The Use Of Adventure Therapy In The Treatment Of Eating Disorders

1. The Use Of Adventure Therapy In The Treatment Of Eating Disorders Rick R. Sieber ESS 777 772 Dr. Jeff Steffen

2. Description of Anorexia and Bulimia Nervosa • Anorexia and bulimia occur most often in women between the ages of 17 and 40 years old (APA, 1994). • Anorexia is commonly characterized by a drastic restriction of calories and low body weight, while bulimia is characterized by a vicious cycle of binge eating and purging. • Patients with bulimia typically binge on large amounts of food, and then they “undo” the binge by either vomiting, taking laxatives, exercising excessively, or fasting. • Symptoms associated with these disorders are an intense fear of becoming fat, low self-esteem, and distorted body image. • Anorexics and bulimics commonly struggle for a sense of control in their lives, which is reflected in the obsessive need to control their bodies (Maddocks & Bachor, 1986).

3. What is Adventure Therapy? • Adventure therapy is a form of experiential therapy that is used in conjunction with other therapeutic approaches to treat clients with eating disorders. • Adventure therapy utilizes a combination of experiences with associative processes of reflection as the tools for change. • Adventure therapy can include initiatives that a group may have to solve together, challenge course activities, and extended wilderness trips. • Adventure therapy allows patients to be active participants in the therapeutic process, and they are given opportunities to develop new behaviors and coping mechanisms. • Adventure therapy integrates an unfamiliar adventure setting with an element of physical and emotional challenge.

4. What Characteristics Make Adventure Therapy Effective? • Adventure therapy is action-centered, engaging clients in “active and multidimensional experiences.” • Adventure therapy utilizes an unfamiliar environment • Through activities in which there is a level of perceived risk, the positive use of stress brings about a climate of change. • Adventure therapy provides therapists with better assessment capabilities, as they observe patients responses and behaviors they may discover things that never would have come up within the confines of an office. • In adventure therapy experiences, the emphasis is put on success and solutions rather than on problems and dysfunctional behaviors. • Integrating adventure experiences into therapy changes the role of the therapist. It allows the patient to see the therapist in a different light and allows for new interactions between the therapist and patient.

5. Key Pieces of Research • Adventure therapy has helped participants with eating disorders improve in the areas of self-esteem, perfectionism, body satisfaction, coping mechanisms, focus on appearance, and focus on thinness. Out of 16 subjects, 100% strongly agreed that the adventure therapy enhanced their treatment experiences and 81% strongly agreed that it was beneficial for their treatment. Furthermore, 100% of the participants strongly agreed or somewhat agreed that the adventure therapy would play an important role in their long-term recovery (Costa, A.G. 2001). • Experiential activities brought out an awareness and existence of trust in oneself and in others during a study conducted with girls at-risk during a 4-day backpacking trip. The girls gained a sense of empowerment, teamwork improved, and the girls recognized personal values during the experiential activities (Autry, Cari E 2001).

6. Advantages Of Using Adventure Therapy In The Treatment of Eating Disorders • Study has found that adventure therapy helps decrease the perfectionist tendencies of women with eating disorders (Costa, A.G. 2001). • Adventure therapy has allowed women to learn importance of asking for help and using others, to recognize and appreciate their unique strengths, and to focus less on the outcome and enjoy the journey (Eilers, G. 1997). • Patients with bulimia have described feeling connected to their body for the first time in y ears through adventure therapy. They’ve used their body to support and help others and have been able to see their bodies in a new light (Maguire, R. & Priest, S. 1994). • Research shows that many women are ashamed of their bodies and adventure therapy can help improve negative thoughts of self and poor body image (Hayes, J. 1997). • Adventure therapy can help women reconnect with their ‘original’ emotions in reaction to a trigger (Mack, H. 1997).

7. Potential Disadvantages Of Adventure Therapy In The Treatment of Eating Disorders • While there is anecdotal evidence of the effectiveness of adventure therapy for the treatment of eating disorders, very minimal research has been conducted to determine its effectiveness for this population (Costa A.G. 2001). • Oftentimes the low activity level required by patients with eating disorders may restrict or limit the amounts and types of adventure therapy that can be offered. • Adventure therapy is less effective at creating lasting change if not implemented over long period of time. Many patients with eating disorders are hospitalized in inpatient unit or their health insurance doesn’t cover long enough stay for adventure therapy to reach full potential.

8. Bibliography • Autry, Cari E (2001). Adventure therapy with girls at-risk: Responses to outdoor experiential activities. Therapeutic Recreation Journal V35, n4 p289-306 4th Qtr 2001 • Eilers, G. (1997). My lessons for living from Adventure Therapy. Journal of Experiential Education, 20(2), 61-65 • Maddocks, K.M., & Bachor, D.G. (1986). The Case of “Kim”: The Feelings and Experiences of a Bulimic. Canadian Journal of Counseling, 20, 66-72. • Maguire, R. & Priest, S. (1994) The Treatment of Bulimia Nervosa Through Adventure Therapy. Journal of Experiential Education, 17(2), 44-48 • Gass, M. & Gillis, L. (1995). Changes: An Assessment Model Using Adventure Experiences. Journal of Experiential Education, 18(1), 34-40 • Gass, M. (1993a). Enhancing Metaphor Development in Adventure Therapy Programs in Adventure Therapy: Therapeutic Applications of Adventure Programming, ed. M. Gass. Dubuque, Iowa: Kendall/Hunt • Arnold, S. (1994) Transforming Body Image Through Women’s Wilderness Experiences. Women and Therapy, 15(3-4), 43-54 • Gass, M. & Gillis, L. (1995). Focusing on the “solution” rather than the “problem”: Empowering client change in adventure experiences. Journal of Experiential Education, 18(2), 63-69.

9. Bibliography Cont. • Hayes, J. (1997). Disordered Eating, Body Image, and Adventure Therapy, in Processing the Experience, eds. J.L. Luckner & R.S. Nadler. Dubuque, Iowa: Kendall Hunt • Kimball, R. (1993). The Wilderness as Therapy: The Value of Using Adventure Programming in Therapeutic Assessment, in Adventure Therapy: Therapeutic Applications of Adventure Programming, ed. M. Gass. Dubuque, Iowa: Kendall/Hunt • Berman, D. & Davis-Berman, J. (1995). Adventure as Psychotherapy: A Mental Healthy Perspective. Leisurability, 22(2), 21-28 • Mack, H. (1997). Dancing on the Sidewalk: Reflections on Working with Women with Weight Preoccupations and Bulimia. Pathways: The Ontario Journal of Outdoor Education, 9(2), 12-15. • Costa, A.G. (2001). Patients’ Perceptions of the Effects of Adventure Therapy on the Treatment of Eating Disorders. MA thesis, University of New Hampshire.