Facilitation Skills: Therapeutic Environment

Practitioners work intentionally to create treatment environments that are conducive to progress toward treatment goals and allow for personal growth and change. The following practitioner guidelines contribute to development of a desired therapeutic environment.

1. Attention is paid to aspects of safety, such as physical, emotional, environmental, interpersonal, intrapersonal, and appropriate boundaries . Consequences are enforced for unsafe behavior. Clients are empowered to monitor for safety. The ability to allow clients to experience natural consequences is balanced with the need to maintain health and safety. Staff and clients are adequately trained for the environment and activities they will encounter (Brown, 1999; Fitsimmons & Elshof, 1993; Hunt, 1994; Lung, Stauffer & Alvarez, 2008; Matthews, 1993; Mitten, 1994; Priest & Baillie, 1995; Priest & Gass, 1997; Schoel & Maizell, 2002; Stich & Gaylor, 1993; Van Der Smissen & Gregg, 1999).

2. Attend to clinical, social, developmental, spiritual, sexual and cultural factors.

3. Practitioners, in partnership with clients, work to develop beliefs or values about expected behavioral norms. These may include:

  • Safety
  • Belonging
  • Appropriate interpersonal relationships
  • Level of challenge
  • Effective communication
  • Empowerment
  • Development of appropriate trust
  • Enjoyment
  • Generosity
  • Empathy
  • Boundaries (physical, emotional, spiritual)
  • Respecting the natural environment
  • Tenacity
  • Self-efficacy
  • Compassion

(Lung, Stauffer & Alvarez, 2008; Matthews, 1993; Mitten, 1994; Priest & Baillie, 1995; Priest & Gass, 1997; Schoel & Maizell, 2002; Stich & Gaylor, 1993; Van Der Smissen & Gregg, 1999)

4. Client motivation is a measure of engagement in the process and impacts the treatment environment. Positive and negative attitudes or behaviors impact the group in various ways, including impacting the quality of engagement in the therapeutic process. Practitioners actively create opportunities to improve engagement from the client in the treatment process (Itin, 1993; Kemp & McCarron, 1993; Lung, Stauffer & Alvarez, 2008; Pickard, 1993; Schoell & Maizell, 2002).

5. The natural environment can be used intentionally for positive therapeutic impact is useful when appropriate and accessible. Attention to the physical space is imperative - a client who is hot, cold, or wet may struggle to engage effectively Lung, Stauffer & Alvarez, 2008; Schoel & Maizell, 2002).

In summary, adventure interventions enhance the engagement of the client in the treatment process. In these situations, clients respond positively to the physical engagement, cognitive challenge, playful nature or activity base of the treatment process with interest and enthusiasm. Clients develop and maintain engagement in the treatment contract and are able to apply elements of the treatment contract to "here and now" circumstances. Adventure interventions provide opportunities for clients to practice behaviors that align with the expectations of the treatment environment. These interventions allow clients to practice responsibility and accountability within the established expectations listed below. Adventure interventions assist clients in developing norms that support therapeutic progress.