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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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The development and validation of the Contemporary Critical Consciousness Measure II. - August 30, 2018
Critical consciousness (CC) has been heralded as an antidote to oppression. Developed by the Brazilian educator, Paulo Freire, CC represents the process by which individuals gain awareness of societal inequities and subsequently take action to dismantle the systems and institutions that sustain them. Empirically supported instruments intended to assess this important construct have only been recently introduced to the literature and have focused specifically on racism, classism, and heterosexism. The purpose of this project was to develop a psychometrically sound measure of CC that expands assessment into sexism, cissexism (genderism/transphobia), and ableism. Two studies with a total of 569 observations provided initial reliability and validity evidence on the Contemporary Critical Consciousness Measure II (CCCMII). Results from exploratory and confirmatory factor analyses suggest that the final 37-item CCCMII provides a general index of CC as well as assesses CC associated with sexism and ableism above and beyond the general factor. Results support the internal consistency and factor structure of the measure. Expected relationships between the CCCMII and existing measures of sexism, cissexism, and ableism provide evidence for the validity of the instrument. Limitations, future directions for research, and counseling implications are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Gendered Racism Scales for Asian American Men: Scale development and psychometric properties. - July 23, 2018
The Gendered Racism Scales for Asian American Men (GRSAM) was developed to assess the frequency and stress level of gendered racism perceived by Asian American men. The development of the new measure was grounded in the Intersectional Fusion Paradigm. This paradigm explains individuals’ experiences of discrimination based on unique combinations of multiple interlocking identities that individuals experience simultaneously. In mixed samples of college students and community adults, GRSAM’s factor structure as well as evidence of convergent validity, criterion-related validity, discriminant validity, incremental validity, internal consistency, and test–retest reliability was examined. Exploratory factor analyses revealed three dimensions of GRSAM: Psychological Emasculation, Perceived Undesirable Partner, and Perceived Lack of Leadership. Confirmatory factor analyses demonstrated that a bifactor model was a better fit to the data than a correlated three-factor model and a higher-order model. Results of correlation and regression analyses further provided evidence for different aspects of construct validity and internal consistency. Both the Frequency and Stress versions of GRSAM positively predicted psychological distress and somatic symptoms above and beyond the effects of general racism experienced by Asian Americans and masculine gender role stress. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Gendered Racial Microaggressions Scale for Asian American Women: Development and initial validation. - July 30, 2018
Asian American women’s (AAW’s) mental health issues have received growing public attention; recent statistics suggest alarmingly high suicide rates among AAW. Yet, little research has examined the nuanced oppression that AAW face and the daily effects of compounded racism and sexism contributing to their mental health issues. Applying the intersectionality and microaggressions framework, we developed the Gendered Racial Microaggressions Scale for Asian American Women (GRMSAAW) using data collected from 564 AAW. Items were developed via literature review, focus group, and expert review. Exploratory (N = 304) and confirmatory (N = 260) factor analyses suggested a 4-factor structure and produced 22-item scales of frequency and stress appraisal with the following subscales: (a) Ascription of Submissiveness, (b) Assumption of Universal Appearance, (c) Asian Fetishism, and (d) Media Invalidation. Internal consistency estimates were .80 and above for frequency and stress appraisal scales, and the scales accounted for 52% and 60% of variance, respectively. Examination of a bifactor model containing one general factor and four group factors suggested that GRMSAAW could be represented unidimensionally (total scale score) for the purpose of applied measurement. Initial construct validity was established as GRMSAAW scores were associated with sexism, racial microaggressions, depressive symptoms, and internalized racism in ways consistent with theory. Implications for research and practice are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Experiences of transmasculine spectrum people who report nonsuicidal self-injury: A qualitative investigation. - August 02, 2018
Transgender populations experience mental and physical health disparities compared to nontransgender populations, including nonsuicidal self-injury (NSSI). Guided by the minority stress theory and Nock’s model of NSSI, this study explored perspectives of transmasculine spectrum people (i.e., people with a gender identity that is man, male, transgender man, genderqueer, or nonbinary and who were assigned female at birth) who engage in NSSI. Qualitative interviews were conducted with transmasculine spectrum people (N = 18) who reported a history of NSSI. Their mean age was 24.9 years old (SD = 5.43, range = 17–38). Participants reported that NSSI was influenced by a variety of factors including stress from gender nonconformity in childhood and adolescence. Stigma related to minority status and identity as well as proximal minority stress processes of concealment and expectations of rejection were identified as contributing to NSSI. Transgender identity development tasks such as coming out and identity exploration also appeared to affect NSSI. Finding a community of peers who engage in NSSI was helpful in mitigating social isolation, but at times reinforced NSSI. We discuss clinical implications at the individual and family levels. Interventions to reduce NSSI among transmasculine-spectrum people should include facilitating connections with gender minority peers and providing individual support and family interventions to facilitate transgender identity development. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
The relative importance of parent–child dynamics and minority stress on the psychological adjustment of LGBs in China. - July 12, 2018
This cross-sectional study examined how minority stress (i.e., internalized homonegativity, self-concealment, and rejection sensitivity) and positive parent–child relationship dynamics (i.e., respect for parents and perceived parental support for sexual orientation) were associated with the psychological adjustment of lesbian, gay, and bisexual (LGB) individuals in China. Based on survey responses from 277 self-identified Chinese LGB young adults, results from structural equation modeling showed that minority stress was not a significant predictor of psychological maladjustment, whereas respect for parents and perceived parental support for sexual orientation were associated with positive psychological adjustment. Tests of gender differences partially confirmed whether Confucian traditions may burden sexual minority men more than women. Gender differences were found in the correlations between minority stress and each measure of positive parent–child relationship dynamics. However, the associations between independent variables and psychological maladjustment were not different between men and women in the sample. Our results suggest that culture-specific variables, such as parent–child factors within the context of China, may be especially important when working with LGB individuals in research and clinical practice. (PsycINFO Database Record (c) 2018 APA, all rights reserved)

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