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Enhancing Your Therapy with Gestalt Approaches
Gestalt Therapy continuing education addiction counselor CEUs

Section 20
Gestalt Principles in Adventure-Based Counseling

CEU Question 20 | CEU Answer Booklet | Table of Contents | Gestalt
Psychologist CEs, Social Worker CEUs, Counselor CEUs, MFT CEUs

Adventure Based Counseling (ABC) is a therapeutic tool that can be adapted to almost any setting and is a mixture of experiential learning, outdoor education, group counseling (Schoel, Prouty, & Radcliffe, 1988), and intrapersonal exploration. Although obviously not a panacea, the conceptual framework of ABC is based on several counseling theories including behavioral and cognitive theories, experiential learning, an affective perspective (Priest & Gass, 1997; Schoel et al., 1988), as well as a process of events that promotes positive change. ABC involves activities in which clients are essentially learning by doing (Gass, 1993a). Galagan's (1987) adventure-based learning by doing program was positively associated with personal growth, accountability, support, trust, and a sense of personal energy. Similarly, Vester (1987) has presented a framework of leisure that focuses on adventure as a form of counseling. Descriptively, a counselor using ABC typically chooses an experiential activity that possesses strong metaphoric relationships to the goals of counseling. The counselor may then give directives for an adventure-based activity and, during the process, make references to metaphors, thereby creating a connection from the adventure activity to real life (Gass, 1995). After this experience, counselors debrief the client to reinforce positive behavior changes, reframe potentially negative interpretations of the experience, and focus on the integration of functional change into the client's lifestyle (Gass, 1995; Hinkle, 1999; Luckner & Nadler, 1992; Priest & Gass, 1997). ABC is developing into a significant area of counseling intervention. The efficacy of ABC has been minimally supported in the research literature; however, methodological flaws in research designs may actually minimize reported effectiveness rates (see Nassar-McMillan & Cashwell, 1997). Continued theory development and empirical research are obviously needed, particularly on the long-term effects of ABC.

Conceptual Framework Of ABC: Although ABC uses traditional psychosocial and educational theories involving individual, group, and family counseling, ABC differs from traditional counseling. These differences include the setting, the use of real and perceived risk, additional required skills, additional ethical considerations, an emphasis on processing and metaphor, and transfer of learning to psychological, educational, sociological, physical, and spiritual benefits. ABC can be used as a primary treatment or as an adjunct to more traditional types bf counseling. Although traditional counseling usually takes place indoors or in an office setting, ABC often takes place in the outdoors. There is also the perception of risk or real risk in ABC that is not found in typical counseling settings. ABC requires traditional counseling skills (i.e., what experiential educators refer to as "soft" skills) as well as additional physical skills (i.e., what adventure based counselors refer to as "hard" skills, such as challenge ropes course management, rock climbing, hiking, camping, and kayaking). Facilitation of activities includes programming, or selecting appropriate activities, and macroprocessing, which includes six facilitation styles. These styles, described more fully in this article, are as follows: no loading, front loading, back loading, or front- and backloading, and the use of metaphor and paradox. Finally, the adventure-based experience is transferred to real life through processing. Because ABC originated from experiential education and outdoor education, a model is needed for the counseling profession to transfer the traditional practices from outdoor and experiential education to a more therapeutic realm. To do so, counselors, counselor educators, and counselors-in-training need to develop an understanding of how the entire process works. Finally, ABC is relatively new to the counseling field, and a model helps to organize the relative information so that it is easier to comprehend, teach, and apply.

Theory Application: ABC is derived from individual, group, and family counseling models, as well as from educational theories. The primary individual counseling theories or therapies that combine to contribute to ABC are cognitive (Beck, 1963), rational emotive behavioral (Ellis, 1962), reality (Glasser, 1965), behavioral (Bandura, 1969; Skinner, 1953), gestalt (Zinker, 1977), narrative (Bruner, 1985), and constructivist (Fosnot, 1989). Cognitive theory is used in ABC to help clients understand the association between their adventure experience and their cognitive processes and how thought processes may affect relationships with others as well as with the self. Rational emotive behavioral theory can be effectively used when assessing risk or perceived risk. For example, if a person is in a low-risk situation but perceives the situation as high risk, irrational thoughts of risk can be challenged so the client is able to confront and differentiate between real and perceived risks (Priest & Gass, 1997). Of course, having a client differentiate between real and perceived risks is consistent with current behavior therapy that relies heavily on a cognitive base. Also, ABC uses reinforcement theory as a basic component of its approach. Reality theory is incorporated into ABC by the highlighting of natural consequences, taking responsibility for one's own actions, and working in the present toward the future (Clagett, 1992).

