways of thinking which support the addictive process. These thinking patterns tend to be rigid, dualistic (either/or) and obsessive (intrusive or repetitive).
6) Low Self Worth/Esteem:
Elements of Adventure Therapy
Games within the adventure therapy context include any activity that has as its primary purpose to have fun. The games in the adventure therapy context are primarily non-competitive, often asking the participant to place themselves in a new or uncomfortable situation (e.g., new games, cooperative games, word games). Games address the issues of the addictive process in several ways. Because games require an element of spontaneity they challenge the predominant paradigm of remaining in control and not having fun. The non-competitive and group orientation of the games promotes a sense of connection between people. This connection serves to develop trust and can enhance a person's spiritual connection to other people. For example a cooperative tag game such as blob tags  requires individual members of a group to work together. The fact that the tag game is cooperative also challenges the traditional paradigm of a win/lose perspective that contributes to some of the destructive thinking pattern of the addictive process. As we saw in the case example, John was able to be invited into the group process by the group and as he participated his level of involvement in the group grew. This participation began the process of building trust and changing the paradigm that games are child's play.
Initiatives have as a central component the need for participants to work together to solve a problem. The activities are termed initiatives because they generally rely on the group's initiative to solve the problem. These activities were originally developed to prepare participants for the type of problem solving skills they would need in wilderness based activities (e.g., crossing rivers with minimal supplies, navigating an obstacle, retrieving an item with limited supplies). Initiatives deepen the ability to help people address issues around control, trust, feelings, thinking patterns and spirituality. Initiatives are usually set up to be successful. The success orientation of initiative activities and the process of working together with others can help develop a person's self-esteem and self-worth. As people see that they can work together to solve difficult problems they begin to feel more empowered in their abilities.
Initiatives can further be tailored to meet the needs of addiction and the issues of the addictive process through metaphoric introductions, and other introduction techniques. Metaphoric introductions rely on setting up an activity so that it is more likely to be similar to the experience of the person doing the activity. For example an activity such as spider's webs  can be framed to be about the addictive process. The web becomes the web of addiction with the pervasiveness of the addictive process. One of the critical aspects of the activity is how the group deals with the honesty of whether any member touches the web and what they do when a touch is made. The activity becomes about how to work with others to not be caught up in the addictive process. It becomes about how one avoids being tangled up in the addictive process and allows others to support the recovery process.
Trust activities have as a central component requiring participants to work together to support each other in a difficult activity. The level of support required involves literally placing one's trust in another person to hold and support the other (e.g., falling into the arms of the group, being led blindfolded). Clearly trust activities will affect the element of trust, but additionally these activities affect spirituality because they demand a relationship with the other participants. There is the natural metaphor of letting go of control and choosing to do so. This metaphor can be further brought forth through appropriate introductions. The dramatic nature of the activities can also allow people to reconnect with feelings. For example the trust fall  can be framed as an activity involving letting go of a behavior, thinking pattern, or feeling that is not working for the person. As the person let's go to fall into the arms of the group the person is letting go of that which is limiting them. The activity can be further strengthened to be about the group supporting the person in a new way of acting, thinking, or feeling that is healthy for the person. As we saw in the case example, John had to make a choice to let go and allow himself to be supported and led by a peer.
Ropes course activities may be thought of as elements or obstacles that challenge an individual but require the support of others. They involve a level of trust and of initiative (e.g., walking across a log 40 feet in the air, walking on a wire using a rope for assistance). The dramatic nature of ropes courses can affect all six areas of the addictive process in positive ways. For example the beam  allows a person to address issues of trusting oneself and trusting the support system that would prevent a fall to the ground. The activity can help the person to address issues of appropriate trust and appropriate risk taking. In the case example, John was able to work with the powerful emotion of fear and to work through this feeling. Rather than attempting to take control or get angry he worked through the fear with the support of his peers.
