Handout: Processing with Teens

Processing with Teens
Association for Experiential Education International Conference 2009 - Montreal, Canada
Presented by David Flack

WHAT IS PROCESSING?
Processing is creating connections between an experiential activity and the Real World. Creating these connections helps assure transfer of learning and lasting change. Processing is often thought of as a discussion or Q&A session after an activity or session. With many teens this may not be most effective.

Three keys for successful processing with teens:
➢ Be genuine – You are the most valuable tool you have when working with teens. If you aren’t genuine, nothing else really matters. So, relax and have some fun. You’ll be glad you did.
➢ Embrace the silence – In other words, don’t expect immediate answers to every question you ask. Most teens will engage if you give them time to do so, but you can’t make them talk before they’re ready.
➢ Teens are teens – They’re not adults and they’re not children. Treating teens in a developmentally appropriate and respectful manner is essential.

FOUR TIPS FOR PROCESSING WITH TEENS
Tip #1: Don’t take it personally.
Let’s break this down a little. Being insightful is a skill that requires practice. In many cases, teens have had little or no prior opportunities to practice this skill. That makes processing seems risky, and despite all you may have heard, most teens are risk-adverse, at least when the risk is interpersonal in nature. Add to all that the fact that many teen participants are mandated to attend our programs and have no desire to engage. Now they’re faced with an adult stranger trying to get them to talk about how they feel!

What can we do with all that?
1. Roll with the resistance.
2. Integrate activities for building trust and cohesion.
3. Directly address the risk of self-disclosure and the “mandatedness” of participants.

Tip #2: Process as you go.
The most transferable insights often come from In-The-Moment Processing. When participants are especially challenged and what they’re doing isn’t working, they’re ready for new possibilities. When processing In-The-Moment, be careful you don’t solve the problem. Rather, guide the participants to their own solution.

Tip #3: Move beyond Q&A processing.
The amygdala is the brain’s Fear Center. However, if the brain is busy with a cognitive task, such as solving a puzzle, the amygdala doesn’t have time to sense fear. What does that have to do with processing? Simple. Keep those brains busy!

Three alternatives to Q&A processing that keep brains busy:
1. Discussion Starters
2. Random Questioning
3. Action Processing.

Think of these as ways to approach processing, not rigid categories. These alternatives are more participant-driven than a facilitator-led Q&A would be, and that means they’re more developmentally appropriate for teens.

Tip #4: Create group rituals around processing.
In ongoing groups, a ritual will quickly becomes a group norm, providing a safe way for participants to practice processing and appropriate self-disclosure. Closing Rituals can be especially useful because they provide a “last chance” to help participants make connections between the new learning and the real world.

PROCESSING ACTIVITIES WE EXPLORED
These are the activities we covered during the workshop:
Chiji Cards • Mousetraps • Getting Rid of Your Junk • Blizzard • Processing Dice • Web of Support • Koosh Ball Check Out

RECOMMENDED READING
The Art of Changing the Brain, by James Zull
This book is an easy to understand introduction to the neuroscience of change. It is packed with practical that’ll change the way you facilitate!

The Primal Teen, by Barbara Strauch
If you work with teens, this book is a must! In this book, Strauch looks at adolescent brain development in an entertaining and readily accessible manner.

The Processing Pinnacle, by Steven Simpson, Dan Miller & Buzz Bocher
This book presents a practical model for processing that will help further develop your skills as a facilitator.

Processing the Experience, by John Luckner & Relden Nadler
A classic text in the experiential education field, this book is filled with both good theory and practical ideas. It is currently out of print, but you can probably find it online.

Handout: From Ambivalence to Action (AEE Int'l Conference, Fall 2009)

From Ambivalence to Action: Facilitating Change in Substance-Abusing Teens
Association for Experiential Education International Conference 2009 - Montreal, Canada
Presented by David Flack

Workshop Premises
• Change is a process, not an event.
• Only the changer can do the changing.
• Everyone is motivated by something.

It is common for teens to deny having a problem with alcohol or other drugs, at least initially. With your help, these teens are often able to identify other problems that do motivate them. For example, teens on probation will usually agree they have a legal problem, even if they don’t think they have a drug problem. Start the process of change where your client is at, not where you want them to be.

GRAY MATTERS
Change is hard because brains are lazy
• More accurately, brains are efficient.
• One way that brains stay efficient is by using cognitive scripts.
• A cognitive script is one example of a neuronal network.

What wires together fires together
• Once a sequence of neurons fires together, it will likely be repeated.
• Neuronal networks become strengthened through this repeated use.
• Repeated firings lead to habits of thought and behavior.

Cognitive scripts are habits of thought
• If wired with maladaptive scripts, the person is probably “stuck” some way.
• Substance-abusing teens have 3 basic scripts: Act Up, Shut Down, Use.
• Maladaptive scripts + Reinforcement = Substance abuse problem.

STAGES OF CHANGE
Change is a process with clearly defined stages
• Pre-contemplation – I don’t have a problem.
• Contemplation – Maybe I have a problem, but I’m not sure.
• Preparation – I have a problem and am thinking about what to do.
• Action – I am doing something about my problem.
• Maintenance – My new behavior has become habit.

There’s also the Recycle Stage. During Recycle, the individual repeats some of the earlier stages. Recycling isn’t necessarily failure. It can be an essential part of the change process and an important teachable moment.

GROWTH ZONES
Change only happens when you leave your Comfort Zone
• Comfort Zone – Most people spend most of their time in their Comfort Zone, where risks and challenges are minimal, but so is growth or learning.
• Change Zone – When you leave your Comfort Zone, you enter your Change Zone. This is where learning occurs. Neuroscience tells us that the moderate stress felt in the Change Zone increase retention of this learning.
• Crisis Zone – In the Crisis Zone, stress is too high for effective learning.

RISKING CHANGE
Taking action always involves risks
Breaking the Cycle of Stuckness requires your clients to leave their Comfort Zones and confront the real risks involved in making change. Help your clients prepare to take action by:
• Acknowledging that change is risky – Increased awareness is one of the first step to changing any behavior or belief.
• Exploring good risks vs. bad risks – For most substance-abusing teens, using and related behaviors are part of their Comfort Zone.
• Providing opportunities to practice safe risk-taking – Despite all evidence to the contrary, most substance-abusing teens are risk adverse.

CO-OCCURRING DISORDERS
Recent studies indicate that 80% or more of all substance-abusing teens have one or more diagnosable mental health conditions. In addition, these youth frequently present with histories of trauma, abuse, and/or neglect. If these co-occurring issues aren’t addressed, they are likely to become insurmountable obstacles to the process of change.

A BIT ABOUT AMBIVALENCE
To do or not to do
• Ambivalence – Simultaneously believing two seemingly contradictory ideas.
• Most teens start treatment ambivalent about change, believing “I have a problem” and “I don’t want or need to do anything about my problem.”
• Ambivalence is indicative of the Contemplation Stage of Change. It comes from being stuck in your Comfort Zone.

Ambivalence is not the same as denial. Denial is a defense mechanism that develops to psychically protect someone from their own maladaptive behavior or situations beyond their control. In most cases, substance-abusing teens haven’t been using alcohol or other drugs long enough to develop such a complex defense mechanism.

Ambivalence has two possible outcomes
• Reinforce the Cycle of Stuckness – By trying to ignore the contradiction, the person becomes more stuck. This leads to thinking errors such as blaming, minimizing, and ultimately denial.
• Create dissonance – Dissonance is an uncomfortable feeling caused by simultaneously holding contradictory ideas. This discomfort results in an urgency to change in order to resolve the discomfort.

USING EXPERIENTIAL LEARNING TO GET UNSTUCK
Getting unstuck requires a believing there is a reason to change, believing you have the ability to change, and possessing the desire to change. Experiential learning is an excellent methodology for building all three of these conditions.

Reason to change
Help your clients identify their own reasons for making change by manufacturing dissonance. Some ideas for this:
• Go new places – Hold learning experiences in unfamiliar environments. When not possible, think of ways to make the familiar seem new.
• Present experiences with uncertain outcomes – Don’t be afraid of failure. Activities should be achievable, but outcomes shouldn’t be guaranteed.
• Address contradictions – Challenge thinking errors as they happen, explore pros and cons, and coach clients in problem solving.

Ability to change
Clients are successful when they believe they will succeed. Self-efficacy can be increased in three ways:
• Magnitude – This refers to the level of certainty the individual has for success and is influenced by perceptions of risk and difficulty.
• Strength – This reflects how long a person holds onto expectations of success, even when contradictory information is present.
• Generality – This refers to the degree of a client’s transfer of new learning from one situation to another.

Desire to change
Motivation is a requirement for doing all this hard work. Continue to build motivation on three fronts:
• Autonomy – Autonomy refers to independence and self-determination. When given true autonomy, motivation increases dramatically.
• Mastery – Mastery is the belief that you can be effective. This is, of course, closely related to self-efficacy.
• Purpose – Purpose means commitment to something larger than yourself.

RECOMMENDED READING
The Art of Changing the Brain, by James Zull
This book is an easy to understand introduction to the neuroscience of change. It is packed with practical ideas that’ll change the way you facilitate!

Drive, by Daniel Pink
This book is groundbreaking in the area of motivational enhancement. It has a business focus, but is highly applicable to other fields.

Changing for Good, by James Prochaska, John Norcross & Carlo DiClemente
These authors created the Stages of Change model and this book presents that model stripped of clinical jargon.

Motivational Interviewing, by William Miller & Stephen Rollnick
This book presents an evidence-based approach to overcoming ambivalence. Not the easiest read around, but definitely worth the effort.

Join Me In Montreal

I'm getting ready for the Association for Experiential Education's International Conference, to be held October 29 to November 1, 2009 in Montreal, Quebec.

On Sunday, November 1, I'll be presenting From Ambivalence to Action: Facilitating Change in Substance-Abusing Teens. Change is a journey, and during this 3-hour Professional Development Intensive, we’ll explore the use of experiential learning to transform this journey into one that is affirming, memorable, and life altering. We’ll look at evidence-based approaches to fostering change in others, experiential learning in treatment settings, the role of processing, and the neuroscience of it all.

