Informed Consent

Clients should be adequately informed as to risks associated with any activity or program component.

1. Due to the nature of the inherent risks, it is important to provide the client with appropriate information about the nature of such services and their rights, risks, and responsibilities. Under circumstances when clients are in program involuntarily, appropriate communication regarding these issues must remain as a primary consideration. It may not be appropriate to withhold information regarding risk-related factors from clients due to concerns that he/she may refuse to participate.

2. The client's ability to understand the informed consent must accurately be taken into account. This may also warrant additional considerations with non-voluntary clients, or situations when an adult enrolls a child/youth in a treatment program without their consent. Specific factors to consider might include whether a youth can really understand the risk involved or does a parent/guardian want a minor in treatment more than they want to truly understand the risks. As a side note, this is a crucial risk management issue and a lack of attention to informed consent makes programs more vulnerable to adverse litigation.

3. Challenge by (of) choice - (LINK) it is important to respect the rights of clients to make decisions and help them to understand the consequences of their choices. Careful consideration to this issue is particularly warranted when participation in an activity is contingent on program completion.

4. It is also appropriate to maintain a therapeutically relevant balance between answering clients' questions and allowing for the "discovery aspect" of adventure (e.g., some clients will benefit from having more information about an activity, whereas others may benefit from less). The crucial piece is that this consideration be based on individual client need, whereas overall program policies to this end may be less useful (e.g., a programmatic mandate of allowing clients "no future information" may be harmful to some clients, particularly those with PTSD and other anxiety-related issues).

5. Use of jargon (e.g., with initiatives) can get in the way of client understanding. It is important to consider whether clients truly understand the language being used and adjust language choice accordingly.

6. Clients must be informed as to the consequences of particular behaviors/types of behaviors prior to the experience. This also helps to provide a foundation for ongoing intervention.

7. The use of secrecy must be considered carefully. Practitioners should have clearly explored the potential benefits ahead of time and its relation to learning/growth (e.g., problem solving activities).

8. "Activity captivity" particularly if a client has not participated in the activity previously. Idea of paternalistic actions - justified in the best interest of the client? (???)

9. Clients should be informed of the multiple roles of the practitioner (e.g., does the practitioner also talk to parents?). See Dual Relationships section for more specific information.

10. Program advertisement: Pictures and descriptions included in advertising materials must accurately reflect and be congruent with the activities in practice. Programs promoting themselves as adventure therapy are expected to be in line with Preferred Practices (e.g., include a licensed practitioner).