Client Welfare

Regardless of ethical governance, practitioners should hold client welfare as a primary ethical consideration at all times.

  • Practitioners should develop and maintain working definitions of appropriate and inappropriate behaviors of clients, including behaviors related to physical and emotional safety (e.g., climbing commands, hurtful communication).
  • Practitioners should be skilled at the application of consequences to client behaviors. There should be an emphasis on the use of natural and logical consequences (LINK) and practitioners should avoid consequences that are shaming to clients (e.g., making the group or client sing because of a "mistake" during the activity). There should also be a direct relationship between clients' physical activity levels and the objective of the experience; i.e., practitioners must refrain from asking clients to perform excessive physical activity as a means of punishment. As a side note, this tenet is a central factor which differentiates AT from "boot camps," which tend to rely on these sorts of consequences.
  • At no time during any program will the withholding of the means to meet physical needs be used as a punitive measure. Physical needs of clients must be met at all times (e.g., necessary water, nutrition, clothing, shelter, or other essential needs they require) and accommodations be made for the environment they are living in. Exceptions to this may be made if there is a prior mutual consent between clients and professionals and it is recognized that this will serve a valid purpose (e.g., solo); although again these factors must be adequately attended to.
  • Careful consideration should be given to the use of deceiving the client or secrecy in an activity frame or for emphasis of lesson (e.g., if a client has a certain cognitive schema about his/her climbing ability and a practitioner creates a situation where s/he is climbing a greater level of difficulty). Concerns include the impact on trust/rapport and the use/misuse of power in relationships. Secrecy carries similar consideration (e.g., problem solving activities). (??? Can you expand on this example?)
  • Appropriate use of risk: the amount of actual emotional and physical risk clients experience in adventure activities will be appropriate for the objectives and competence level of clients. Levels of risk should also be in line with the therapeutic goals of the activity, and careful consideration should be given as to whether clients are likely to benefit enough from a higher level of risk to warrant such a choice. Along these same lines, it is essential to highlight that higher levels of perceived risk (whether it is actual risk or not) can trigger anxiety and other client reactions that may adversely impact the treatment process (e.g., PTSD reactions may be triggered which could have a negative impact on multiple aspects of ongoing treatment). Practitioners must also be certain that they have realistic expectations for levels of client performance, and that performance expectations are associated with treatment goals. Additionally, it is important to consider what level of choice clients have in assuming risk.
  • Assisting clients in obtaining alternative services: As is common to all therapeutic settings, practitioners assist clients in obtaining other services if the practitioner is unwilling or unable (for appropriate reasons) to provide skilled professional help. Practitioners will not unilaterally terminate services to clients without making reasonable attempts to arrange for the continuation of such services (e.g., referrals to other professionals). Experiences are planned with the intent that decisions made during and after the experience are in accordance with the best interest of clients.
  • Fixed length of stay (program) vs. achievement of maximum therapeutic value: Practitioners continue services only as long as it is reasonably clear that clients are benefiting from that service. Issues to consider include activities with a fixed time of participation (e.g., a 30 day trip), or when curriculum completion is a required to complete the program (e.g., Johnny is refusing to complete the curriculum, yet appears to have gained the maximum treatment benefit that the program can reasonably be expected to provide, under the current circumstances). Other considerations might include if /when paternalistic actions are justified in the best interest of the client.
  • It is essential that activities be chosen based on client need and assessment vs. practitioner enjoyment (e.g., climbing because it is something you like to do vs. in line with client needs).