I'll also be presenting Processing with Teens. This 90-minute workshop is for any experiential facilitator who works with teens and has ever wondered, “Why won’t they talk?” We’ll explore common reasons teens can be reluctant to process, practical ideas for breaking through that reluctance, and processing strategies guaranteed to increase participant engagement. Along the way, we’ll look at developmental considerations, ideas for creating more intentional learning opportunities, and the neuroscience of it all.

To find out more about AEE and this upcoming conference, visit their web site.

I hope to see you there!

Jittery and Paranoid is My Normal

Recent studies indicate that adolescents who engage in substance abuse are highly likely to present with a variety of mental heath issues. These include conduct disorder, attention deficient disorders, mood disorders, and anxiety disorders (Brown, p. 1). When this happens, the adolescent is considered to have co-occurring disorders.

In my experience, anxiety disorders are among the most common mental health challenge in this population. I’ve found that it is also common for anxiety disorders to “travel with” other mental health challenges. In other words, a youth would have a substance-related disorder, a primary mental health challenges (such as depression), and an anxiety disorder.

In this post I’ll be looking at causal issues related to co-occurring anxiety disorders and substance abuse among adolescents. Before proceeding, though, defining the terms anxiety disorder and substance abuse is warranted. Evans and Sullivan wrote that that the defining features of anxiety disorders are “anxious arousal and avoidance of the anxiety-provoking situation.” They then identified several specific conditions that are considered anxiety disorders. These include panic disorder with or without agoraphobia, agoraphobia, social phobia, specific phobia, obsessive-compulsive disorder, post-traumatic stress disorder, acute distress disorder, and generalized anxiety disorder (p. 115).

According to the DSM-IV-TR Desk Reference, a diagnosis of substance abuse requires at least one of the following: recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home; recurrent substance use in situations in which it is physically hazardous, such as driving a car or using heavy machinery; recurrent substance-related legal problems; or, continued substance use despite persistent or recurrent social or interpersonal problems caused or exacerbated by use (American Psychiatric Association, p. 115).

In my experience, adolescents with any mental health problem, especially anxiety disorders, frequently report self-medication as a primary reason for their use of alcohol and other drugs. It is not uncommon for these adolescents to report that substance use makes them “feel better” and causes their problems to “go away.” Alcohol and other drugs can, indeed, be effective in this regard, but as we shall see, this is only temporary relief.

In the long term, substance abuse actually increases anxiety symptoms. Meanwhile, the youth has likely not developed other more adaptive coping skills. Often this leads the adolescent to do the only thing that has worked in the past, abuse more substances, leading to a co-evolutionary cycle of increasing abuse and anxiety disorders.

For adolescents stuck in this loop, an integrated treatment strategy can be essential to end the cycle. This requires an understanding of both substance abuse and anxiety disorders, as well as the complex interconnections between them. In a future post, I’ll explore the use of experiential learning to develop emotion regulation and distress tolerance skills.

Which Came First?
According to Brown, approximately two-thirds of all adolescents enrolled in a substance abuse program meet the diagnostic criteria for at least one mental health problem (p. 1). Other studies have suggested up to 90% of teens in treatment warrant a mental health diagnosis. Most prevalent are anxiety disorders (Evans & Sullivan, p. 117). In adolescents, co-occurring substance abuse and mental health disorders most often reflect common risk factors, such as genetic predisposition or environmental influences, for both problems.

However, this is not always the case. Some studies have shown that one problem can cause or exacerbate the other (Brown, p. 1). Even moderate use of alcohol and other drugs has been shown to increase anxiety symptoms (Evans & Sullivan, p. 117), and conversely adolescents with an anxiety disorder have an increased likelihood of substance abuse problems (Evans & Sullivan, p. 147).

From a clinical perspective, it can sometimes be useful to determine which can first, the anxiety disorder or the substance abuse. Either way, though, adolescents can quickly enter into a seemingly endless looping cycle of substance use leading to increased anxiety which then leads to attempted relief through additional use.

Evans and Sullivan wrote, “Individuals with severe anxiety use substances to seek relief, and this can start the abuse cycle. Taking a drink or tranquillizers ‘just in case’ becomes behavior that reinforces avoidance” (p. 117). As we saw in the definition above, this avoidance is considered a diagnostic criterion for a clinical diagnosis of an anxiety disorder. As such, not only can substance abuse be problematic itself, it could actually be considered symptomatic of an anxiety disorder.

“Mark,” a client with a history of early childhood abuse, substance abuse and two recent physical assaults, said, “My whole life I’ve felt like I never knew what would come next. Getting high didn’t make that stop, I just cared less.” Ironically, both of Mark’s recent assaults occurred while he was under the influence of alcohol. Thus, although Mark used alcohol and other drugs in an attempt to seek relief from his anxiety, his substance abuse actually increased the likelihood of him being exposed to traumatic experiences, further perpetuating the cycle of anxiety and substance abuse.

This cycle is quite common. Indeed, I’ve worked with adolescents who have suffered a wide variety of trauma and environmental stressors while under the influence, attempting to obtain alcohol or other drugs, or as a direct result of their substance abuse. These include engaging in prostitution, sexual assaults, physical assaults, severe injuries, homelessness, and incarceration.

As Long As I’m High, Everything Seems Okay
In my experience, youth with anxiety disorders have an especially difficult time committing to, engaging in, and remaining abstinent during and after treatment. Most often, I see this expressed through high levels of ambivalence regarding treatment, poor attendance at group sessions, and frequent situational relapses. These observations are supported by studies that indicate anxiety disorders are associated with a variety of adverse outcomes, including school drop out, poor treatment outcomes, and the development of other mental health disorders (Romer & Walker, p. 219).

Sustained exposure to environmental stressors has been shown to lead to a diverse range of high-risk conditions, including anxiety and “dysfunctional cognitive processing of potentially threatening stimuli” (Romer & Walker, p. 149). I have frequently had adolescent clients report situations or behaviors that are clearly dangerous, with an apparent lack of understanding about the dangers involved. “Sam,” a sixteen-year-old client is a good example. Sam has a history of using stimulants and then engaging in dangerous activities such as mountain biking. Initially, he denied the risk involved in his behavior, even when confronted about it. Although there may be a developmental aspect to this, based on a history of early childhood neglect it seems likely that dysfunctional cognitive processing may have played a part in Sam’s decision-making process.

If environmental stressors lead to dysfunctional cognitive processing, it seems likely that additional stress or anxiety could be created. In other words, anxiety that is ignored will likely lead to more anxiety. For an adolescent caught in such an anxiety loop, the use of alcohol and other drugs could be considered a reasonable response.

“Sarah” has diagnoses of Generalized Anxiety Disorder and Cannabis Dependence, plus a history of self-harming behavior and disordered eating. She said, “When I smoke weed, all the anxiety goes away. I don’t want to cut. I don’t want to purge. As long as I’m high, everything seems okay.” Anxiety is considered pathological when it “disrupts functioning and interferes with the successful completion of daily living tasks… [and] when the degree of distress is extreme, in terms of intensity, frequency, and duration” (Romer & Walker, p. 221). For Sarah, this level of disruption is clearly evident.

Even when anxiety does not rise to a diagnostic level it can still be problematic in the lives of adolescents. Based on my experience, even clients who do not exhibit diagnosable anxiety disorders frequently present a heightened level of anxiety and poor skills at dealing with stress. This is supported by the observation that adolescence is “marked by heightened vulnerability for affective dysregulation and distress” (Romer & Walker, p. 219).

Both affective dysregulation and distress can be considered an expected part of adolescence, a result of normal brain development. However, when an adolescent is predisposed to mental health challenges or when substance abuse complicates this normal developmental process, problems can occur, especially if the individual has been exposed to significant environmental stressors during early childhood.

Environmental Stressors in Early Childhood
Research indicates that adolescents who enter substance abuse treatment are more likely than their peers to have experienced childhood neglect, abuse, and other significant family problems (Riggs, p. 19). In fact, these types of stressors have been found in studies to be “a powerful predicator of alcohol and other drug abuse” in both adolescents and adults (Romer & Walker, p. 392). In addition, early childhood environmental stressors—especially abuse and neglect—are closely “correlated with increased incidence of psychiatric illnesses,” including anxiety disorders (Romer & Walker, p. 350).

“Adversity in early life alters the development of neural systems in a manner that predisposes individuals to disease in adulthood,” both physical and psychiatric (Romer & Walker, p. 149). In addition, “childhood adversity, in the form of trauma, neglect, deprivation, or abuse, may be especially harmful during critical periods in brain development… [E]xternal stressors impact the structure, organization, and activity of the CNS [central nervous system]” (Romer & Walker, p. 350).

Several laboratory studies on the impact of neglect and early childhood stress have been conducted on rats. “[M]aternal care [in rats] alters the expression of genes in brain regions that subserve emotional, cognitive, and endocrine responses to stress” (Romer & Walker, p. 161). This conclusion comes from a study that tracked levels of maternal care based on licking and grooming behavior exhibited, both natural variations and imposed differences. When less maternal licking and grooming occurred, the rat pups exhibited increased fearfulness, heightened HPA (hypothalamus-pituitary-adrenal) axis responses to stress, and reduced performances on tasks requiring sustained attention or declarative learning, especially when under stressful conditions (Romer &Walker, p. 163).

Romer and Walker stated that the HPA axis is “a neural system activated by stress” (p. 481). It is “sensitive to environmental challenges and is activated in response to physical and psychological factors that threaten homeostasis” (Romer & Walker, p. 265). When activated, a chain of events occurs that leads to the release of cortisol, a hormone that increases blood pressure, blood sugar levels and has an immunosuppressive action (Romer & Walker, p. 478), helping to assure a quick return to normal functioning following stressful events.

The hippocampus is “the major center for conscious, declarative, explicit memory processing” (Siegel, p. 178). In rats, studies suggest that maternal care influences the development of the hippocampus by effecting the expression of genes involved in neuron survival and synaptic development (Romer & Walker, p. 155). If this is true in humans as well, then neglect and other early childhood environmental stressors could have negative impacts on the hippocampus. Indeed, the hippocampus has been found to be particularly vulnerable to the effects of trauma and environmental stress.

