Abstract
Background: Adventure therapy (AT) involves engaging activities close to nature with some degree of risk and seems developmentally appropriate for adolescents. While some AT is of the long and remote group expedition form, it is increasingly used as a brief weekly intervention within the community, often using the traditional therapeutic dyad. Many theories inform complex trauma (CT) informed practice in AT although no purpose-built theory or framework has been evident to date. When some AT theories are applied to adolescents with CT there appear to be some mismatches. Also, some CT practices with adolescents seem to be difficult to reconcile. This doctoral research sought to create a stand-alone theory that could resolve potential conflicts, and produce a practice framework for both clinical and non-clinical practitioners.

Methods: The CT and AT literature were scoped, critically analyzed and synthesized to create a draft process was critiqued by 30 experts from both fields, including young AT participants. These interviews were subjected to reflexive thematic analysis.

Findings: Both fields seems divided along ontological and epistemological lines with sometimes incompatible approaches to healing. Assisting the development of a sense of self was identified as the central therapeutic aim. Four phases, five domains of experience, and four broad healing benefits were proposed, examined, refined and presented as a practice framework. Interviewees viewed practitioner attitude and knowledge as more important than specific skills.

Discussion: The CT-informed AT (CTIAT) theory requires rich and dynamic experiences that help restore a healthy and rounded sense of self. Caring, kind and humane practitioners, with a healthy sense of self, can use the framework regardless of whether they have clinical talk therapy skills. Several cautions include the need to eliminate coercion, replace treatment models with reflexivity and avoid forcing the pace of AT programs. Ecological dynamics and an ethic of care are proposed as core AT and CT approaches. The practice framework will be presented after a brief discussion of overarching concepts.

Limitations: The research participants were only recruited in Australia from the ISSTD and a specific AT association and were not selected for diversity. Further research might consider cultural, neuro and gender diversity applicability. While the framework is being used it has not been formally field tested and efficacy research is recommended. As the potential AT risks increase practitioners require formal skills training however, any practitioner might employ outdoor activity in nearby nature.

Potential to distress: No

This presentation was originally presented as a live webinar in April 2024.