The more I explore ideas about facilitating change, the more I come to see my job as a substance abuse counselor as helping my clients become unstuck by providing them the opportunities to write new cognitive scripts, rather than simply getting them to stop using alcohol and other drugs. It seems to me that our job as counselors and therapists is not to eliminate those old cognitive scripts, but to help them discover new, more adaptive possibilities.
As our clients utilize these new, more adaptive possibilities, those old scripts will just fade away from neglect. Neuroscience tells us that what wires together fires together, but the opposite is true as well. What no longer fires together becomes unwired. If we help our clients write new, more effective scripts, and help our clients integrate these scripts into their daily lives, the neuronal networks that have hardwired those old, less effective scripts become like a forgotten path overgrown after years of no use. It seems to me that experiential activities are especially useful in achieving this.
In my last post, I discussed using experiential learning as a way to create disequilibrium for the sake of exploring that disequilibrium. In my experience, teens in treatment often lack motivation to change because they perceive their lives as being in balance. Brains like this misperception. It allows the brain to remain lazy, continuing to use those same old, all-purpose maladaptive scripts of Act Up, Shut Down, or Use, continuing to go down that same well-trodden path.
More accurately, of course, brains are exactly lazy. They're efficient, and the known response is more efficient. It takes less energy. It maintains a sense of balance. Experiential activities can be effectively used to disrupt this sense of balance, thereby creating disequilibrium. However, that is not the only use for experiential activities in a clinical setting. Experiential learning can also be used for illustrating concepts, practicing new skills, and improving group cohesion.
Illustrate Concepts
Zull wrote that we are most likely to trust sensory input from experiences. “One of the most important and powerful aspects of experiential learning is that the images in our brains come from the experience itself” (p. 145). Simply put, the use of an activity to illustrate a new concept helps it come to life in a way that makes it more memorable. In other words, the brain remembers what the body does. By framing activities as interactive metaphors, perhaps we can increase the likelihood that our clients will remember new information, thereby integrating it into their lives and creating lasting change.
An example of an activity that illustrates a concept is Journey to Recovery. This activity is more commonly referred to as Minefield, but I prefer my title for clinical settings. Use lengths of rope or webbing to establish start and finish lines, then scatter various items between the two ropes to create an obstacle course. I use polyspots, beach balls, Koosh balls, hackeysacks, stuffed animals, rubber chickens, a plastic pig, and so on.
The goal of Journey to Recovery is for a blindfolded participant to make it from the start to the finish without touching any of the obstacles. This will, of course, require the assistance of other participants. I usually start with one person going through the obstacle course. After a round or two of this, I have two participants go simultaneously, starting from different sides. Eventually I may move obstacles around to increase the challenge level.
Different obstacles can stand for different recovery-related concepts. For example, should a participant touch a polyspot, she would be given a relapse scenario and be required to share her likely response. If other clients decide her response is effective, she can continue. However, if other clients decide her response is ineffective, she must start over. I also use beach balls to represent using friends, hackeysacks can be triggers, and so on.
Practice New Skills
Ross and Bernstein stated, “[G]ames and activities offer youth a workshop for discovering and developing new ways to manage obstacles” (qtd. in Rose, p. 24). I believe experiential activities do this by only providing the opportunity to try new behaviors, and to practice those new behaviors in a safe, supportive environment. As clients practice these new behaviors, new neural connections are being made and new cognitive scripts are being written. In other works, they are getting unstuck.
This work of getting unstuck happens by presenting clients with new, more adaptive possibilities and opportunities for practicing them. Experiential activities serve this treatment goal well, especially when such activities are presented in ways that reinforce trying alternate behaviors. Requiring the group’s “natural leaders” to follow, framing activities so that they are symbolic of real life, using metaphor-rich language throughout activities, and spending as much time debriefing as doing are a few ways I strive to reinforce the practice of alternate behaviors during experiential activities.
In addition, the use of experiential activities provide opportunities for clients to increase their problem-solving skills, sense of self-efficacy, and openness to taking good risks, so that the are more willing to implement their newly developed, more adaptive scripts.
An example of an activity that provides opportunities to practice a new skill is Fill the Crate. I’ve encountered several variations of this activity. This is how I generally present it in clinical settings. Use a long rope or piece of webbing to create a large perimeter circle on the floor or ground. In the middle of the circle, place a milk crate. Scatter tossable items on the outside of the circle.
The goal of Fill the Crate is for the group to get all the tossable items into the milk crate without stepping into the circle, moving the rope, or talking. A few ways to adjust the challenge level to meet a specific group’s needs is to vary the size of the circle, use tossable items of different sizes and weights, blindfold some participants, and give a time limit for accomplishing the task.
Improve Group Cohesion
Experiential activities can certainly be effective for team-building as part of employee retreats, during corporate trainings, or with sport teams. However, it seems to me this application isn’t especially relevant to clinical settings. When a client leaves an experience—be it a group session, an extended adventure outing, or graduating from an ongoing treatment program—he will likely not be part of a real world team with his group-mates. As such, it seems to me that team-building isn’t particularly relevant in a clinical setting.
