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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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Critical consciousness moderates the relationship between transphobia and “bathroom bill” voting. - July 12, 2018
In recent years, antitransgender legislation that focuses on gender and the use of public restrooms—so-called bathroom bills—has been considered in many states in the United States. The present study was designed to extend research on transphobic attitudes and elucidate links between religious fundamentalism, social dominance orientation, transphobia, and voting for bathroom bills. Further, we examined the moderating influence of critical consciousness on the relationship between transphobic attitudes and voting on a hypothetical bathroom bill. Results of a moderated mediation multinomial logistic regression path analysis using data from a sample of 282 college students (154 women and 128 men) indicated that religious fundamentalism and social dominance orientation were associated with transphobic attitudes. Transphobia was associated with lower likelihood to vote against or abstain from voting on the bill, compared to voting for it. Critical consciousness was also associated with greater likelihood of voting against the bill rather than for it. The interaction between transphobia and critical consciousness was associated with voting against rather than for the bill, such that at higher levels of transphobia, those higher in critical consciousness were more likely to vote against the bill rather than for it. Implications for incorporating critical consciousness into advocacy efforts to promote transgender rights are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Socialization and well-being in multiracial individuals: A moderated mediation model of racial ambiguity and identity. - July 12, 2018
Scholarly interest in racial socialization is growing, but researchers’ understanding of how and when racial socialization relates to well-being is underdeveloped, particularly for multiracial populations. The present study investigated moderated mediation models to understand whether the indirect relations of egalitarian socialization to subjective well-being and self-esteem through integrated multiracial identification were conditional on phenotypic racial ambiguity among 383 multiracial adults. Tests of moderated mediation in primary analyses were significant for subjective well-being and self-esteem. Consistent with the hypotheses, egalitarian socialization was linked to a stronger multiracial integrated identity, which was positively associated with subjective well-being and self-esteem for those with moderate and high phenotypic racial ambiguity. This indirect effect was not significant for those reporting low phenotypic racial ambiguity. Results suggested a positive role of egalitarian socialization in relation to integrated identity and well-being for multiracial adults. This study highlights a culturally relevant pathway through which egalitarian socialization impacts well-being through racial identification for multiracial adults and the conditions of phenotypic racial ambiguity that contextualize this indirect effect. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Work as a calling: A theoretical model. - July 12, 2018
Perceiving work as a calling has been positioned as a key pathway to enhancing work-related well-being. However, no formal theory exists attempting to explain predictors and outcomes of living a calling at work. To address this important gap, this article introduces a theoretical, empirically testable model of work as a calling - the Work as Calling Theory (WCT) - that is suitable for the contemporary world of work. Drawing from research and theory in counseling, vocational, multicultural, and industrial-organizational psychology, as well as dozens of quantitative and qualitative studies on calling, the WCT is presented in three parts: (a) predictors of living a calling, (b) variables that moderate and mediate the relation of perceiving a calling to living a calling, and (c) positive (job satisfaction, job performance) and potentially negative (burnout, workaholism, exploitation) outcomes that result from living a calling. Finally, practical implications are suggested for counselors and managers, who respectively may seek to help clients and employees live a calling. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
When in doubt, sit quietly: A qualitative investigation of experienced therapists’ perceptions of self-disclosure. - July 12, 2018
Using consensual qualitative research (CQR), we analyzed 13 interviews of experienced psychotherapists about general intentions for therapist self-disclosure (TSD), experiences with successful TSDs, experiences with unsuccessful TSDs, and instances of unmanifested urges to disclose. For TSD generally (i.e., not about a specific instance), typical intentions were to facilitate exploration and build and maintain the therapeutic relationship. Therapists typically reported becoming more comfortable using TSD over time. In successful TSDs, the typical content was accurate, relevant similarities between therapist and client; typical consequences were positive. In unsuccessful TSDs, the typical antecedent was countertransference reactions; the typical intention was to provide support; typical content involved therapists mistakenly perceiving similarities with clients; and the general consequences were negative. In instances when therapists repressed the urge to disclose, the typical antecedent was countertransference and the content typically seemed relevant to the client’s issues. We conclude that effective use of TSD requires general attunement to the client’s dynamics, attunement to the client’s readiness in the moment, ability to manage countertransference, and ability to use a specific TSD appropriately. Implications for practice, training, and research are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
Self-compassion buffers the link between self-criticism and depression in trauma-exposed firefighters. - June 21, 2018
Firefighters are frequently exposed to highly stressful, potentially traumatic events (PTEs). More than 50%, however, show no significant elevation in trauma-related symptomatology (e.g., depression). In the past, self-compassion has been discussed to promote psychological and behavioral flexibility that is vital to a successful adaptation to PTEs. The goal of this study was to understand whether and how self-compassion may alleviate personal suffering in the face of PTEs. We hypothesized that individuals who encounter their profession-related affective experiences with greater self-compassion, show lower levels of depressive symptoms because self-compassion buffers processes that perpetuate negative affectivity in response to PTEs (i.e., self-critical tendencies). Male firefighters (N = 123) completed self-report questionnaires about the severity of current depressive symptoms; prior traumatic, duty-related events; and the self-compassion scale that assesses two distinct factors: self-criticism and self-compassion. A stepwise regression model was employed to examine differential and interactive contributions of self-criticism and self-compassion to symptoms of depression across the cumulative range of exposure to PTEs. Our results indicate that the positive association between self-criticism and depression is buffered by enhanced levels of self-compassion. This moderation, however, only emerged for firefighters with substantial amounts of PTEs experience in the past. The present work provides insight into protective effects of self-compassion in the face of cumulative PTEs. It suggests that, particularly for severely trauma-exposed firefighters, self-compassion may confer resilience, that is, act as a protective factor from the development of depressive symptoms. Findings are discussed in light of counseling implications. (PsycINFO Database Record (c) 2018 APA, all rights reserved)

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