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Intervention Summary

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Behavior Management through Adventure

Behavior Management through Adventure (BMtA) is a form of outdoor therapy for youth with behavioral, psychological, and learning disabilities; students excluded from school for disciplinary reasons; and juvenile offenders. BMtA incorporates group-based adventure challenges (e.g., ropes courses) and developmental exercises with problem-solving components in an effort to help participants change feelings, thinking, and social behaviors; reduce dysfunctional behaviors; improve functional life behaviors; and avoid rearrest.

Trained facilitators deliver BMtA over approximately 60-120 days to groups of 12-20 youth who live together and participate in therapy together. Participants are required to create and understand safe and respectful behavioral norms under which the group will operate, to commit to those norms, and to accept a shared responsibility for the maintenance of those norms. The group participates in adventure challenges, which are introduced incrementally, to allow trust to develop within the group. Over time, these exercises are used to reinforce skills such as patience, listening, seeing another's point of view, leading, following, planning, and experiencing the consequences of actions. BMtA's intent is to enable participants to use these skills in dealing with problem behaviors, and members of the group, as well as facilitators, can call group meetings at any time to acknowledge positive actions or address problems.

In studies reviewed for this summary, BMtA was used with adjudicated youth between the ages of 8 and 18 who were committed to the program by the court system; as such, BMtA was delivered under conditions of incarceration, although not necessarily through a traditional detention facility. In one study, the population was composed of male juvenile offenders, whose offenses included buying and selling drugs, nonviolent sexual offenses, and violent offenses. In another study, the population was composed of male juvenile sex offenders. In a third study, the population was composed of juvenile drug offenders; this population also was primarily made up of male participants.

Descriptive Information

Areas of Interest Mental health treatment
Substance abuse treatment
Outcomes Review Date: January 2012
1: Rearrest rates
2: Time period from release until rearrest
3: Depression symptoms
4: Family self-concept
5: Social introversion
Outcome Categories Crime/delinquency
Family/relationships
Mental health
Ages 6-12 (Childhood)
13-17 (Adolescent)
Genders Male
Female
Races/Ethnicities Black or African American
White
Settings Correctional
Geographic Locations No geographic locations were identified by the developer.
Implementation History BMtA was originally developed and implemented by Project Adventure in the early 1980s to address the needs of at-risk youth in Georgia. Since that time, the program has been implemented by more than 20 schools, agencies, and programs with more than 5,000 youth in Georgia, Massachusetts, New Jersey, New York, and Pennsylvania. BMtA is now one of several related programs that are included within Project Adventure's Building Respectful Learning Communities model.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: No
Evaluated in comparative effectiveness research studies: Yes
Adaptations No population- or culture-specific adaptations of the intervention were identified by the developer.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories IOM prevention categories are not applicable.

Quality of Research
Review Date: January 2012

Documents Reviewed

The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.

Study 1

Gillis, H. L., Gass, M. A., & Russell, K. C. (2008). The effectiveness of Project Adventure's behavior management programs for male offenders in residential treatment. Residential Treatment for Children and Youth, 25(3), 227-247.

Study 2

Gillis, H. L., & Gass, M. A. (2010). Treating juveniles in a sex offender program using adventure-based programming: A matched group design. Journal of Child Sexual Abuse, 19(1), 20-34.  Pub Med icon

Study 3

Gillis, H. L., Simpson, C. A., Thomsen, D. D., & Martin, B. A. (1995). Final evaluation of Project Adventure's CO-OP program for court referred, drug involved youth. Unpublished manuscript.

Supplementary Materials

Medina, N. J., & Hay, S. (2009). Evaluation report on BMTA implementation at Stillwater. Unpublished manuscript.

Outcomes

Outcome 1: Rearrest rates
Description of Measures Rearrest rates were assessed using Georgia Department of Juvenile Justice records for all youth committed to the State by juvenile courts.
Key Findings One study compared rearrest rates of juvenile offenders in three groups: (1) those who received BMtA; (2) those who received an outdoor therapeutic program (OTP), which included base camping in cabins and short-term adventure programming (e.g., challenge ropes courses, backpacking, rock climbing, caving); and (3) those who received the State of Georgia's Youth Development Center program (YDC), which consisted of treatment as usual in 90-day boot camp programs in State institutions. At 6 months and 1, 2, and 3 years after treatment, rearrest rates of youth who received BMtA were lower than those of youth who received an OTP or YDC (p < .001 for all time points). The differences between the BMtA and OTP groups at 6 months and 1 year after treatment were associated with very small effect sizes (Cohen's d = 0.04 and 0.17, respectively), and the differences between these groups at 2 and 3 years after treatment were associated with small effect sizes (Cohen's d = 0.21 and 0.34, respectively). The differences between the BMtA and YDC groups were associated with small effect sizes at 6 months and 1, 2, and 3 years after treatment (Cohen's d = 0.43, 0.41, 0.45, and 0.49, respectively).

