Week 10: Ethics

Topic: What are the ethical principles of APA most relevant to AT?

After reading chapter 12 of Adventure Therapy: Theory, research, and practice, I hold a solid understanding of the ethical considerations that surround the field of Adventure Therapy (Gass, Gillis, & Russell, 2012). By reviewing the ethical principles of the American Psychological Association, which can be viewed here, it is clear that the two fields share similar ethical values, which is entirely sensical. Under the section of the APA's 'General Principles,' the first listed is the notion of doing no harm, the 'Hippocratic Oath,' which is widely applied in human service fields, especially anything related to medicine, and is most certainly relevant to AT.

To answer the question posed above, it becomes necessary to consider what ethics are most important and at the heart of AT. The APA's ethical principles include 10 standards. The standards which I consider to be most relevant to AT are Competence, Human Relations, Education and Training, Assessment, and Therapy. Granted, all 10 of the standards are relevant to AT, however, I feel the five just listed are most relevant. These standards are wonderful examples of ethical guidelines that provide in depth considerations for the qualifications, abilities, and overall ethics of adventure therapists. I feel I could argue for the importance and relevancy of any of the information included on the APA's website regarding their ethics. They really cover all the bases, something of extreme importance, especially in preventing ethical dilemmas between therapist and client, therapist and company, therapist and government, and therapist and his or herself.

Understanding the potential for ethical dilemmas, what they could look like, and how one should go about solving such dilemmas is of utmost importance in Psychology, Adventure Therapy, and LIFE in general. In light of this, I have found a lovely article on solving ethical dilemmas from the Loyola Marymount University. Not surprisingly, step one is analysis of consequences, positing who will be helped versus who will be harmed. And we are back to Hippocrates.



References:

American Psychological Association. Ethical Principles of Psychologists and Code of Conduct: Including 2010 Amendments. Retrieved from: http://www.apa.org/ethics/code/index.aspx

Gass, M. A., Gillis, H. L., & Russell, K. C. (2012). Adventure therapy: Theory, research, and practice. New York: Routledge/Taylor & Francis Group.

LMU/LA. Resolving an Ethical Dilemma. Retrieved from: http://www.lmu.edu/Page27945.aspx

Week 9: Adventure Therapist Competencies

Topic: How do competencies for becoming an adventure therapist compare and contrast with a different method of experiential treatment?

Gass, Gillis, and Russell provide a detailed chapter on the competencies held by adventure therapists in Adventure Therapy: Theory, Research, and Practice. The authors explain how a true adventure therapist is competent in three areas, holding the knowledge and skills of an adventure leader, a counselor or therapist, and a client specialist. Possessing an exemplary level of competency in each of these areas would take a substantial amount of time, therefore, I feel such individuals are extremely valuable.

Another form of experiential therapy that has a similar method for competency development is equine assisted psychotherapy. This website discusses the EFPL (Equine Facilitated Psychotherapy and Learning) Certification. Similar to AT, there are different areas of competency that come together to form a true equine therapist or a complete treatment team. These include a licensed counselor or therapist, an education specialist, a horse specialist, and a riding instructor. As seen here, according to the EAGALA Certification information, they require a treatment team of a mental health specialist and equine specialist as opposed to allowing one individual to perform both roles.

The Certification Board for Equine Interaction Professionals website provides information on this organization and the training programs they provide. This organization came together with the purpose of creating a knowledge base for best practices in this field as well as standards for excellence. The website expresses the concern felt when equine programs began to spring up and there were no such standards or certification boards. A few incompetent programs or services could catch media fire and potentially ruin the whole profession. AT professionals have also recognized the need to create standards and best practices as well as conduct research to inform the public as to the benefits of AT.

One thing is clear from the text and from both of the websites discussed here; in both fields, professionals are expected to continuously build their knowledge, skills, and overall competencies throughout their career. This not only means keeping up to date certifications and attending the latest training seminars, but also simply having an open outlook and always making room for growth.



References:

Certification Board for Equine Interaction Professionals. Retrieved from: http://www.cbeip.org

EAGALA. Certification Program. Retrieved from: http://www.eagala.org/Certification_Program

Gass, M. A., Gillis, H. L., & Russell, K. C. (2012). Adventure therapy: Theory, research, and practice. New York: Routledge/Taylor & Francis Group.