Gestalt therapy is relevant to the adventure experience in that individuals process events while they are occurring. This happens in microprocessing as new skills or insights from the experience are applied to real life. Furthermore, the "in the moment" focus of ABC is consistent with gestalt therapy. Narrative therapy, a technique used to write and rewrite a person's "story," is similarly used in ABC. The adventure experience can be used as a metaphor to rewrite a person's past. Finally, constructivist theory is based on the individual creating his or her own reality. ABC can assist with this process by adding another dimension to a person's reality through the insight gained from the adventure experience (Luckner & Nadler, 1992).

ABC can be used intentionally to address individual needs, but many ABC activities emphasize work in groups. The application of group counseling models is important for understanding group development and group dynamics (Gazda, Ginter, & Horne, 2001). Luckner and Nadler (1992) have identified a model of group development that is specific to ABC. These stages include acquaintance, goal ambiguity, diffusing anxiety, members' search for position, focus on affect and confrontation, sharpened interactions (growth), norm crystallization, distributive leadership, decreased defensiveness and increased experimentation, group potency, and termination.

Adjunct and Primary Treatment: The aforementioned theories have been identified to provide a better understanding of how ABC is grounded and supported. ABC can be used as an adjunct to treatment or as the primary treatment (Gass, 1995). In counseling, it will most likely be used as an adjunctive treatment intervention (Bandaroff & Parrish, 1997). For example, a day hike may be used adjunctively with breast cancer survivors to help them relax, engage in a peaceful environment, and have success with something that requires healthy, physical exertion. In contrast, an adolescent residential treatment facility may use longer trips using an outdoor setting with ABC as the primary treatment, and clients are expected to make behavioral changes as a result.
- Fletcher, Teresa B.; Hinkle, J. Scott; Adventure Based Counseling: An Innovation in Counseling; Journal of Counseling & Development, Summer2002, Vol. 80 Issue 3
The article above contains foundational information. Articles below contain optional updates.

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Personal Reflection Exercise #6
The preceding section contained information about Gestalt principles in Adventure-Based Counseling.  Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 20
What are two ways in which Gestalt therapy is relevant to Adventure-Based Counseling? Record the letter of the correct answer the CEU Answer Booklet.

