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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 Test | 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 Test.

 
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Health disparities between genderqueer, transgender, and cisgender individuals: An extension of minority stress theory. - March 21, 2019
Interpersonal, social, and structural stressors have been identified as key elements that explain health disparities between transgender and cisgender individuals. However, most of this research has focused on binary transgender individuals or has not differentiated between binary and nonbinary individuals; little research has examined the experiences of minority stress or health of those identifying outside the gender binary. Guided by intersectionality and drawing on a sample of 3,568 college students from the Center for Collegiate Mental Health’s 2012−2016 database—of whom 892 identified outside the gender binary—we conducted analyses of demographic and outcome measures administered in participants’ 1st counseling appointment, examining differences between cisgender, transgender, and genderqueer individuals. We found that genderqueer individuals were harassed, sexually abused, and subjected to traumatic events at higher rates than were either cisgender or binary transgender individuals, with approximately 50% of genderqueer individuals reporting one of these experiences. We found that genderqueer individuals experienced more anxiety, depression, psychological distress, and eating concerns than did binary transgender and cisgender individuals and more social anxiety than did cisgender individuals. Genderqueer individuals more frequently reported self-harm and suicidality than did any other group, with approximately 2/3 of participants’ having contemplated and nearly 50% making a suicide attempt. We extend current theorizing about minority stress (Hendricks & Testa, 2012; Meyer, 2003) to include genderqueer individuals and delineate several structural aspects of genderqueer experiences that may be responsible for these trends, including others’ lack of knowledge about genderqueer experiences and pronouns, poor access to legal and medical resources, and systemic discrimination. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
A caballo regalao no se le mira el colmillo: Colonial mentality and Puerto Rican depression. - April 18, 2019
Dignifying the colonizer and depreciating the colonized is a reflection of internalized colonial oppression (i.e., colonial mentality). The current study examined the effect of colonial mentality on depression symptoms in a sample of mainland Puerto Ricans (N = 352). A structural equation model was examined, in which colonial mentality was hypothesized to be directly and positively associated with depression symptoms. The proposed model also tested the indirect effect of colonial mentality on depression symptoms via acculturative stress. Results indicated that a full mediation structural equation model (SEM) had a better fit to the data than our hypothesized partial mediation model. Bias-corrected bootstrapping indicated that the effect of colonial mentality on depressive symptoms was mediated by acculturative stress. That is, colonial mentality increased the risk of experiencing depression symptoms in Puerto Ricans when they felt pressured to maintaining a connection with Puerto Rican culture and society and when they experienced rejection by the society they want to emulate (acculturative stress). The current results underscore the need for researchers and clinicians to consider and assess colonial mentality when conceptualizing depression symptoms among mainland Puerto Ricans. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
The development and validation of the Emotional Cultivation Scale: An East Asian cultural perspective. - April 15, 2019
Research on emotion regulation in East Asian children and adolescents is limited. One obstacle hindering the development of emotion regulation for East Asian children and adolescents is the lack of a culturally sensitive measure. To fill this gap, we have developed and validated the Emotional Cultivation Scale using samples of Taiwanese children and adolescents. In Study 1, an exploratory factor analysis (n = 341) identified two factors: Cultivating Emotion Strategies and Understanding Emotion Connotations. A confirmatory factor analysis (n = 358) confirmed this two-factor structure. Coefficient αs were .69 to .88 for Emotional Cultivation. Convergent validity was evidenced by positive associations with cognitive reappraisal and cognitive flexibility. Discriminant validity was supported by a nonsignificant association with suppression. Concurrent validity was revealed by positive associations with positive affect, basic psychological need satisfaction, gratitude, responsiveness from teachers, responsiveness from parents, and academic self-efficacy. Incremental validity was evidenced by the finding that emotional cultivation significantly accounted for an additional 2 to 20% of the variance in predicting cognitive flexibility, positive affect, basic psychological need satisfaction, gratitude, responsiveness from teachers, responsiveness from parents, and academic self-efficacy above and beyond cognitive reappraisal and suppression. Results from the multigroup analysis further indicated factor loading invariance and validity invariance between boys and girls and between elementary and middle schools. The factor structure was cross-validated by a clinical sample of Taiwanese children and adolescents (N = 161) and their parents in Study 2 (N = 159). The counseling implications were discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Cognitive and affective expectation of stigma, coping efficacy, and psychological distress among sexual minority people of color. - May 30, 2019
There is a paucity of research on the potentially distinctive functions of cognitive and affective expectation of stigma. Moreover, expectation of stigma has received limited research attention with sexual minority people of color who may anticipate interlocking heterosexist and racist stigmatization. In this study, data from 209 sexual minority people of color were analyzed using path analysis and bootstrap procedures to test direct and indirect relations among perceived discrimination, expectation of stigma, coping self-efficacy, and psychological distress. Analyses disaggregated expectation of stigma into its cognitive (i.e., perceived likelihood of stigma) and affective (i.e., worry and anxiety about stigma) components. Results revealed that perceived discrimination had a unique direct link with psychological distress. In addition, perceived discrimination was linked indirectly with greater distress through affective expectation of stigma and problem-focused and emotion-focused coping self-efficacy. These findings suggest the importance of social justice interventions to reduce discrimination. Additionally, the findings suggest that interventions should attend to affective worry and anxiety about stigma and foster problem-focused and emotion-focused coping self-efficacy. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Surviving and thriving: Voices of Latina/o engineering students at a Hispanic serving institution. - April 15, 2019
This study examined factors that played a role in Latina/o undergraduate students’ persistence in engineering at a Hispanic serving institution (HSI; N = 10) using the consensual qualitative research method (CQR; Hill, Thompson, & Williams, 1997). Data analyses resulted in five domains: institutional conditions, additive intersectional burdens, personal and cultural wealth, coping skills, and engineering identity. Participants described how they persisted in the face of stressors, citing specific coping skills they developed over time as well as general personal and cultural strengths they carried with them into their pursuit of engineering. Although the structures of the students’ institution were generally described as supportive, Latina participants reported experiences with gendered racism that created added barriers to their persistence in engineering. Supportive institutional conditions, personal and cultural assets, and adaptive coping strategies appeared to facilitate the development of a strong engineering identity, which helped to solidify students’ sense of belonging, pride, and commitment to complete their degree. Results highlight the need to address intersecting experiences of privilege and oppression to promote access and equity for Latinas/os in engineering. (PsycINFO Database Record (c) 2019 APA, all rights reserved)

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