Power of One: Using Adventure and Experiential Activities Within One-On-One Counseling Sessions
SIZE: 8.5 x 11
PAGE COUNT: 168
“The therapist has the opportunity to connect with the client at the point of performance, in the concrete reality of that moment, rather than relying on abstract descriptions of experiences that occurred prior to the session.”
This powerful new resource for the therapist is loaded with activities and processing considerations that can help facilitate personal growth and change in sessions with individual clients. Adventure-based, individual counseling invites clients to take action during the session and utilize the material that arises in the moment, at the point of performance, to address and move toward treatment goals. The connection to DSM-IV TR diagnoses and treatment planning represents an alignment with mental health treatment that strengthens the literature, making this book an innovative and important contribution to the fields of counseling and therapy.
“Lung, Stauffer, and Alvarez are front-runners in a new and refreshing wave for psychotherapy. This book offers practitioners a wonderful tool to incorporate in their professional repertoire by providing therapists with clinically focused activities for individual sessions. This text serves as a resource for the technically eclectic therapist and offers a concise and pragmatic explanation of the associated conceptual framework.”
Joshua Meyer M.S. LCPC, ACCT Level 2 Facilitator
“The Power of One answers that question of how to work with individual clients using active, experiential methods. This book provides thoughtful, tested adaptations of adventure activities and connects them to common client issues and psychiatric diagnoses. Note to mental health providers: This is a ‘must have’ for your library!”
H. L. "Lee" Gillis, Ph.D., Chair of Psychology and Licensed Psychologist, Georgia College & State University, Milledgeville GA
“This text is a valuable resource for any therapist/counselor. The authors did a great job of tying activity ideas to the diagnostic work and documentation that we are all required to do. I particularly appreciated the DSM Connection with treatment goals, matching activities, and treatment notes for each diagnosis. The book’s structure is simple enough for providers unfamiliar with adventure work to understand and apply these activities, but deep enough for experienced providers to enrich their practices.”
Bobbi L. Beale, Psy.D.
“This publication is critical to the development of the field of adventure therapy, as it fills a large void in the literature related to individual adventure practice. It concisely details accepted practices in experiential and adventure clinical practice and remains focused on applications to individual adventure therapy. The authors have given us a wonderful guide to using adventure in individual therapy.”
Kim Sacksteder, MSW, LISW-S
“This text provides a valuable addition to the field of adventure therapy in moving the work to individual psychotherapeutic interventions. It moves many of the ideas that have been honed and developed in the application of adventure activities to the therapeutic process with groups to work with individuals. The case examples provide a glimpse as to how three master practitioners engage with individuals doing adventure therapy.”
Dr. Christian M. Itin, MSW
“The Power of One is an excellent resource for clinicians. It is easy to use with clear, understandable directions of activities as well as their clinical utility with a variety of treatment modalities. This resource will appeal to the seasoned therapist as well as clinical trainees. I have used these activities in my practice and teaching to reach productive and positive results.”
Mary Ortega, LMSW, ACSW, Clinic Administrator, Family Assessment Clinic, School of Social Work, University of Michigan & Supervising Faculty, University Center for the Child and the Family, University of Michigan
Excerpt from the Book
We Engage Our Client in Action
The old adage that “actions speak louder than words” finds affirmation in the work we do. When we involve our client in action, the opportunity to watch the treatment issues acted out in front of our eyes within the therapeutic setting is incredibly valuable (Bacon, 1983; Hovelynck, 1998). We can see and validate personal strengths and limitations, as well as attend to the central treatment issues being demonstrated in the moment. Kolb (1984) developed a model, called the Experiential Cycle that describes how people learn from experience. This model suggests that learning from an experience involves the client reflecting on what happens, generalizing about how the issues from the here-and-now behaviors apply to other areas of functioning, and applying the lessons to life outside the counseling session. We have learned that this process is on-going throughout a client’s experience, and therefore, not something we reserve for debriefing after the fact. Rather, we use many facilitation techniques aimed at encouraging the learning process from the beginning of treatment throughout the session. These techniques include (but are certainly not limited to) changing the rules of an activity to match the clients life circumstances (Gass, 1995), changing how we present or frame the problem being presented, prescribing the skills we want the client to learn at the beginning of the activity, and consciously or intentionally using of different theoretical perspectives (such as Ericksonian hypnotic language or cognitive behavioral approaches). The therapist makes the choice of what intervention style to use based on the needs of the client and the overriding importance of encouraging the transfer of learning from the therapeutic setting to the client’s ongoing personal life (Itin, 1998; Priest & Gass, 1993).
We Engage in the Action With Our Client
The shared nature of the activities used during individual sessions requires that we take on an involved, interactive style of facilitation as a therapist. It is normal for us to be an active participant in the therapeutic activities. We not only present the rules and describe the objective of the activity; we hold onto our clients during activities when necessary and sometimes rely on them to hold us up. We experience the frustration of things not working out and join in the celebration when success is achieved. This style of practice enhances the therapeutic relationship tremendously and leads to many metaphors and analogies applicable to the treatment goals.