Siegel wrote that high levels of stress, especially when severe or ongoing, can block hippocampal functioning and even lead to “neuronal death” and decreased hippocampal volume (p. 50). Additionally, the use of alcohol and other drugs has been found to negatively impact the hippocampus (Romer & Walker, p. 393). This is true at all ages of life, but during adolescence the hippocampus may be especially vulnerable (Romer & Walker, p. 271). Here again, we can see the potential for a looping cyclic pattern. Stress leads to hippocampal impairment, leading to decreased ability to endure anxiety, leading to substance abuse in an attempt to self-medicate, resulting in further impairment of the hippocampus.

Moving Into Their Teens
When individuals already exposed to significant childhood stressors move into adolescence, they face a new cascade of problems. These can include a higher incidence of mental health disorders, school-related concerns, placement in separate classes, and increased association with peers who exhibit similar maladaptive issues. This cascade of life problems frequently results in youth with limited academic success, a continued escalation of behavioral problems, social marginalization, interactions with deviant peers, and a significantly increased likelihood of substance abuse (Riggs, p. 19).

In addition to these new environmental concerns, it is likely that the “neurobiological alterations associated with early adverse experience confers vulnerability or sensitizes” the individual to the future development of various anxiety disorders (Romer &Walker, p. 350). Studies have shown that “deficient neurocognitive function may also be associated with increased risk for alcohol and other substance abuse” (Romer & Walker, p. 446). Here again we see a cyclic loop of problems as adverse childhood experiences, anxiety disorders, and substance abuse co-evolve in the lives of high-risk youth.

An additional factor in this co-evolution is brain development. For an adolescent already suffering the negative impacts on the hippocampus due to early childhood environmental stressors, the additional impact caused by these problems would contribute to the looping cycle of anxiety and substance abuse that we have already seen. This cycle can be readily seen in many of my client’s life histories. One example is “Andrew.”

By the time he was three-years-old, Andrew’s parents were both heroin dependent and the family was homeless, living in a car. It is reasonable to make two assumptions at this point. First, the environmental stressors caused by addicted parents and homelessness had already negatively impacted his hippocampus and general brain development. Second, with both parents being heroin dependent, Andrew was born with a high genetic predisposition for addiction.

At four-years-old, Andrew witnessed the death by overdose of both parents. With no relatives to provide care, he entered the foster care system. Between the ages four and fifteen, he had over a dozen different placements. Andrew reported, “I was moved around so much that I wouldn’t even unpack my suitcase.” Not surprisingly, his behavior became increasing maladaptive. He reported first use of alcohol at age eleven and first use of marijuana shortly thereafter. At thirteen he went to detention for the first time. At fifteen, he ran away from the group home where he was living.

When I met Andrew at sixteen, he had just moved into a shelter after being homeless for almost a year. He reported two recent assaults and had mental health diagnoses that included PTSD, Conduct Disorder, ADHD, and Major Depressive Disorder. He also had diagnoses for substance abuse disorders including Alcohol Dependence, Cannabis Dependence, and Amphetamine Abuse. In addition, he had difficulty remembering details, time frames, and other factual information.

Andrew reported that using “makes me feel normal,” even though he acknowledged amphetamines made him “jittery and paranoid.” With a blank look he continued, “I guess jittery and paranoid is my normal.”

Substance abuse and mental health counselors frequently attempt to determine which came first, the substance abuse or the mental health issues. As we can see with Andrew’s case, as well as the others presented in this paper, it is often not that simple. Co-occurring substance abuse and anxiety disorders are often not progressive. Instead, they are frequently an intricate, co-evolving, cycling loop. Breaking that loop requires addressing both problems.

Works Cited
American Psychiatric Association. (2000). Desk Reference to the Diagnostic Criteria from DSM-IV-TR. Arlington, VA: American Psychiatric Association.

Brown, S. (2008). Comorbidity. Retrieved May 26, 2008, from
http://www.drugstrategies.org/teens/comorbidity.html.

Riggs, P. (2003) Treating Adolescents for Substance Abuse and Comorbid Psychiatric Disorders. Science & Practice Perspectives, 18-28.

Romer, D. and Walker, E. (Eds.). (2007). Adolescent Psychopathology and the Developing Brain. New York: Oxford University Press.

Siegel, D. (1999). The Developing Mind. New York: Guilford Press.

Soft Skills

It seems to me that in the experiential learning field, facilitators are often hired for their "hard skills." In other words, they're hired because they possess specific, concrete knowledge--for example, rock climbing, orienteering, wilderness first response certification, and ropes course experience.

It is certainly understandable that program directors would seek these skills in potential new hires, but it seems to me that "soft skills" -- such as active listening, motivational interviewing, and an understanding of the neuroscience behind learning -- are equally important in a facilitator. In fact, it seems to me that these soft skills are vital to assure that experiential programming achieves it full educational or therapeutic potential.

If I was going to teach a soft skills course for experiential facilitators, this would be my reading list:

7 Kinds of Smart, by Thomas Armstrong
An accessible and easy-to-read introduction to Multiple Intelligences theory, this book will help broaden your perspective on what “smart” means.

The Art of Changing the Brain, by James Zull
This book is an easy to understand introduction to the neuroscience of change. It is packed with practical ideas that’ll change the way you facilitate!

Becoming Naturally Therapeutic, by Jacquelyn Small
Considered a classic in the substance abuse field, this book explores how to empathize without enabling, care without controlling, and help in a genuine spirt of giving.

Brain Rules, by John Medina
This book explores how the brain sciences can influence the way we teach, work, and live, including neuroscience basics and practical ideas for putting this knowledge to use.

Changing for Good, by James Prochaska, John Norcross & Carlo DiClemente
These authors created the stages-of-change model, an evidence-based approach to creating change. This book presents that model stripped of clinical jargon.

Motivational Interviewing, by William Miller & Stephen Rollnick
This book presents an evidence-based approach to overcoming ambivalence. Not the easiest read around, but definitely worth the effort, especially if you work with clinical populations.

The Primal Teen, by Barbara Strauch
If you work with teens, this book is a must! In this book, Strauch looks at adolescent brain development in an entertaining and readily accessible manner.

The Processing Pinnacle, by Steven Simpson, Dan Miller & Buzz Bocher
This book presents a practical model for processing that will help further develop your skills at processing.

Processing the Experience, by John Luckner & Relden Nadler
A classic text in the experiential education field, this book is filled with both good theory and practical ideas. It is currently out of print, but fairly easy to find online.

The Resilient Self, by Steven Wolin, M.D. & Sybil Wolin, Ph.D.
An accessible book on fostering resiliency in yourself and others, by founders in the field.

Do you know of a book that should be included on this list? Let me know!

Outside the Comfort Zone: Dissonance & Self-Efficacy as Mechanisms of Change

Beard and Wilson define experiential learning as “the sense-making process of active engagement between the inner world of the person and the outer world of the environment” (p. 19). It is during this sense-making process that a state of dissonance can develop and that change will most readily occur. However, change does not happen solely through experience. If an experience serves solely to confirm already held beliefs, it won’t serve as a catalyst of change. Instead, it will simply reinforce the individual’s current cognitive processes (Beard & Wilson, p. 20).

It seems to me that the facilitator’s goal during an experience should be to assure that learning opportunities occur during this sense-making process of active engagement. With this in mind, perhaps the facilitator must purposefully introduce a state of dissonance into the activity. Dissonance creates confusion, and “the act of restructuring or reordering to regain balance… is where change in feelings, thoughts, attitudes, and behavior patterns occur” (Luckner & Nadler, p. 23).

One way for a facilitator to create this dissonance is by holding the learning experience in an environment that is unfamiliar to the participants. This approach is commonly used in adventure programming, where the participants are placed outdoors in an unknown setting. In-patient treatment programs are also unknown settings, of course, so serve as another example of environmental dissonance being created.

This summer, I will again be leading a series of hikes with my clients. One goal of these hikes is to place them into unknown settings. Opportunities like summer hikes are often scare scarce or seasonal in many clinical settings. That means it is important to look for other ways to create dissonance. Presenting experiences with uncertain outcomes can do this.

Ropes courses and initiative activities are example of this, since participants are unsure if they will be able to successfully complete the challenge. In my experience, some clinicians only use activities that they know the participants will be able to successfully complete. I believe this is appropriate for some clinical applications of experiential learning, such as illustrating a concept or improving group cohesion (see my post “Experiential Activities in Clinical Settings,” November 2008).

However, I strongly believe doing this is a sort of codependency that is not in the best interest of the participants. For teens in treatment, failure is a real possibility and avoiding experiences with unknown outcomes is a disservice. In fact, I strongly believe that the greatest learning can come from a failed activity—as long as it is adequately and appropriately processed. In a treatment setting, it is easy to connect failed or uncompleted activities to relapse, but there are many other rich processing possibilities.

Presenting the Possibility of Success
Whatever the experience, it is the unknown aspects of the activity that force the participant to leave her Comfort Zone and enter into a state of dissonance (Priest & Gass, p. 146). Through successful completion of an activity, through going outside a position of comfort, the participant’s dissonance will decrease. For example, when on a challenging mountain hike, a timid or fearful participant is likely to expect a negative outcome. Perhaps he will fail at the activity, perhaps he will be injured, perhaps he will not be as good as his peers, or perhaps a wild animal will attack.

When none of these negative outcomes occur, the participant is confronted with a new indisputable possibility: perhaps he can be successful. As a result, he is presented an opportunity to alter his future expectations. If an opportunity is also presented to generalize this learning, these changed expectations may be extended to all dimensions of his life.

A former client, Marie, serves as a useful example. Although not fearful, she was extremely resistant to the weekly hikes that were part of her inpatient treatment program. On a couple occasions, she claimed to be sick in an effort to avoid them. Throughout the hike, she would make negative comments, stating she could not or would not go any further. One time, she actually sat down on the side of the trail and for nearly 30 minutes refused to continue. However, when we hiked Little Si, one of the most difficult hikes we made and one of her last outings while in treatment, she actually encouraged other clients by saying, “If you can complete this hike, you can stay clean!”

