1. Embracing Nature: Wilderness Adventure Therapy and Adolescents with Mental Health or Substance Use Disorder Diagnoses
Taylor M. Welytok
GRC MSW Program
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Abstract
Wilderness Adventure Therapy (WAT) is a transpiring modality of treatment that can be used to work with adolescents. Adolescents are a population with outstanding mental health and substance abuse needs that are seemingly impervious to traditional treatment modalities. Historically, Wilderness Adventure Therapy has been a growing treatment modality whereas more research is currently being done to fit it into a clinical model of treatment, where clients are working with licensed, qualified clinicians through assessment, treatment planning, interventions, and discharge planning in an outdoor nature milieu, engaging in adventure-based activities (Hill, 2007). The purpose of this project is to examine how social workers can incorporate Wilderness Adventure Therapy into their practice ethically and effectively.
Figure 1. Hiking adventure in Blue Ridge Mountains, North Carolina.
Theoretical Perspectives & Concepts
Purpose
Family Systems Theory – importance of family involvement in treatment, contingency management, familial education, participation. Family systems highlights importance of understanding the family to understand the individual, and the dynamic of systems that interact within that emotional unit.
Psychosocial Development Theory – Erik Erikson proposed this theory of development with 8 stages throughout a lifetime, adolescence being a time for identity versus role confusion. “Who am I?” and “What do I want in life?” are two main questions adolescents have during this time to discover their true values, beliefs, and goals.
Ecosocial Approach- Using the “person-in-environment” perspective, focusing on the natural world. This focuses on the importance of a connection with nature and the Earth.
Strengths-Based Perspective- WAT is a strengths based approach, designed to help individuals realize their power and what they can truly accomplish.
Studies have shown that adolescence is one key developmental stage in which humans tend to face many dilemmas, both internal and external. whereas they begin to dabble with different, meaningful life topics such as their sense of identity, social role, increase in intimate relationships and their meaning, and they begin to develop their very own “sense of self” (Roberts, Stroud, Hoag, & Massey, 2017). Adolescents are often lost in the mix when mental health professionals are looking for appropriate interventions. WAT is a therapeutic approach that focuses on kinesthetic, or active, adventure experiences often coordinated in a natural setting to engage clients physically, cognitively, emotionally, and behaviorally to help the client learn to adapt and improve their overall functioning (Gass, Gillis, & Russell, 2012). The concept of adventure is more naturally attractive to the adolescent due to their developmental stage, where there is a greater interest in the meaning of life, setting goals, moral reasoning, sense of identity, and desire of independence. They are in a stage of exploration of themselves, so the notion of adventure itself is appealing (Sokol, 2009).
Results
WAT has shown many positive implications for treatment of mental health in adolescents.
Social learning; Symptom identification & reduction; Acquire healthy lifestyle behaviors; Strengthen protective factors; Stress reduction; Less rumination -decreased neural activity in the subgenual prefrontal cortex; part of the brain associated with mental illness; Benefits of general physical activity including increased mood, healthier weight, healthier self-image, and symptom reduction
WAT’s true effectiveness as a treatment intervention for adolescents dealing with a mental health or substance use disorder requires further research in the area. Current studies have shown promising results, with participants possessing increased protective factors, symptom reduction, lower levels of substance use .and higher overall life satisfaction in the post assessment analyses. Rate of completion of WAT programs highly outcompetes that of other traditional therapy programs with an over 90% completion rate (Russell, 2007).
The Issue
Most mental health disorders and substance use disorders generally appear in adolescence and only worsen through the life course if they go untreated. Adolescence is a key time period for early intervention to give these individuals a better chance at becoming a productive member of society as an adult (Gillespie & Allen-Craig, 2009; Hulvershorn, Quinn, & Scott, 2015). It is estimated than not even twenty percent of children and adolescents between the ages of six and sixteen that are diagnosed with a psychiatric disorder have been seen by a mental health professional in the previous year, suggesting a large amount of that specific population that has not had their mental health needs met (Paula, Bordin, Mari, Velasque, Rohde, Coutinho, 2014). Researchers have not yet been able to identify a clinical treatment geared towards adolescents with co-occurring disorders, but the answer may not be that of such a “clinical” sense.
Implications for Social Work
Social workers are accountable to strive to give their clients the best care they are able, which varies for everyone. Adolescents are a population in which traditional therapy is not always as successful as desired, therefor introduction of new therapies is important in practice. A random sample collected of 646 clinical social workers were asked if they use any adventure-based activities in their treatment interventions, with approximately 35.1 percent reporting they do (Tucker & Norton, 2012). WAT uses a strengths-based approach, building upon present protective factors in which social workers should be focusing on in the client. WAT allows social workers to further engage in diversity while promoting diversity both in practices and in clientele, for social workers should advocate for WAT program availability to more populations than it currently serves. Social workers should engage in evidence based practice while conducting their own research within practice for the sake of future treatment, which in the fairly new field of WAT will be crucial for its further development.
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