Another study compared rearrest rates of juvenile sex offenders in three groups: (1) those who received LEGACY, a behavior management program that incorporated BMtA; (2) those who received an other specialized program (OSP), including individual and group therapy programs with experiential exercises and residential psychiatric programs with outdoor components; and (3) those who received YDC, which consisted of treatment as usual in 90-day boot camp programs in State institutions. At 2 and 3 years after treatment, rearrest rates of youth who received LEGACY were lower than those of youth who received an OSP or YDC (p = .013 at 2 years after treatment and p = .004 at 3 years after treatment). The differences between the LEGACY and OSP groups at 2 and 3 years after treatment were associated with small (Cohen's d = 0.48) and medium effect sizes (Cohen's d = 0.63), respectively. The differences between the LEGACY and YDC groups at 2 and 3 years after treatment were associated with medium effect sizes (Cohen's d = 0.56 and 0.54, respectively).
Studies Measuring Outcome Study 1, Study 2
Study Designs Quasi-experimental
Quality of Research Rating 3.0 (0.0-4.0 scale)
Outcome 2: Time period from release until rearrest
Description of Measures Time period from release until rearrest (i.e., the number of days from release to rearrest) was assessed using Georgia Department of Juvenile Justice records.
Key Findings One study compared the time period from release until rearrest for juvenile offenders in three groups: (1) those who received BMtA; (2) those who received an outdoor therapeutic program (OTP), which included base camping in cabins and short-term adventure programming (e.g., challenge ropes courses, backpacking, rock climbing, caving); and (3) those who received the State of Georgia's Youth Development Center program (YDC), which consisted of treatment as usual in 90-day boot camp programs in State institutions. Results from a log-rank test indicated that the time period from release until rearrest was significantly different by treatment group (p < .001). A comparison of 95% confidence intervals indicated that the average time period from release until rearrest for youth who received BMtA was longer than that of youth who received an OTP or YDC. The differences between the BMtA and OTP groups and the BMtA and YDC groups were associated with small effect sizes (Cohen's d = 0.24 and 0.40, respectively).

Another study compared the time period from release until rearrest for juvenile sex offenders in three groups: (1) those who received LEGACY, a behavior management program that incorporated BMtA; (2) those who received an other specialized program (OSP), including individual and group therapy programs with experiential exercises and residential psychiatric programs with outdoor components; and (3) those who received YDC, which consisted of treatment as usual in 90-day boot camp programs in State institutions. Results from a log-rank test indicated that the time period from release until rearrest was significantly different by treatment group (p = .007). A post hoc multiple comparison procedure indicated that the average time period from release until rearrest for youth in the LEGACY group was longer than that of youth in the YDC group (p = .042); however, no significant difference was found for a comparison of youth in the LEGACY group and youth in the OSP group.
Studies Measuring Outcome Study 1, Study 2
Study Designs Quasi-experimental
Quality of Research Rating 3.0 (0.0-4.0 scale)
Outcome 3: Depression symptoms
Description of Measures Depression symptoms were assessed using the Beck Depression Inventory (BDI), a 21-item self-report instrument. Participants rate each item on a scale from 0 to 3. All item ratings are summed to produce a total score, which is divided into ranges representing minimal, mild, moderate, and severe depression symptoms. A higher score indicates greater severity of symptoms.
Key Findings Juvenile drug offenders were assessed before and after receiving CO-OP, a residential substance abuse treatment program that incorporated BMtA. Results indicated that the youth had lower average BDI scores after receiving the intervention (p < .0001).
Studies Measuring Outcome Study 3
Study Designs Preexperimental
Quality of Research Rating 2.3 (0.0-4.0 scale)
Outcome 4: Family self-concept
Description of Measures Family self-concept was assessed with the Family Self-Concept subscore of the Tennessee Self-Concept Scale (TSCS). The TSCS consists of 100 items intended to measure the respondent's self-worth and self-image. Using a scale ranging from 1 (always false) to 5 (always true), respondents rate each item (e.g., "I am a member of a happy family," "I am not loved by my family," "I often quarrel with my family"). Ratings for each item are summed to produce 14 profiled subscores (including the Family Self-Concept subscore) and a total score. Higher scores indicate greater self-esteem.
Key Findings Juvenile drug offenders were assessed before and after receiving CO-OP, a residential substance abuse treatment program that incorporated BMtA. Results indicated that the youth had higher average Family Self-Concept subscores after receiving the intervention (p = .022).
Studies Measuring Outcome Study 3
Study Designs Preexperimental
Quality of Research Rating 2.2 (0.0-4.0 scale)
Outcome 5: Social introversion
Description of Measures Social introversion was assessed with the Social Introversion clinical scale of the Minnesota Multiphasic Personality Inventory. The scale consists of 69 items intended to measure this personality dimension. Raw scores from the individual items are standardized mathematically and summed. A higher standardized score indicates greater social introversion.
Key Findings Juvenile drug offenders were assessed before and after receiving CO-OP, a residential substance abuse treatment program that incorporated BMtA. Results indicated that the youth had lower average Social Introversion scale scores after receiving the intervention (p = .045).
Studies Measuring Outcome Study 3
Study Designs Preexperimental
Quality of Research Rating 2.2 (0.0-4.0 scale)

Study Populations

The following populations were identified in the studies reviewed for Quality of Research.