Priest and Gass wrote, “The mastery or competence produced by successfully resolving the adaptive dissonance presented by a situation motivates behavior change” (p. 152). This motivation to change her behavior can be seen in Marie. Through the weekly outings, not only did she come to believe that she was able to successfully complete even a challenging hike, she took on a leadership role by becoming a source of encouragement to her peers. Indeed she went a step further, connecting her ability to complete the hike to her ability to accomplish other difficult goals, such as staying clean.

Luckner and Nadler wrote that central to experiential education is the idea that “we encourage people to try things that they wouldn’t generally do on their own. In other words, they leave their safe, familiar, comfortable and predictable world for uncomfortable new territory” (p. 28). This is certainly true also for substance abuse treatment! With that in mind, I frequently talk with my clients about Growth Zones, a model common in experiential learning. In my version, these three concentric circles consist of the individual’s Comfort Zone in the middle, then the Change Zone as the middle ring, and the Crisis Zone as the outside ring.

By default, an individual’s Comfort Zone contains only what is already known, feels safe, and presents no challenges or distress. It is only when an individual leaves his Comfort Zone that learning and change can occur. By doing this, though, dissonance is created, and with the dissonance comes discomfort. By working to eliminate the discomfort caused by the dissonance experienced when leaving your Comfort Zone, the change process can occur. This is true even with resistant participants like Marie, who are initially unwilling to even consider leaving her Comfort Zone.

The Role of Self-Efficacy
Important to this change process is the idea of self-efficacy. Perceptions of self-efficacy have three dimensions: magnitude, strength, and generality. Magnitude refers to the level of certainty the individual has for success (Priest & Gass, p. 55). This is primarily influenced by the participant’s perceptions of risk, as well as the perceived difficulty of the experience. Many experiential learning activities are purposefully designed to present a high apparent risk level.

This perceived risk often includes both the risk of failure and physical risks. I have heard ropes course participants say, “We can’t do this” or “I’ll break my leg if I even try that!” As important as a perceived risk of possible failure or injury is the possibility of social risks, or looking inadequate or incapable in front of peers. With all three perceived risks, successful completion of an activity that initially seemed impossible has a high likelihood of increasing perceptions of self-efficacy. Marie perceived our weekly hikes as highly challenging in all three ways. As such, her repeated successes on these hikes dramatically increased the magnitude of her self-efficacy.

Strength reflects how long a person holds onto expectations of success despite contradictory information (Priest & Gass p. 55). A history of succeeding after multiple unsuccessful attempts can play an important role in building strength. Although Marie completed every hike she participated, she frequently reported, “I’m just not good at outdoor stuff. That’s why I hate nature.” Her past experiences clearly influenced her perceptions of her own ability. However, through her repeated successes on hikes while in treatment, she was able to move past her unusual self-limiting beliefs, thereby contributed to the strength of her self-efficacy.

Generality refers to the degree of an individual’s transfer of self-efficacy beliefs from one situation to another (Priest & Gass, p. 55). Transfer is the integration of learning from the adventure program into the participant’s life (Priest & Gass, p. 184). In clinical setting, I believe this is the most important concept of the three, and an area when strong facilitation skills are especially vital. To assure that change happens as a result of participation in an experience, transfer of learning must occur.

For Marie, successfully working through her own dissonance provided an important opportunity for her to increase her sense of self-efficacy. As this increased, her engagement in processing grew. Initially, she would say little during debriefing sessions, even when called on directly. Toward the end of her treatment, not only was she increasingly vocal during debriefings, during hikes she actively encouraged her struggling peers.

“When clients enter into adventure programs that focus on change, they may strongly resist [that] change… Adventure experiences often reduce such resistance by placing clients in situations that are new and unique, yet supportive” (Priest & Gass, p. 148). Marie’s initial resistance to change is clearly evident. She was taken out of her Comfort Zone, and repeatedly placed into new and unique situations that she considered risky. In her efforts to reduce the dissonance she felt, she was forced to reconsider her preconceived views. Through opportunities to process her experiences, she generalized her learning to other areas of her life and began to believe in her ability to accomplish other meaningful goals, such as staying clean after treatment.

Works Cited
Beard, C. & Gross, J. Experiential Learning: A Best Practice Handbook for Educators and Trainers. Philadelphia: Kogan Page, 2006.
Luckner, J. & Nadler, R. Processing the Experience. Dubuque, IA: Kendall/Hunt Publishing Co., 1997.
Priest, S. & Gross, M. Effective Leadership in Adventure Programming. Champaign, IL: Human Kinetics, 2005.

It’s About The Climb, Not The Destination

In all forms of experiential education, transfer of learning is considered a vital part of the process. Necessary for fostering change, this transfer involves the integration of learning from the experience into the participant’s life (Priest & Gass), in order to allow for generalizing that experience to daily events. In other words, in clinical settings transfer of learning answers the question, “What does this have to do with recovery?”

To assure transfer of learning occurs, processing is an essential component of all experiential education programs (Luckner & Nadler, p. 8). In their book, The Processing Pinnacle, Simpson, Miller and Bocher identify a variety of goals when processing. I believe that most important of these in a clinical setting are assuring participants understand the lessons of the experience, analyzing and synthesizing the action, helping give the experience permanence, and transferring the learning to daily life (p. 19).

To help assure these goals are met, the authors present a model they call “the processing pinnacle,” an approach they initially present as a continuum and then later transform into a mountain. At one end is facilitator-centered processing with the leader retaining complete control of the processing. At the other end of the continuum is participant-centered processing, with all processing tasks relinquished by the leader (p. 59).

The authors identified four specific points along this continuum: facilitator frontloading, traditional question and answer, participant-directed processing, and independent reflection.

Facilitator Frontloading
Facilitator front-loading is farthest to the facilitator-centered side of the continuum. In this approach, the leader explicitly states the purpose of the activity before it even takes place, spelling out exactly what will be experienced and learned. When frontloading occurs, reflection generally happens throughout the activity, either during pauses for discussion or as the activity proceeds (p. 59).

As I initially read this book, facilitator frontloading seemed heavy-handed to me, and I didn’t think it fit at all with my personal facilitator style. However, I do frequently use metaphors as a way to frontload an activity, and that use often shapes the experience for the participants. In addition, I always do a lot of in-the-moment processing.

For example, I sometimes frame Trolleys, a common experiential activity, with recovery metaphors, giving participants the task of crossing the Sea of Relapse using the skills they have learned in treatment (the trolleys themselves) and arriving at the finish line, Long-Term Sobriety.

To me, this type of metaphor-rich framing isn’t necessarily as heavy handed as the authors’ definition initially seems. However, it certainly fulfills their definition. In discussing the use of metaphor in frontloading, they state, “The more ways and more times that a metaphor gets linked to everyday life, the more effective it will be” (p. 88). For example, during Trolleys-As-Recovery, I encourage participants to take things “one step at a time” and to not “future-trip” about getting to the end.

In some settings, this sort of predetermined shaping of the activity could clearly limit outcomes. However, when frontloading isn’t heavy-handed, it seems to me that this processing approach can be extremely appropriate within a clinical context where a specific goal has usually been determined in advance. Indeed, moving participants toward a specific goal is most often the point for doing an activity.

Traditional Q & A
The next on the continuum is traditional question and answer, in which the facilitator leads a discussion following the activity. This discussion includes input from both the facilitator and the participants, but is leader-driven. The leader chooses the questions, calls on specific participants, and guides the discussion in a predetermined direction (Simpson, Miller & Bocher, p. 60).

The authors state that this is the most common of all processing styles, but in clinical settings I attempt to avoid this traditional question and answer approach entirely. I’ve found that with youth in treatment, it is usually most effective to provide some structure to the processing. However, I want to do this in a way that isn’t facilitator-oriented. In my experience, participant-directed processing approaches work well for balancing these seemly contradictory goals.

Participant-Directed Processing
This third point on the continuum involves processing where “the direction of the discussion and reflection is determined by the participants, not the facilitator” (Simpson, Miller & Bocher, 2006, p. 61). One example of this approach is processing cards.

About a two year ago, I started using Chiji Processing Cards, a deck of 48 cards with different images on them such as a lighthouse, a compass, and a piece of shattered pottery. The most typical way to use these cards as a processing tool is to spread them out and ask participants to “pick a card that represents your role in the group today” or a similar prompt. I have found these cards to be a powerful processing tool, encouraging even the most reluctant participants to speak.

Teens in treatment can sometimes be challenging to get talking, and it seems to me that this approach helps that to happen. As such, I use a lot of other participant-directed and active processing approaches. I have another post on this blog -- Talking Despite Themselves -- that addresses this topic in more detail.

Independent Reflection
The final point on the processing continuum, independent reflection, is what the authors called “processing in the intentional absence of formal processing” (p. 60). In Outward Bound, this approach is common and frequently referred to as “letting the mountain speak for itself.” I feel there may be times, places, and participant populations were this approach is appropriate. However, it seems to me that not providing a formal processing opportunity of some type in a clinical setting would be therapeutically inappropriate.

Time for transfer of learning is a necessary part of the therapeutic process, and I believe some formal processing should always occur. However, authors wrote, “Even though it might be used rarely, [independent processing] is the appropriate processing methodology when a particular set of conditions has been met” (p. 125). They define these conditions as an appropriate setting, that participants have a strong commitment to the experience, that participants have the requisite knowledge to understand the significance of an experience, and that the group has prior training in processing.

I suppose that if these four conditions were all present in the entire participant population, it might be appropriate to have the group sit quietly on a mountain top watching a sunset and consider that a processing experience. Even then, though, the counselor in me would follow up the independent reflection time with a short group process of it.

Climbing the Mountain
I see processing as an important part of experiential learning. In fact, it may be the most important part, since it provides participants the opportunity to develop awareness, identify thinking patterns, and practice mindfulness—all skills I believe essential for recovery. In a clinical setting, it seems to me that the activity is often less important than the processing opportunities it provides. In other words, climbing a mountain is not about reaching the pinnacle, but about what happens along the way.

