Ideas & Theories

This page contains descriptions for the mechanisms of change that catalyze client transformation and the helping and hindering forces that moderate and mediate the processes of outdoor therapies.

MECHANISMS OF CHANGE

Mechanisms of change explain how these forms of outdoor therapy combine risk taking, conflict resolution, nature immersion, and intentional psychotherapy to transform clients behaviors, thoughts, and feelings. These theories are generalized and in need of hypothesis testing. Obviously, each type of program will blend these mechanisms in differing amounts.

CHALLENGE

The principal mechanism of change for adventure therapy programs (overcoming risk and conflict challenges in small groups) is diagrammed below. The engine for this process is a repeating cycle of Distressful Dissonance, Attempt at Resolution, (if successful) New Found Competence, and Facilitated Reflection. Typically, these four are arranged in a sequential cycle, however, advanced practitioners are capable of mixing and matching these so each can occur at any point and in any order (even simultaneously) within the therapy. This meta-theory is explained with two relationships examples: intrapersonal (risk taking) and interpersonal (conflict resolution).

RISK TAKING: Psychological Self (Intrapersonal)

In the psychological INTRApersonal relationship sequence (1), adventure therapists seek out conditions that most people fear (2): remote isolation (wilderness), fast/deep water (white water or ocean paddling), dark underground (caving), and heights (climbing or challenge courses). These unfamiliar exposures present the appearance of a high perceived risk (while real dangers are actually kept quite low by competent outdoor leaders) and the clients experience a fear response (3). In their minds, they have trouble reconciling two disparate extremes: "I’m safe and I’m going to die!"

(4) This dissonance is distressful, so they attempt to resolve the situation by applying their personal skills and behaviours against the risk. If successful, they gain new competence and facilitated reflection helps them understand their growth with questions like: "what did you learn, where does that apply in your life, and what will you do differently next time or when you leave the program?" This cycle repeats, with the outdoor setting providing natural consequences, until personal growth results (5).

Depending on the activity, therapy program, and its duration, location or intensity, this personal growth can have dozens of different outcomes, but at least three are common and worth following further: self-efficacy, confidence, and resilience (6). These respectively indicate clients who know their limitations and capabilities, while holding a shield against future adversity (7) and in combination these three characteristics make for astute individuals (8) who will use personal growth to assist or enhance their recoveries and prevent further relapses (9).

CONFLICT RESOLUTION: Social Self (Interpersonal)

In the social INTERpersonal relationship sequence (A), adventure therapists wait for inevitable disagreements (navigation decisions), resentments (who impedes progress), misperceptions (favouritism), and arguments (unequal food portions) that often arise in small groups (B) under stress during outdoor living and ultimately lead to conflict (C). Again, the dissonance is distressful: “I have to be a team player, but I am so ready to settle this with agression!”

(D) Under the guidance of the adventure therapist (present to also prevent violent escalation), the clients attempt to resolve the conflict by practicing their social skills and behaviours. If successful, they gain new competence and facilitated reflection helps them understand their growth with the same questions: “what did you learn, where does that apply in your life, and what will you do differently next time or when your leave the program?” Once more, the cycle repeats, with the small group milieu giving social rewards and penalties, until prosocial growth results (E).

Depending on the activity, therapy program, and its duration, location or intensity, this prosocial growth can have a myriad of various results, but at least three are common and worth discussing further: mutual trust, cooperation, and communication (F). These respectively indicate clients who can be relied on, work well together with others, while actively listening to differing opinions (G) and in combination these three qualities make for affable individuals (H) who will use prosocial growth to improve or transform their societal behaviours going forward (I).

NATURE IMMERSION

The principal mechanism of change for nature or eco-therapy programs (focused on sensorily immersing individual clients in the restorative properties of nature) is diagrammed below. One fundamental tenet of conventional psychology is that unaddressed negative emotions can lead to diminished physical and mental health. Negative or antagonistic emotions might include anger, guilt, sadness, grief, loneliness, disgust, failure, resentment, apprehension, jealousy, and helplessness.

The main premise of this form of eco-therapy is that exposure to nature brings a positive emotional outlook that can lead to healing, well-being, and enhanced physical and mental health. Examples of positive or affirmative emotions might be: joy, happiness, serenity, tranquility, peacefulness, hope, amazement, awe, admiration, inspiration, and appreciation of beauty. These can be accessed and accentuated by immersing the client in sensory awareness of a natural environment. This immersion is followed by a traditional talk therapy to clarify and cement change, while depending on the restorative properties of nature. The metaphor of a flower is used to describe this process of simply replacing negative emotions with positive ones inspired by nature.

