Counseling in Photo Series, Therapist Journal

Group Therapy: An Updated Understanding

“Sometimes we don’t fully understand what the client is going through until we take a step back, clean our mind, and look at the situation with new eyes. I like to think of this as if I have cleaned my windshield before driving. How do you accomplish this?”

I first wrote these words in my first year of my graduate program at Alfred University. Since then I have learned more about groups and group therapy; even led multiple groups myself. Currently, as a field therapist at Blackwater Outdoor Experiences I have led groups for individuals that are dealing with anxiety, depression, substance use, low self-esteem, and antisocial behaviors.

In these groups one of the key things we find is that most of the individuals coming to our program because their coping skills have not been effective. As a result, they have been kicked out of their homes, involved in the court system, or been given an ultimatum. In order to highlight their situations motivational interviewing and cognitive behavioral therapy are key in helping the participants start to gain the motivation to change and develop new coping skills.

David Flack, at the American Counseling Association Conference in March 2015 shared his 5 R’s of motivational interviewing: Relevance, Risks, Rewards, Roadblocks, and Repetition.

Relevance – Highlighting why change is important

Risks – Highlighting the risks of changing and not changing

Rewards – Highlighting the gains from changing

Roadblocks – Highlighting the obstacles to changing

Repetition – Reviewing these pieces of information frequently

As a therapist these 5 R’s have been helpful in working with these clients and making a key goal of treatment helping clients develop motivation to change. In order to help participants develop their motivation to change psychopharmacotherapy is discussed as a treatment team at Blackwater Outdoor Experiences as each case requires it.

Psychopharmacotherapy is used to help the participants create and maintain gains by allowing them to get the full benefits of individual and group therapy whether in the wilderness or in a therapist’s office. Typical Blackwater Outdoor Experiences participants have a past history with substances or their personality profile benefit from psychopharmacotherapy in helping them break rigid, circular thinking or maintenance from substances.

Counseling in Photo Series, Therapist Journal

Finding Balance Through Adventure

When talking about balance in our lives in the mental health field we try and focus on how we can achieve a minimum of satisfaction in the following areas of wellness: Spiritual, Emotional, Intellectual, Physical, Social, Environmental, and Financial. A useful tool that has been used in these discussions has been the wellness wheel assessment. The wellness wheel looks similar to the diagram below excluding the colored in portions (University of Utah, 2015). The goal is for the client to fill in each of the areas to show how much of each area they currently have satisfaction or have achieved their goals in. When a client joins an adventure based counseling program or any other form of experiential education based form of therapy (generally referred to as adventure therapy) they are asked to assess themselves in a similar way in order to keep themselves and other safe while also working towards achieving goals.

Image result for wellness wheel

Throughout adventure programming (such as in adventure therapy, on challenge courses, or workshops) participants are challenged through portable activities like “Toxic Waste”, challenge elements like “The Wall”, or even a wilderness experience. These experiences are debriefed so participants are able to take lessons away from their experiences immediately and be ready to start applying them to new goals or help them modify their plans to achieve older goals that have not yet been achieved.

In May 2015, I took a workshop through Project Adventure called Adventure Based Counseling in order to help further my understanding of this process and start to make sense of how I could blend my learning of mental health counseling with the adventure and fun that I have experienced as a summer camp staff member at Vanderkamp Center. As part of this experience I participated in the Mohawk Walk challenge course element pictured above. On this element you had to work with other members of your group in order to walk on wires from point to another point. The challenge was increased by each of placing a stuffed animal representing a goal of ours at various locations throughout the course. As you can see from the picture above there was difficulty in this element which required our group to work towards balance of our minds and balance of ourselves physically in order to help each other accomplish our goals.

I would challenge you to think about the goals you are trying to accomplish and decide for yourself whether you are in a place in which you believe an adventure program or adventure therapy might be right for you. Adventure programming can be recreational such as a local university climbing wall. These programs may have a facilitator and can hold lessons around team building, communication skills, and more. Adventure Therapy takes this process a step further in order to look at an individual’s mental health as a part of the process and helping those with mental health issues work towards their goals of recovery and mental health management.

Continue reading “Finding Balance Through Adventure”