 
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Work and well-being in TGNC adults: The moderating effect of workplace protections. - September 13, 2018
The present study used a psychology of working theory (PWT) framework to test the direct and indirect relations of perceived social status and transgender and gender nonconforming (TGNC) marginalization (i.e., victimization, nonaffirmation of gender identity, negative expectations for the future) with work volition, overqualification, and vocational and emotional well-being outcomes (i.e., job satisfaction, meaningful work, satisfaction with life, depression) in a sample of 175 TGNC working adults. This study also tested the moderating effect of one form of structural marginalization (lack of legal protections from employment discrimination) on the overall pattern of results. Participants were recruited using online social media and discussion forums and completed the study survey online. For the full sample, perceived social status and nonaffirmation of gender identity were associated with vocational and emotional well-being outcomes through the mediating role of work volition, and for some paths, overqualification. Significant differences emerged in the overall pattern of results for those without protections, suggesting that protections from discrimination buffer the adverse links of some forms of TGNC marginalization with work volition and vocational outcomes. Implications of study findings for research, counseling, and advocacy are provided. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
The development and psychometric evaluation of the Trans Discrimination Scale: TDS-21. - July 23, 2018
[Correction Notice: An Erratum for this article was reported in Vol 66(1) of Journal of Counseling Psychology (see record 2018-66276-001). In the article “The development and psychometric evaluation of the Trans Discrimination Scale: TDS-21” by Laurel B. Watson, Luke R. Allen, Mirella J. Flores, Christine Serpe, and Michelle Farrell (Journal of Counseling Psychology, 2018, Advance online publication. http://dx.doi.org/10 .1037/cou0000301), there were two errors in the Methods section of the article. In Study 1, Participants paragraph of The development and psychometric evaluation of the Trans Discrimination Scale: TDS-21 for the Methods section, the gender listed at birth was incorrect in the following sentence, The majority of participants in this study identified as trans women and along a trans feminine spectrum, were assigned male at birth, White, had attained some college but no degree, and were employed full time. The correct gender assigned at birth was predominantly female. In addition, the gender coding procedures was incorrectly described. Specifically, those who identified as FAAB and AFAB were actually coded as trans men or along a transmasculine spectrum, whereas those who identified as MAAB and AMAB were coded as trans women and along a trans feminine perspective. In Study 3, Participants paragraph of The development and psychometric evaluation of the Trans Discrimination Scale: TDS-21 for the Methods section, the gender identity listed in the following sentence was incorrect, The majority of participants identified as trans women and along the trans feminine spectrum, were assigned female at birth, White, had attained some college but no degree, and were students. Rather, participants primarily identified as non-binary trans.] To date, researchers assessing the role of discrimination in trans peoples’ lives have relied upon measures that were developed and normed on LGB populations, culled specific items from large-scale survey data, or used more generalized measures of discrimination that do not specifically assess the unique forms of discrimination that trans people may encounter. Thus, the purpose of this three-part study was to develop and provide psychometric support for a measure of trans peoples’ discrimination. In Study 1, a five-factor model emerged, which included: Microaggressions and Harassment, Restricted Career and Work Opportunities, Maltreatment in Health Care Settings, Harassment by Law Enforcement, and Bullying and Harassment in Educational Settings. Internal consistency estimates for subscale and total scale scores ranged from acceptable to excellent. Results from Study 2 revealed that a bifactor model provided the best fit to the data, revealing that the scale is essentially unidimensional. In addition, convergent and concurrent validity was supported, demonstrating significant positive correlations with another measure of trans discrimination, internalized transphobia, nondisclosure, negative expectations for the future, psychological distress, and perceived stress. In Study 3, results revealed excellent test–retest reliability up to a three-week period. Collectively, results suggested that the Transgender Discrimination Scale-21 (TDS-21) is a psychometrically sound measure that may be used to advance research on the role of discrimination in trans peoples’ lives. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
“The Development and Psychometric Evaluation of the Trans Discrimination Scale: TDS-21”: Correction to Watson et al. (2018). - January 03, 2019
Reports an error in "The Development and Psychometric Evaluation of the Trans Discrimination Scale: TDS-21" by Laurel B. Watson, Luke R. Allen, Mirella J. Flores, Christine Serpe and Michelle Farrell (Journal of Counseling Psychology, Advanced Online Publication, Jul 23, 2018, np). In the article “The Development and Psychometric Evaluation of the Trans Discrimination Scale: TDS-21” by Laurel B. Watson, Luke R. Allen, Mirella J. Flores, Christine Serpe, and Michelle Farrell (Journal of Counseling Psychology, 2018, Advance online publication. http://dx.doi.org/10 .1037/cou0000301), there were two errors in the Methods section of the article. In Study 1, Participants paragraph of The Development and Psychometric Evaluation of the Trans Discrimination Scale: TDS-21 for the Methods section, the gender listed at birth was incorrect in the following sentence, The majority of participants in this study identified as trans women and along a trans feminine spectrum, were assigned male at birth, White, had attained some college but no degree, and were employed full time. The correct gender assigned at birth was predominantly female. In addition, the gender coding procedures was incorrectly described. Specifically, those