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Outdoor Adventure Interventions - Young People and Adversity: a Literature Review Outdoor Adventure Interventions - Young People and Adversity: A Literature Review Prepared for Berry Street by: Dr Anita Pryor with assistance from Reima Pryor & Dr Cathryn Carpenter Adventure Works Australia Ltd ISBN: 978-0-6482088-1-5 © Berry Street Victoria Inc., 2018 This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced by any person without prior written permission from Berry Street Victoria. It may be reproduced and used by licensees, in whole or part, subject to acknowledgement of the source but not for commercial usage or sale. Requests and inquiries concerning reproduction rights should be addressed to: Director, Berry Street Childhood Institute 1 Salisbury Street, Richmond VIC 3121 1800 2377 978 [email protected] www.childhoodinstitute.org.au ii Outdoor Adventure Interventions - Young People and Adversity: A Literature Review Outdoor Adventure Intervention Recipe Select: 8-12 people who are ready for an adventure Stir: a sense of anticipation Add: a few skilled practitioners Remove: social and emotional dependencies (friends, family, tobacco, alcohol, flushing toilet, phone) Place: in a wild environment Mix: until a team starts to form Fill: with unusual and exciting experiences Stir in: responsibility for self and others Watch: to see that all are fully immersed Add: the opportunity to learn and master skills Sprinkle: moments of awe and beauty Simmer: carefully for many days and nights Prepare: for going home Invite: participants to reflect on their experiences Take: lessons learned and hopes revealed Serve: when ready1. 1 Adapted from Pritchard, D. (Date unknown). Outward Bound Recipe, Minnesota Outward Bound School. Retrieved 10 Oct 2017 from: http://www.wilderdom.com/outwardbound/obmain.html Outdoor Adventure Interventions - Young People and Adversity: A Literature Review iii Table of Contents Glossary vii Executive Summary 1 1. Introduction 4 Background 4 Guiding questions 5 Methods used 5 Search strategy 7 Literature evidence base 7 Terminology and working definitions used in this report 8 2. Young people who have experienced adversities 10 Needs of target group 10 Evidence on effective interventions with this target group 11 Trauma-responsive OAI 14 Evidence-informed OAI in support of this target group 16 3. Outdoor adventure interventions 18 Spectrum of interventions 19 Readiness for change 21 Depth of intervention 21 Intensity of experience 22 Therapeutic intent 23 Paradigms of practice 24 Typology of Australian OAI 26 Comprehensive safetynet 28 Ethical principles 29 International perspectives 30 4. What the literature says 32 Current uses of OAI with this target group 32 Outcomes for young people 35 Known benefits for young people generally 35 Likely benefits for young people who have experienced adversities 38 Likely longitudinal benefits for young people who have experienced adversities 44 Mechanisms of change 47 Examples of effective OAI 52 Ineffective and negative outcomes 55 5. What works 60 Responding to history and heritage 60 Staff values, skills, approaches and self awareness 62 Program design 70 A note on limitations 83 iv Outdoor Adventure Interventions - Young People and Adversity: A Literature Review 6. Key messages 85 Bibliography 88 Appendices 100 Appendix 1: Recommended Reading 100 Appendix 2. Important Considerations for this Target Group 101 Appendix 3: OAI Principles Aligned with AABAT Ethical Principles 104 Appendix 4: Secondary Literature Review Search Strategy 108 List of Tables Table 1. OAI Spectrum of interventions 20 Table 2. OAI Paradigms of practice 26 Table 3. Empirically supported OAI outcomes 37 Table 4. Central mechanisms of change within OAI 49 Table 5. Attributes of trauma-responsive organisations 60 Table 6. Attributes of culturally responsive organisations 61 Table 7. Evidence-informed attributes for OAI practice 67 Table 8. Evidence-informed attributes for OAI program design 80 List of Figures Figure 1. OAI Readiness for change 21 Figure 2. OAI Depth of experience 22 Figure 3. OAI Intensity of experience 23 Figure 4. Typology of Australian OAI 27 Figure 5. Professional OAI flowchart 29 Figure 6. Key mechanisms of change within OAI experiences 52 Figure 7. Key structures and components within OAI 74 Outdoor Adventure Interventions - Young People and Adversity: A Literature Review v vi Outdoor Adventure Interventions - Young People and Adversity: A Literature Review Glossary The following terms are used within this Review: Fields of practice • Outdoor Adventure Intervention (OAI) - services that use outdoor adventures as an intentional medium to intervene or influence a given problem or trajectory, including group-based and non-group-based programs. In Australia, OAI sit within the