Wilderness activities are all those activities that occur in the wilderness or natural environment utilizing the challenges presented by the natural environment (e.g., rock climbing, white water activities, backpacking). Wilderness activities can be even more dramatic than other aspects of adventure therapy. Besides the adventure component there is also a connection with the natural world. This connection with the natural world can deepen the therapeutic impact of the programming. Miles (1993) discussed the healing benefits of wilderness. Citing the work of Kaplan and Talbot, Miles indicated that wilderness can help reestablish a proper relationship with control. Miles goes on to discuss how the wilderness can increase self-esteem and self-worth and decrease feeling of alienation. Furthermore the wilderness can increase feelings of joy and pleasure. An example of the use of the wilderness is the solos . During a solo the person may be provided with an opportunity to reexamine the changes they have made in treatment. They may be provided with the opportunity to take an inventory of their assets and the issue they want to work on. The case example illustrates how John was able to draw connections between many of his experiences and the issues of his recovery.
Adventure Therapy Process
Adventure therapy attempts to build upon a person's strengths to address both the current issues affecting recovery and those that may arise later in recovery. The basic model provides people with opportunities and skills to deal with difficult situations. The model assumes that people can draw upon the experiences presented in the adventure context to cope with difficult situations in the addictive process. In the context of working with the addictive process adventure experiences allow the person to address issues of denial, trust, control, feelings, self-esteem, and spirituality. Through addressing these issues in the adventure situation a person is provided with opportunities to transfer their issues to real life situations.
One of the powerful elements of adventure therapy is to break through much of the denial that surrounds addictive processes. The dramatic nature of adventure activities and the heavy use of peer support provides a mirror for the person to experience themselves in a new way. Mechanisms that an individual uses to prevent themselves from confronting the addictive process are exposed within the context of a supportive group experience based on addressing the issues of trust. Throughout therapy the person is provided with experiences that provoke strong feelings and encouraged to experience and share these feelings. Because the therapy builds upon the strengths of the person, the person is able to address issues of self-esteem and self-worth.
Within adventure therapy people are able to experience how they are not only responsible for their actions but how these actions impact others. If a person does not put on a rain jacket in a cold rain; not only will they get cold and wet, but their condition will affect the group. The group might have to stop an activity to treat the client's hypothermia or address the person's condition. This event can become a natural metaphor for the person's effect on others in the addictive process. If the person is an alcoholic their drinking not only affects them; but also affects others. The activities provide an opportunity to experience the addictive process in different ways and to act on these experiences differently. It is the opportunity to experience the situation differently that provide the opportunity for change.
Adventure Therapy Programs
Adventure therapy as an adjunct to treatment began with the Colorado Outward Bound's Alcohol and Drug Courses (CAD). This program began at St. Luke's Hospital in 1978. It was a four day experience offered to patients as a part of a 28 day inpatient treatment program. The program was adjunctive in that primary treatment staff were usually not a part of the treatment process that occurred on the 4-day Outward Bound course. This adjunctive process has continued to include programming for survivors of sexual assault, Vietnam veterans, perpetrators of abuse, and people with eating disorders.
In some cases, adventure therapy may be the primary treatment. When adventure therapy is the primary treatment it is the main form of treatment used. For example the entire treatment may occur in a wilderness setting where the participant is helped to explore the issues that are important for them completely within the context of the adventure therapy experience.
One of the first primary treatment programs was created by Hurricane Island Outward Bound School and Beech Hill Hospital. This program used a standard multi-element model (several different wilderness environments) as the primary device for the delivery of treatment. Addiction counselors along with Outward Bound staff jointly delivered all aspects of the program. The adventure therapy and wilderness therapy aspects of the program were central to all aspects of treatment. The elements of the course were used to address all aspects of the addictive process. Traditional drug and alcohol counseling were weaved into the overall program.
Adventure Therapy programs are offered in many different ways to people seeking these services. An adventure therapy program may exist as an independent service, an independent program within a hospital, or as a part of an experiential therapy department (art therapy, music therapy, psychodrama, movement therapy, recreational). Some programs may integrate adventure therapy in varying degrees from adjunctive to primary. Adventure therapy can be seen as more primary to the degree that adventure activities are integrated into overall treatment planning, staff conducting adventure therapy are trained clinical staff, and other treatment staff participate and are involved in adventure experiences. Adventure experiences can be seen as adjunctive to the degree that these elements are not present.
