The Role of Counseling and Psychotherapy Theory - Essay Example

?Topic: Critically evaluate the role counseling and psychotherapy theory and practice in the application of adventure therapy Adventure Therapy is based in a practical application of the insights gained from counseling as to what is truly missing from the lives of patients and provides an active, non-conventional treatment that can be evaluated against other medical and psychological responses to mental illness. Adventure Therapy involves the use of wilderness expeditions, camping, rafting, mountain climbing, sailing, and other similar activities as an alternative to pharmaceutical, psychotherapy, or clinical methods of psychiatry or in association with personal counseling. It is important to note the appropriate role and use of counseling in the context of society and in relation to abnormal psychology. For example, the counselor is primarily dealing with normal, functioning children and adults that may at some point during their life develop psychological or emotional problems with which they benefit from personal and professional assistance. Generally, between 5% to 10% of the population at any time can be expected to display the signs and symptoms of major mental illness as defined in abnormal psychology, such as schizophrenia, bipolar disorders, manias, psychosis, etc., though less than 1% will require clinical hospitalization. (NIMH, 2008, See: Appendix) This leaves counseling as a profession tasked with first separating cases of abnormal psychology from problems of normal development of individuals, and secondly, assisting in the provision of effective treatment to the individuals who are seeking counseling. It is in this context that Adventure Therapy should be understood, as well as its application, for there may be human development problems that are caused by the individual’s relation to modern society that can better be solved by treatments fostering social relationships and exercise activities as opposed to pharmaceuticals or institutionalization. Nevertheless, there may also be instances where a combination of medication and Adventure Therapy can also assist in the treatment of those afflicted with psychological problems and mental illness. Creating the ability to distinguish the causes and treatments for patients is an important aspect of training that the counselor must undertake, including research in a multiplicity of methods and a willingness to experiment in finding the treatment that best suits the unique nature of every individual and effectively promotes positive mental health recoveries. The life of an individual can be viewed on a continuum of functionality related to self-realization with normality at the center, functioning at the highest levels of individual mental and physical operations at one extreme, and the psychoses and neuroses of severe mental illness or insanity at the other extreme. The counselor can expect the range of behavior for most people to stay within the realm of normal operations on usual occasions, straying into psychological crisis through challenges, problems, and obstacles in life or relationship issues that occasionally need to be addressed by the individual. Viewing the counselor’s office as a mixture between a general practitioner’s office and an emergency room highlights the manner that the counselor must prepare for all of the contingencies of not only mental illness, but also for mental health, in the population he or she is tasked with serving. Counseling in this regard can be seen as a tool to help maintain or restore normalcy to individuals based upon their own self-definition of importance and accepted societal standards of functioning. In being able to distinguish between the critical and clinical symptoms of severe mental illness and the factors that are required to build a stronger sense of well-being and mental health, the counselor can begin to serve the diversity of needs that he or she will encounter within a given population, as well as to understand some of the causes that lead people to psycho-spiritual crisis and life problems. Thus, it is in this regard that Adventure Therapy has come to be seen as a valuable and effective means of treating psychological and social problems, as well as a method that can be used to promote positive mental health. Adventure Therapy encourages exercise and physical strength through the engaging in outdoor activities, but also promotes teamwork and solidarity between group members working together. When children or adults go hiking, camping, rafting, or on similar natural adventure activities, they leave the world of the city or suburbs which may be the cause of many of the relationship issues that are causing the psychological problems. This gives the individuals an opportunity to re-connect to nature, an important aspect of linking Adventure Therapy to the holistic paradigm of the environmental movement and humanistic psychology. Where there is criticism that modern psychiatrists are too liberal with prescribing medications to both youth and adults to treat mental problems that create only borderline issues of functionality, Adventure Therapy presents a possibility for a first intervention or ongoing treatment that is organic and holistic in design. That it may also be used in association with medication is another possibility for those suffering from chronic and genetic causes of mental illness. Studies have found Adventure Therapy to be effective in treating overweight teens, children