HEAL: Equine-Facilitated Psychotherapy and Learning. EFPL Certification. Retrieved from: http://humanequinealliance.org/the-heal-model/efpl-certification/

Week 8: AT Assessment

Topic: Compare and contrast the approach to AT assessment presented in Chapter 7 to at least 2 different approaches to assessment in mental health treatment


In Adventure Therapy: Theory, Research, and Practice, Gass, Gillis, and Russell provide information on primary processes Adventure Therapists utilize in forming client assessments. The authors detail two models that compliment each other well when used simultaneously. The CHANGES (Context, Hypothesis, Action, Novelty, Generating, Evaluation, and Solutions) model provides a system for assessing the client at a macro level from the beginning of treatment to to solution discovery. On the micro level, the GRABBS (Goals, Readiness, Affect, Behavior, Body, and Stage) model provides an outline for assessing the client in the moment. Putting the two models together provides the Adventure Therapist with an overarching assessment ability as well as an in the moment assessment ability. It is key to recognize how much these models benefit Adventure Therapists in performing the ongoing assessment of clients throughout an AT experience. Ongoing assessment gives Adventure Therapists the necessary information to make treatment adjustments and shifts which is vital to maintaining a productive treatment plan concurrent with evolving client needs.

In my search for different assessment approaches, I came across this webpage from the National Clearinghouse on Families and Youth (NCFY). The webpage displays a table with an extensive list of assessment tools for "measuring mental health, substance abuse, and independent living skills in adolescents." The webpage provides three roles of assessments: "Identify strengths and needs; Measure baseline and changes over time; Accurately identify youth in need of treatment." According to the table, none of the assessments last more than 2 hours and the majority only take 30 minutes or less. Out of 39 assessment tools, 20 do not require any special training to perform the assessment. The good majority of these assessments are in the form of questions. From this information, it appears that these assessments are designed to gain information on a specific aspect of adolescent issues in a short amount of time.

A study from the World Psychiatry online journal studied the reliability and benefits of the development of the Global Mental Health Assessment Tool- Primary Care Version (GMHAT/PC). Results indicated that this computer-based assessment tool is reliable and due to its ease of use, it is very beneficial for Primary Care Physicians and professional who do not have extensive training in mental health disorders. The article spoke on how beneficial such a tool could prove to be because of the great benefits it would provide for early detection of mental health disorders. You can find the article here.

In relating these three different assessment approaches, I feel that each type obviously serves its own purpose. The purpose for which the GMHAT/PC was created is definitely important. Children and adolescents do not receive mental health treatment unless the need is noticed. For far too many, the supervision is not present that would notice such disorders. Having a way for the everyday general practitioner to quickly and effectively assess mental health in patients is extremely positive. If more adolescents were diagnosed earlier in their lives, they would be able to receive necessary treatment earlier as well. Suffice to say, this would decrease the likelihood of adolescents engaging in destructive and harmful behavior to themselves and others.

The many assessment tools listed on the table provided by the NCFY, are similarly beneficial for determining the presence of a mental health condition and appropriately naming it, however these tools are appear much more specific. For the purposes of my discussion here, administering assessments like these would be the appropriate next step. Of course, I will argue that an appropriate third step is AT. An Adventure Therapist can information provided from various assessments in determining the context of clients' situations. The main difference comes in the ongoing assessment of the clients. A seasoned Adventure Therapist can effectively utilize the CHANGES and GRABBS models to provide a system and means for assessment that is far more detailed, personalized, and up to date with clients' ever-developing treatment. I do not suggest any one tools as better or worse than another. They all have their use and place in mental health treatment.


References:

Assessment and Screening Tools for Measuring Mental Health, Substance Abuse, and Independent Living Skills in Adolescents. Prepared for the Family and Youth Services Bureau by the National Clearinghouse on Families and Youth. Retrieved from: http://ncfy.acf.hhs.gov/book/export/html/476

Gass, M. A., Gillis, H. L., & Russell, K. C. (2012). Adventure therapy: Theory, research, and practice. New York: Routledge/Taylor & Francis Group.

Sharma, V.K., Lepping, P., Cummins, A.GP., Copeland, J.RM., Parhee, R., Mottram, P., (June 2004). The Global Mental Health Assessment Tool- Primary Care Version (GMHAT/PC). Development, reliability, and validity. World Psychiatry, 3(2). Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414685/