Renewed Freedom Center treats anxiety and Obsessive Compulsive Disorder (OCD) using Exposure and Response Prevention (ERP). This experiential approach helps patients learn they are not in danger in the face of a perceived threat to eliminate avoidance, seeking reassurance, or engaging in safety behaviors that reinforce their fears. As far as exposures go, they can be done indoors, outdoors, one-on-one in a therapist’s office, or in a large, public area, like a concert hall, park, or shopping mall. And as summer approaches, so does the opportunity to be more creative with our exposures.
One technique for therapists to consider this summer as an adjunct to ERP, which also uses learning, is Adventure Therapy developed by Kurt Hahn in 1941. Adventure therapy is a short-term, experiential approach and could be the creative key to summertime exposures. Adventure therapy utilizes the wilderness and outdoor activities in applying learning theory. This approach helps patients engage in experiences to overcome emotional difficulties, addiction, behavioral issues and many other challenges. Its goal is to reduce a particular behavior (e.g., compulsions, safety behaviors) and increase psychological resilience. Adventure therapy has been seen to show benefits in as high as 95% of clinical research participants that underwent this treatment in a 6-week program, with parents reporting significant improvement in the behavior and mindset of their children. So what better adjunct to exposure therapy than to include the California sun and outdoor adventures?
One way to incorporate adventure therapy this summer could be with treating contamination OCD. For example, exposures could begin with touching things in nature that patients might perceive as dirty, filthy, or contaminated (e.g., dirt, sand, seaweed at the beach), and could gradually lead to entering and participating in an outdoor obstacle race, such as the Mud Run. These outdoor exposures can include every aspect of the patient’s OCD fear while encouraging creativity, humor, and fun this summer.
Both Adventure therapy and ERP are based on experiential learning because therapists in each approach purposefully engage with the learner in direct experiences to help individuals gain knowledge, develop skills (e.g., distress tolerance and rational thinking), and clarify their values. Therefore, the next time you develop exposures, consider using the wilderness and structured outdoor activities to foster habituation, insight, and personal growth. It is these creative activities that provide healing opportunities that might otherwise remain untapped.
References
Association for Experiential Education. Retrieved March 25th, 2019 from www.aee.org.
Bandoroff, S., & Scherer, D. G. (1994). Wilderness family therapy: An innovative treatment approach for problem youth. Journal of Child and Family Studies, 3(2), 175-191. doi:10.1007/bf02234066
Barlow, D. H. (2014). Clinical handbook of psychological disorders: A step-by-step treatment manual. New York: The Guilford Press.
Berman, Dene., Davis-Berman, Jennifer. 1995. Outdoor Education and Troubled Youth. Eric Publication, Eric Digest
Bowen, D. J., & Neill, J. T. (2013). A meta-analysis of adventure therapy outcomes and moderators. The Open Psychology Journal, 6, 26. doi:http://dx.doi.org.tcsedsystem.idm.oclc.org/10.2174/1874350120130802001
Ewert, A; McCormick, B; Voight, A (2001). “Outdoor experiential therapies: Implications for TR practice”. Therapeutic Recreation Journal.
Norton, C. L., Tucker, A., Russell, K. C., Bettmann, J. E., Gass, M. A., Gillis, H. L. “Lee,” & Behrens, E. (2014). Adventure Therapy With Youth. Journal of Experiential Education, 37(1), 46–59. https://doi.org/10.1177/1053825913518895
