Process factors explaining psycho-social outcomes in adventure therapy.

The development and factor analysis of the Adventure Therapy Experience Scale (ATES) is the first attempt found in the literature to empirically and quantitatively identify therapeutic factors theorized to affect change in the adventure therapy experience (Russell & Gillis, 2017). This study utilizes the ATES to explore how its inherent factors may impact treatment outcome utilizing a routine outcome monitoring process to empirically test how these factors may contribute to treatment outcome over time. The sample of 168 males 21.5 years of age completed an average of 79.6 days in the 90-day adventure-based substance use disorder residential treatment program. In the model, adventure-based experiences are a primary treatment tool. For outcome monitoring, all clients were administered the Outcome Questionnaire (OQ-45.2) at intake, every 2 weeks, and at discharge. In addition, clients were administered the 18-item ATES every 2 weeks. The ATES contains 2 items measuring how helpful the adventure experience was as well as how mindful they were of their treatment process during the experience. Clients also answer 16 Likert items measuring responses on 4 subscales: group adventure, nature, challenge, and reflection. Results reveal that clients, on average, improved in their psycho-social functioning as measured by the OQ 45.2. Weeks with higher helpfulness, mindfulness, and group adventure scores than the client's average helpfulness, mindfulness, and group adventure score, had greater decreases in OQ scores than weeks with lower helpfulness, mindfulness, and group adventure scores. Clients with higher aggregate helpfulness and group adventure scores, across all treatment weeks, had greater decreases in OQ scores than clients with lower aggregate helpfulness and group adventure scores. Implications for practice and future research are also discussed. (PsycINFO Database Record

Between-client and within-client engagement and outcome in a residential wilderness treatment group: An actor partner interdependence analysis.

We examine aspects of engagement (MacKenzie, 1983) as predictors of longitudinal change in Outcome Questionnaire-45.2 scores (Lambert, Kahler, Harmon, Burlingame, & Shimokawa, 2011) for 68, 18-24-year-old male residents in a 10-bed, open enrollment 90-day residential, substance use treatment program. Engagement was partitioned into within-member, between-member, within-other members, and between-other members' effects. Within-member engagement represented how a group member's score for a week deviated from that member's average engagement score (across all weeks), whereas between-member engagement was the member's average engagement score. Similarly, within-other member engagement represented how the other group members' scores for a week deviated from the other group members' average engagement score (across all weeks), whereas between-other member engagement was the other group members' average engagement score. A 2-level hierarchical linear model showed the interaction of between-member engagement and between-other member engagement was related to decreasing OQ-45 scores. When other group members generally saw the group as more engaged, higher group member average engagement ratings were related to improvement. There was a significant interaction between within-member engagement and between-member engagement in predicting OQ-45 scores. When clients generally saw the group as more engaged, weeks with relatively more member engagement, compared with other weeks, were associated with improvement in OQ-45 scores. However, when clients generally saw the group as less engaged, weeks with relatively more group member engagement, compared with other weeks, were associated with greater deterioration in OQ scores. We recommend tracking week-to-week changes in member and other member engagement to identify group members who are not getting optimal program benefits. (PsycINFO Database Record