Early in the book, the authors wrote, “According to Chinese Tao thinking, action and reflection cannot exist without each other” (p. 18). I found this book interesting and practical in many ways, providing a comprehensive system for viewing various processing methodologies. Independent reflection is one extreme end of a spectrum, and fostering movement toward independent processing has obvious value. After all, a client will eventually no longer be a client, and the skills learned in a clinical context need to transfer to life.

That said, the authors failed to convince me that achieving independent reflection should be the ultimate goal of processing, at least within a clinical context. Getting to the pinnacle is not what’s important in a learning experience. Working toward the pinnacle is. Without a formal processing experience of some sort, it seems to me that this dialectic of action and reflection will not be assured, and transfer of learning may not occur.

Work Cited
Luckner, J., and Nadler, R. (1997). Processing the Experience. Dubuque, IA: Kendall/Hunt Publishing Company.
Priest, S., and Gross, M. (2005). Effective Leadership in Adventure Programming. Champaign, IL: Human Kinetics.
Simpson, S., Miller, D., and Bocher, B. (2006). The Processing Pinnacle. Oklahoma City, OK: Wood’n’Barnes.

Puzzle Pieces

I've recently read two books, Beautiful Boy and Tweak. Beautiful Boy, by David Sheff, is about the author’s struggles with his son Nic’s addiction, as well as his own denial and codependency. David wrote, “Addicts are in denial and their families are in it with them because often the truth is too inconceivable, too painful, and too terrifying” (p. 15). One aspect of this book I found especially interesting is the way the author integrates three different threads—his son’s addiction, general information on chemical dependency, and his own growing codependency. Tweak, by son Nic, provides another perspective.

While Beautiful Boy covered Nic’s entire life, Tweak covers about two years when Nic is in his early twenties, starting with a relapse that becomes a 28 day methamphetamine and heroin binge, followed by a stint in at an inpatient facility, about a year of clean time, another relapse, and another stint at an inpatient facility. While Beautiful Boy contains much confusion and helplessness, Tweak is about anger and desperation.

Throughout Beautiful Boy, David reports on his ongoing attempts to talk Nic into treatment for one more try. Like most addicts, Nic does not believe he needs treatment and does not believe it will help. Considering at least four treatment attempts are documented in David’s book, Nic’s skepticism seems understandable. It hasn’t worked before, why will it this time? This is something I face with clients frequently.

Most of my clients have been in treatment before, some several times. In fact, I’m currently working with a client who has completed inpatient twice in the past, has been in three different outpatient programs, and has been to mental health therapists off and on for nearly five years. This client is now eighteen and court mandated. Failure to follow through with all treatment recommendations would most likely lead to jail time. So he reluctantly agreed to begin treatment one more time, but he reported, “It probably won’t do any good.” Why would he think otherwise?

There is another level to Nic’s ambivalence, though, which seems quite common. Nic wrote, “Using is suck a fucking ridiculous little circle of monotony. The more I use, the more I need to kill the pain, so the more I need to keep using. Pretty soon it seems like going back, facing all my shit, well, it’s just too goddamn overwhelming. I’d rather dies than go through it” (p. 146).

At a certain point, using is no longer about getting high or the initial positive reinforcements. Instead, it becomes about escaping—at least temporarily—from the ever-mounting number of negative outcomes of using. It seems easier to just keep using. Nic wrote, “I don’t care. Isn’t that the greatest gift in the world—just not to care? I feel so grateful for it. That’s nothing I ever knew sober” (p. 60). Why give that up? For many of my clients, that’s the biggest question that needs answering in treatment.

Getting clean is hard work. It means changing everything in your life. It also means taking huge risks. Nic wrote, “Trying is terrifying because I know I will just fail” (p. 296). Nearly all my clients know that feeling. Nearly all my clients have made very similar comments. What if they say they want to get clean, but then can’t actually do it? What if they take that risk, but then fail? If they don’t try, then there's no possibility of failure. My clients know how to use. They've never failed at using. That sounds strange, perhaps, but addicts understand. And, that “circle of monotony” may be a bit of a bore, but at least it is predictable.

Many of my clients live in highly dysfunctional families, frequently filled with the chaotic fallout of substance abusing parents, family members with mental health issues, economic pressures, and similar stressors. For these youth, the predictable circle of monotony can have a certain appear. As a client once said, "I use. I get high. No surprises."

Chaos is not Nic’s history, though. Although divorced, both parents are successful and his childhood appears reasonably healthy. He went to private schools. He was successful and popular as a child, active in sports and other extracurricular activities. He doesn’t seem like a future meth addict. So what happened? I wondered that the entire time I was reading Beautiful Boy. I wondered that through much of Tweak.

Nic has a certain level of genetic predisposition, a grandfather who was an alcoholic. However, one grandparent who died before he was even born doesn’t seem enough to me, even though Nic wrote about his first using experience, with alcohol, “I drank some and then I just had to drink more until the whole glass was drained completely. I’m not sure why. Something was driving me that I couldn’t identify and still can’t comprehend” (p. 2).

Although this sounds very disease-like, I don’t believe in the disease model all that much, especially for adolescents. There must be more. There must be a missing puzzle piece. If Nic finds that missing puzzle piece, maybe he can get and stay clean. If I can help my clients find their missing pieces, maybe they can get and stay clean, too.

Maybe recovery is really about finding missing puzzle pieces.

In Beautiful Boy, this missing piece is not addressed. David is simply too helpless to look beyond the next crisis. In Tweak, though, it seemed obvious fairly quickly that Nic might have mental health issues. At first, I wondered if I was looking for this because of my work experience. After all, my clients all have co-occurring disorders, I’ve always worked with co-occurring clients, and I feel strongly that most adolescents with significant substance abuse issues probably have challenges in this area.

Much of Nic’s writing reflects a depressive state. At other times, though, he seems almost manic, even though it usually seems related to his use of meth. Nic wrote, “I… have an incredible anxiety socializing with people. I mean, if I’m at work, or I’m high, then that’s okay. But sober, going out with people my age, I am just really uncomfortable.” (p. 161). Eventually, after all his other treatment episodes, all the therapists he’s seen in his life, past diagnoses of depression and prescriptions for antidepressants that he simply abuses, and all the time spent high, Nic is given a diagnosis of bipolar disorder.

In my opinion, bipolar disorder is the new overly diagnosed condition. However, when accurately applied, I’ve seen treatment for this condition change lives dramatically. After two weeks on medications for bipolar disorder, Nic wrote, “Something has changed. And then it hits me—maybe it’s the medication… Sure, the change isn’t very dramatic. It’s no like shooting meth or something. But there is a slight difference. Keeping my head above water suddenly doesn’t seem so tiring. The blackness doesn’t swallow me up to such a horribly suffocating depth” (p. 204).

Both Beautiful Boy and Tweak can be grueling. David seems to often be lost in his helplessness and codependency, unable to live his life or even care for his other children. Indeed, David frequently wrote that he is addicted to Nic’s addiction. This is apparent throughout his book. This is also something I see frequently in the family members of clients.

Reading the relentless passages about using, crime, prostitution, and self-inflicted trauma is almost unbearable at times. After being diagnoses with bipolar disorder, Nic wrote, “How could I have spent my whole life battling so hard, not knowing what was wrong?” The better question, I think, is how could so many therapists, treatment centers, and other counselors have missed that puzzle piece?

With some of my clients, treatment is about learning skills to resist using. That's pretty simple. For other clients, though, there's much more. They know these skills. Heck, they could lead group sessions on triggers, relapse prevention, emotion regulation, and mindfulness. But, they still use. There's something missing in their recovery. They haven't found their puzzle piece. Yet.

Riskier Risks

I’ve recently re-read The Primal Teen, by Barbara Strauch, to help me prepare for an upcoming workshop I’ll be presenting. In the book, Strauch presents findings from several studies showing that the human brain undergoes “dramatic changes around puberty and early adolescents” ( p. 15).

These changes include a thickening of the outer layer, which then thins suddenly and significantly. This thickening is thought to be the result of an “overproduction” of brain cells. Many scientists believe that during this overproduction, “the brain may be highly receptive to new information” (Strauch, p. 15).

While this overproduction is happening during adolescents, there is also a significant amount of synaptic pruning, explaining that sudden thinning. Strauch states that “some dendrite branches and their synapses develop and thrive simply because they’re used the most and grab the most neurochemical juice” (p. 17). On the other hand, less used or unused branches and synapses tend to get pruned.

Life experiences determine which synapses get used and which do not, thereby “impacting the brain’s essential architecture” (Strauch, p. 17). Siegel conceives of the mind as separate from the brain, stating, “The human mind emerges from the activity of the brain, whose structure and function are directly shaped by interpersonal experiences” (p. 1). He continued, “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).

However, while experience is shaping the brain during adolescence, “it remains more exposed, more easily wounded, perhaps much more susceptible to critical and long-lasting damage than most parents and educators or even most scientists had though” (Strauch, p. 21).

Taking Risks
It seems to me, based on my experience working with high-needs teen, that this critical time of brain development is also a time of risk-taking and impulsive behavior. In other words, while the brain is at most risk, the likelihood of risk taking is highest. Strauch states, that high impulsivity is “one of the world’s stereotypes about teenagers that just happens to be true” (p. 24). This is true, at least partly, because the frontal lobes, part of the brain that is used to resist impulses, is not yet fully developed in an adolescent’s brain (Strauch, p. 26).

So, all teens are impulsive. That’s not really news. However, this developmental appropriate impulsiveness can manifest itself in extremely different ways.

What is different between “Alex,” a seventeen year old neighbor kid who is on the soccer team, vice president of his class, and planning to attend UW next fall, and “Carl,” a seventeen year old client who has an extensive criminal record that includes auto theft and drug dealing, a history of unsuccessful chemical dependency counseling, and an alphabet soup listing of mental health diagnosis including ADHD, PTSD, and ODD?

