Week 6: Nature's Benefits

Topic: Pick one of the therapeutic benefits of nature and link them to research in one or more of the following areas: Abnormal, Behavioral Neuroscience, Cognitive, Developmental, Learning, and Social.

The therapeutic benefit of nature that I found most interesting in chapter 5 of Adventure Therapy: Theory Research, and Practice, is the idea of soft fascination originally theorized by Kaplan and Kaplan (Gass, Gillis, and Russell, 2012). According to the text, "Soft fascination occurs when involuntary attention is engaged and demands on a depleted direct attention are diminished, thus making restoration possible" (p. 106). An example of this is watching a butterfly flutter from flower to flower. This does not necessitate a great deal of attention on the part of the onlooker, but its ability to fascinate the onlooker is ever-present nonetheless. The text explains how cognitive reflection can take place during such experiences because the onlooker is fascinated and stimulated.

In this entry of her Blog entitled, Threads of Awakening, Leslie Rinchen-Wongmo discusses research on direct attention and soft fascination. She provides an interesting comparison between these two types of attention and two types of meditation. She links direct attention to breath work and visualization techniques. She links soft-fascination to sky gazing and simple resting meditation. She sums up her insight suggesting, "With directed-attention meditation methods, one pulls the attention back from its wanderings and places it on the object of meditation. In what I’m now viewing as soft-fascination methods, the task is to notice, to open, to include, and to rest – in fascination." 

In relation to Adventure Therapy, I feel that mediation techniques similar to this idea of soft fascination could be extremely useful tools. I think AT practitioners could build on soft fascination to teach participants meditation methods which they can utilize once they leave the wilderness. It would be extremely beneficial for participants who are to return to homes where they will not experience significant time with nature to learn a mediation practice that utilizes soft fascination but does not necessarily require a remote natural setting. 

In a Psychology Today article, Michael Formica discusses research on meditation and the brain. Results demonstrate long term meditators as having larger areas of the brain that deal with emotion regulation. "Meditators displayed a significantly larger volume of hippocampal tissue, as well as a similarly increased volume of tissue in the orbito-frontal cortex, the thalamus and the inferior temporal gyrus." Formica goes on to explain that while meditation has been long recognized to reduce stress and aid cognitive functioning, this research highlights significant evidence of such occurrences in brain structure. 

As seen here, there are many different recognized forms and styles of meditation. Some of this could be considered "directed-attention" methods and some "soft-fascination methods," and they may all have the potential for positive effects on brain structure and cognitive functioning. Project Meditation even provides meditation techniques for specific mental illnesses and overall psychological issues. 

All in all, there is a great deal to be learned about the benefits of meditation and soft fascination in the world of Adventure Therapy. I wonder what methods of meditation will provide the best results for participants. I also wonder in what ways soft fascination type practices will be beneficial and in what ways direct attention practices will be beneficial. Most importantly, how can AT professionals ensure that participants leave programs with such skills so that they can reap the benefits back home?

References:

Faregreen, C. Project-Meditation.Org. Meditation Psychology. Retrieved from: http://www.project-meditation.org/a_bom1/meditation_psychology.html

Formica, M. J. (June 10, 2010). Psychology Today. Enlightened Living: Mindfulness practice in everyday life. Research Suggests Meditation Increases Gray Matter. Retrieved from: http://www.psychologytoday.com/blog/enlightened-living/201006/research-suggests-meditation-increases-gray-matter

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

Rinchen-Wongmo, L. (2009). Threads of Awakening. Environment, Meditation, & Soft Fascination. Retrieved from: http://threadsofawakening.com/environment-meditation-soft-fascination

The Meditation Society of America presents Meditation Station. 108 Meditation Techniques. Retrieved from: http://www.meditationsociety.com/108meds.html

Week 5: AT Research

Topic: Pick one of the outcome areas of AT research and link them to research in one or more of the following areas: Abnormal, Behavioral Neuroscience, Cognitive, Developmental, Learning, and Social.

In Adventure Therapy: Theory, Research, and Practice, Gass, Gillis, and Russell include the results of a few studies that showed a decrease in client substance abuse after an AT experience (2012). The key word here is ‘few’. The authors make it clear that more research with greater significance must be obtained to understand the relationship between AT and clients with substance abuse. With much time and attention, AT researchers will better understand this relationship, the AT elements that impact substance abuse reduction most, and how to best implement this knowledge and form programs that consistently report significant research results.

In chapter 13, the authors mention the “black box effect in AT research.” Essentially, clients enter an AT program, the “black box,” and exit a changed person. It is clear that the client has been transformed, however placing a finger on the exact elements of the AT experience which facilitated the transformation proves difficult.

In a best-case scenario: a client enters a program with a drug abuse problem and exits with the skills necessary to abstain from drugs, live a fulfilling life, and become a positive force in society. 

In a best-case scenario: the AT program providing this experience knows the exact aspects of the experience that facilitated the transformation and knows how to adapt them to other clients to produce positive results time and time again. 