It must be noted that adventure therapists operate under the same standards of ethical practice and observation of appropriate boundaries with clients, as every other clinical approach. Decisions about physical touch and the degree of involvement with a client are made throughout the treatment process. Our experience has been that the opportunities to discuss issues important to the therapeutic process, such as boundary issues, are often enhanced by the participatory nature of the facilitation.
Whether you are accustomed to adventure therapy or traditional group practice, you may be struck by the loss of the dynamic interaction between learners that is inherent in group work practice. However, there are dynamic interactions between learner and therapist as well as learner and environment that will be familiar. These interactions serve as key elements of this treatment modality.
Activities are Matched to the Needs of Our Client
The nature of an adventure therapy approach requires us to be open to matching intervention tools with current assessment. It is essential that we connect with our clients on the issues they present in the moment and match what we do to fit their needs. In this process, metaphors from our clients, and analogies that arise from the material they present, can be integrated into our work. The match between clinical issues and specific activities that have the potential to move our clients closer to achieving their treatment goals is fundamental to all applications of adventure therapy (Itin, 2003). We can maintain this flexibility in our choice of activity while maintaining adherence to the requirements of evidence-based practice simply by developing program protocols that emphasize the importance of intentionality in this treatment decision (Tucker & Rheingold, n.p.).
Choose a Theoretical Orientation
Adventure therapy, as a method or model for therapy, is compatible with any theoretical perspective held by the therapist. The use of adventure activities will present the therapist with the gift of having the clinical issues demonstrated in front of his/her eyes. How this material is understood and managed will be determined by the theoretical perspective that the therapist brings into the session. Whether to deal with the issues presented from a cognitive behavioral perspective or any other orientation is open to the individual therapist. What we do know is that these demonstrations of clinical material will occur in the moment, at point of performance. They are shared with the therapist and are undeniable by the client, making them easily accessible for therapeutic intervention. To more clearly illustrate these points, our work with an adult client may serve as an example:
The Point A issues included the facts that this client suffered from early childhood physical abuse and emotional maltreatment from his father. He had developed symptoms of obsessive compulsive disorder and panic attacks as an adult that were his reasons for seeking treatment. His spouse was dedicated to the marriage, but complained that his personal issues were limiting them severely and causing problems with their teenage children who had started to rebel against some of the unreasonable restrictions being imposed on their activities. We met together for nearly 6 months and went through great struggles related to mistrust in the therapeutic relationship, along with fears related to self-disclosure and generally being vulnerable to other people. These issues were improving greatly and the current treatment environment appeared to be very supportive of his continued personal growth and learning.
One day, this client let out a huge sigh as he sat in his customary chair. Eager to engage with action, the therapist imitated the sigh and said, “Wow, that was a huge sigh.” This connection was enough to precipitate a description of the feelings that went along with the client’s actions. He described being overwhelmed and experiencing extreme anxiety over the demands of life, which he knew were exaggerated by his need to complete every task perfectly, without a single flaw in his eyes. It was wonderful to hear him talk about his feelings rather than become enmeshed in a lengthy description of the details of his day! Any movement, like this, away from describing the concrete details of life and toward a more balanced perspective that included some affective understanding of those details, represented great progress toward our ultimate treatment goals.
As the client talked about that sigh, it became apparent that he was overwhelmed with the need to prove himself worthy to the people around him. Knowing that his Point A prohibited him from revealing any need for help from other people, the therapist decided to invite him to participate in The Dump activity (see p. 37). This activity required the client to move a cup of water using six or eight strings tied to an elastic band. It was very close to impossible to accomplish with just one person. This client struggled for nearly 10 minutes before heaving a heavy sigh and saying he thought it was impossible. “That sigh was just like the one you started this session with,” was the therapist’s response. He agreed and quickly stated that his whole life seemed just like this moment. There were too many things to accomplish, and it made him feel totally incompetent and overwhelmed.
From this poignant moment, the therapist was able to suggest a solution to the current problem. It was simply noted that, although the therapist was sitting there the entire time with two perfectly good hands and a great deal more experience of how the activity worked than the client, he was never asked to help. The client laughed and readily acknowledged that asking for help was not one of his strengths. We discussed how that personal attribute could be contributing to his sense of being overwhelmed. And we entered a phase of treatment where he was asked to experiment with asking for help and working through the problem in a new and different fashion than his customary pattern.
Due to the anxiety issues present in this client, the therapist had chosen to utilize cognitive behavioral interventions. The concept of self-talk was a familiar topic during these sessions. The client was readily able to accept making a personal statement that it was okay to ask for help, and to cognitively understand that he was not going to be ridiculed for revealing those needs. In addition, the successful experience of asking for help during the therapy session would provide powerful fodder for the on-going treatment sessions.
Table of Contents
Welcome and Purpose
The Art of Facilitation
How to Use the Activity Selections
The DSM-IV TR Connection
Activity Suggestions for Specific DSM-IV TR Diagnosis