A concept developed by the late psychologist Carl Rogers back in the 1960's, unconditional positive regard is to accept and respect others without judgement and I would argue a determining factor in the relationship building process. It is a key element of our work as therapists, both 'in the office' and out in the bush on our adventure therapy programs.
As Will recently mentioned in a previous blogpost, 'unconditional positive regard and genuine warmth are the best relationship building tools we have.' Research strongly supports that relationship factors between the worker and client make up to 30% of the key elements for positive outcomes. Studies also suggest that a huge number of people report positive outcomes simply from just attending therapy, regardless of what approach the therapist takes - people feel better seeing a therapist, than not.
To me, this suggests that simply having someone to talk to, feel comfortable with, and to sit in a non judgemental space is beneficial; developing a relationship with the person providing this is therapeutic in itself.
In the field, we live with our participants - so we have time. More time than most. And generally what we find, is that after perhaps some boundary testing, young people often realise that they cannot push us away. We accept their thoughts and values, even if different from our own.
And so they're somewhat forced to sit uncomfortably sometimes. As it can be a strange feeling to have someone share your space, even when you feel at your worst - the compassionate and caring relationship actually invites young people to reflect and inquire about their troubles.
I believe providing this unconditional positive regard through relationship building with clients, is how we attempt to move away from these self destructing patterns, and begin finding positive ones.
Last week I wrote a short blog about Dr Bruce Perry and the Three R’s: Regulate, Relate & Reason. Dr Perry’s neurological focus has clarified how the brain operates during times of stress, anxiety and really any emotionally heightened time. Due to so much interest from our followers, I thought it would be good to open further dialogue into what the Three R’s really mean and how to implement them.
In a nutshell, the brain cuts off our ability to significantly relate and reason through our problems. This often causes more challenges. Especially for children and teenagers.
As neuroscience gives us more and more research about the brain, there is further justification for adventure therapy programs and how they may help our troubled teenagers. This post will talk briefly about the first R – Regulate.
Helping our participants become centred and feel safe is our first priority during our expeditions. Some may feel anxious about attending the program, meeting new people and being away from home. In the first few days, our goal is 100% about regulating emotions and building a sound relationship for us to work from.
There are many things in therapy that work for some but not all. What works for me may not be the thing that works for you. But the truth is there are some things that help all of us stay regulated. In the adventure therapy setting, they tend to be quite obvious.
Sleep: After our first or second hike into the Southern Flinders Ranges our group starts to adapt to a sleep cycle that often consists of heading to sleep between 8:30-9 and waking up at first light. Sufficient sleep is crucial for the treatment of depression, anxiety, stress and other mood disorders.
Exercise: Hiking each day provides our adolescents with a plentiful amount of exercise and movement. Earlier this week we posted an article on our Facebook page about Music and Rhythm being so important for a healthy brain. By hiking and exercising daily, our groups start that process of settling our emotional systems and begin feeling great.
A Predictable Environment: The consistency of the adventure therapy setting is absolutely fundamental to its success. Almost all adolescents engaged with our program leave feeling as though they could be themselves and didn’t need substances or superficial modifiers to help them socially. The reason for this is that adolescents thrive in environments that have predictable boundaries. That is, everything is ok as long as we are inside these walls. It makes them feel safe.
Nurturing & Caring Adults: Being an adventure therapy program, we are often thrown in with boot camps and other youth programs. True North Expeditions is a relationship-focused program. We are here to understand not prescribe, to learn not preach, and to provide an environment that allows children to thrive.
My favourite example of this nurturing environment comes from the metaphor of a plant. If I have a plant in my garden that is struggling, gasping for life, it is not going to be my job to yell, lecture or punish this plant. Instead, I need to think clearly about the environment this plant is living in and how I can set it up for the best chance of success.
Next week we will be continuing to discuss Dr Perry’s Three R’s and how relationship can help more than anything to bring about new success and change.
Studying social work at university, I never had the pleasure of learning about 'adventure therapy'. We studied the social sciences, psychology, social research, social policy, group work skills and therapy techniques.