wider field of bush adventure therapy. • Bush Adventure Therapy (BAT) - the suite of Australian interventions that combine nature-contact and uses of adventure with small groups of people towards therapeutic outcomes, including for personal development, learning and therapy aims. BAT encompasses adventure therapy, wilderness therapy and other uses of outdoor or experiential adventure for targeted therapeutic outcomes. A national body of the same name supports the BAT field in Australia. Internationally, BAT services sit within the wider field of international adventure therapy. • International Adventure Therapy (IAT) - the worldwide suite of services that include adventure therapy, wilderness therapy and other uses of outdoor or experiential adventure as interventions or approaches for targeted therapeutic outcomes. The Adventure Therapy International Committee (ATIC) supports the IAT field in over twenty-five countries globally. Features of Outdoor Adventure Interventions Structures - the basic structure or features of a given OAI, sometimes described as its overarching program model (e.g. preparation, expedition, follow-up). Components - a meaningful set of ‘working parts’ within a given model, sometimes described as key steps in the participant pathway through the OAI (e.g. promotion, recruitment, assessment, orientation, goal-setting, etc.). Processes - this term encompasses the approaches, strategies, activities and practices used by staff (e.g. use of a specific assessment tool, story, game, etc.). Attributes - a quality or inherent feature of safe and effective OAI. Principles - a set of guidelines to assist with the design and implementation of OAI. Outdoor Adventure Interventions - Young People and Adversity: A Literature Review vii Executive Summary This report provides research evidence and practical guidance for organisations intending to use outdoor adventures as an intervention with young people who have experienced adversities. Berry Street commissioned Adventure Works to undertake this literature review as one component of a yearlong formative evaluation of Berry Street’s Gippsland Wilderness Program (GWP), an expedition-style outdoor adventure intervention for high-risk young people living in Eastern Victoria, Australia. Outdoor adventures are used around the world as a form of intervention, and tend to involve small groups of people in out-of-doors adventures for therapeutic benefits. Within this report, these services are called ‘outdoor adventure interventions’ (OAI). The purpose of this report is to help guide GWP program development, and provide information for other organisations choosing to use outdoor adventures as an intervention with this target group. It offers a synthesis and summary of Australian and international literature on uses of outdoor adventures as an intervention with young people aged 13 to 18 who have experienced adversities, including potential or known trauma. Findings offer a summary of OAI in Australia and internationally; a set of evidence- informed principles to inform future enhancements of the GWP model and practices; and practical advice for practitioners, program managers and organisations. The report also provides an extensive library of literature evidence for further use, in the form of an extended bibliography. Literature review findings demonstrate that: • Therapeutic OAI are a highly engaging and motivating form of intervention for this age group, and are appropriate for the adolescent stage of development. • Due to their physical, psychological and social dimensions in particular, OAI are well suited to young people who have experienced adversities such as abuse and neglect. • Overall, OAI achieve positive outcomes with this target group, with potential for negative outcomes if OAI are not designed and delivered appropriately. • Boot camps and other forms of OAI that emphasise punitive and coercive approaches are not considered psychologically safe for this target group. • While OAI evaluations have tended to be small, with research methods sometimes lacking rigor, a growing body of empirical evidence exists. • A growing number of OAI are evidence-informed and promising, with potential to become evidence-based. • A significant body of research evidence has been collated and reviewed. Further systematic analysis of the body of research would provide additional guidance for organisations, programs and practitioners seeking to support young people who have experienced adversities. 1 Outdoor Adventure Interventions - Young People and Adversity: A Literature Review Findings for young people who have experienced trauma demonstrate that: • Therapeutic OAI typically provide a range of mechanisms though which participants may experience (or re-experience) their own physical-,
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