Assessment in Adventure Therapy

The treatment application section will deal with assessment of individuals and the treatment environment that is necessary for the effective and intentional use of adventure tools and techniques. In some clinical contexts, more formal psychological assessment occurs as well. While access to that type of information could potentially provide relevant and useful information, this section is focused on the type of assessment that occurs during an intervention, as well as immediately before and after. Practitioners vary in the degree of emphasis they put on an in-depth initial assessment, although many consider having information about a clients' previous history to be an important aspect of providing effective treatment.

During the course of an activity, assessment is an on-going process that occurs during an intervention, as well as before and after activities might include checking-in during every session with individual clients to assess their mental status and reported emotional state, monitoring their readiness for the intervention, or observing interpersonal interactions and making note of observable behavioral change based during the course of an experience. A thorough assessment informs treatment decisions such as what activity to choose, how to frame that activity, and what facilitation decisions one makes during the course of the session (Lung, Stauffer & Alvarez, 2008; Gass, 1995, 1993a, 1993b; Hoyer, 2004; Kimball, 1993, Kimball & Bacon, 1993; Russell, 2004; Newes, 2000). The needs of individual clients should be taken into consideration, as well as the overall needs of the group. AT goes beyond focusing on the achievement of group goals by taking the individual clinical needs of clients into consideration, as well as the clinical value of the group interaction.

Within an experiential context, every activity clients engage in can be used to gather assessment information. From the very initial introduction, the way in which clients engage with the process provides valuable information. The way clients engage in the invitation to participate, how they engage with peers and the practitioner, whether they plan or jump ahead impulsively, how they discuss and think about the challenge presented, what expectations they have for interaction with others, and the non-verbal communications that occur are just a few examples of the range of assessment information available throughout the course of one activity. Experience-based therapeutic assessment depends greatly on the skill level of the facilitator to ascribe meaning to what he or she observes during any activity, to continually assess the needs of individual clients, and to choose ongoing activities based on that information. Applying the information gained from on-going assessment to the application of adventure interventions, requires a high level of in-session flexibility to meet the demonstrated needs (Hoyer, 2004; Gass, 1995; Russell, 2004; Newes, 2000).

The skill of the practitioner lies in the ability to use the assessment data to inform choices such as when it may be appropriate to strengthen or lessen the intensity of the ongoing interaction, when to stop and process, when to focus more on a group or more on the individuals, and a myriad of other ongoing factors. These factors are also what tend to differentiate the experienced from the less experienced practitioner, and those new to the field are encouraged to seek mentorship in these aspects. The primary assumption held is that outward behavior is often the function of underlying causes, and that the activities provide an opportunity to activate and observe this relationship.

It is also important that practitioners engage in on-going self-assessment. Due to the shared nature of adventure interventions, the practitioner must be aware of personal responses that have the potential to either enhance or interfere with the treatment process. It is essential that the practitioner be able to differentiate his or her own personal reactions to the activity or the clients from reactions specific to the context at hand. This allows the practitioner to effectively use that interaction as an assessment tool, as opposed to inadvertantly remaining in a primarily reactive mode. This is quite similar to the clinical concept of transference and the skilled practitioner learns to utilize their reactions as an additional assessment tool.

Assessment topics that will not be discussed in this session include the following:

1. Intake or initial assessment: See Operational Guidelines for Clinical Practice

2. Assessment for environmental context of treatment: See Operational Guidelines for Clinical Practice

3. Assessment for interpersonal context: See Operational Guidelines for Clinical Practice

4. Assessment of what activity to use: See Matching

5. Assessment of outcomes: See Research

Practitioner Guidelines for Assessment

1. Continuously assess client functioning and needs in the treatment context and use the information to inform and impact the course of treatment (Gass & Gillis, 1995; Kimball, 1993; Russell, 2004; Newes, 2000; Schoel & Maizell, 2002; Nadler, 1993):

  • Determine the mood, level of readiness to participate, and general attitude of participants going into the intervention.
  • Assess physical capabilities of the client.
  • Assess the client’s readiness, interest, and involvement in any assumed process of change.
  • Assess client's internal state and external behaviors relative to emotional and physical safety.
  • Assess client’s progress toward stated treatment goals.
  • Attend to disequilibrium and discomfort as it is experienced during the activities and attend to the needs of clients.
  • Attend to the client's interpersonal functioning and be aware of interpersonal factors that may relate to behavior change or trigger behavioral issues.
  • Attend to issues that could lead to escalated or crisis situations and take action to de-escalate whenever possible.

2. Attend to both positive and negative behaviors in assessing clients, groups and families as well as different behaviors based on contextual factors.

3. If working with groups, assess group roles, stage of group development, and group dynamics (Newes, 2000; Kimball & Bacon, 1993).

4. If working with families, assess family structure, dynamics, and needs of various family members in the treatment process (Newes, 2000; Russell, 2004).

5. Be proficient in behavioral observation. Use the activities as a platform to continually add to your information base about the client’s current status, worldview, behavior patterns, internal belief structures, and needs (Gass, 1993c). Looking for congruence across contexts can be useful as an observation of differences in client behavior based on context. By using activities as the platform for ongoing assessment, practitioners can observe activated communication patterns, coping abilities, problem-solving skills, cognitive structures, and degrees of congruence in behavior (Newes, 2000; Gass, 1993b).

6. Use activities to assess environmental conditions experienced by clients and to re-create desired conditions for the treatment context. (Gass & Gillis, 1995; Kimball, 1993; Russell, 2004; Newes, 2000; Schoel & Maizell, 2002).

7. Ongoing assessment of safety issues in the physical environment is an important aspect of effective application of adventure interventions. This includes environmental factors such as weather, gear, and risk. Psychological and emotional factors should be considered and the possible negative impacts of activities should be continually evaluated.

8. Continually assess the interpersonal process and attend to associated behaviors, such as client anxiety, conflicts between group members, giggling and other behaviors that may signal avoidance of deepening interactions, non compliance, or any other unusual or notable behaviors for this client group.