Practitioner Roles

Adventure therapy is a dynamic and diverse field, with practitioners from many different educational and training backgrounds. The field of medicine provides a useful metaphor in considering the variety of practitioners in adventure therapy. In medicine, providing medical care is different than practicing medicine. There are many roles in the provision of medical care (doctor, nurse, physical therapist, etc.). Clinicians and paraprofessionals provide adventure therapy collaboratively. It is important to consider multiple practitioner roles and how these roles operate together when AT is provided with a multi-disciplinary team. The provision of adventure therapy is accomplished through many roles - administrators, supervisors, doctors, therapists, direct care/field staff, and many others.

In this section, we look at practitioners, defined as the individuals engaging in direct service with clients in settings where adventure therapy is offered. We identify roles and explore the interplay between them. There are a number of roles and responsibilities in the practice of AT and organizations must consider who does what within their organization and assist practitioners in maintaining the competence and scope of practice of their identified role. This is further addressed in the training section.

Practitioner roles can be categorized in the following manner:

  • Adventure Therapist - a clinician with a graduate level degree in a mental health field who has additional training, education and experience in the application of adventure tools and techniques in a treatment setting. An adventure therapist is expected to effectively integrate their clinical and adventure training. Adventure therapists are licensed or certified to provide mental health services by appropriate governmental agencies, such as mental health or licensing boards.
  • Clinician - a person with a graduate level degree in a mental health field, training and experience that is have licensure (or its equivalent) according to the requirements of governmental agencies, such as state departments of mental health or licensing boards. Clinicians who have little or no training in adventure or adventure therapy are expected to collaborate with other adventure therapy professionals in the provision of adventure therapy.
  • Paraprofessional - a person that provides adventure therapy under the supervision of a clinician. The terms used for this role are diverse and include field staff, line staff, guide, direct care, or residential staff. In fact, within this category, the exact role played will vary considerably depending on the organization or program.

Each role requires different competencies in order to be effective; the clinical oversight is provided by practitioners with clinical training, the oversight of adventure activities and facilitation is provided by practitioners with adventure facilitation training, and the adventure therapist has competency in both. However, even where competencies are absent, the clinician should know enough about the adventure activity to support the paraprofessional and the paraprofessional should have enough clinical training to support the clinician. This categorization of practitioner roles reflects that when adventure therapy services are delivered to clinical populations, it is best practice to have clinical oversight provided by trained and licensed mental health professionals.

Many organizations utilize a treatment team in their work that may include collateral professionals, such as doctors or nurses. As with treatment teams in other settings, attention to appropriate roles and effective collaboration is critical. Each practitioner role provides an important piece of the overall service. Practioner roles have distinct, although often overlapping and interconnected functions. As part of best practice, when treatment teams are utilized, the delineation of function, responsibilities, and roles should be carefully considered. The training required for each role may vary considerably depending on the organization, environmental context, and types of services provided.

Adventure therapy is practiced in many settings, including but not limited to private practice, schools, residential treatment, outpatient therapy, inpatient psychiatric treatment, wilderness therapy, or community-based services. The adventure therapy practitioner may operate as an individual therapist, school counselor or social worker, guide or direct care staff, as part of a treatment team, or in a variety of combinations of these and other roles.

The range of potential settings present additional challenges in sorting out what the appropriate roles may be for whom. Most importantly, it is critical to remain aware of issues of competence and scope of practice when working with clinical populations, including maintaining quality clinical oversight. Each of the elements described (practitioner roles, competence and scope of practice, and collaboration among treatment team members) are of central importance to providing effective adventure therapy.