Assessing treatment integrity: A case example

This paper presents an example of assessing treatment integrity as part of an experimental study of home-based, intensive family preservation services (IFPS). Participants were 103 IFPS workers and 24 state public child welfare agency workers (FC). The structured, self-report questionnaire included questions about specific components of the services, as well as the characteristics of the family and the workers themselves. Findings suggest that IFPS workers delivered services according to the treatment model guidelines. The procedure yielded a good estimate of whether the structural components of treatment were delivered according to the model as delineated in the treatment manual. The paper discusses the advantages and disadvantages of this approach to assessing treatment integrity

The value of outdoor behavioral healthcare for adolescent substance users with comorbid conditions

The damage inflicted on our society by mental health and substance use issues is reaching epidemic proportions with few signs of abating. One new and innovative strategy for addressing these comorbid issues has been the development of outdoor behavioral healthcare (OBH). This study compared the effectiveness of three post-acute adolescent substance use situations: OBH, treatment as usual (TAU), and no structured treatment (NST). The simulated target population was 13-17 years old with comorbid substance use and mental health issues. When costs were adjusted for actual completion rates of 94% in OBH, 37% in TAU, and $0 for NST, the actual treatment costs per person were$27 426 for OBH and $31 113 for TAU. OBH also had a cost–benefit ratio of 60.4$36 100, and 424% better treatment outcomes as measured by the Youth Outcome Questionnaire (YOQ) research instrument

Adventure-based group therapy to promote social skills in adolescents

This article presents adventure-based group therapy as one type of activity-based group treatment that can be used to promote social skills in adolescents. Adventure-based therapy groups are a blend of experiential education, outdoor education, and group therapy. Key components of adventure-based therapy groups include activities that provide immediate and concrete consequences of behaviors, reliance on problem solving, their use of novel and unfamiliar environments, and the use of physical trust. The article includes practice examples of how these factors can be used to promote social skills and discusses limitations and implications for social work group practice

Enhancing fidelity in adventure education and adventure therapy

Although the importance of addressing and evaluating treatment and program fidelity is clearly emphasized in the literature on psychology, education, and health, little attention has been given to fidelity in adventure literature or research. Program fidelity refers to whether or not, and how well, a specific intervention or program was implemented as planned. This article provides a background on fidelity, including program adherence and competence, factors that affect fidelity, and ways that adventure practitioners as well as evaluators can be intentional in addressing and measuring fidelity in adventure programming and research

New heights: Adventure-based group work in social work education & practice

Training in groupwork in social work education is a critical aspect of promoting the continued use of groupwork in social work practice. Groupwork courses in social work education should integrate theory and practice; emphasize the processes that make groups effective; and train group leaders by providing experiential learning opportunities for how to lead groups. Likewise, groupwork in social work education should keep up with practice trends in the field of social work. According to Tucker and Norton’s (2009) research, current trends in social work practice with groups in the United States include the use of adventure-based practices with clients to effect positive change. Research also shows the increased use of adventure-based practices in the U.K. and other parts of the world. This practice trend is not new; however, Tucker and Norton found that very few social workers in the United States ever receive hands-on training in challenge and adventure activities while they are in school. The lack of experiential training in challenge and adventure activities in groupwork may lead to professional incompetence and poor programming, or the absence of challenge and adventure programming in social work practice with groups altogether. This study addressed the issue of groupwork training in social work education by providing social work students with an opportunity to participate in adventure-based groupwork. Pre- and post- survey research measured the impact of adventure-based groupwork on student’s self-concept and perception of competence in major life skills, group cohesion, and level of knowledge regarding application of challenge and adventure activities with social work clients. Data analysis revealed statistically significant improvements in all areas

The use of adventure therapy techniques by clinical social workers: Implications for practice and training

Adventure therapy, an experiential intervention that combines outdoor, adventure based activities and group process, is used in direct practice by clinical social workers; however, it is unclear to what extent clinical social workers are actually utilizing these techniques. This research project surveyed a random sample of clinical social workers and examined in greater depth how they are utilizing adventure therapy programming with different clients in various treatment settings, as well as what type of education and training they received for engaging in these practices. A random sample of 646 clinical social workers in NASW responded to the survey, and more than 1/3 of this sample (35.1 %) reported the use of adventure based activities for therapeutic purposes in their social work practice. However, few of the social workers reported formal education or training in the use of adventure therapy, highlighting the need for more attention in both educational and clinical settings to proper instruction around this growing intervention

Shifts in attachment relationships: A study of adolescents in wilderness treatment

This study examined shifts in adolescents’ attachment relationships with parents and peers during a 7-week wilderness therapy program. Ninety-six adolescents, aged 14–17, completed three quantitative measurements evaluating attachment relationships with mother, father and peers pre and post treatment. Adolescents reported improved attachment relationships in terms of decreased anger and increased emotional connection towards parents. Results also showed adolescents’ more troubled attachment relationships in terms of trust and communication with parents by the end of treatment. Adolescents reported similarly mixed results in both a positive and negative direction regarding peers. These findings indicate the complexity of parent–adolescent relationships particularly considered in the context of out-of-home care and point to the importance of continued exploration in this area