Oh, if you saw Carl on the street, you’d think he was in his early 20s, not 17. If you talked to him, though, you’d think he was about 13. It is also important to know that when Carl was four years old, his family was living in their car when he witnessed the death by overdose of both parents. He’s spent most of his life being shuffled between group homes or on the run.

Is the differences between neighbor kid Alex and Carl a case of use-it-or-lose-it synaptic pruning? Carl’s past experiences have certainly had significant influence on his current multi-dimensional challenges, but it seems to me there must be more.

When asked, Carl describes his past risky behaviors—from stealing cars to having unprotected sex—by stating that such behavior “gives me a rush you just can’t believe.” Strauch cites several studies that suggest risk-taking in teens is developmentally necessary, a way to test boundaries and explore autonomy. In addition, adolescent risk taking involves “complex interactions across several brain systems of motivation and reward, including those that involve the neurotransmitter dopamine—one of the key brain chemicals that carry and influence the messages between nerve cells” (Dahl, qtd in Strauch, p. 92). However, not all teens steal cars, deal drugs, become meth addicts, and end up as my clients—even when they have pasts similar to Carl’s.

Could the answer be that Carl has an imbalance in dopamine that compels him to take riskier risks? Could the answer be that having physically matured earlier than his peers he has a particular vulnerability because his brain is “an engine without a driver” (Dahl, qtd in Strauch, p. 96). The answer to these questions would seemingly suggest very different treatment strategies.

If Carl has a chemical imbalance, medication would probably be an appropriate treatment approach. If he simply needs to mentally catch up with his physical development, perhaps he simply needs to be kept safe until this happens. That might suggest he needs a more structured environment, as his current home environment is clearly not preventing him from engaging in risky, even life-threatening, behavior. Or, maybe he just needs better choices of risky behavior. Could activities such as hang gliding, snow boarding, mountain climbing, and auto racing “cure” Carl?

Riskier Risks
All teens do not become chemically dependent car thieves. However, it does seem to me that, in general adolescents today take riskier risks than in the past. I hypothesize that there are three inter-related reasons for this. First, adolescence starts earlier than ever before, with the onset of puberty at eleven or twelve in many cases. That means youth are younger when physical development begins and their drive for autonomy surfaces. However, the onset of cognitive development, especially problem solving abilities, has remained consistent. This leads to physical maturity without cognitive maturity. I have certainly witnessed this with Carl and other clients.

Second, adolescence ends later, both physically and culturally, generally not ending until the early 20s (or even later). Combined, these factors have led to a significantly longer period of time spent within The Danger Gap, that space where physical development has raced significantly ahead of cognitive development.

Finally, there's the third reason: risks lurking within that Danger Gap are riskier today than ever before. A few examples: the THC levels in marijuana are now as high as 25-30%, making it more addictive than in the past; other substances of abuse, such as meth and crack, are highly addictive and readily available; youth are less supervised then ever before, and this lack of supervision starts at an earlier age.

Siegel wrote, “Experience, gene expression, mental activity, behavior, and continued interactions with the environment are tightly linked in a transactional set of processes” (p. 19). These processes that begin at birth continue into adolescence and beyond. Perhaps it is these early experiences that influence how a teen will respond to the ever-growing Danger Gap. Perhaps for Carl, his early life experiences have created synaptic connections that compel him to engage in the highest risk behaviors available to him.

If this were the answer, it would seem a combination of treatment strategies is most appropriate. In other words, keep him out of danger while he continues to cognitively develop, encourage participation in “appropriate” risky behavior, but also expose him to experiences that allow new, more adaptive synaptic connections to be nurtured.

Works Cited
Siegel, D. (1999). Developing Mind, The. New York: Guilford Press.
Strauch, B. (2003). Primal Teen, The. New york: Anchor Books.

Fostering Resiliency with Experiential Activities

Children who grow up in troubled families often develop skills that help them cope with the adversity in their environment and grow emotionally stronger in the process. Wolin and Wolin refers to this ability to “spring back” as resiliency. They began researching resiliency in 1989, while they were interviewing adults who had grown up in families with parents suffering from chemical dependency, co-occurring disorders, and other family issues. To their surprise, none of their subjects exhibited characteristics typically associated with adult children of troubled families: fear of abandonment, a sense of isolation, co-dependency, and substance abuse. With this discovery, Wolin and Wolin began to focus their research efforts on how these subjects had become resilient.

Resiliency isn't a new concept. In 1955, Werner and Smith began a study that followed nearly 700 children born on the island of Kauai, Hawaii. All their subjects had come from families dealing with issues that included chemical dependency, mental illness, and economic difficulties. Thirty-four years later, Werner wrote:

Risk factors and stressful environments do not inevitably lead to poor adaptation. It seems clear that, at each stage in an individual’s development from birth to maturity, there is a shifting balance between stressful events that heighten vulnerability and protective factors that enhance resilience. (Werner, 1989.)

In 1978, Bleuler, who spent thirty years studying schizophrenics and their families, wrote:

It is surprising to note that their [children of schizophrenics] spirit is not broken, even of children who have suffered severe adversity for many years. In studying a number of the family histories, one is even left with the impression that pain and suffering has a steeling – a hardening – effect on the personalities of some children. (Bleuler, 1978.)

Kagan stated that children should not be viewed as passive objects, but rather be considered active participants in their emotional lives. He goes on to propose that a child’s understanding of what occurs to him or her is more important than what actually happens. He wrote:

The effect of an emotionally significant experience – like a father’s prolonged absence or a bitter divorce – will depend on how the child interprets these events… Rarely will there be a fixed consequence of any single event – no matter how traumatic – or special set of family conditions. (Kagan, 1984.)

Felsman and Vaillant studied seventy-five inner-city American males, all from families that were impacted by chemical dependency, economically disadvantaged, or included a parent with mental illness. They wrote:

Our preliminary indications are that the successful men in our high-risk group are…not free from their difficult early memories. We would speculate that it is their style of remember and feeling that is important… Most do have access to their pasts and are able to bear that pain and sorrow, and in so doing, to draw upon it as a source of strength… [This ability] seems to inform that generative quality in the way they live. (Felsman & Vaillant, 1987.)

The Seven Resiliencies
According to Wolin and Wolin, resilient individuals exhibit specific behaviors, or competencies. They classified these competencies into what they call the Seven Resiliencies: insight, independence, relationships, initiative, creativity, humor, and morality. Each competency has three stages, which develop progressively: the childhood stage, the adolescent stage, and the adult stage. In children, competencies appear as unformed, non-goal oriented, intuitive behavior. In adolescents, these behaviors sharpen and become deliberate. In adults, the behaviors broaden and deepen, becoming a fully integrated part of the individual.

• Insight
Insight is “the mental habit of asking searching questions and giving honest answers.” (Wolin & Wolin, 1993.) According to Wolin and Wolin, developing insight is an essential foundation for the other competencies, because it allows the individual to think objectively about her circumstance. Sensing, the initial stage of insight, occurs with a resilient child’s realization that her family is different than most, accompanied by an awareness of the antecedents for problems. In the next stage, knowing, a resilient teen develops awareness of the family’s underlying issues. Understanding, the adult stage, involves re-examining childhood memories, as well as developing practical strategies for dealing with a troubled past.

• Independence
Independence is the purposeful creation of both physical and emotional space between a resilient individual and the troubled family. The first stage of independence is straying. This happens when a resilient child starts to seek physical distance from his troubled family, perhaps by playing in unused corners of the house, spending time at neighbors, or going on secret adventures. Disengaging is the second stage of independence, and begins when a resilient teen starts to stray farther. Some examples of this include getting a job, participating in after-school activities, and spending time at the homes of friends and relatives. During this stage, a resilient teen will also begin to disengage emotionally. In the final stage, separating, a resilient adult establishes strategies to reduce and control interactions with his family, such as moving a significant distance, or limiting contact to phone calls or letters.

• Relationships
Relationships are “connections with other people based on sharing, mutual respect, and openness.” (Wolin & Desetta, 2000.) Connecting is the first stage. A resilient child enters this stage by making tentative steps to engage with non-family members, most frequently an adult neighbor or teacher. A resilient teen moves on to recruiting, the second stage, by actively applying the skills developed in the connecting stage to establish a meaningful relationship with an adult who can serve as a substitute parent. Resilient adults enter the final stage, attaching, by establishing relationships with partners from healthy families, and consciously choosing to not repeat past patterns.

• Initiative
Initiative is a determination to prevail over one’s troubled past experiences or present environment. The first stage is exploring. In this stage, through “conducting trial-and-error experiments that often succeed, resilient children find tangible rewards and achieve a sense of effectiveness.” (Wolin & Wolin, 1993.) In the second stage, working, resilient teens move from random experimentation to participating in focused, goal-oriented activities such as school, community service, and clubs. Having moved to the final stage, generating, a resilient adult exhibits leadership, strong practical skills, and an enthusiasm for planning.

• Creativity and Humor
Creativity and humor are closely related competencies. Both use imagination to relieve troubling emotions and environmental chaos. These two resiliencies also share the first two stages. Playing—the first stage for both—includes all the imaginative activities in which a resilient child engages to escape from real life difficulties. When a resilient adolescent moves to shaping—the second stage for both—playing evolves into the tentative creation of art. In the final stage of creativity, composing, a resilient adult engages in more skilled pursuits of the arts, possibly at a professional or semi-professional level. However, resilient adults are more likely to move into the final stage of humor, which is laughing. At this stage, having developed an awareness of a larger context, a resilient adult discovers the absurdity in situations that seem sad, embarrassing, or stressful.

• Morality
Morality, the final competency, is doing the right thing even when difficult, and striving to see the strength possible in human nature despite personal adversity. A resilient child enters the first stage of morality, judging, by distinguishing between right and wrong, even as it relates to her own family. A resilient adolescent moves to the second stage, valuing, by developing an understanding of concepts such as decency, compassion, and honesty. In this stage, resilient teens often attempt to apply this growing understanding at home and in the world. In the final stage, serving, a resilient adult is strongly committed to doing what’s right at home and work, and is frequently involved in community service and political causes.