who identified as FAAB and AFAB were actually coded as trans men or along a transmasculine spectrum, whereas those who identified as MAAB and AMAB were coded as trans women and along a trans feminine perspective. In Study 3, Participants paragraph of The Development and Psychometric Evaluation of the Trans Discrimination Scale: TDS-21 for the Methods section, the gender identity listed in the following sentence was incorrect, The majority of participants identified as trans women and along the trans feminine spectrum, were assigned female at birth, White, had attained some college but no degree, and were students. Rather, participants primarily identified as non-binary trans. (The following abstract of the original article appeared in record 2018-35350-001.) To date, researchers assessing the role of discrimination in trans peoples’ lives have relied upon measures that were developed and normed on LGB populations, culled specific items from large-scale survey data, or used more generalized measures of discrimination that do not specifically assess the unique forms of discrimination that trans people may encounter. Thus, the purpose of this three-part study was to develop and provide psychometric support for a measure of trans peoples’ discrimination. In Study 1, a five-factor model emerged, which included: Microaggressions and Harassment, Restricted Career and Work Opportunities, Maltreatment in Health Care Settings, Harassment by Law Enforcement, and Bullying and Harassment in Educational Settings. Internal consistency estimates for subscale and total scale scores ranged from acceptable to excellent. Results from Study 2 revealed that a bifactor model provided the best fit to the data, revealing that the scale is essentially unidimensional. In addition, convergent and concurrent validity was supported, demonstrating significant positive correlations with another measure of trans discrimination, internalized transphobia, nondisclosure, negative expectations for the future, psychological distress, and perceived stress. In Study 3, results revealed excellent test–retest reliability up to a three-week period. Collectively, results suggested that the Transgender Discrimination Scale-21 (TDS-21) is a psychometrically sound measure that may be used to advance research on the role of discrimination in trans peoples’ lives. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Testing intersectionality of race/ethnicity × gender in a social–cognitive career theory model with science identity. - October 04, 2018
Using social–cognitive career theory, we identified the experiential sources of learning that contribute to research self-efficacy beliefs, outcome expectations, and science identity for culturally diverse undergraduate students in science, technology, engineering, and math (i.e., STEM) majors. We examined group differences by race/ethnicity and gender to investigate potential cultural variations in a model to explain students’ research career intentions. Using a sample of 688 undergraduate students, we ran a series of path models testing the relationships between the experiential sources, research self-efficacy beliefs, outcome expectations, and science identity to research career intentions. Findings were largely consistent with our hypotheses in that research self-efficacy and outcome expectancies were directly and positively associated with research career intentions and the associations of the experiential sources to intentions were mediated via self-efficacy. Science identity contributed significant though modest variance to research career intentions indirectly via its positive association with outcome expectations. Science identity also partially mediated the efficacy-outcome expectancies path. The experiential sources of learning were associated in expected directions to research self-efficacy with 3 of the sources emerging as significantly correlated with science identity. An unexpected direct relationship from vicarious learning to intentions was observed. In testing for group differences by race/ethnicity and gender in subsamples of Black/African American and Latino/a students, we found that the hypothesized model incorporating science identity was supported, and most paths did not vary significantly across four Race/Ethnicity × Gender groups, except for 3 paths. Research and practice implications of the findings for supporting research career intentions of culturally diverse undergraduate students are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Construction and validation of the Multicultural Orientation Inventory—Group Version. - July 12, 2018
Given the continued racial/ethnic diversification of the United States, it is not uncommon for therapy groups to consist of members with diverse racial/ethnic backgrounds and various cultural identities. Scholars have underscored how this cultural diversity can directly impact many processes and outcomes of group-based interventions (Chen, Kakkad, & Balzano, 2008). However, there is presently a paucity of empirical research testing the relationship between cultural processes of therapy groups and members’ outcomes. Moreover, no psychometrically sound measure of the cultural process that unfolds in group therapy currently exists. As such, this study sought to adapt the Multicultural Orientation Inventory to develop and validate the Multicultural Orientation Inventory—Group Version (MCO-G), a measure assessing the cultural humility, cultural comfort, and cultural missed opportunities in therapy groups. Data for this validation study consisted of 208 members of 49 therapy groups across 10 university counseling centers. Confirmatory factor analyses supported a 3-factor structure of the MCO-G Inventory, wherein the 3 factors corresponded with the underlying constructs of cultural humility, cultural comfort, and cultural missed opportunities. This study provides initial evidence for the estimated internal and convergent validity of the MCO-G, as measured by clients’ perceptions of a higher-order group therapeutic factor and improvement in therapy. Results provide initial support for the psychometric properties of the MCO-G. Moreover, groups’ cultural humility and cultural missed opportunities were related to members’ improvement in therapy. Clinical implications and future research are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)

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