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Enhancing Your Therapy with Gestalt Approaches Gestalt Therapy continuing education MFT CEUs

Section 21
Guidelines for Implementing Gestalt Techniques
in Adventure-Based Counseling

CEU Question 21 | CEU Answer Booklet | Table of Contents | Gestalt
Counselor CEUs, Psychologist CEs, Social Worker CEUs, MFT CEUs

Counseling Skills: ABC requires different types of skills. In the experiential and counseling fields these are referred to as "soft" skills and "hard" skills. Soft skills are those associated with traditional counseling and are more interpersonal. These skills include reflective listening, verbal and nonverbal communication, reflection, reframing, leadership style, problem solving, decision making, effective communication, and ethical behavior. Hard skills include the physical skills required to do an activity, such as rock climbing or kayaking. Hard skills include not only the ability to perform physical and technical tasks but also the ability to manage the activity while others engage in the task. In addition, the ability to teach the task is a cross between hard and soft skills and is typically an important aspect of the adventure based counselor's repertoire. Counselors without the appropriate hard skills will need a cocounselor or facilitator who possesses the respective competencies. Likewise, facilitators without soft skills will need the assistance of counselors.

Priest and Gass (1997) have outlined hard skills specific to ABC in three categories: metaskills, generic competencies, and specific competencies. The first category is metaskills, or the ability to use a combination of hard and soft skills. The second category, generic competencies, is the skills applicable to all adventure experiences such as physical fitness, weather interpretation, first aid, trip planning, appropriate level of performance, mental awareness associated with the activity, selecting a location, understanding the needs of the participants, and knowledge of anticipated adversity. The third category, specific competencies, includes skills unique to particular activities. Priest and Gass (1997) have listed eight adventure activities that require specific competencies; they include backcountry travel, rock climbing and rappelling, mountaineering, challenge (ropes) courses, caving or spelunking, flatwater and whitewater paddling, on-road and off-road bicycling, and cross-country skiing. Ewert (1989) also included hot air ballooning, rafting, snowshoeing, orienteering, wilderness camping, sailing, scuba diving, sky diving, and hang gliding, all of which incorporate a measure of real risk.

Many of the ethical guidelines for the American Counseling Association and the Association for Experiential Education are quite similar. However, some ethical considerations reflecting the combination of counseling and adventure therapeutics are warranted. For example, counselors of all types are concerned with the welfare of the client. In ABC, this includes the element of risk, both physical and emotional, wherein the client is challenged by choice. The client's physical and mental welfare should be taken into consideration when programming ABC activities as well as participating in them. Any Diagnostic and Statistical Manual of Mental Disorders, text revision (DSM; American Psychiatric Association) Axis III medical conditions such as allergies, heart conditions, or physical limitations should be identified and precautions taken. For example, all professionals using ABC should complete courses in first aid and CPR.

In ABC, the therapeutic relationship is different in that the amount of time spent with clients and the types of activities might make it more difficult to keep professional boundaries. This is depicted in some OB trips that may be scheduled for up to 90 days in length. Some ABC interventions include overnights with clients (e.g., camping), which can create a different type of relationship than that in an office setting. Due to the nature of the time clients spend together, a friendship, or the perceptions of friendship, can form. However, dual relationships should be guarded against.

In relation to competence and professional responsibility, ABC may include an outdoor trip for certain populations, such as adolescents with conduct disorder, survivors of breast cancer, or court-ordered perpetrators of domestic violence. To work with these populations, the counselor must be competent and knowledgeable. For example, if a survivor of sexual abuse was on a hiking trip and had a traumatic flashback, the counselor would be required to handle that situation within the wilderness setting.

Counselors using ABC will be respectful of client's rights. Clients should not be persuaded beyond the level of what might be thought of as challenging to complete a task, and counselors should adhere to the "challenge by choice" philosophy. However, clients are generally encouraged to participate in activities. Ewert (1989) has suggested that there is an optimal point of risk; however, if there is too much risk, the client could have a negative experience. Certainly, when given a choice some individuals will choose the "easier way out," but the easy way may not be the most therapeutic. Clients avoiding the "impossible task" that could result in a "breakthrough" may not reap the full benefits of the adventure experience. Similarly, Leahy and Associates (see http://www.leahy-inc.com) of Lafayett, Colorado, discuss the phenomenon of "the learning edge," which propels people to breakthrough, breakdown, or bailout, all of which are therapeutic depending on the task of the adventure process (P. Hazelrigg, personal communication, August 18, 1999).