 AT has great potential for clients with substance abuse problems due to the fact that the population with the greatest need for treatment falls in the age range of most AT programs. According to the National Institute on Drug Abuse, “Drug use is highest among people in their late teens and twenties. In 2011, 23.8 percent of 18- to 20-year-olds reported using an illicit drug in the past month (Drug Facts, 2012).”

From much research, the National Institute on Drug Abuse also reports “Principles of Effective Treatment”.  The nature of substance abuse and its effects on the individual are explained in regard to effective treatment. The various principles are easily linked to each of these schools of psychology: 

• Abnormal: 
• Principle 9. "Many drug-addicted individuals also have other mental disorders."

• Behavioral Neuroscience:
• Principle 1. "Addiction is a complex but treatable disease that affects brain function and behavior."

• Cognitive: 
• Principle 3: "Treatment needs to be readily available."
• When individuals think they may want help, it needs to be available because before long, the individual may reconsider. 

• Developmental: 
• Principle 8: "An individual's treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs."

• Learning: 
• Principle 5. "Remaining in treatment for an adequate period of time is critical." 
• Three months or longer is advised for substance abuse treatment.

• Social: 
• Principle 6. "Behavioral therapies—including individual, family, or group counseling—are the most commonly used forms of drug abuse treatment." 

Overall, it is clear that AT research has a long way to go in determining the magic inside the black box. Multiple schools of psychology and respective research need to be in constant consideration and regularly utilized in the ongoing development of AT research and program development. It seems clear that the major difficulty will be determining the most successful practices and treatment programs for varied individuals. Between client factors of age, drug(s) of choice, co-occuring mental health diagnosis, family, education, and other demographics and AT therapeutic factors of instructor, therapist, location, activities, and discussion AT researchers have many variables to take into account and twiddle around with in the black box until the box turns crystal clear.

                                                                                                                  Picture done by me in Paintbrush

References:

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

National Institute on Drug Abuse (December 2012). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). Retrieved from: http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment

National Institute on Drug Abuse (December 2012). Drug Facts: Nationwide Trends. Retrieved from: http://www.drugabuse.gov/publications/drugfacts/nationwide-trends

Week 4: Outward Bound process Model

Topic: How might The Outward Bound Process be used in psychology other than treatment?


The Outward Bound process Model, which was developed by Walsh and Golins in 1976, is presented by Gass, Gillis, and Russell “because it represents a foundational model from which many AT programs have theoretically evolved” (2012). After analyzing the various components of the model as they relate to therapy, I found it difficult to think about ways in which the OB Model could be utilized in the field of psychology for anything other than therapy.

Upon greater reflection, I stepped away from thinking about patients and focused on professionals in the field of psychology. I began to think about the possibilities of utilizing the OB Model for special training programs for psychologists. Taking this idea further, I thought about the potential outcomes of various groups completing an actual course together; a group of first year students in a psychology graduate program, a group of therapists at a residential treatment center, or even a group of professional psychologists from various locations who want to take part in such an experience. I feel that specific curriculum could be incorporated into a program that is based on the OB Model.

I am left with questions: 
How such a course would benefit psychologists? 
Would the primary outcome be to teach specific skills related to psychotherapy? 
Would participants walk away with some sort of certification? 
Could the focus simply be on creating an opportunity for professionals to participate in experiential, problem based, group oriented learning? 
Could such an experience be advertised and framed in a way that offers the professional psychologist a first hand opportunity to understand the benefits and potential of group work and experiential learning?

Here is a link to a Psychotherapy Training Program at the Washington School of Psychiatry that utilizes six intensive weekends to conduct the training. Participants are assigned to groups where they do experience some of the training material first hand. I think that a week long, or even weekend, adventure experience based on the OB Model could be amazingly beneficial for a program like this to utilize. I feel it would give participants first hand group development and group dynamics experiences to process and refer to throughout the course that simply cannot be simulated. This is just one example of how this could play out.

As an aside, Adventure Therapy: Theory, research, and practice offers a cooking metaphor in explaining the Outward Bound process Model and its relation to AT (Gass, Gillis, & Russell, 2012). I found this on the Outward Bound page of the wilderdom.com site and wanted to share it:

Outward Bound Recipe

Select: 10 strangers

Remove: Social dependencies - tobacco, spouses, friends, wristwatches, alcohol

Place on the edge of a pan: filled with unusual and stressful circumstances

Give a slight push: and watch to see that all are fully immersed

Add: the opportunity to learn and master skills

Shake: a sprinkling of natural grandeur

Stir in: a soupcon of skilled instructors

Simmer: carefully for 26 days.  Skim off the fat and deep-freeze until needed.

Derek Pritchard, Director
Minnesota Outward Bound School

References:

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

Neill, J. (March 8, 2007). Outward Bound: History, Philosophy, Theory, Research, and Evaluation. Retrieved from: http://www.wilderdom.com/obmain.html

Washington School of Psychiatry (2013). Group Psychotherapy Training Program. Retrieved from: http://www.wspdc.org/education/group-therapy/

Week 3: Comparing Approaches

Topic: Compare and contrast the approach to AT treatment presented in Chapter 3 to at least 3 different approaches to mental health treatment.


