Assessment [blog 8]

Compare and contrast the approach to AT assessment presented in Chapter 7 to at least 2 different approaches to assessment in mental health treatment.

"In the process of assessment, wilderness adventure experiences can be viewed as similar to projective psychological tests..."(Gass, Gillis, and Russell 2012).

There are many different approaches to mental health treatment. Each different approach also comes with a different assessment. According to the book, the macro view of assessment in Adventure Therapy is seen in the CHANGES model (Gass, Gillis, and Russell 2012). Part of the CHANGES model is made up of the three elements of adventure therapy assessment: Diagnosis and design, Delivery, and Debrief. "We have found the CHANGES model to be a helpful way to organize interactive steps to acquire information and reflect upon it to enable the development of functional client change"(Gass, Gillis, and Russell 2012).

There are seven stages to the CHANGES model (context, hypotheses, action, novelty, generating, evaluation and solutions). I will provide an example from each of theses steps:

1. How long will the client be involved?
2. What behavior might be expected?
3. How involved individuals are in adventure experiences?
4. The use of new experiences to bring out the real self, instead of the "socially proper self"
5. What are specific qualities of the group?
6. Was the hypothesis confirmed or rejected?
7. What is the solution to the problem? 

As I was reading a study on Mental health assessment in rehabilitation I learned that assessment in mental health research has evolved from only focusing on symptoms and diagnosis to addressing a broad range of change. Which ironically enough is the acronym for the assessment model used in AT (McQuaid, Marx, Rosen, etc. 2012). To focus in more on a specific type of therapy I will give the details of Cognitive Behavioral Therapy. This type of therapy builds a set of skills that helps the client to be aware of their thoughts and emotions. This is accomplished by: first identifying how situations, thoughts and behaviors can influence our emotions and what the consequences of those thoughts are. Throughout this process the clients would be able to complete surveys or something of the sort to convey how they are feeling and how their thoughts are changing about the situation. 

Here is a video that shows what Cognitive Behavior Therapy is all about: 

I found it interesting to explore the type of assessment that is done in Art Therapy. According to Donna J. Betts in her doctoral dissertation, "Art-based assessment instruments are used by many art therapists to determine a client's level of function; formulate treatment objectives; assess a client's strengths, gain a deeper understanding of a client's presenting problems; and evaluate client progress." Since a lot of the work done through Art Therapy is drawings or paintings, there are different analysis' used to examine those parts of the therapy (Art Therapy Assessment). These are all different steps that relate to the steps we take in AT. Learning the client and how they function, coming up with goals, finding their strengths, and evaluating their progress. 

We all make assessments during the day about the various experiences we have and the different problems we face. Along the way we will always assess the situation, consider the possibilities, as the questions that need to be asked, and continue forward towards the end goal that will give us a solution to the problem. This is a parallel to the way that different types of therapies go about figuring out how to help people. I can see similarities in many different ways of going about the assessment in mental health treatment, even though each approach has its own particular qualities. 

Citations

Betts, Donna, J. (2005). Art therapy assessment. Retrieved from: http://www.art-therapy.us/assessment.htm

Gass, M. A., Gillis, H.L., Russell, K. C. (2012). Adventure therapy: Theory, research, and practice. New York, Routledge/Taylor & Francis Group.

McQuaid, J. R., Marx, B.P., Rosen, M. I., Bufka, L. F., Tenhula, W., Cook, H., & Keane, T. M. (2012). Mental health assessment in rehabilitation research. Journal Of Rehabilitation Research & Development, 49(1), 121-137. 

Video : http://www.youtube.com/watch?v=fSFaaChAV8I

Outward Bound Process [blog 4]

How might The Outward Bound Process be used in psychology other than treatment?

There are many ways that people could use The Outward Bound process in psychology other than just for treatment of patients in adventure therapy settings. Here is a website that talks about what Outward Bound is. This website says the idea behind Outward Bound “is that people can grow through challenge.”

The first way I thought that the Outward Bound process could be used is in research. Since the Outward Bound process is not as conventional as say, traditional ways of looking at therapy, there could be more time spent investing in the research that lead to the models that these programs are working after. It would be interesting to learn about the long-term effects of Outward Bound processes that have been used in adventure therapy and how they have influenced the clients’ life shortly following the time of treatment and then years down the road. By researching the long-term effects of these types of programs we would be able to change them in a way to better fit each new client that would be looking to processes of the same category.

            As I was reading chapter 4 it became clear to me why Adventure Therapy and Outward Bound processes would seem like a great option (especially for substance abusers). Because when you think about it, whether or not a person wants to be there, with programs like that (vs. more traditional or cognitive behavioral therapies) the client has no other choice than to be present and involved, in a sort of way that cannot be found in the traditional indoor, client/therapist setting. Through more research on the Outward Bound process, researchers may gain a better understanding of how effective the Outward Bound process is. “Thinking, feeling, & behaving as if there is something to be gained from participating.” (Gass, Gillis, and Russell 2012). All of these different emotions and behaviors lead into a change in the participants’ beliefs, as they believe they can have control & influence their own life direction. All of which could benefit from more research on the process.