with suicide risk, substance abusers, as well as other social and developmental problems. For example, in the study "Wilderness Adventure Therapy in Adolescent Psychiatry," the authors Simon Crisp and Matthew O'Donnell write: “The Brief Intervention Program (BIP) is a mental health day program in Melbourne (Australia) for adolescents with severe mental health problems who are at risk for suicide. The 10-week program serves closed groups of 6-8 adolescents aged 13-18 years and has 3 phases: engagement and orientation (week 1), treatment (weeks 2-9), and integration (week 10). Followup support is offered as appropriate for the client's needs. Wilderness-Adventure Therapy is provided 1 day per week and during two 4-5 day expeditions, and is integrated into other components of the program such as work experience, drama, music, sex education, and group and individual therapies. Wilderness Adventure Therapy provides a challenging and novel situation that forces clients to relate to others in an adaptive way, allowing for a natural "reconstruction" of developmental gaps as clients correct fundamental assumptions and misconceptions about themselves and others.” (Crisp & O'Donnell, 1998) The BIP in this example is similar to one of the most popular examples of Adventure Therapy, the “Outward Bound” program. This organization intervenes in the life of troubled teens by offering them the ability to engage in adventure and wilderness activity as part of teams to build friendship, companionship, a sense of self-esteem, and to provide an alternative to negative social models found in the urban environment. Counselors have realized that a large number of developmental problems can be solved by removing the individual from the negative influence which conditions behavior, such as peer pressure. Adventure Therapy provides not only alternative activities, but also an alternative social group for friendship in the Outward Bound and BIP examples that allow for positive social values to be constructed and understood within the individual’s own experience over time. As Michael A. Gass writes in “Adventure Family Therapy: An Innovative Approach Answering the Question of Lasting Change with Adjudicated Youth?,” “The field of adventure family therapy has emerged as a means to construct lasting functional change for troubled youth. Seven reasons why Adventure Therapy can be successful with troubled youth are: (1) therapeutic processes are centered in action-oriented experiences; (2) therapy is conducted in an unfamiliar environment; (3) Adventure Therapy centers on producing a climate of functional change through the positive use of stress; (4) adventure experiences can be rich in assessment possibilities; (5) adventure experiences are generally conducted in a small-group, supportive atmosphere; (6) adventure experiences are constructed to be "solution oriented"; and (7) the role of therapist is changed.” (Gass, 1995) The action-oriented nature of Adventure Therapy can be contrasted with the couch model of traditional psychotherapy, which some patients especially youth may have a personal aversion to and reject. Thus, rather than limiting the counseling session to the office or a type of questioning intellectual and emotional discourse, the patient can discover vital principles from personal experience through Adventure Therapy. This is important especially in individuals who need assistance in building relationships in order to overcome social isolation and low self-esteem. Similarly, the Adventure Therapy technique should not be taken as the solution for every example of psychological problems, but can be a tool for those with behavioral problems such as drug addiction, obesity, or low self esteem that would be encouraged to improve without medication. As a treatment, Adventure Therapy can be evaluated in relation to other types of medication, counseling, and approaches to mental health in order to determine whether or not it is effective in building improvement in patients. These problems are addressed in a Journal article by Jim Sibthorp titled "An Empirical Look at Walsh and Golins' Adventure Education Process Model: Relationships between Antecedent Factors, Perceptions of Characteristics of an Adventure Education Experience, and Changes in Self-Efficacy," where the author writes: “A cadre of philosophers and theoreticians have offered models of the adventure process (e.g., Kiewa, 1994; Luckner & Nadler, 1997; Walsh & Golins, 1976), some of which are largely accepted as doctrine within the industry. For example, the Walsh and Golins model includes a motivated (a) learner or program participant being placed into a prescribed (b) social and (c) physical environment where he or she masters specific (d) problem solving tasks. The course (e) instructor acts as a guide to ensure that the tasks are both authentic and manageable and provides the necessary feedback to aid mastery which, in turn, leads to participant development (e.g., an increase in self-esteem). While some readers may argue that this model is atheoretical, it has resonated with practice, a fact to which longevity and popularity attest; it is difficult to find a text on adventure-based programs without the Walsh and Golins citation (e.g., Ewert, 1989; Miles & Priest, 1999; Priest & Gass, 1997).” (Sibthorp, 2003) Taken together, these factors build a consistent set of criteria with which to define Adventure Therapy across a wide number of applications and thereby to assess the effectiveness of the programs empirically. The