Complex Trauma Focused Adventure Therapy
Process and Benefits
Trauma Focused Adventure Therapy works differently to, yet compliments, talking therapy.
Bottom-Up
Adventure Therapy works ‘bottom-up’ following the Australian Practice Guidelines for the Treatment of Complex Trauma ... (Kezelman & Stavropoulos, 2012). That means that the hind brain and Limbic system are targeted allowing the participant to physically and emotionally regulate. The hind brain controls heart and breathing rates, digestion, body temperature etc. Being active outside helps participants to expend energy and, through repetitious activity, to recognise physiological states. In simple terms they become connected to their bodies. They also become connected to place through engaging with and noticing the natural environment. These connections help them to become grounded and to remain present.
The Limbic system is taregetted by sharing adventures with people with whom they can co-regulate their emotions. As long as the participant is not distressed by the people they are with they will share experiences and match the emotional state of their companions. They will experience people as helpers, problem solvers, assistants, and simply as companions. This helps participants to view themselves as normal and like others. These companions will help the participant to understand firstly, what is going on and how things work, and secondly, what can happen later.
Top-down
This bottom-up approach involves activity, companionship and opportunities to experience engaging activity that does not overwhelm or dysregulate. The result is that the fore-brain, (cortex) becomes available for…top-down approaches. Before attempting any talking therapy there are opportunities for coaching. This initially involves the practical aspects of adventure activity, how to do this and to solve that, and then more abstract thought such as how to relate to others and how to understand myself. Basic psychoeducation becomes understood and opens the door to talking therapies with a therapist.
Adventure therapy is deep, rich, rapid and engaging. It is a sophisticated approach to therapeutic intervention for complex trauma. Yet, Adventure Therapy seems as simple as fun and games. The following describe Adventure Therapy:
Strength based, positive, solution focused, trauma informed, empowering, narrative, dynamic, somatically experiencing, mindful, and playful.
Phased Treatment
The three phased Complex Trauma treatment process (Cloitre et al., 2012) is followed in most Adventure Therapy and required of all Complex Trauma focused Adventure Therapy (Pringle, 2016). The phases are:
1 Safety, in all components of experience, relationship and location,
2 Processing New and Positive Experiences (Pringle, 2015), and
3 Integration.
This phased approach moves the participant gently and with control through the bottom-up and then the top-down process. This takes time and repetition of lived experiences. However, the process can be startlingly rapid when using Complex Trauma Focused Adventure Therapy.
Domains of experience
The sophistication of the 4x4=4 model of complex trauma focused Adventure Therapy is through the phased treatment, following current neurological based bottom-up and top-down practices while also simultaneously harnessing four domains of adventure experience (Pryor, Carpenter, & Townsend, 2005):
Natural environment,
Adventure activity,
Social group, and
Participants biopsychosocial situation.
Outcomes
Trauma Focused Adventure Therapy targets four key benefits (Pringle, 2015):
Attachment skills and lived experience,
Resilience to, and management stress,
Skills development (motor, technical and social skills), and
Revised and more positive schemas (world view).
References
Cloitre, M., Courtois, C.A., Ford, J.D., Green, B.L., Alexander, P., Briere, J.N., Herman, J.L., Lanius, R.A., Stolbach, B.C., Spinazzola, J., van der Kolk, B.A., & van der Hart, O. (2012). The ISTSS expert consensus treatment guidelines for complex PTSD in adults.
Kezelman, C.A., & Stavropoulos, P.A. (2012). Practice guidelines for treatment of Complex Trauma and trauma informed care and service delivery. Sydney: ASCA.
Pringle, G. (2015). Engage and change complex young people; The 4x4=4 model of trauma focused Adventure Therapy. Mapleton: Youth Flourish Outdoors.
Pryor, A., Carpenter, C., & Townsend, M. (2005). Outdoor education and bush adventure therapy: A social-ecological approach to health and wellbeing. Australian Journal of Outdoor Education, 9(1), 3-13.