The Life-changing Power of Adventure Therapy

For students struggling with anxiety and depression, adventure can be an essential avenue for treatment in part due to the benefits of physical activity on their mood.  For people struggling with depression and anxiety, bringing exercise into their routine has been shown to create better treatment outcomes and improve physical health. At Aspiro, students develop good habits surrounding the daily exercise routine as they learn how to do a variety of adventure activities.

Aspiro students walk away with the skills to continue any of the activities in their post-treatment lives. They will also be able to experience the benefits of physical activity on their mood.

Students struggling with anxiety and depression show particularly good treatment outcomes when incorporating adventure activities that trigger flow theory concepts. Mountain biking and skiing meet many of the requirements to regularly trigger a mental “flow” state where students learn to eliminate the thought cycle between sensory input and action. They read and react to the terrain in front of them without worrying about possible outcomes. This is nearly the opposite of anxiety. Mountain biking can create a borderline euphoric experience that is highly effective at treating depression and anxiety.

Further, overcoming seemingly impossible challenges like climbing a rock wall or rappelling off a cliff helps these students build self-efficacy. Increasing self-efficacy is one of the building blocks that can contribute to teens and young adults overcoming anxiety and depression.

Wilderness adventure therapy is well suited to address poor self-esteem/self-efficacy. For a variety of reasons, youth often struggle to see themselves in a positive light. They may have developed self-defeatist internal narratives or learned to dislike themselves.  They may have learned an attitude of helplessness in life and expect to fail.

Wilderness adventure therapy has consistently shown to improve self-efficacy through a process by which youth are exposed to seemingly impossible challenges, in novel environments, and through guidance, hard work, and grit, they can find success. This process is backed up by several studies. Including one that showed statistically significant positive outcomes over 3.5 times greater than alternative therapy methods in the area of self-concept. Another study showed that improvement in self-efficacy translated from the outdoors to academics.

This suggests that wilderness adventure therapy’s outcomes are generalizable to other aspects of life. A foundational work on self-efficacy indicates that efficacy beliefs are the best predictor of future performance; therefore, by addressing these issues through wilderness adventure therapy, one can effectively improve the chances of future success.

Relational conflict can take many forms, but one of the most common is conflict within the family. Family units are the most important structures for youth as they develop into adults. Maintaining positive and healthy relationships within a family unit, while at times challenging, is critical to overall healthy development. When relationships are unhealthy, it may be time to seek help.

Aspiro addresses relational and family conflict through the adventure therapy model. Recent research has shown that adventure therapy has a positive effect on outcomes for overall family development. These positive effects were greater than other alternative therapies. Clinicians at Aspiro take a whole family approach and try to facilitate healing on behalf of students, parents, and other family members.

Identity development is a crucial step for youth and is tied closely to ideas of self-concept and social development. Developing a clear concept of who you are, your values, and where you fit into the social world is central to achieving success and happiness. Many young people find that they struggle to define these areas and may fall behind in terms of identity development.

In a recent study, adventure therapy was shown to have significant positive effect outcomes on factors that contribute to identity development. These include; social development, self-concept, and morality & spirituality. Further, these positive effects were more significant than non-adventure-based therapies. Finally, these effects show no post-treatment regression.

This study attributes the lasting positive change effects to the adventure therapy model. It also singles out experiential education’s “active and direct use of client participation and responsibility” as a critical treatment element. The study indicates that key programmatic elements for adventure therapy included

• the presence of, and interaction with nature,
• use of perceived risk to heighten arousal and to create eustress (positive response to stress)
• meaningful engagement in adventure experiences
• solution-based focus on positive change (present and future functional behavior)
• ethic of care and support holistic process and effect on participants.

Understanding how wilderness adventure therapy can apply as a treatment for school failure means looking beyond the academic failures and delving into the reason behind them. School failure can be a symptom of a variety of issues, from anxiety to depression to trauma.

While each case of school failure is unique, wilderness adventure therapy has shown to be an effective treatment. In a large study, adventure therapy had a statistically significant positive impact on school failure. Further, the impact was over four times greater than that of alternative, non-adventure model therapy. School failure can be a significant barrier to future success, and the adventure therapy model has shown to be a highly effective treatment.

The adventure therapy model at Aspiro is grounded in creating seemingly impossible challenges, and guiding students through the difficult, but rewarding process of overcoming those challenges. Studies have shown that this process has led to “large to very large, statistically significant improvements in behavioral and emotional functioning.” Behavioral issues can vary widely. However, the adventure therapy approach appears to be versatile in meeting each student where they are at.

All of the adventure activities at Aspiro are conducted in a group setting including group therapy. They all require cooperation, communication, collaboration, and conflict resolution. These are all skills that many of our neurodiverse students are working on while at Aspiro.

Whether a student is struggling with symptoms associated with being on the autism spectrum, or from another neurodevelopmental disorder like a non-verbal learning disorder, Aspiro can provide individualized treatment plans to meet them where they are at. The adventure therapy setting creates authentic social interactions that can be tailored by staff to meet the group’s needs and allows for processing and debriefing of behaviors. Karoff et al. breaks down the reasons that adventure therapy is effective for youth on the autism spectrum or with other neurodevelopmental disorders into three elements:

• Adventure therapy is inherently unpredictable. This provides ASD youth with frequent opportunities to engage with peers in an authentic, uncontrived way. They can engage with peers in the way while in an environment of support and trust.
• Adventure therapy is a group-driven process that is, by nature, flexible and adaptable to the specific needs of the group and individuals within it.
• Adventure therapy is a here-and-now approach that creates space for youth to cognitively process how behaviors and feelings experienced in the moment relate to participants’ lives beyond the treatment setting.