Walsh and Golins study of the Outward Bound program model has been diagramed by Priest in Gass in a later study (1997) to show the process which is represented by the Adventure Therapy model in practical application. Thus, in summary, the Adventure Therapy model can be seen as an instance where “a learner is placed into prescribed physical environments and into prescribed social environments then given a characteristic set of problem solving tasks creating a state of adaptive dissonance leading to mastery or competence (and) leading to the reorganization of the meaning and direction of the experience.” (Priest & Gass, 1997) Through this paradigmatic experience, the individual finds his or her personal integrity restored and the ability to participate in society, sharing in the goals of the culture. Though this requires the motivation of the individual to be able to accept the process and its results, the use of small groups encourages both friendship and leadership in the team members. The personal learning process encouraged by the outdoors activity of the Adventure Therapy setting allows for the values and lessons learned to be integrated into the individual’s personality in a manner that is consistent with his or her experience, and thus more likely to last as a realization and to provide the force required to transform from negative states of mind. While Adventure Therapy may not be suited for every individual or mental illness, the counselor should recognize it as a valuable tool for treating those with social and development problems, encouraging its use where necessary as an alternative or addition to pharmaceutical treatment and counseling with a goal towards the restoration of the mental health and personal functionality of the patient. Appendix: References: Bandroff, S., & Newes, S. (2004). Coming of Age: The evolving field of adventure therapy. Boulder, CO: Association of Experiential Education. Berman, J., & Berman, D. (1995). Wilderness Therapy: Foundations, Theory and Research. Kendall/Hunt, Iowa. Berman, J., & Berman, D. (2008). The promise of wilderness therapy. Boulder, CO: Association of Experiential Education. Brown, S., & Richards, K. (2005). Outdoor Cure: therapeutic processes and the natural world. Therapy Today, Special Issue. December, 16 (10). BACP: Rugby. Clinebell, H. (1996). Ecotherapy: Healing ourselves, healing the earth. Minneapolis: Fortress Press. Crisp, S. (1996). International models of best practice in wilderness and adventure therapy: Implications for Australia. (Winston Churchill Fellowship Final Report). Australia: Winston Churchill Fellowship. Crisp, Simon and O'Donnell, Matthew (1997). Wilderness Adventure Therapy in Adolescent Psychiatry. Exploring the Boundaries of Adventure Therapy: International Perspectives. Proceedings of the International Adventure Therapy Conference,1st, Perth, Australia. Gass, M. (1995). Adventure Family Therapy: An Innovative Approach Answering the Question of Lasting Change with Adjudicated Youth?. Kendall/Hunt, Iowa. Gass, M. (1993). Adventure Therapy: Therapeutic Applications of Adventure. Educational Resources Information Center, Alternatives to Incarceration: Prevention or Treatment. Monograph on Youth in the 1990s. Issue #4. Gass, M. (1995). Book of Metaphors. Volume 2. Association of Experimental Education. Kendall/Hunt, Iowa. Gass, Michael A. and McPhee, Pamela J. (1990). Emerging for Recovery: A Descriptive Analysis of Adventure Therapy for Substance Abusers. Journal of Experiential Education, v13 n2 p29-35 Aug 1990. Itin, C. M. (1998). Exploring the boundaries of Adventure Therapy international perspectives. Proceedings of the Second International Adventure Therapy Conference: Perth, Australia. Colorado: Association for Experiential Education. Luckner, J., & Nadler, R. (1992). Processing the Experience: Strategies to Enhance and Generalise Learning. Kendall/Hunt, Iowa. Mayhew, J. (1997). Psychological Change: A Practical Introduction. Macmillan, Hampshire. McLeod, J. (2009). An introduction to counseling (4th Edition). Maidenhead: Open University Press. NIMH (2008). Prevalence of Serious Mental Illness Among U.S. Adults by Age, Sex, and Race. The National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Published: July 29, 2010. Priest, S. (1993). A new model for risk-taking in adventure programming. Journal of Experiential Education, 16(1), 50-53. Richards, K., & Smith, B. (2003). Therapy within adventure. Proceedings of the second international Adventure Therapy conference, University of Augsburg, 20-24 March, 2000. Germany: Zeil Verlag. Richards, K., Peel, C.F., Smith, B., & Owen, B. (2001). Adventure Therapy and eating disorders: A feminist approach to research and practice. Ambleside: Brathay. Ringer, M., & Abbott, C. (1996). Adventure Therapy: Proceedings of the 1995 Pre-Conference Workshop. 9th National Outdoor Education Conference.' Victorian Outdoor Education Association. Sibthorp, Jim (2003). An Empirical Look at Walsh and Golins' Adventure Education Process Model: Relationships between Antecedent Factors, Perceptions of Characteristics of an Adventure Education Experience, and Changes in Self-Efficacy. Journal of Leisure Research, Vol. 35. Walsh & Golins (1976). The Outward Bound Process Model. Outdoor Education R&E Center Theories (James Neill, Last updated: 11 Mar 2007). Woolfe, R., Drden, W., & Strawbridge, S. (Eds.) (2003). Handbook of counselling psychology. London: Sage Publications. Read More

 

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