Changes in psychiatric symptoms and psychological processes among veterans participating in a therapeutic adventure program.

Abstract

When veterans need effective mental health treatment, many are reluctant to engage in traditional treatment modalities because of stigma. Therapeutic adventure shows promise as a way to engage veterans and enact positive changes in functioning, but little is known about how therapeutic adventure impacts mental health symptoms among veterans. This study examined changes in mental health symptoms and related psychological processes over the course of a 6-day Outward Bound for Veterans (OB4V) program and at a 1-month follow-up. This study examined data from 77 U.S. military veterans with psychiatric diagnoses. The authors hypothesized that participants would report significant reductions in mental health symptoms over the course of the program and following its completion, as well as significant improvements in psychological processes that included initiative for psychological growth, psychological attitudes, attitudes toward help-seeking, psychological mindedness, and emotional suppression. A repeated-measures analysis of variance was performed on each of the dependent variables. Results showed that, from pre- to postprogram, participants reported significant improvement in life purpose satisfaction and self-confidence during stressful situations. Further, from preprogram to 1-month postprogram, veterans reported increased psychological mindedness, increased engagement to promote personal growth, decreased mental health symptomology, decreased emotional suppression, and an increase in positive attitude toward seeking professional psychological help. These improvements were significant during the OB4V program and even continued to improve after the program ended, showing the promise of therapeutic adventure as a modality to address veterans' mental health issues. (PsycINFO Database Record

Psychosocial Outcomes of Australian Male and Female Veterans Following Participation in Peer-Led Adventure-Based Therapy

“…It is important to note that these improvements are in the context of ongoing psychological treatment, with over 70% of participants receiving treatment at the time of the program. However, our results are consistent with outcomes from other peer-to-peer interventions (Nelson et al, 2014;Possemato et al, 2019;Romaniuk et al, 2019) and adventure-based therapeutic programs such as Outward Bound for Veterans (OB4V), a similar program to Trojan's Trek in the US and Canada (Bettmann et al, 2019;Ewert, 2014;Harper et al, 2014;Scheinfeld et al, 2017;Scheinfeld & Spangler, 2013). In a recent study by Bettmann and colleagues (2019), 77 ex-service personnel taking part in the 6-day OB4V program reported significant improvements including increased life purpose satisfaction and self-confidence post-program and decreased mental health symptomology at follow-up.…”

“…In a systematic review, self-efficacy was significantly negatively correlated with posttraumatic stress following multiple types of trauma (Simmen-Janevska et al, 2012). Previous studies have also suggested both adventurebased therapy and peer-to-peer interventions may help to maintain positive outcomes through improved attitudes towards help-seeking (Bettmann et al, 2019;Hamblen et al, 2019;Jain et al, 2013). However, help-seeking was already high in this cohort, with over 70% of participants reporting current psychological treatment.…”

“…Adventure-based therapy has been shown to be moderately effective in improving psychological, behavioural, emotional, and interpersonal outcomes in children and young adults (Bowen & Neill, 2013). Furthermore, there is a small but growing evidence base suggesting the effectiveness of adventure-based therapy for current and ex-serving military personnel (e.g., Bennett et al, 2014a;Bennett et al, 2017;Bettmann et al, 2019;Bird, 2015;Duvall & Kaplan, 2014;Ewert, 2014;Gelkopf et al, 2013;Harper et al, 2014;Scheinfeld & Spangler, 2013;Vella et al, & 2013). These studies show considerable variability of adventure-based therapy, with the duration of programs ranging from 2 days to 12 months, and the inclusion of both residential and outpatient programs and a variety of adventurous activities (e.g., camping, water rafting), therapeutic components (e.g., peer mentoring, CBT, and inpatient PTSD therapy), and outcome measures (e.g., PTSD symptomology, leisure satisfaction, and self-confidence).…”

“…While promising, the majority of adventure-based therapy studies are from the United States (US) and Canada (e.g., Outward Bound for Veterans [OB4V]; Bettmann et al, 2019;Ewert, 2014;Harper et al, 2014;Scheinfeld et al, 2017;Scheinfeld & Spangler, 2013;and Warrior Adventure Quest [WAQ], see Hayden, 2010;McIlvaine, 2008), and the United Kingdom (e.g., The Battle Back Programme, see Carless et al, 2013;Peacock et al, 2019), with very little research examining the effectiveness of adventure-based therapy for Australian current and ex-serving military personnel. One exception, however, is the Trojan's Trek program.…”

Wilderness Adventure Program May Help Combat Perceptions of Stigma Among Veterans

“…In recent years, a number of support programs have emerged to help address issues surrounding OSI and transition from military to civilian life, such as OSI clinics, available through CAF or nongovernment organizations (NGOs), like Outward Bound Canada (Harper, Norris, & D'Astous, 2014) and Warrior Adventures Canada (Warrior Adventures Canada, 2018). Similar programs in the United States include Outward Bound for Vets (OB4V) (Bettmann, Scheinfeld, Prince, Garland, & Ovrom, 2018;Scheinfeld et al, 2017) and Warrior Adventure Quest (WAQ) (Hayden, 2010;McIlvaine, 2008). Outdoor-based programs have been gaining popularity as an alternative to traditional programming (Scheinfeld et al, 2017), citing the mental health benefits to veterans including improvements in ''coping skills, stress management, problem solving, communication, self-esteem building and community reintegration'' (Greer & Vin-Raviv, 2019).…”