In Adventure Therapy: Theory, Research, and Practice, Gass, Gillis, and Russell explain an integrative approach that is used in the field of AT (2012). This approach is termed the ABC-R model, which stands for Affect, Behavior, Cognition, and Relationships. The text explains how adventure therapists are able to use this model to adapt to the client’s needs. The therapist will recognize where to start with a client, utilizing the client’s affect, behavior, or cognition as an initial way to make a connection. Once the therapist has made it this far, the text explains how important the building of quality relationships is in the ability for the therapist to access the other two components. The relationship between the therapist and the client is definitely the highest priority, but other relationships, like with the family or field staff are important as well.

Group therapy is closely related to the AT therapeutic approach due to the fact that they both utilize a combination of the foundational psychotherapeutic schools of thought, like psychoanalytic, interpersonal, behavioral, and cognitive psychology among others. Here is the American Group Psychotherapy Association website.

Art Therapy is quite similar to AT. Other than the fact that one utilizes adventure and the other art, both share the common approach to meet the client where he or she is. According to the American Art Therapy Association’s website, art therapists are trained to bring out clients' inherent art producing abilities to access their thoughts, feelings, and behaviors. 

Another approach to mental illness treatment is Dialectical Behavior Therapy (DBT). According to Behavioral Tech, LLC, DBT was first created for patients with Borderline Personality Disorder in response to problems that surfaced when applying the Cognitive Behavioral Therapy (CBT) approach. Essentially DBT is a form of CBT with three significant added, or more focused strategies; validation of feelings and thoughts, desire to change, and dialectical strategies which serve as the means to balance acceptance (validation) and change. Practicing mindfulness is essential to this process. This approach is extremely client driven and requires the therapist to meet the client where he or she is, just like the AT approach.

It seems clear that all of these approaches have in some way come about due to a recognized need for psychotherapy to be more adaptable to clients' needs as opposed to applying a specific and rigid approach that leaves little room for sufficient adjustments. All of these can be used individually (other than group therapy) or in a group setting or can utilize a combination of the two. It seems as though the more flexible an approach can be without jeopardizing the integrity of the treatment.



References:

American Art Therapy Association. Retrieved from: http://www.arttherapy.org

American Group Psychotherapy Association. Retrieved from: http://www.agpa.org

Behavioral Tech, LLC. DBT Resources: What is DBT? Retrieved from: http://behavioraltech.org/resources/whatisdbt.cfm.

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

Week 2: AT History vs. PSYC History

Topic: What are your insights from creating a timeline of the history of AT superimposed on (selected events from) the history of psychology and/or psychotherapy?


I decided to conquer the world of concept mapping by utilizing the 'Simple Mapper' website. Initially, I did not find it exceptionally simple. Once I figured out how the program worked, however, I found myself enjoying the process of creating my concept map: AT History v. PSYC History. The history of AT was summarized from Adventure Therapy: Theory, Research, and Practice by Gass, Gillis, and Russell. I utilized a timeline from the 'AllPsyc Online' website to choose events from the history of psychology to compare the two fields. These events mostly include the dates marking the beginning of a new school of psychological thought as well as the development of the profession. Similarly, the AT events mostly include dates marking the beginning of a new program, camp, or organization and also the development of the profession.

From the view of my concept map, psychology events dominate from the late 1800s to mid 1900s. From the 1950s to the present day, the map shows less and less psychology events and more and more AT events, mostly representing a major boom in adventure and AT programming. Ultimately, the major schools of psychological thought developed between the late 1800s and mid 1900s. After the 1950s, most of the psychology events revolve around the development of the field, including the development of the DSM. 

Although the first intentional therapeutic adventure camp, Camp Ramapo, began in 1922, most other camps and organizations prior to the first publication of the DSM were primarily focused on building the character of youth. While these experiences were undoubtedly therapeutic for participants, they did not incorporate intentional, prescriptive therapy. Ten to twenty years after the first DSM was published, programs like Outward Bound and the Brigham Young University 480 course began to emerge. These programs incorporated more intense wilderness adventure experiences. By the 1970s, programs like Project Adventure, Expedition Outreach, and the Santa Fe Mountain Center began to appear, focusing on intentional adventure based therapy and counseling services. 

It appears that the more sophisticated the field of psychology became, the more it was incorporated into adventure activities and eventually programs were being introduced that fit the definition of Adventure Therapy provided by Gass, Gillis, Russell (2012). The field of psychology developed means for establishing standards and guidelines, as well as research practices, very early in its history by way of the American Psychological Association. AT has more recently developed professional organizations, however, research and time is needed to develop quality standards and reliable best practices.

References:

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

Heffner, C. L. (2003, August 19). AllPsych Online. History of Psychology: 387 BC to Present. Retrieved from AllPsych: http://allpsych.com/timeline.html

Simple Mapper: Concept Maps, Network Diagrams and Workflows. Retrieved from: http://simplemapper.org