Adventure therapy for child, adolescent, and young adult cancer patients: a systematic review

Chan, Ying Tung; Lau, Hoi Yee; Chan, Wai Yan; Cheung, Chi Wo; Lui, Winnie; Chane-Thu, Yuk Sze Jacqueline; Dai, Wen Lam; To, Ka Ching; Cheng, Hui Lin

doi:10.1007/s00520-020-05642-3

Cited by 9 publications

(6 citation statements)

References 42 publications

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“…The lacuna in safety aspects of wilderness programs for young cancer survivors is surprisingly persistent. Recent systematic reviews and meta-analysis on the effectiveness of adventure and wilderness programs among AYA cancer survivors [ 29 ] or juvenile delinquents [ 65 ] do not mention nor discuss program-related safety issues. Safety reporting is also lacking in another recently published study on the effects of a wilderness program among AYA cancer survivors [ 66 ].…”

Section: Discussionmentioning

confidence: 99%

“…Given the multitude of chronic health issues among childhood and AYA cancer survivors and given that there are few interventions that have the potential to impact on multiple factors, we developed and piloted a multi-component health promotion intervention: The Wilderness program for childhood, Adolescent and Young Adults (WAYA) program [ 28 ]. Adventure- or wilderness therapy could be a promising intervention to better support the needs of childhood and AYA cancer survivors [ 29 , 30 ]. Although there is no universally accepted definition for these type of interventions, adventure therapy is commonly regarded as the umbrella term under which a large variety of other outdoor programs appear [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

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A randomized controlled pilot study assessing feasibility and safety of a wilderness program for childhood, adolescent, and young adult cancer survivors: the WAYA study

et al. 2023

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Background The majority of childhood, Adolescent and Young Adult (AYA) cancer survivors suffers from long-lasting health issues following cancer treatment. It is therefore critical to explore effective health promotion strategies to address their needs. Exposure to nature is a promising approach to support the needs of young cancer survivors. This study investigated whether it is feasible to conduct a randomized controlled trial (RCT) of a wilderness program for childhood and AYA cancer survivors. Methods Eligible participants were aged 16–39 years, had a cancer diagnosis, and met minimal criteria. Seventy-one individuals expressed interest and 59 were randomized to either a wilderness or a holiday program. The wilderness program involved an 8-day expedition including backpacking, sea kayaking, gorge climbing, camping, bush-craft skills, and mindfulness-practices. It was followed by a 4-day basecamp after 3 months. The comparison was an 8-day holiday program at a Spa-hotel followed by a 4-day holiday program at the same hotel after 3 months. Primary outcome was study feasibility and safety. Results Ultimately, 19 AYAs participated in the wilderness and 23 in the holiday program. All completed the study at one-year follow-up. Participants were mostly female (70%) and represented diverse cancers. Clinical characteristics were similar between study arms excepting greater age at cancer diagnosis in the wilderness program (age 19.1 vs. 12.5; p = 0.024). Program adherence and data completeness was high (> 90%) in both arms. Adverse Effects (AEs) in the wilderness vs. the holiday program were similar (Relative Risk: 1.0, 95% Confidence Interval 0.8–1.3). The most frequent AE was tiredness, all were mild to moderate in severity, and serious AEs were not reported. Nature connectedness significantly increased over time in the wilderness program participants, but not in the holiday program (p < 0.001). No differences were found between the two study arms regarding quality of life, self-esteem, or self-efficacy. Conclusion It is feasible to conduct a RCT and a supervised wilderness adventure is equally safe for childhood and AYA cancer survivors as a holiday program. This pilot study lays the foundation for a larger RCT to investigate the effectiveness of wilderness programs on the health of young cancer survivors. Trial registration date and number 18/02/2021, NCT04761042 (clinicaltrials.gov).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A randomized controlled pilot study assessing feasibility and safety of a wilderness program for childhood, adolescent, and young adult cancer survivors: the WAYA study

et al. 2023

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“…Moreover, decreased depression, anxiety, anger and confusion symptomatology has been associated with outdoor physical activity [39][40][41]. Furthermore, quality of life benefits have also been reported in people with chronic pain [42], as well as in psychological distress and sleep quality in people with or surviving cancer [37,38].…”

