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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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The scientific future of counseling psychology: Five specific areas of predictions. - June 29, 2017
To honor the 125th anniversary of the American Psychological Association, the scientific future of counseling psychology is highlighted in this special section. Five areas of research growth are covered: three in psychotherapy (research relative to sexual and gender minorities, the importance of the client perspective, and applications of machine learning), one in the application of the cultural lens approach, and one on aspects of privilege. Each of these areas has specific, testable hypotheses that can serve as stimuli for future research. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
White male power and privilege: The relationship between White supremacy and social class. - June 29, 2017
Counseling psychologists have studied privilege as an individual behavior, belief, and attitude related to an individual’s privileged identity such as masculinity, Whiteness, or Christianity. Conceptualizing individual privileged identities in this way means that privileged identities may exist alongside marginalized intersectional identities. However, in this article, the author defines privilege as a multi-identity act that is facilitated and supported by institutions and organizations (e.g., banks, law enforcement, and schools). These institutions are defined as power-governors that regulate access to scaffolds of privilege afforded to the affluent and wealthy. The author posits that power-governors were created to support an ideology of White supremacy and to organize actors within the system to perpetuate and legitimize the status quo. The author describes the ways in which White wealthy men use privilege as a means to access and gain power while White men in lower- and working-classes use privilege to build relationships and legitimize inequality. The author also discusses the proxy privilege of White women and people of color and how this privilege is in fact restricted to specific physical spaces and is limited due to their overt marginalized identities. Recommendations for privilege research are provided. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
The future of counseling psychology research viewed through the cultural lens approach. - June 29, 2017
In this article, we address the need for the future of counseling psychology research to adequately address issues of relevance and application of our theories across cultural groups. We bring the cultural lens approach (CLA; Hardin, Robitschek, Flores, Navarro, & Ashton, 2014) home to its roots in counseling psychology and address the approach’s application specifically within counseling psychology theory. First we provide a brief description of the CLA. Then we offer an in-depth example of how to apply the CLA to a specific theory, using Super’s (1953, 1957) Life-Span, Life-Space Theory of Career Development, and more specifically, the self-concept as an example. Importantly, we articulate how the CLA yields specific, testable hypotheses, providing multiple examples. We conclude with implications of the CLA for implementation of counseling psychology values, evaluating psychological theory, and research training. Adopting the CLA in future counseling psychology research will increase the cultural sensitivity of our work and widen the relevance and applicability of our findings. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Client-focused psychotherapy research. - June 29, 2017
Although the field of professional psychology has definitive evidence that therapy is effective, we do not yet have a good understanding of how therapy works or what makes it so effective. Although hundreds of research studies have been conducted on various aspects of psychotherapy, including client factors and outcome, in the current paper we argue that a key component of the psychotherapy enterprise that warrants additional empirical attention is the client. We readily acknowledge the need for researchers to continue to examine other aspects of psychotherapy, such as therapist factors, the therapy relationship, and the effectiveness of certain therapies or interventions for specific psychological conditions and problems. However, we believe that by pursuing research questions from the perspective of the client that we might be able to better understand clients’ experience in therapy and ways to tailor therapies and interventions to clients, uncover evidence about what actually engages and motivates the client, and gain a broader perspective about the nature of the therapy relationship. In the current paper we highlight fruitful areas for client-focused research, and within each area, we propose research questions that might stimulate further thinking and future empirical inquiries. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Improving the lives of sexual and gender minorities: The promise of psychotherapy research. - June 29, 2017
Current psychotherapy research with sexual and gender minorities (SGMs) is inadequate to address the health disparities in this population. Psychotherapy can benefit from research demonstrating the unique experiences of SGMs with respect to behavioral health, internalized stigma, coping, and resilience. This article describes research approaches, questions, and measurement that can be employed to study psychotherapy. Given the impact of minority stress and microaggressions on SGM individuals, many of the recommendations provided in this article focus on how these components should be infused throughout a diverse range of psychotherapy interventions. Namely, we provide recommendations for researchers focusing on SGM populations in randomized controlled trials and psychotherapy process research. We also provide 7 specific recommendations that focus on psychotherapy research measurement with SGM populations and how researchers can focus their efforts to reduce disparities for SGM individuals. Finally, we identify additional constructs to consider for future intervention research with SGM individuals. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

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