What is relevant, though, is group cohesiveness. Luckner and Nadler defines group cohesiveness as “the sense of connection and good feelings when the group works together” (p. 49). Group cohesiveness helps assure the best possible treatment outcomes by assuring that the group collectively and individually is functioning at the highest level possible.
An important aspect of group cohesiveness, especially in a clinical setting, is trust. “Individuals are often less willing to share and participate fully in groups that have not built a trustworthy community” (Stanchfield, p. 14). If a participant doesn’t trust the other group members or the facilitator, it is only reasonable that she would be reluctant to engage in a meaningful way.
Increased group cohesion is a secondary benefit of nearly an experiential activity. However, there is also value in intentionally addressing this issue. In fact, I believe this is so important for effectively working in a group that I address cohesiveness in some manner nearly every time a treatment group meets. An example of an activity that helps improve group cohesion is The Trust Walk. For this activity, the participants will pair off, with one partner being the Guide and the other partner being blindfolded.
Once blindfolded, this participant is spun around a few times to create a sense of disorientation and the Guide then takes over, leading the blindfolded participant around the area. When doing this activity inside my agency’s building, we leave the group room, which gives us access to several long, narrow halls, various public spaces, and a stairway, as well as exterior spaces. I’ve also conducted this activity in a nearby, heavily wooden park, which worked quite well. After about fifteen minutes, have the participants switch roles.
Based on the overall functioning level of the group, you can allow the participants to choose their partners or you can use randomly assignment them to pairs. Allowing them to choose their own partners gives them some control and will reduce the sense of risk inherent in the activity. You can also increase or decrease the sense of challenge by either silencing the Guide or banning physical contact.
Framing the Experience
Framing refers to the manner in which it is presented to the participants. Three types of framing are possible. I call these Nuts-N-Bolts, StoryTime, and Metaphorical. Nuts-n-Bolts framing involves simply providing the basic rules and goals. A Nut-n-Bolts framing of Journey to Recovery might go like this: “In this activity, you’re goal is to get from the starting line to the finish line without touching any of the obstacles.” A StoryTime presentation might start like this: “You are on a great quest. There are many obstacles on your quest, obstacles which you must avoid.” The version described above would be a Metaphorical framing of the activity.
Pressure Pads, one of my favorite experiential activities, provides another example of Metaphorical framing. Use lengths of rope or webbing to establish a start and finish lines. Then, explain to the participants that their objective is to get from the starting point here in Treatment to the finish line over there, Long-Term Sobriety. They must do so without touching the Sea of Relapse. To do this, they would be given several polyspots that represented the skills they’d learned in treatment.
Once the group has been handed the polyspots, someone must remain in physical contact with each spot. If contact with a spot is lost, if a spot is slid on the floor (or ground), or if anyone touches the Sea of Relapse, the group is given a setback. I try to use setbacks as a way to adjust the challenge of the activity to the functioning level of a group. Setbacks can include answering recovery-oriented questions, requiring a participant to start over, or even loosing a spot. Another way to adjust the challenge level of the activity is by the distance the group must travel to cross the Sea of Relapse.
Pressure Pads requires the group to effectively work together to utilize their limited resources to solve the problem. As such, it has clear value for promoting critical thinking skills. More importantly, from a clinical standpoint, the activity includes a long learning curve, frequent false starts, and is harder than it seems. That sounds like treatment and recovery to me.
I believe framing helps makes experiential activities therapeutic and processing assures transfer of learning. Without framing to make the activity relevant to the clinical setting, the full value of these activities may be lost. Without processing, this generalizing of the activity to the real world wouldn’t happen. Processing the activity and finding the connections between it and the real world are important parts of the experience. I believe that is true anytime experiential learning is utilized, but especially in clinical settings.
Siegel wrote, “Experience can shape not only what information enters the mind, but the way in which the mind develops the ability to process that information” (p. 16). Perhaps the effectiveness of experiential learning—in a clinical setting or elsewhere—is that it changes the way information is processed. If so, then Pressure Pads isn’t really about crossing the room without touching the floor. It is about replacing previous maladaptive cognitive scripts with more adaptive ones.
Works Cited
Luckner, J. & Nadler, R. (1992). Processing the Experience. Dubuque, IA: Kendall/Hunt
Publishing.
Rose, S. (1998). Group Therapy with Troubled Youth. Thousand Oaks, CA: Sage Publications.
Siegel, D. (1999). Developing Mind, The. New York: Guilford Press.
Stanchfield, J. (2007). Tips & Tools: The Art of Experiential Group Facilitation. Oklahoma City,
OK: Wood ‘N’ Barnes.
Zull, J. (2002). Art of Changing the Brain, The. Sterling, VA: Stylus Publishing.
