The purpose of this study was to review the current state of Adventure Therapy (AT) as it is practiced with youth in North America, examining the research to identify critical issues and formulate recommendations for potential areas of improvement.
Current themes within the literature were organized by the type of intervention, including wilderness therapy, residential therapy, and community-based applications. Wilderness therapy research is described as being the most prevalent and consistent to date, which the authors suggest has helped lead to more uniformity and understanding of standards of care and best practices within the field. In contrast, the evidence base for understanding the effectiveness of adventure therapy within community-based programs is described as being more limited and in need of attention. Overall, while the evidence base is reported to be growing, the authors highlight a number of areas in which additional research is needed including more rigor around which factors facilitate positive outcomes, such as the role of nature, relationships, and activity type. The authors describe the field of adventure therapy and its evidence base as being limited by a lack of models, insufficient rigor in identifying how outcomes are being achieved, and little in the way of longitudinal data.
Beyond the need for continued advancement in terms of research, they identified critical issues within the field. They cite the need for improvements in accreditation and risk management related to operating locations, the detoxification process, licensure, and adherence to state health and safety standards. Quality training for all personnel, from clinicians to field staff, is recommended. The authors recommend increased professionalization of the AT industry to be characterized by evidence-based practice, open communication with other mental health professionals, and clear ethical and accredited practices.
The authors do a skillful job of drawing on the evidence to assert positive outcomes for troubled youth through adventure therapy interventions while also raising serious issues that warrant action to increase the benefits and reduce the risks associated with the application of these approaches.
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