Adventure therapy

Domain XV · Nature, philosophy, social & rites of passage · Michael A. Gass, Gillis, Russell

What it is

Adventure therapy (AT) is not a single manualised therapy but a family of methods. TAPG describes it as the prescriptive use of adventure experiences by mental health professionals, often in natural settings, engaging clients cognitively, affectively and behaviourally through active, kinesthetic…

Format

• The framework below follows Gass's CHANGES sequence (before, during, after an experience) nested inside the overall course of treatment; the outer phases are built from TAPG's requirements.
• Format: intake interview, collateral information with written consent, medical clearance routed to the client's physician.

Who practises it, and how they are trained or regulated

• AT has no fixed protocol or published session count; neither TAPG nor the Gass abstracts give one. Duration ranges from a single outpatient session using one activity, through weekly groups, to multi-day expeditions within residential or outdoor behavioural healthcare (OBH) programmes. AEE accredits adventure programmes and OBH programmes separately; OBH programmes must have licensed mental health professionals as…
• Adventure therapy (AT) is not a single manualised therapy but a family of methods. TAPG describes it as the prescriptive use of adventure experiences by mental health professionals, often in natural settings, engaging clients cognitively, affectively and behaviourally through active, kinesthetic methods, with therapeutic goals, a dynamic therapist-client relationship and intentional use of the environment. It can…

Evidence status, as the guide reports it

• Evidence status, one line: Bowen and Neill's 2013 meta-analysis of 197 studies reported a moderate short-term effect (g = .47), larger than for alternative-treatment and no-treatment comparison groups, with gains largely maintained at follow-up and age the only significant moderator.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• fatigue after expeditions; skipped records in the field. Working: records match what happened.
• pushing ahead because the activity was planned. Working: you can say why today's activity fits today's client.
• pressure from a timetable or from enthusiastic group members. Working: the group raises its own level of challenge.
• games that single out or embarrass a client. Working: laughter, lowered guard, and readier engagement in harder tasks.
• picking the activity first and finding a goal afterwards. Working: you can link every activity to a goal in the record.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.