Whilst in my first student placement I stumbled across adventure therapy as an alternative way to connect with teenagers. Outside of university, working and student placements, I began a quest to learn about what exactly encompassed this type of practice. At first glance, I thought I understood that it simply utilised the outdoors as a therapeutic tool, as being in nature is deemed therapeutic in itself, and it is! However through further reading, conversations and interning with True North, now 2 years ago, I discovered there was a whole lot more to it than simply being in nature.
After attending the 7th International Adventure Therapy Conference this year in the States, I understood that many of our international friends and colleagues used this concept of adventure therapy predominately, that it is, as they say 'letting the mountains speak for themselves'; which is beautiful and metaphoric and can do wonders for our mental health.
But over the years I have also learned that a key element to adventure therapy is experiential learning, as well as having a therapeutic focus combined with a number of therapies all built upon from a foundation of knowledge from social work. Our teaching and outdoor education friends may be familiar with the concept of experiential learning as it used quite regularly in these fields. Experiential learning is learning through experience. By doing and reflecting.
Examples can be in metaphors along the path of an expedition; an eagle we see flying in the sky and looking down upon the land, what that signifies and how we can relate to it; or with our actions, what happened today that made it easy to climb the mountain; or natural consequences such as not taking the time to build a strong shelter, and then having to re do it in strong wind.
Other times, we sit around camp and natural discussion occurs relating experiences that day to life outside the bush, or we discover that we have learned something about ourselves, through that experience. We reflect.
So as well as 'letting the mountains speak for themselves' we also create our own meaning from what happens in the mountains, as we reflect and learn by doing we figure out ways to implement changes back at home. We find insight, and turn insight into action. And this is one of the most incredible things I see during on our expeditions with our participants.
Adventure therapy is more than the mountains, and I'm excited to be here in Adelaide to be practicing outside our expeditions, in our garden office space as a practitioner with True North. Thank you for the warm welcome!
Sarah, a 14 year old from Sydney, came to True North Expeditions in late 2014 after her parents became worried about her self-harming behaviours of cutting and smoking cigarettes with a negative influencing group of friends. Although she did not wish to attend the adventure program she agreed to go just to “get her mum off her back.”
In the first few days of the program, the group hiked through the rugged mountains of the Flinders Ranges. Sarah struggled to get along with the other girls and didn’t see a point to the program. She cried at night saying that she wished her life hadn’t come to this point and that she missed her family at home.
After the third night of the program, Sarah woke to say she had just had the best sleep since she could remember. She felt more energised and said that she hadn’t felt this alive since she’s been feeling numb for over a year. She sat with Emily, one of program leaders, on the side of a mountain and they talked. Laughing and drawing in their journals, they spoke of her strengths and ways she could use them to overcome adversity and build resilience. The practiced new ways to self-regulate and stay calm and clear.
Much of our program’s philosophy comes from the work of Dr Bruce Perry and his experience in working with traumatised children across America. Dr Perry’s research on the brain has led to remarkable breakthroughs for educators, psychologists and anyone providing helping services to children and families. The real breakthrough is his work in using literature on the brain’s development to tailor-fit interventions that really help children and adolescents grow.
Important to this process is the Three R’s, or Regulate, Relate, Reason. A lot of us think that we should “Relate” with children before we attempt to regulate difficult emotions. There are also times where we try to “Reason” with them creating a battle of wills where we may yell, command or punish. However, research has indicated that children who are stressed and anxious struggle to use the parts of their brain that allow for strong relationships and rational reasoning.
So our first step, before relationships or therapy can occur, is to help our children to feel calm and regulated. Being a relationship-focused program, our practitioners focus heavily on relationships that are built on genuine trust and mutual respect, not authority or teaching. Although Dr Perry’s research is fairly modern, Carl Rogers has been saying this since the 1960s. Unconditional positive regard and genuine warmth are the best relationship building tools we have. And a nurturing environment helps children to stay regulated.
There are no bad kids that need fixing or children that are just a diagnosis or effected by this trauma or that. There is a person that we can help but only if we are connected. This is where the reasoning comes in.