Flower

Life is full of stressors, including many minor ones which humans can easily cope with. However, some major ones leave a lasting influence. Surviving war or conflict violence, ultimately leads to post traumatic stress disorder. Living with poverty, food insecurity, homelessness, unemployment, and other socio-economic factors can govern a lifetime of fighting with friends and family. Recovering from medical surgery or living with daily chronic pain may diminish concentration, increase insomnia, and cause fatigue or irritability. Even a life lived indoors with artificial light, conditioned air, and controlled temperatures can directly alter health such as a deficiency in Vitamin D or an abundance of adrenaline and cortisone. Other major stressors include: the death of a loved one, marriage, divorce, separation, incarceration, job loss, retirement, work difficulties, accident, illness, injury, financial trouble, natural disaster, victim of crime or violence, and moving house.

Stem & Leaves

All of these stressors cause a flood of negative or antagonistic emotions that are known to impact physical and mental health. These negatives substantiate disarray in feelings, thoughts or behaviors with the subsequent development of mood, anxiety, attention, hyperactivity, somatic, and stress disorders. Closely associated with these disorders are common physiological impacts of elevated muscle tension, blood pressure, and heart rate, with suppressed cognition and immune response.

Psychological & Spiritual Self

Just as the animal-human bond potentiates equine and canine therapies, the spiritual connection between humans and nature drives the influence of eco-therapies based in forest, jungle, bush, parks, or other kinds of natural settings. Nature provides the restorative properties and positive feelings that wash away the negative feelings and cleanse the damages. A focus on individual change through traditional talk therapies addresses the mental health disorders which in turn treat the physical health symptoms and physiological indicators. Affirmative emotions arise from sensory immersion in nature and replace the antagonistic emotions, thus leading toward healing and well-being. Nature nourishes the soul and feeds the spiritual healing and well-being of the client.

Bulb & Roots

Healing and well-being are grounded to nature, where health is not the absence of disease, disorder, or infirmity, but the presence of physical, emotional, mental, cognitive, social, behavioral, self, and spiritual well-being. As an example, in land-based healing, an indigenous approach to wellness in Canada, people dispossessed from their ancestral lands return to those territories to follow traditional practices with cultural knowledge and elder story telling. They heal themselves from the trauma of forced dispossession by spiritually reconnecting with nature.

INTENTIONAL PSYCHOTHERAPY

The principal mechanism of change for psychotherapy is talk. Talking about feelings, thoughts, and behaviours, rather than holding everything inside, can help people to better cope with problems, stress, troubles, worry, and difficulty. By “talking it out,” humans are able to determine what bothers them, develop solutions, and then calm down and relax. Shared talking builds new relationships, strengthens existing ones, and lets a person know they are cared about by others.

The aim of psychotherapy is to assist clients in dealing with their potentially harmful feelings, thoughts or behaviors, and replacing these with healthy and effective feelings, thoughts, or behaviors that they can use to cope with their current concerns and future problems that may arise. Grounded in dialogue (to explore and understand the issues without deciding or passing judgment) and discussion (to confirm a course of action toward change and transformation), psychotherapy is typically conducted in a comfortable office setting. Confidentiality is guaranteed (except for certain disclosures of illegal intent or harm from a client) and the therapist remains objective, unbiased, and impartial. Established ground rules make sure the sharing is conducted in a climate of privacy and support.

Traditional Talk Therapy

Traditional talk therapies depend on the relationship congruency between client and therapist or among clients and therapeutic modalities (see hindering forces below). When these are misaligned, therapy can fail. The modalities used by a therapist are: often informed by research, a likely strength of the therapist, and hopefully custom modified for each client. The therapist may rely on a combination of talk therapy modalities and vary these to better suit each of the clients as more is learned about their particular issues. Here are descriptions of the philosphical schools of psychological thought and several therapy techniques evolving from these (as diagrammed below).