Independent programs may offer their services directly to the person or through contracts to other agencies. Many wilderness treatment programs are completely independent programs. When independent programs offer their services through contracts to other mental health agencies or hospitals, they are often adjunctive. These programs are often not fully integrated into the inpatient or outpatient programming offered by the agency. Adventure therapy programs located within a mental health agency or a hospital are not necessarily more integrated than contract agencies. The integration is directly affected by treatment philosophy. When a treatment program has a philosophy that values and is compatible with adventure therapy, then adventure therapy can be fully integrated into the treatment of the addictive process.
Adventure therapy programs may be effective as adjunctive or primary treatment. The distinction is important in understanding how and where services are offered. It also begins to identify who is offering adventure therapy services. Within all these programs actual adventure therapy services are offered by a range practitioners. Adventure therapy practitioners may include people with extensive wilderness or adventure training but limited formal human service training and individuals with extensive training in one of many human service professions but with limited adventure experience. Unfortunately there are also some practitioners who have limited training in both the adventure and human services. Obviously the more highly skilled the practitioner is in both the adventure skills and the human service skills, the better the treatment is likely to be. Furthermore it is advisable if the person has specific training and experience in working with the addictive process.
The person considering adventure therapy as a part of the treatment of the addictive process will want to consider how the service is offered, who is offering it and the qualifications of those offering the service. The consumer will want to do this because of the variety of ways that adventure therapy can be effectively offered. This overview will give you some starting places in the decision making process related to choosing an adventure therapy program.
Any professional considering referrals to adventure therapy programs, adding this therapy technique to their practice, or other involvement in adventure therapy should explore the programs and practitioners closely. An excellent resource for the practitioner interested in this field is the Association for Experiential Education's Therapeutic Adventure Professional Group . Practitioners are encouraged to explore the use of adventure therapy as a modality in their work with all aspects of the addictive processes.
Davis-Berman, J., & Berman, D.S. (1994).
Wilderness therapy: Foundations, theory & research. Dubuque, IA: Kendall/Hunt Publishing Company.
Gass, M.A. (Ed.). (1993). Adventure therapy: Therapeutic applications of adventure programming. Dubuque, IA: Kendall/Hunt Publishing Company.
Itin, C., & Gault, L. (1989). Addiction, recovery and experiential therapy. Different pathways, one world, the 17th international conference of the Association for Experiential Education. October 27-30, Santa Fe, NM.
Miles, J. (1993). Wilderness as a healing place. In M. A. Gass (Ed.), Adventure therapy: Therapeutic applications of adventure programming. (pp. 4355). Dubuque, IA: Kendall/Hunt Publishing Company.
Rohnke, K. (1989). Cowstails and cobras &A guide to games, initiatives, ropes courses & adventure curriculum. Dubuque, IA: Kendall/Hunt Publishing Company.
Schoel, J., Prouty, D., & Radcliffe, P. (1988). Islands of healing: A guide to adventure based counseling. Dubuque, IA: Kendall/Hunt Publishing Company.
* Christian [tin, MSW is a social work doctoral student at the University of Denver in Denver Colorado. His work includes over 12 years in the field of adventure therapy including 9 years working with addictions. He has worked for inpatient treatment programs and wilderncs5 treatment programs associated with several Outward Bound Schools, 1350 Balsam Ave., Boulder, CO 80304, USA.
1. This case example is a composite picture of my experience with many people dealing with recovery from the addictive process in adventure therapy contexts.
2. A trust walk involves one participant being blindfolded and being led by a sited peer. The activity is often done in silence.
3. The ropes course is a series of obstacles that are up in the air some 30-40 feet.
4. Solo is an opportunity for people to spend time alone in a wilderness environment for a given amount of time.
5. Blob tag involves one person being "it". As this person tags other people they join hands and become a single "blob". The attempt is to make everyone a part of the "blob".
6. Spider's web involves the group getting itself from one side of a web of string to the other without touching the string.
7. The trust fall involves falling from shoulder height into the arms of the group.
8. The Beam usually consists of a pole suspended 30-40 ft. in the air. The beam is usually 10-15 ft. long.
9. Solo is an activity that involves a person spending time alone in the wilderness. The time may vary from a few hours to several days.
10. Association for Experiential Education, 2885 Aurora Ave. #28, Boulder, CO, USA 80302-2252.
Other articles from this issue:
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