Section: Introductionmentioning

confidence: 99%

“…These approaches are considered to be useful in both overall and specific populations, revealing positive physiological, social, emotional, physical, and psychological outcomes [11,[34][35][36]. Regarding the positive effects of nature-based therapy on healthy behaviours, physical activity levels have increased in people with mental disorders [33], older adults with depression [32], children and adolescents [36], people with cancer [37] and young adult cancer survivors [38], among others. Moreover, decreased depression, anxiety, anger and confusion symptomatology has been associated with outdoor physical activity [39][40][41].…”

Section: Introductionmentioning

confidence: 99%

Bibliometric Analysis of Nature-Based Therapy Research

et al. 2023

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Unrestrained urbanisation and natural space loss are reducing contact with nature in today’s society, producing negative consequences for people’s mental and physical health and wellbeing. Nature-based therapies, such as physical activity in natural settings, forest bathing, therapeutic hiking, or experiential learning, reduce anxiety and depressive symptoms and improve the quality of life in both general and specific populations. A bibliometric analysis of research on nature-based therapies was performed by applying the traditional laws of bibliometrics (exponential growth law, Bradford’s concentration law, Lotka’s law, Zipf’s law, etc.) to documents published in journals indexed in the Core Collection of the Web of Science (WoS). Graphical visualisation was performed using the VOSviewer software. Annual publications between 2006 and 2021 presented an exponential growth trend (R2 = 91%). The International Journal of Environmental Research and Public Health (MDPI) and Urban Forestry & Urban Greening (Elsevier) were the most productive and cited journals. Ikei, Miyazaki, and Song are the most cited prolific authors. The USA and South Korea were the countries with the highest scientific production. In recent years, there has been a growing interest in adventure, nature, and forest therapies among researchers. Nature-based therapies have experienced a growing interest in recent years. Positive effects on mental, physical, and emotional health have been found in different populations and research lines, although more studies with different designs and populations are needed.

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“…Several studies support the effectiveness of AT. People with autism spectrum disorders [ 16 , 22 ]; with psychotic spectrum disorders [ 23 , 24 ]; and children, adolescents, and young adults with cancer [ 25 ] have benefited from AT. Recent meta-analyses [ 13 , 18 , 26 ] and reviews [ 27 ] present studies on AT in different populations (people at risk or undergoing treatment for behavioural or mental health problems, adolescents, juvenile offenders, people with chronic diseases, substance users, etc.).…”

Section: Introductionmentioning

confidence: 99%

Short- and Long-Term Outcomes of an Adventure Therapy Programme on Borderline Personality Disorder: A Pragmatic Controlled Clinical Trial

Gabarda-Blasco,

Elias,

Mendo-Cullell

et al. 2024

Brain Sciences

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Adventure Therapy (AT) is a therapeutic intervention utilizing the natural environment and adventure activities as tools for psychotherapeutic interventions. It has been demonstrated to be appropriate for the intervention of patients with borderline personality disorder (BPD). This study aims to evaluate the response to AT treatment compared with the response to treatment as usual (TAU), based on cognitive behavioural therapy, in the short and long term, assessing clinical, psychosocial, and functional outcomes; quality of life; and physical health levels. This study extends the sample of and is a follow-up to a pilot study published in 2021, with a sample of 30 patients in the AT group and 10 in the control group. It does not allow us to affirm that AT provides better outcomes than TAU, as the positive effects observed immediately after therapy seem to be attenuated in the long term. Therefore, the effectiveness of long-term psychotherapy did not show differences between AT and TAU therapies in the treatment of BPD patients. However, the effects of intangibles observed during therapy by professionals and patients were not reflected in the measurements collected. Therefore, we believe it is necessary to increase the programme duration, complement treatment with a specific physical health programme, assess results with more specific instruments, and/or move towards a qualitative methodology to measure perceived changes in clinical improvement. New studies are needed to evaluate the results of the proposed changes.

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Adventure therapy for child, adolescent, and young adult cancer patients: a systematic review

Cited by 9 publications

References 42 publications

A randomized controlled pilot study assessing feasibility and safety of a wilderness program for childhood, adolescent, and young adult cancer survivors: the WAYA study

A randomized controlled pilot study assessing feasibility and safety of a wilderness program for childhood, adolescent, and young adult cancer survivors: the WAYA study

Bibliometric Analysis of Nature-Based Therapy Research

Short- and Long-Term Outcomes of an Adventure Therapy Programme on Borderline Personality Disorder: A Pragmatic Controlled Clinical Trial

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