My Adaptations of the Wolin Model
In my own resiliency-oriented work with substance abusing teens, I’ve adapted the Wolin Model in three ways. First, I consider humor a type of creativity. Since I work exclusively with teens and the Wolins define the child and adolescent stages of these competencies as the same, this seems appropriate. Also, humor can serve as an example of ways to be creative beyond the arts, inviting the exploration of of creativity as an approach and not an act.

The second way I’ve adapted the Wolin Model is by referring to the final competency as integrity, not morality. In my experience, the word morality can be highly charged for many people. (As you'll read below, reframing is an important concept in resiliency-work, and I'm well aware of the irony of me avoiding this particular reframing challenge. However, I believe that integrity is an equally valid name for this competency, and thus would rather avoid this clinical roadblock than spend precious treatment time working through it.)

The third way I’ve adapted the Wolin Model is by linking independence and relationships in the new competency of interdependence. I believe adding this competency is especially important with the population I work with because it reinforces key recovery concepts such as needing sober supports, working on family systems challenges, addressing peer group issues, and establishing appropriate boundaries.

Resiliency as a Strengths-Based Practice
Wolin and Wolin stated, “The most important part of a strength-based approach is believing that youth in trouble actually have strengths and can act on them” (Project Resilience, 2004). For youth who grow up in families impacted by chemical dependency or other problems—which is true for the vast majority of the clients I work with—some or all of the competencies often develop naturally. Helping clients identify, explore, and develop their natural competencies should be a part of any treatment strategy.

All youth have strengths or talents, but not all naturally develop resilience. When this is the case, the Wolin Model can provide an effective foundation for fostering resiliency. Wolin and Wolin have identified three closely related steps for doing this. The first step is reframing, or “viewing an old story from a new perspective.” (Wolin, Desetta & Hefner, 2000.) Derived from traditional family therapy practices and cognitive-behavioral theory, reframing focuses on the subjective nature of personal stories to uncover alternative, positive themes that will allow an individual to transform his thinking from that of a damaged victim to that of a survivor with strengths forged from adversity.

The second step identified by Wolin and Wolin is the assumption that everyone who grows up in a troubled family has some degree of natural resilience, even if an individual does not presently exhibit well-developed strengths in all, or even most, of the resiliency categories.

The final core concept is survivor’s pride, which Wolin and Wolin defined as “the well-deserved feeling of accomplishment that results from persisting in the face of hardship or adversity.” (Wolin & Wolin, 2004.) A mixture of pain and empowerment, survivor’s pride can be a powerful motivator, but often remains unacknowledged.

Fostering Resiliency
It seems to me that experiential learning methodologies inherently reinforce insight, independence, relationships, interdependence, initiative, creativity, and integrity. In other words, if you’re using experiential learning, you’re fostering resiliency. I suggest, though, that by becoming more intentional about integrating resiliency, we can increase the effectiveness of experiential learning to foster resilience in our clients.

One way to do this is by selecting activities that provide increased opportunities for the practice of the competencies, and then frame the activities to emphasize this. An example is the activity Pressure Pads. In this activity, participants must get from the Starting Line to the Finish Line without touching the ground. To do so, they're given carpet squares, polyspots, or something similar—generally fewer spots than total number of participants.

For me, Pressure Pads is an excellent metaphor for recovery: the task is harder than it initially seems, you start with limited resources, you'll only be successful if you have help from others, many people want to give up along the way. Several of these ideas easily connect to the competencies and the three Core Concepts, including the need for relationships and interdependence, creative problem solving, and reframing what initially might seem impossible. In addition, it is extremely easy to cheat during Pressure Pads, which provides rich opportunities for exploring integrity.

So much to talk about! In fact, it seems to me that when you integrate resiliency-work into any clinical application of experiential learning, you have the opportunityl to exponentially increase the outcome potentials. How can you possibly pass that up?

Here are a few other ideas to assist in being more intentional about integrating resiliency into experiential activities:
• Teach clients the basic concepts and vocabulary of resiliency.
• Use the basic concepts and vocabulary of resiliency when framing, doing, and processing activities.
• Help clients identify and develop competencies they already possess.
• Challenge clients to practice competencies they do not yet possess.
• Connect the competencies practiced during experiential activities to real world situations.

As we’ve seen, the Wolin Model is a method to understand strengths, identify weaknesses, and re-conceptualize a family past troubled by chemical dependency or other dysfunction. This model can also be taught to individuals who do not exhibit natural competencies and experiential learning provides an excellent fit for this. While the Wolin Model cannot change a troubled past, it can provide a source of personal pride and renewed strength to help assure a healthier future.

Works Cited
Project Resilience. (1999). http://www.projectresilience.com.
Wolin, S. & Desetta, A. (2000). The Struggle to Be Strong. Minneapolis, MN: Free Spirit Publishing.
Wolin, S., Desetta, A. & Hefner, K. (2000). The Leader’s Guide to the Struggle to Be Strong. Minneapolis, MN: Free Spirit Publishing.
Wolin, S.J. & Wolin, S. (1993). The Resilient Self. New York: Villard.

Adventure Programming with GLBT Youth

(NOTE: Most of my posts on this blog are "new writing" based on my current reading, preparation for workshops, and so on. Periodically, though, I'll post "old writing" such as this paper written about two years ago in support of a grant proposal. Although not specific to clinical uses of experiential learning, I believe it is relevant. Hopefully you agree.)

A Chinese proverb states, "Tell me and I will forget. Show me and I may remember. Involve me and I will understand." The primary objective of adventure programming is to do just that, involve clients in a physically engaging manner so that they come to understand. In this paper, I will present evidence that supports the use of this physically engaging manner as an effective methodology to reduce at-risk behaviors in gay, lesbian, bisexual, and transgender (GLBT) youth by decreasing the likelihood of alienation, fostering resiliency, and countering internalized homophobia.

First, though, a deeper exploration of adventure programming and its goals is warranted. According to the Association of Experiential Education, adventure programming, like all types of experiential learning, is “a philosophy and methodology in which educators purposefully engage with learners in direct experience and focused reflection in order to increase knowledge, develop skills, and clarify values” (AEE, p. 1).

Any form of experiential learning has two critical steps: doing and processing. The doing step is the activity. Common activities for the doing step are hikes, kayaking, initiative games, and ropes courses. In the processing step, participants talk about the experience of doing, with the facilitator helping them to review the activity and generalize the learning to other areas of their lives (Luckner & Nadler, p. 10).

In his groundbreaking work, Kolb presented a model for the experiential learning cycle that expanded beyond this basic doing then processing model. Kolb identifies four components: concrete experience, reflective observation, abstract conceptualization, and active experimentation (Webb, p. 2). In this model, a concrete experience provides an opportunity for reflection, which is then integrated by the participant and abstracted or generalized in a way that can be actively tested in other areas of the individual’s life.

All models for adventure programming, as well as most other types of experiential learning, include a core belief that learning occurs most readily when the participant is “confronted with a balance between stress and comfort” (Webb, p. 3). Through “activities that provide compelling tasks to accomplish” (Priest & Gass, p. 17), adventure programming provides this balance in three inter-related ways. First, adventure programming strives to create an uncertain outcome. Second, adventure programming most often contains a high level of perceived physical, emotional, or social risk. Finally, adventure programming typically occurs outdoors or in an environment unfamiliar to the participant (Coons, p. 1).

Adventure programming and other types of experiential education “are a major strategy for accomplishing holistic development outcomes” (Bernard & Marshall, p. 1). Priest and Gass have cataloged significant affective gains from participation in adventure programming, both intrapersonal and interpersonal. Intrapersonal improvements include new confidence in oneself, increased willingness to take risks, improved self-concept, increased logical thinking, and greater reflective thinking (p. 19). Interpersonal improvements include enhanced cooperation, more effective communication, greater trust in others, increased sharing of decision-making, new ways of resolving problems, and enhanced leadership skills (p. 20).

A meta-analysis conducted by Hattie, March, Neill, and Richards reviewed results from 96 studies on adventure programs. These studies had a combined participation of over 12,000 at-risk youth and identified a wide variety of positive outcomes. The most significant outcomes were improvements in self-control, such as increased autonomy, confidence, self-efficacy, self-understanding, decision-making, and assertiveness. Other notable outcomes were increased interpersonal skills, improvements in mathematics and other academic areas involving critical thinking or problem solving, and significant gains in self-esteem (qtd. in Bernard & Marshall, p. 3). Another noteworthy finding, unlike outcomes from most interventions, was that these areas of improvements were maintained and even continued to increase over time (Bernard & Marshall, p. 4).

While outcomes for GLBT youth were not specifically addressed by Hattie’s meta-analysis, it was determined that there were no outcome differences attributable to ethnicity, socioeconomic status, or prior academic achievement (Bernard & Marshall, p. 4). As such, the results of Hattie’s meta-analysis support the use of adventure programming as an effective methodology to prevent at-risk behavior with all adolescent populations, including GLBT youth.

GLBT Youth As Inherently At-Risk
Almost no research focusing specifically on the efficacy of adventure programming with GLBT could be found during research for this paper. However, Hattie’s meta-analysis and several other studies report positive results from incorporating adventure programming into both therapeutic and developmental work with at-risk youth. Kallisky defined the term at-risk to include all adolescents who “live in a negative environment and/or lack the skills and values that help them become responsible members of society” (qtd. in Cross, p. 2).

A disproportionate number of at-risk youth are GLBT (Berger, p. 2). GLBT youth are particularly at-risk for suicidal ideation and attempts, parasuicidal behavior, verbal and physical harassment, substance abuse, sexually transmitted diseases, engagement in prostitution or truancy, and declining school performance (Mufioz-Plaza, et al, p. 3; Berger, p. 2). Additionally, the National Network of Runaway and Youth Services has reported that up to forty percent of all youth who experience homelessness identify as GLBT (qtd. in Berger, p. 2).

In response to the stressors noted above, the American Academy of Pediatrics has stated:

The psychosocial problems of gay and lesbian adolescents are primarily the result of societal stigma, hostility, hatred and isolation…These youth are severely hindered by societal stigmatization and prejudice, limited knowledge of human sexuality, a need for secrecy, a lack of opportunities for open socialization, and limited communication with healthy role models… [This] may lead to isolation, runaway behavior, homelessness, domestic violence, depression, suicide, substance abuse and school or job failure…Pediatricians should be aware of these risks (qtd. in Ryan and Futterman, p. 23).