PSYCHOANALYSIS/PSYCHODYNAMIC: Originated by Sigmund Freud, but modified by countless others since, this philosophy aims to change by discovering the underlying and unconscious incentive and inspiration to problematic feelings, thoughts or behaviours in a close working therapy partnership.
HUMANISTIC: Influenced by philosophers Kierkegaard and Sartre, this perspective considers the whole-client (mind, body, and soul), highlights their capacity for rational choice, and develops their optimal potential through self-aware expertise, responsibility, determination, and free will.
BEHAVIORAL: Arising from Pavlov’s classical conditioning with dogs, this viewpoint emphasizes behaving over feeling and thinking, and so changes phobias through controlled desensitizing of clients by increasingly powerful or repeated exposures to a fear, with consequential rewards and punishments.
COGNITIVE: This outlook emphasizes thinking over feeling and behaving, with the philosophy that dysfunctional thinking causes dysfunctional behaviours and feelings, and so best to change thinking through mindfulness and meditation to reduce stress and switch off from difficult thoughts and feelings.

Modalities

MODALITIES commonly used by Canadian outdoor therapy programs

COGNITIVE BEHAVIORAL THERAPY (CBT): The most common approach, CBT is well used in all outdoor therapy programs and is an obvious combination of the two philosophies above. It helps clients correctly comprehend their causal relationships from feelings, through thoughts, to behaviours and back again. Once the causal influence each has on the others is understood, CBT assists the clients with learning how to shape these relationships to their advantage. Instead of letting the negative feelings, thoughts, and behaviours rule over them, clients can consciously make a change in one to positively impact the others. The approach is therapist directed, structured, and short term. It is goal-oriented and centered in the here and now. It begins with education about a client’s presenting issues and how these influence daily living. It continues with learning and practicing skills and strategies for adjusting one’s feelings, thoughts, and behaviours. It ends with a set of healthy competencies and tactics that can be used to deal with future difficulties, should these arise.
DIALECTIC BEHAVIOUR THERAPY (DBT): The next most common approach is a socio-emotional variation on the above. DBT addresses extreme or unstable emotions and potentially harmful behaviours by showing clients how to regulate unhealthy emotions. The term “dialectic” refers to the therapist and a client engaging in dialogue to jointly investigate and discover the truth of the client’s difficulties without judgment or blame. An emphasis is placed on reality, acceptance, and validation regardless of the extreme client difficulties being examined. Relationships are at the centre of DBT: not just the therapist relationships, but also relationships with friends and family who have been damaged by harmful behaviours and will now need to support a client’s new methods of managing those behaviours. The approach is therapist enabled, but client directed. DBT takes place individually and in group sessions, with clients who are willing to self-explore, and may involve meditation or reflective contemplation. Due to the intensity of presenting issues and depth of exposure from risk taking, conflict resolutoin, and remoteness in small groups, DBT is more relied upon in adventure and wilderness therapy programs than in nature-based ones.
NARRATIVE THERAPY (NT): This story-telling technique separates clients from their entwining problems (allowing the therapist to externalize sensitive or damaging events) and encourages clients to rely on their own competence to minimize the difficulties they encounter. They are held as the experts in their past histories and the sources of their future solutions. Therefore, NT clients become the narrators of their own stories, where they can reinterpret and rewrite events to change the account. In doing so, the therapist helps clients to remain true to their reality (not seeing themselves as something they are not), to deconstruct the description, to see reoccurring patterns in their perceptions, and to reconstruct more life-enhancing interpretations. NT aids clients to reframe their prior problems in a more helpful and favourable light, while preparing them with tools to objectively reshape their projected future troubles. NT is well suited to both nature-based eco-therapies as well as adventure and wilderness therapies.
EYE MOVEMENT DESENSITIZATION AND REPROCESSING (EMDR): This technique is controversial, lightly researched, but widely accepted for the treatment of trauma, especially, post traumatic stress disorders from military combat, violent assault, abuse, and accidents. EMDR stimulates the brain through the repetition of rapid and rhythmic back and forth eye movements that appear to reduce distress and dampen the power of emotionally-charged events. In EMDR, the therapist asks a client to watch and follow hand motions, while briefly recalling a disturbing memory. As the client re-experiences the emotions and body sensations that accompany that trauma, the therapist will quickly guide the client away from the trauma to shift all thoughts toward more pleasant memories. The talk that follows helps to desensitize the energy of the past trauma, instead of discussing changes to feelings, thoughts or behaviours. One theory behind the action of EMDR suggests that the negativity associated with trauma overwhelms the brains natural healing power and the treatment by eye movements allows the brain to either be diverted or stimulated long enough to heal slightly during reframing of the memory in a safe setting. Due to the peacefulness of EMDR, it is best suited for use in nature-based eco-therapies.

