Thinking Outside the Clinic: The Impact of an Adventure-Based Therapy Intervention on Adversarial Growth for Young Adults with Experiences of Chronic Illness

With improved treatment and increased survivorship for young people facing life-threatening illnesses, many conditions, such as cancer and chronic kidney disease have now been re-conceptualised as chronic illnesses. Accordingly, research and clinical priorities have been required to shift towards managing the short, mid and long-term psychosocial implications of chronic disease experienced during adolescence and young adulthood. While the stress of facing a chronic illness for many young people is experienced as a significant hardship, a growing body of research recognises that highly aversive life events, may not be uniformly concerned with negative outcomes, but may instead be viewed as opportunities for growth and positive transformation, ‘Adversarial Growth’. One novel intervention that has seen initial and promising results in recuperating the psychosocial effects of chronic illness, and facilitating Adversarial Growth is Adventure Therapy. This research study adopted a mixed-method, quasi-experimental, and longitudinal study design to investigate and explore the impact of an Adventure Therapy intervention in the promotion of personal growth in the face of adversity, as well as changes in participants’sense of belonging, self-concept, and sense of mastery. The study adopted an interrupted time series design with self-report measures for the intervention and control condition (N = 92) completed at multiple time points (pre-intervention; post-intervention; 3-month and 6-month follow-up) for Adversarial Growth, Social Connectedness, Self-Esteem and Self-Efficacy. A ‘priority-sequence model’ of mixed methods, used qualitative approaches to elicit personal experiences and rationales for making sense of positive transformation following involvement in the intervention. Beyond a model of resilience and recovery, findings support research for Adversarial Growth, which argues that highly aversive life events may not be uniformly associated with maladjustment but instead may be opportunities for personal growth, benefit-finding and thriving. Accordingly, this study found that participants attending the Adventure Therapy intervention had statistically significant improvements in Adversarial Growth, Social Connectedness, Self-Esteem and Self-Efficacy, with large effect sizes pre-post intervention. A longitudinal effect, over three months was also found for Adversarial Growth, with the experimental design demonstrating a significant interaction between group and time for Adversarial Growth and other psychosocial dependent variables. Further findings provide initial evidence to suggest that Adversarial Growth for this sample did not occur over time, as a natural process of recovery, but instead only occurred when facilitated by the researched Adventure Therapy intervention. Mixed-method findings also provide complementary evidence for participants’ experiences of change and positive transformation, as well as insight into some of the possible rationales for change. With United Kingdom policy guidelines acknowledging the limits of current service provision to support the psychosocial effects of chronic illness, this research provides initial evidence to claim that Adventure Therapy, as a psychotherapy, may provide young adults with the right conditions in which to achieve personal growth, and thrive ‘outside of the clinic’. Theoretical and clinical implications are discussed, as well as strengths and limits of the present study