THERAPEUTIC RECREATION JOURNAL Vol. 35, No. 2, 107-122, 2001 Outdoor Experiential Therapies: Implications for TR Practice Alan W. Ewert, Bryan P. McCormick, and Alison E. Voight The outdoor environment has a long history of being a popular venue for a variety of therapeutic recreation (TR) programs. Its potential to add a unique dimension to practice has been increasingly used by many TR programs. This article provides an overview of the basic theoretical frameworks underlying outdoor experiential therapies (OET), explores related terms (e.g., Adventure Therapy), and discusses some of the implications of including OET into TR programs. Also described are specific benefits of OET, the relationship between OET and TR practice models, types of OET, and emerging trends and issues. KEY WORDS: Experiential Activities, Adventure Activities, Outcomes, Conceptual Develop- ment, Therapeutic Modality The outdoor environment is increasingly article will explore some of the salient features being used as a therapeutic setting with many and applications of the therapeutic uses of organizations and programs now incorporating outdoor experiential settings. We discuss rel- a variety of therapeutic modalities in outdoor evant terminology, types of outdoor experien- and wilderness experiences (Kelley, 1993; tial therapy (OET) programs, the various ben- Roberts, 1988). These modalities have been efits associated with these programs, and some referred to under a number of terms including considerations in incorporating OET activities adventure therapy, experiential therapy, chal- into therapeutic recreation (TR) programs, lenge education, and wilderness therapy. This Several assumptions have been made prior Alan Ewert, Ph.D. is a Professor and holder of the Joel and Patricia Meier Endowed Chairship in the Department of Recreation and Park Administration at Indiana University; Bryan McCormick, Ph.D., CTRS is an Associate Professor in the same department. Alison Voight, Ph.D., CTRS is a former Visiting Assistant Professor, also in the department at Indiana University and the current SRAC representative for the State of Indiana. Second Quarter 2001 107 to this discussion. First, it is believed that this evaluation for the population being served. discussion is both timely and relevant to the Thus, the assumption made in this paper is that TR profession as a number of programs utiliz- professional therapy programs featuring ad- ing outdoor experiential activities are now em- venture and/or outdoor activities and utilizing bedded in a variety of TR programs. To date, carefully planned assessments and interven- there has been little written about the overall tions can be used for both the amelioration of impact of these types of modalities in TR a disability or limitation, as well as for the settings (see Austin, 1999; Groff & Dattilo, optimization of overall functioning and im- 2000). proved health. Second, it is readily acknowledged that using experiential activities in outdoor settings Defining Outdoor Experiential is only one of many types of modalities that Therapies and Related the therapeutic recreation specialist (TRS) can Terminology use effectively. There also are times in which the TRS may find the use of outdoor settings A number of terms have emerged regarding and specific adventure activities to be inappro- the different types of therapeutic interventions priate, or not fully effective, depending on the in an outdoor setting (Crisp, 1998). A partial situation and the client population. listing of these terms are described as follows: The third assumption has to do with the nature of the term "therapy." Historically, Adventure Therapy many therapeutically-related programs using Adventure therapy frequently utilizes the outdoor settings and activities have served components of adventure (e.g., real or per- people who have no medically diagnosed dis- ceived risk, uncertainty of outcome, and per- ability or functional limitation. Examples of sonal decision-making) as part of its curricu- these types of programs might include those lum structure Adventure therapy refers to serving at-risk youth or adults in transition therapeutic interventions that utilize experien- (e.g., divorce, loss of employment, etc.). As a tial and risk-taking activities, that are both result, some readers may question the use of physically and emotionally challenging, and the term "therapy" with these types of popu- usually involve an outdoor setting. It should be lations. This criticism is based on the assump- noted, however, that not all adventure thera- tion that therapies are limited to a "deficit- peutic programs contain significant levels of reduction" role, and can offer nothing to risk and danger or take place in undeveloped people seeking to enhance or optimize their outdoor settings. For example, indoor climb- leisure functioning or overall health. Another ing walls and ropes courses have become an perspective suggests that therapeutic programs increasingly popular venue for some adventure can also be used with people to improve func- therapy programs. This point will be discussed tioning or seeking greater physical and/or psy- in more detail later in this paper. chological challenges regardless of the pres- Crisp (1998) suggested that adventure ther- ence or absence of a medically-diagnosed apy is effective because it employs the "dis- problem. Austin (1999) referred to this as the equilibrium" principle, as described by Nadler "actualizing" component of high-level well- and Luckner (1992). That is, clients are faced ness. Similarly, both Gass (1993) and Crisp with novel situations in which they need to (1998) have identified a concept in "adven- develop new ways of thinking and acting. For ture-based practice" that they termed "enrich- example, people who use wheelchairs and ment." The basic premise of these types of have no prior experience being lowered down programs proposing therapy continues to be a one-hundred foot cliff, will need to develop having a clearly delineated program purpose, ways to deal with this novel situation. This goals, assessment, planning, and on-going approach emulates the widely ascribed Out- 108 Therapeutic Recreation Journal ward Bound process, as originally described matically involve adventure (i.e., the deliber- by Walsh and Golins (1976), in which the ate inclusion of risk or danger) or require participant is placed in novel physical and wilderness-like environments (Ewert, McCor- social settings and is encouraged to develop a mick, & Voight, 1999). For example, taking a new set of skills and behavior in order to group of people who have developmental dis- master the situation. abilities on a backpacking trip can precipitate a variety of beneficial outcomes without involv- Wilderness Therapy ing a high degree of risk or using a wilderness- like environment. Within this context, outdoor Friese (1996) identified over 500 programs experiential therapy (OET) is defined in the that currently operate in the United States and following way: use "wilderness-type" settings for therapeutic purposes. In addition, Cooley (1998) found A treatment modality which utilizes or that over 10,000 adolescents were being emulates an outdoor setting or natural served on an annual basis by wilderness ther- environment for the purposes of reha- apy programs constituting over 33,000 user bilitation, growth, development, and en- days on the public lands and generating over hancement of a individual's physical, $60 million in annual revenues. Although wil- social and psychological well-being derness therapy has traditionally been associ- through the application of structured ated with remote and relatively isolated natural activities involving direct experience. settings, Davis-Berman and Berman (1994) (Ewert et al., 1999) suggested that any outdoor environment may offer a suitable location for therapeutic appli- cations. Remote areas, in particular, are often A point in common with all three of the more amenable to offering a sense of change previously described therapy programs is the from "normal" living. utilization of "direct experience" for therapeu- tic interventions. Direct experience involves Crisp (1998) suggested that programs using the components of participant-centered ther- a wilderness-therapy orientation utilize the apy, cognitive dissonance, reality-based out- concept of "adaptation" or coping with comes, and assessment and program structure change, either in the individual's social envi- (Gass, 1993; Gillis & Bonney, 1986). ronment or physical setting. Moreover, like Participant-Centered Therapy. Clients are adventure therapy, wilderness therapy can in- often required to take action rather than simply volve the use of a residential or base-camp serve as spectators. This action is often holistic facilities, small group dynamics, and group in the sense of involving physical, social, and psychotherapy. Given these components, pro- cognitive personal resources. Thus, whether it gram outcomes often revolve around personal be participation in an adventure-based activity, change and social development. moving down a quiet trail, or engaging in a group discussion regarding how to accomplish Outdoor Experiential Therapy a particular task, the client is exposed to situ- More recently, outdoor experiential ther- ations in which he or she is encouraged to take apy (OET) has emerged as an umbrella term some form of personal action in an outdoor that encompasses the different, but related mo- setting. In addition, the individual is often dalities