Also commonly being used in outdoor therapy within Canada are other modalities including:

Solution-Focused Brief Therapy (SFBT),
Acceptance and Commitment Therapy (ACT),
Mindfulness-Based Stress Reduction (MBSR),
Circle of Courage (CC),
Emotion-Focused Therapy (EFT), and
Satir Transformational Systemic Therapy (STST).

HELPING & HINDERING FORCES

Beyond the contributions to outdoor therapies of challenge, nature immersion, and intentional psychotherapy, four helping forces (positive, black arrows) and four hindering forces (negative, white arrows) are constantly at work on the viability of a client's therapeutic change. These eight are shown in the diagram below and described afterward.

Helping

FOUR HELPING FORCES THAT CONTRIBUTE TO CLIENT CHANGE (+)

PERSONAL ALLIANCES encompass the strengths of the client partnership with a therapist, how well clients match or get along with staff, the relationships they develop with their peers, and toward an awareness and understanding of themselves.
ACQUAINTANCE INVOLVEMENT is mostly parental support, but can also involve sustenance from additional family members, friends, and notable others in a client’s life such as coach, elder, teacher, community leader, or neighbour. The value of such involvement and support is enormous and encourages the client to feel sustained and cheered on by others, leading to greater success in therapy.
CLIENT CONNECTIONS are the degree to which an association is made with the unfamiliar settings in which clients find themselves and the potential for metaphoric transfer. The novelty of a situation disarms old habits and tactics used to deflect change and leads to intense engagement in unavoidable and immediate action that counters notoriously difficult-to-engage clients with high levels of motivation. Since the outdoor setting is unfamiliar and very different from daily life, clients might normally have difficulty transferring their learning from the outdoors to life at home, work, or school. However, the conscious use of metaphor in activity descriptions, in language (questions and answers), and in linkages explored during discussions, allow the unfamiliar environment to become analogous with daily living and so transfer becomes much easier and more effective than without metaphor.
CLIENT INTENTIONS include the propensity to take responsibility for therapeutic goal setting, to willingly participate in activities and discussions, to engage in creating activities and conducting discussions, to be accountable for their progress, and to adopt, adapt, or improve on new healthy habits such as exercise, nutrition, sleep, and the absence of digital devices. The client, open to the therapeutic approach, is given the opportunities to make concrete comparisons between their behaviors in therapy and their behaviors prior to therapy. They have a chance to practice tangible behavioral changes and develop self-protection factors or coping strategies that will mitigate future psychosocial disorders or problems.

Hindering

FOUR HINDERING FORCES THAT DETRACT FROM CLIENT CHANGE (-)

UNRESOLVED TRAUMA can overwhelm, block, and prevent clients from reaching their therapeutic goals. Adverse Childhood Experiences (ACEs) can potentially create unresolved trauma that may last through future generations and lead to chronic health problems, mental illness, substance addiction, and terminal diseases in adulthood. ACEs include neglect and abuse (emotional, physical, sexual), or having a family member who is violent, incarcerated, abusing substances, suffering from mental illness, divorced, separated, or succumbed to suicide. We further wonder whether the absence of children’s outdoor risky play (known to build their resilience against adversity) contributes to the troubles of disaffected teenagers later on and explains why outdoor therapies utilizing risk taking are such powerful treatments for despondent youth. A case could be made for denial of outdoor risky play as yet another Adverse Childhood Experience.
MANDATED PARTICIPATION refers to clients being forced by parents or the courts to attend therapy and perhaps also being abducted or transported against their will to the therapy program (especially in the USA). Clearly, client who show up feeling kidnapped and betrayed are not in advantageous starting places to change their behaviours.
INCONGRUENT MODALITIES exist when the client’s interests, needs, and goals are misaligned with the therapist (who may have a different style or personality) or the therapy (which may have an underlying psychology that fails to resonate with the client). Therapists employing traditional talk therapies such as Cognitive Behavioral, Dialectic Behavioral, and Narrative Therapies may work well in concert with outdoor therapies, but a few clients may gravitate more toward other forms of expressive therapy such as play, drama, art, dance, poetry, or music.
CLIENT RESISTANCE to change takes many shapes ranging from lack of awareness and unwillingness to change, through disagreement with the change and unconsciously opposing it, to consciously opposing it and finally feeling apathetic toward change. Of the four hindering forces, this one can be addressed by using stepwise fortifying techniques, such as: clarification, negotiation, confusion, paradox, double bind, and role shift.