Some participants struggle to adapt to life in the bush during one of our 14-day adventure therapy programs. Instead of letting them suffer, as some programs do, science tells us that we need to help them become calm and clear. It is only at this time that true psychotherapy begins.
Last week a new client came to our practice to work individually with me. He has struggled academically and has regular fights at home. For him, and his parents, this felt like any ordinary appointment that they had become so used to after spending the last few years scanning for the perfect professional to help bring more happiness and togetherness into their home.
I introduced myself to the 14 year old and brought him back, with his parents, into my small counselling office. I told the boy that I wanted to get an idea of how he was feeling about certain things in life and gave him a short four-question survey to rate how he is feeling individually, about home and how he feels about school.
I let him know that if I was going to do anything during our time together that I just wanted to be useful. I let him know that if I did things that didn’t work, felt uncomfortable or seemed to not fit that he could tell me so that I did not do “more of the same”. I asked him to tell me what other counsellors or psychologists had done that may have been annoying or maybe just didn’t work so that I could avoid them.
After his parents left, we talked about how things were going at home. He talked about fights, getting in trouble and wishing that there would be less conflict. We talked about ideas of what to do but he felt that these conflicts were out of his control. He said he wanted to feel less anxious about social situations, more independent and less depressed.
As our initial session came to an end I gave him another short questionnaire to provide a rating for how he viewed me and our time together. When asked if he felt listened to he rated me a 7.42 out of 10. Although a rating is just a rating and may not mean much, when I reached out to his parents to schedule our second session they reported feeling more hopeful than ever. That in the car after our first session he talked about feeling safe, listened to and that there is a connection that has not been present before.
We had our second session this week. He scored me a 9 of 10 on listening. Things are improving. I asked him why he scored that and he reported that it makes him feel as though he is the centre of attention while we are together and that there is no issue that should not be discussed.
One of our biggest theories in working with people, whether its those who have never been to a helping professional or seasoned therapy veterans, is that we need to create a relationship that is open to honest feedback. If we are doing something that is not useful to the child or family then there is little point in doing it. It will not be helpful.
To be useful, we need to allow our clients to be the best judge of the experience and allow our time together to be as meaningful as possible. This is when people begin to feel confident enough to change and build a higher quality of life.
As traditional therapy goes, a client comes to our office, sits and talks about some of the areas in life that they would like to improve. For children and teenagers specifically, this could be conflict in the family, school difficulties or feelings of depression and anxiety. For the one-hour session, the client may learn new strategies for handling their difficulties or spend time finding out why certain patterns have emerged. A plan would then be created for how the client can best manage their life for the next seven days until they return for next week’s session. The important message here is that the most important changes occur outside of the therapist’s office!
One of the reasons we use Adventure Therapy or Experiential Therapy techniques with our clients is to make our office as important of a time for their growth as necessary. The difference is that instead of talking about what changes we will make and doing the changes.
Research has suggested that the repetition of desired outcomes is important for long-term change. Giving adolescents the chance to act out their desired change may be a key to success. It may also be an effective alternative for those that have been to see traditional therapists without much gain.
During our expeditions we see many students struggling with family life at home. Their behaviours have gotten worse and the atmosphere at home is restless. While in the bush, our groups need to function like a team to practice survival and accomplish group tasks. For the adolescent that struggles in this area at home, he or she is given a time where they can operate as a team with the support of helping professionals. Instead of talking about teamwork, empathy or responsibilities, we are doing all these things and helping the participant to reflect and review on how they went during each initiative.
Because of the nurturing environment and genuine relationships built during our program, our students feel comfortable reflecting on how they have done with each experience and build more insights that could help them to become successful. Upon returning home, we continue supporting the adolescent and keep this feedback going. Each time the adolescent is successful, out of the office, the better chance we have for them to be successful again. In this light, we actually learn more from our successes than our failures.
True North Expeditions, Inc. provides adventure therapy programs and services for children and teenagers in Australia. Based in Adelaide, the TNE team writes about child and adolescent psychology, family dynamics and how adventure therapy programs can connect with struggling adolescents.