As this evidence supports, all GLBT youth should be considered inherently at-risk. Further, one can assume that research supporting the efficacy of adventure programming with at-risk adolescents in general can be applied to GLBT youth specifically.

Ripples of Disruption
Understanding how at-risk behavior develops, in all adolescent populations, is key. Bronfenbrenner identified four dimensions of influence upon adolescents: family, school, peers, and work or play (qtd in Cross, p. 2). Subsequent research suggested that alienation, a significant element in at-risk behavior in adolescents, is the result of disruptions in these dimensions. Calabrese stated, “Trouble comes when an adolescent experiences alienation in more than one world at a time, or finds no solace in their other worlds” (qtd. in Cross, p. 2). When an adolescent does experience disruption in one dimension, a ripple effect is likely to occur with negative impacts in the other dimensions.

GLBT youth are likely to confront these negative ripples in all of Bronfenbrenner’s dimensions, especially school. Many schools condone or tolerate homophobia (Owen, p. 84). Kevin Jennings, executive director of the Gay, Lesbian and Straight Education Network, or GLSEN, said, “Anti-LGBT bullying and harassment remain commonplace in America's schools" (GLSEN, p. 1). In fact, a 2005 study conducted by GLSEN found that over 75% of high school students who identified as LGBT regularly heard derogatory remarks such as "faggot" or "dyke." Additionally, over 35% of these students suffered harassment at school due to their sexual orientation; and almost 20% of them had been physically assaulted (GLSEN, p. 1).

School experiences play a particularly important role in determining how adolescents define their place in the larger community (Cross, p. 2). As such, negative experiences such as those reported in the GLSEN study are highly likely to create a negative ripple effect throughout all other dimensions. Since these ripples are frequent for GLBT youth, concerns regarding alienation and the probability of at-risk behaviors are especially heightened for this population.

While Bronfenbrenner identified four dimensions of influence, Dean states that alienation is the result of three factors: powerlessness, or feeling unable to influence one’s own choices; normlessness, or feeling one’s value system is inconsistent with that of society; and isolation, or feeling acute loneliness or separation (qtd. in Cross, p. 2). Dean’s three factors of powerlessness, normlessness, and isolation are exacerbated for nearly all GLBT youth. Mercier and Berger point to the lack of social supports for LGBT youth, again giving particular attention to the school environment, as the cause of isolation for LGBT youth (qtd. in Mufioz-Plaza, et al, p. 4). Ryan and Futterman wrote, “The need for support is particularly critical to avoid isolation when adolescents begin to question their sexual identity” (p. 10). It is at this time that adventure programming would be a particularly effective strategy for this population to decrease alienation, foster resiliency, and counter internalized homophobia.

Use of Adventure Programming To Decrease Alienation In GLBT Youth
Cross conducted a study to determine the effects of adventure programming program on perceptions of alienation and personal control among at-risk adolescents. Cross’ study had two hypotheses: (1) “At-risk adolescents who participate in an outdoor intervention program will demonstrate significantly lower perceptions of alienation [than] their counterparts who receive no such program”; and, (2) “At-risk adolescents who participate in an outdoor intervention program will demonstrate significantly greater perceptions of personal control…as compared to their counterparts who receive no such program” (Cross, p. 3).

Cross’ study included 34 at-risk adolescents. Half the group served as controls, and the other half participated in a five-day intensive rock climbing experience designed to be a typical example of adventure programming. It included the following fundamental components: the participants were placed in a novel setting; a cooperative, caring, and trusting environment was created; unique problem solving opportunities were presented; opportunities for success and accomplishment were provided; and daily opportunities for processing the experience were given (Luckner & Nadler, p. 257).

Both the treatment group and the control group completed pre- and post-tests to measure alienation and perceptions of control. After participation in the rock-climbing program, the experimental group was less alienated and exhibited higher perceptions of control than the study participants who did not participate (Cross, p. 8). Cross’s study included only thirty-four subjects, all of whom attended the same alternative high school, with the majority of the participants being male, Caucasian, and of lower socioeconomic status. Due to the small size and lack of diversity among the participants, the results cannot be considered conclusive. However, the study results do suggest that adventure programming has the potential to positively effect perceptions of alienation in at-risk youth, including GLBT adolescents.

Use of Adventure Programming To Foster Resiliency In GLBT Youth
“Resiliency is the ability to thrive in spite of risk or adversity” (Brendtro & Longhurst, p. 2). In 1955, Werner and Smith began a longitudinal study of nearly 700 children, all born on the island of Kauai, Hawaii and all from families dealing with issues such as chemical dependency, mental illness, and economic difficulties. After following the subjects for thirty-four years, Werner wrote:

Risk factors and stressful environments do not inevitably lead to poor adaptation. It seems clear that, at each stage in an individual’s development from birth to maturity, there is a shifting balance between stressful events that heighten vulnerability and protective factors that enhance resilience (qtd. in Wolin & Wolin, p. 19).

Resilience is a combination of inner strengths and external supports (Brendtro & Longhurst, p. 2). Those external supports can come from within any of Bronfenbrenner’s dimensions. When provided this supportive environment, adolescents are able to develop their own natural resiliencies. However, as previously stated, school is often particularly difficult for GLBT youth. Hyman wrote that the “most dangerous schools are those with negative climates of disrespect among peers and adults” (qtd. in Brendtro & Longhurst, p. 2). When lacking support in any of Bronfenbrenner’s dimensions, adventure programming can provide an effective methodology for fostering resilience.

Fostering resiliency in adolescents has three primary goals. The first goal is assisting the individual to reframe his or her life experiences. Reframing, or “viewing an old story from a new perspective” (Wolin, Desetta & Hefner, p. 4), is derived from basic cognitive-behavioral theory and focuses on the subjective nature of personal stories to uncover alternative, positive themes (Wolin & Wolin, p. 21). The second goal in fostering resiliency is helping the individual to acknowledge untapped survivor’s pride, “the well-deserved feeling of accomplishment that results from persisting in the face of hardship or adversity” (Wolin & Wolin, p. 11). The final goal in fostering resiliency is facilitating the individual to identify current strengths or competencies while developing weaker areas.

Wolin and Wolin have identified seven specific areas of competence exhibited by resilient individuals: insight, independence, relationships, initiative, creativity, humor, and morality. Green conducted a study to examine the effects of adventure programming on the development of these competencies in at-risk youth. For the study, twenty-five minority youth age ten to sixteen participated in a six week ropes course program consisting of one four-hour session each week. A group of over 150 other minority youth served as a control. All subjects were pre- and post-tested. The results from Green’s study indicated that protective factors related to these competencies improved significantly within the treatment group (p. 1).

Green’s study focuses on at-risk low-income minority youth. However, his results suggest that adventure programming delivered to GLBT youth has the potential to provide significant gains in resiliency for this population. Hattie’s meta-analysis supports this conclusion. Bernard and Marshall wrote that adventure programming not only fosters resiliency, but also provides “a powerful prevention strategy” for at-risk youth (p. 1).

Use of Adventure Programming to Counter Internalized Homophobia
All adolescents face the psychosocial challenges of developing identity, autonomy, intimacy, sexuality, and achievement (Steinberg, p. 12). GLBT youth have the additional challenge of learning to manage a stigmatized identity (Ryan & Futterman, p. xii). Based on their own study, Mufioz-Plaza, et al, wrote, “Confronted with their own sense of alienation and confusion, as well as the overwhelmingly negative messages about homosexuality…respondents described their sexual identity formation as a process characterized by varying degrees of denial and acceptance” (p. 2).

Ryan and Futterman stated, “Unlike their heterosexual peers, lesbian and gay youth consolidate identity against a backdrop of social disapproval” (p. 21). In their study of GLBT youth ages 14-17, they found an overwhelming acceptance of negative stereotypes, including beliefs that all gay men were effeminate, all lesbians were masculine, that all homosexuals were unhappy, and that all lesbians hated men (Ryan & Futterman, p. 73).

Common reactions to such internalized homophobia include adjustment problems, impaired psychosocial development, family alienation, inadequate interpersonal relationships, alcohol and drug abuse, depression, suicidal ideation, and sexual acting out (Ryan & Futterman, p. 29). These reactions can be effectively countered through participation in adventure programming.

As stated earlier, learning occurs most readily when an individual is “outside a position of comfort” (Priest & Gass, p. 146). Priest and Gass wrote, “By responding to seemingly insurmountable tasks [found in typical adventure programming], participants often learn to overcome self-imposed perceptions of their capabilities to succeed” (p. 18), such as those created by internalized homophobia.

Through involvement in experiences that move the individual outside a position of comfort, adventure programming provides GLBT youth an opportunity to test their own assumptions and reject those they discover to be faulty. In doing so, adventure programming provides an effective treatment strategy for GLBT youth who need to change behaviors and move beyond self-defined limits.

Discussion
As I have presented in this paper, adventure programming is a process of “learning by doing with reflection’ (Priest and Gass, p. 16). This dynamic process provides participants unique opportunities to try new behaviors, to improve self-esteem, and to see one’s self in ways that move beyond personal or societal expectations (Bradish, p. 92), outcomes that positively impact at-risk participants. GLBT youth face unique social and emotional stressors resulting from a stigmatized identity. These stressors increase their risks for a wide range of physical and mental health concerns (Ryan & Futterman, p. 5). As such, all GLBT youth can be considered inherently at-risk. Studies that support adventure programming as an effective treatment modality for at-risk adolescents can therefore be generalized to GLBT youth.

Adventure programming specifically targeted to GLBT youth provides a safe alternative to the negative environment and experiences encountered at school and within Bronfenbrenner’s other dimensions. By providing powerful learning experiences that move participants beyond their personal positions of comfort, adventure programming presents opportunities to develop beneficial resiliencies, decrease the likelihood of alienation, and counter internalized homophobia. As such, adventure programming can be considered an effective methodology for use with GLBT youth.

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