Because ABC is often used as an adjunct to treatment, it is important to be respectful of the integrity of other therapeutic relationships. Confidentiality in a group setting in ABC needs to be addressed appropriately. ABC may appear less formal compared with traditional counseling, and this aspect of confidentiality should be clearly addressed. Finally, counselors-in-training and counselors in the role of teaching and supervising should be properly trained in counseling and experiential/adventure education or at least be knowledgeable enough to know when consultation is necessary.

Client Disequilibrium: Putting clients in a state of dissonance is crucial for client change (e.g., Bandura, 1986; Minuchin & Fishman, 1981; Perls, 1969). In ABC, Gass (1993a) has referred to this as a state of disequilibrium. This concept involves taking individuals out of their respective comfort zones, such as taking athletes off the athletic field and into a setting that will increase or enhance anxiety, frustration, or dissonance, thereby creating a state of disequilibrium. For example, in collegiate volleyball, players have already established patterns of functioning based on leadership skills and ability. An ABC treatment would take players out of a comfortable environment, which is often uneven in terms of roles and abilities, and place them in a setting that is uncomfortable (e.g., a low-element challenge course or climbing wall). This is called "leveling the playing field" (Gass, 1993a). In doing so, it might be easier to detect personal and team dynamics and address issues that might otherwise be masked on the volleyball court.

When clients are in a state of disequilibrium, oftentimes their established coping mechanisms are not sufficient to address the anxiety. Therefore, counselors are required to intervene in order to teach a new coping skill, execute crisis intervention, and process the state of discomfort. As the challenge increases, the client grows, thereby enhancing the outcome of the experience (Csikszentmihalyi & Csikszentmihalyi, 1988). Similarly, during the adventure activity, counselors need to be supportive but also challenging (Ewert, 1989).

Macroprocessing: The facilitation of the adventure process is necessary to enhance the experience for clients. Gass (1995) has outlined six facilitation styles. The first three styles are the following. First, letting the experience speak for itself (no loading) is essentially letting clients figure out the meaning of the activity for themselves. Second, speaking for the experience (front loading) occurs when the facilitator or counselor sets up the experience. Directly front loading the experience requires counselors to brief clients before the experience regarding how the activity should work. Third, speaking after the experience (back loading) is learning by reflecting and by guiding clients to discover their own meanings.

The last three styles—front and back loading, metaphor, and paradox—are more proactive in nature, reflecting a philosophical shift among adventure based counselors and facilitators to create a more powerful experience. Front and back loading consists of setting up the activity and processing the activity after it is completed.

Metaphors are a common phenomenon in counseling; however, the use of metaphor in ABC is intentional and somewhat unique. In ABC, metaphors are emphasized and intentional in the process of transferring the adventure activity to real life. When designing adventure programs, it is important to keep in mind the metaphor that provides an effective transfer back to personal life or the workplace. Gass (1995) has outlined steps to assist in achieving a successful experience: stating and ranking goals; selecting metaphoric adventure experiences; identifying successful resolution to the therapeutic issue; strengthening an isomorphic framework or personalizing it so the metaphor is more apparent to the participant; reviewing client motivations; and debriefing, or processing experiences. Often, clients can create their own metaphors during the activity or debriefing process.

Although used less often in ABC, paradox can be an effective processing procedure. According to Gass (1995), this style is often used when clients' problematic issues are more significant. This includes double binds, symptom prescriptions, symptom displacements, and proactive refraining.

Transferring the Experience and Benefits: It is important that adventure-based experiential therapeutics be designed in a manner that provides for effective implementation to ensure transference back to personal social life and the workplace. Debriefing is an important aspect of facilitation and is critical to the ABC process. For example, a debriefing session may include a lack of emphasis on winning, reducing competition, exerting or not exerting personal power, or simply letting the activity speak for itself (see Crone, 1999). Benefits include the enhancement of psychological, educational, sociological, physical, and spiritual domains. Psychological benefits can include new confidence in oneself, increased willingness to take risks, improved self-concept, enhanced leadership skills, increased logical reasoning skills, and greater reflective thinking skills (Priest & Gass, 1997). Educational benefits include a greater knowledge of the environment and nature (Ewert, 1989). Enhanced cooperation, more effective communication skills, greater trust in others, increased sharing of decision making, new ways to resolve conflicts, improved problem-solving skills, and enhanced leadership skills are manifested as sociological benefits (Priest & Gass, 1997). Adventure activities require both muscular and cardiovascular exertion, therefore providing clients with physical benefits (Ewert, 1989). Spiritual benefits include connection with the greater environment and the feeling that one is part of a force that embraces other people as well as nature (Hinkle, 1999).
- 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 #7
The preceding section contained information about guidelines for implementing Gestalt techniques 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 21
What are Gass's six facilitation styles? 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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