            If we look at the model that is found in the book on page 71, we see that the model “illustrates how the Outward Bound process functions, as characteristic problem-solving tasks are set in a prescribed physical and social environment, which impel the participant to mastery of these tasks and which, in turn, serve to reorganize the meaning and direction of his life experience.” (Walsh and Golins, 1967, p.16).

            To make the connection between the Outward Bound process, research, and neuroscience it would be interesting to study the effects of the model of the Outward Bound process on cognitive processes and the way the brain reacts to and is activated by certain types of activities specific to the Outward Bound process. In the Outward Bound process Model, one of the key characteristics of it is the “contrasting/novel physical environment.” This helps people involved “to generalize about old or to see old with new perspectives and options available in it” (Gass, Gillis, and Russell 2012). This could definitely be a topic of research in connection with the change in cognitive processes. If the focus was then moved to social psychology, it would be interesting to investigate the differences in interactions between groups of people and which socioeconomic groups they come from. There is a lot to be learned about the way in which a persons experience could be different depending on how many people or which people they are interacting with during the programs. According to a study done by Kalisch, it was found through prior research that when a person has a solo experience, as a small part of the overall program, the quality of their experience is enhanced (Kalisch, 2011). 

            

           

           

Citations

Gass, M. A., Gillis, H.L., Russell, K. C. (2012). Adventure therapy: Theory, research, and practice. New York, Routledge/Taylor & Francis Group.

Kalisch, K. (2011). The Outward Bound Solo: A Study of Participants' Perceptions. Journal Of Experiential Education, 34(1), 1. doi:10.5193/JEE34.1.1

Outward Bound Professional. Retrieved from: http://www.obusa.org/index.cfm/do/pro.about 

Types of Therapy. [blog 1]

According to the text, "adventure therapy is the prescriptive use of adventure experiences provided by mental health professionals, often conducted in natural settings that kinesthetically engage clients on cognitive, affective, and behavioral levels." The types of activities used in AT vary from extreme wilderness expeditions to a challenge course used to help a family with group dynamics. There are many other approaches to mental health therapy. Just to name a few...

1. Art Therapy 

2. Cognitive Behavior Therapy 

3. Dog Therapy 

     The first from the list is art therapy. Art therapy is "a therapeutic use of art making, within a professional relationship, by people who experience illness, trauma, or challenges in living, and by people who seek personal developmental. Through creating art and reflecting on the art products people are able to increase awareness of self and others, cope with symptoms, stress and traumatic experiences; enhance cognitive abilities; and enjoy the life-affirming pleasures of making art." This type of therapy is different from adventure therapy in the obvious way that art is the main focus of this therapy. But there is a similarity in that two that each activity is very much what the person involved makes of it. It is a very personal experience between the individual and the art they are creating, just as in AT it is how the individual responds to nature and the activities that take place there. According to a study done by Yvonne Thomas he and his colleagues found that "art provides an alternative from the problems problems associated with homelessness, mental health and substance abuse and allows for public recognition and social inclusion." 

     The next one is cognitive behavior therapy. Cognitive behavior therapy is focused on helping individuals understand how changing their behavior can lead to changes in how they are feeling. Usually the goal of behavior therapy is to engage the individual in more positive or socially reinforcing activities. This is similar to AT in the way that they are both focused on involving the person in experiences that are both focused on their feelings and actions. 
     Another type of therapy is dog therapy. Individuals volunteer to work with the therapy dogs and they are dedicated to visting nursing homes, hospitals, other institutions and wherever else the therapy dogs are needed. In study done by Moretti to evaluate the effects of pet therapy on cognitive function, mood and perceived quality of life on elderly inpatients affected by dementia and depression the researchers found that pet therapy is efficient in improving depressive symptoms and cognitive function in residents of long-term care facilities with mental illness. 
   

Photo came from this website. 

Citations

About behavior therapy . (2013). Retrieved from http://psychcentral.com/lib/2006/about-behavior-therapy/.

American art therapy association. (2012). Retrieved from http://www.americanarttherapyassociation.org/aata-aboutus.html.

Gass, M. A., Gillis, H.L., Russell, K. C. (2012). Adventure therapy: Theory, research, and practice. New York, Routledge/Taylor & Francis Group.

Life stream therapy . (2009). Retrieved from http://lifestreamtherapy.com/adventure_therapy.html.

MORETTI, F., DE RONCHI, D., BERNABEI, V., MARCHETTI, L., FERRARI, B., FORLANI, C., & ...    ATTI1, A. (2011). Pet therapy in elderly patients with mental illness. Psychogeriatrics, 11(2), 125-129. doi:10.1111/j.1479-8301.2010.00329.x

Therapy dogs international. (2012). Retrieved from http://www.tdi-dog.org/About.aspx.

Thomas, Y., Gray, M., McGinty, S., & Ebringer, S. (2011). Homeless adults engagement in art: First steps towards identity, recovery and social inclusion. Australian Occupational Therapy Journal, 58(6), 429-436. doi:10.1111/j.1440-1630.2011.00977.x.