Karoff et al. sum up the value of Adventure Therapy in treatment for those on the autism spectrum writing, “The power of Adventure Therapy lies in experiencing real behaviors, in real-time, and reflecting on how they are either helpful or limiting to a participant’s life, and then learning new ways of behaving, thinking or feeling, and providing a space to practice those new behaviors before trying them out in the real world.”

Eating disorders present unique clinical challenges and are often difficult to manage in the home. While the presentation of eating disorders can vary, a common thread is often an issue with body image.

Wilderness adventure therapy can be an effective treatment option for eating disorders with proper planning and supervision of eating habits to address and mitigate health concerns. A research journal article (focusing on women) describes the wilderness treatment process as an opportunity to reconnect with one’s physical body.

The author emphasizes that “the wilderness experience alone is not sufficient to create a major transformation. Other critical elements are the therapeutic effect of the group process and risk-taking activities, such as hiking and team-building exercises, which contribute to breaking down the stereotypes concerning women and their bodies.” 

Eating disorders present unique treatment and health challenges, but evidence supports that wilderness adventure therapy is an effective therapeutic intervention for various presentations.

Traumatic brain injuries (TBIs) are known to cause behavioral, cognitive, and executive functioning impairments. Cognitive rehabilitation for TBIs traditionally consists of a context-sensitive method like the Positive Behavior Supports (PBS) approach.

Context-sensitive approaches aim to enhance the quality of life and minimize problem behaviors by expanding the patient’s range of behaviors. These approaches emphasize that cognitive rehabilitation must take place in natural environments. Wilderness adventure therapy can effectively facilitate cognitive rehabilitation by allowing students to practice behavior skills in novel environments.

One study on treating TBIs with a wilderness adventure therapy model indicates that “wilderness adventure therapy (WAT) relies on teaching through experience in natural contexts and, consequently, can also be considered a contextualized intervention.”

The critical elements of wilderness adventure therapy that make it an excellent option for the treatment of TBIs are:

• That the client becomes a participant rather than a spectator in therapy.
• Therapeutic activities require client motivation in the form of energy, involvement, and responsibility.
• Therapeutic activities are real and meaningful in terms of natural consequences to the client.
• Reflection is a critical element of the therapeutic process.
• Functional change must have present as well as future relevance for clients and their society

Wilderness adventure therapy is, therefore, able to leverage its fundamental components in a way that makes it an excellent option for those looking for a contextualized intervention based in cognitive rehabilitation for traumatic brain injuries (TBIs).

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that can significantly impact youth’s lives. ADHD is often associated with academic issues and school failure, relational issues, and behavioral issues. Evidence has shown that wilderness adventure therapy is both an effective treatment for ADHD, and for many of its associated issues.

A study assessing nature interactions and ADHD found that 7 out of 13 high-quality studies identified a significant relationship between increased nature interactions and decreased ADHD symptoms. Further, the study found that increased accessibility to nature showed significant positive findings in six out of nine cases and that increased exposure to nature showed significant positive findings in seven out of nine cases.

While this study looked at the overall efficacy of including nature in treatment for ADHD, other studies look more closely at some of the issues associated with ADHD and treating them with experiential therapy. One of these studies found that adventure therapy had significant positive outcomes on academics, behaviors, and social development. It is, therefore, possible to address both ADHD directly, and many associated issues in a wilderness adventure therapy model.

When someone experiences trauma, they can get stuck in what is called a heightened or arousal state. They start to feel a heightened state of fear similar to that that was felt at the time of the initial trauma. Many people hold on to that state of fear and do not have a chance to finish the arousal cycle. This is supposed to be four stages ending in a stage where they feel safe again.

For those who get stuck in this fear stage, high adventure activities can be an effective treatment. They can mimic feelings of fear and anxiety, by introducing perceived risk, and then help students complete the last phase of that cycle to where they feel safe. Any adventure activity that provokes this fear response, including rock climbing, skiing, canyoneering and mountain biking, is particularly useful in treating trauma.

One study on treatment of posttraumatic chronic stress disorder found that Nature Adventure Rehabilitation (NAR), a component of wilderness adventure therapy, had positive impacts on:

• perceived control over illness (PCI)
• emotional and social quality of life
• hope
• and functioning

Further, the study indicated that NAR “seems to work through a process of behavioral activation, desensitization, gradual exposure to anxiety evoking situations, and gaining control over symptomatology.” By engaging outdoor therapy activities, students who have experienced trauma can learn to control their lives.

Adventure therapy is an excellent tool for addiction treatment because it provides healthy, non-substance, natural high for the student. These are skills that the student can take with them into their post-treatment life. It is a healthy alternative to substance seeking behaviors and often lets them access a new network of friends who are also participating in the adventure activity. This can draw them away from negative influences that may encourage substance abuse relapse and assist in addiction recovery.

Adventure therapy has proven effective in treating youth with addictions. This is particularly effective in raising awareness of strengths, allowing for a healthy dialogue between students struggling with similar issues, promoting positive family relationships, and increasing resilience related to maintaining sobriety.

Wilderness therapy has proven highly effective in treating oppositional defiant disorder (ODD), It provides space separation to members of the family unit, slowing down the parent-child communication process, and makes room for relationship resolutions and restoration. Further, this research has shown that in strong-willed adolescent males, especially those with co-occurring ADHD, ODD can emerge in an environment where parents are unable to hold firm boundaries or set clear expectations. At Aspiro guides can provide those clear instructions, set achievable goals, and allow natural consequences to take effect. This, combined with the other factors mentioned above, contributes to the efficacy of wilderness therapy for youth struggling with oppositional and defiant issues.