Study Age Gender Race/Ethnicity
Study 1 6-12 (Childhood)
13-17 (Adolescent)
100% Male 58.4% White
41.6% Black or African American
Study 2 6-12 (Childhood)
13-17 (Adolescent)
100% Male 65.3% White
34.7% Black or African American
Study 3 13-17 (Adolescent) 76.5% Male
22.9% Female
50% Black or African American
48.2% White

Quality of Research Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:

  1. Reliability of measures
  2. Validity of measures
  3. Intervention fidelity
  4. Missing data and attrition
  5. Potential confounding variables
  6. Appropriateness of analysis

For more information about these criteria and the meaning of the ratings, see Quality of Research.

Outcome Reliability
of Measures
Validity
of Measures
Fidelity Missing
Data/Attrition
Confounding
Variables
Data
Analysis
Overall
Rating
1: Rearrest rates 3.6 3.6 1.3 3.5 2.5 3.8 3.0
2: Time period from release until rearrest 3.6 3.6 1.3 3.5 2.5 3.8 3.0
3: Depression symptoms 4.0 4.0 1.3 1.3 1.3 2.0 2.3
4: Family self-concept 3.9 3.6 1.3 1.3 1.3 2.0 2.2
5: Social introversion 3.9 3.5 1.3 1.3 1.3 2.0 2.2

Study Strengths

The outcome measures used in the three studies were sound and either had known psychometric properties or were State law enforcement data records. The use of public databases and historical (retrospective cohort) study designs in two of the studies minimized the possibility of missing data. The same two studies also showed a pattern of increasing sophistication in design and analysis; one of the studies matched participants to address a concern about potential confounding factors raised in the discussion of the preceding study.

Study Weaknesses

Little evidence for the degree of intervention fidelity was presented. One study had substantial attrition. None of the studies adequately controlled for potential confounding factors. Two of the studies included multiple statistical tests but without any analytical approach (e.g., Bonferroni correction) to control for possible type I errors (i.e., the finding of a significant relationship when one does not exist).

Readiness for Dissemination
Review Date: January 2012

Materials Reviewed

The materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.

Project Adventure, Inc. (2007). Behavior Management through Adventure: Level 1 training manual. Beverly, MA: Author.

Project Adventure, Inc. (2007). Debriefing tools: Workshop manual. Beverly, MA: Author.

Project Adventure, Inc. (2009). Behavior Management through Adventure: Level 2 training manual. Beverly, MA: Author.

Project Adventure, Inc. (2009). Stepping stones: A therapeutic adventure activity guide. Beverly, MA: Author.

Schoel, J., & Maizell, R. (2002). Exploring islands of healing. Beverly, MA: J. Weston Walch.

Schoel, J., Prouty, D., & Radcliffe, P. (1988). Islands of healing. Hamilton, MA: Project Adventure.

Other program materials:

  • Behavior Management through Adventure implementation survey (short and long versions)
  • Behavior Management through Adventure level 1 staff assessment
  • Behavior Management through Adventure level 2 staff assessment
  • Behavior Management through Adventure pamphlet

Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)

External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:

  1. Availability of implementation materials
  2. Availability of training and support resources
  3. Availability of quality assurance procedures

For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.

Implementation
Materials
Training and Support
Resources
Quality Assurance
Procedures
Overall
Rating
3.5 3.5 3.3 3.4

Dissemination Strengths

The program materials are comprehensive and very clearly state what is needed for implementation. The workshop manual is a well-developed systematic tool aimed at enhancing the knowledge and development of future facilitators. The training manuals are comprehensive and easy to understand, and they provide many tools and examples. Training is required and emphasizes facilitator preparation, follow-through, and debriefing as a part of each phase of implementation. The developer provides consultation and support (including an initial telephone-based assessment as well as seminars, sample workshops, and hands-on training) during the implementation process to facilitate the intervention's fit with the implementing agency and successful intervention delivery. The multilevel fidelity measures are designed to provide information on program implementation and facilitator performance.

Dissemination Weaknesses

The organization of program materials does not facilitate ease of use. The overall process of program implementation is not sufficiently explained. Some of the graphics used throughout the materials do not provide sufficient guidance or explanation. Details are lacking on how implementers should interpret fidelity data and use this information to improve program delivery. It is unclear how the implementation survey data should be collected and used for performance improvement.

Costs

The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.

Item Description Cost Required by Developer
Training manuals, workshop manual, activity guide, and books (Exploring Islands of Healing and Islands of Healing) $190 per set Yes
Portable Adventure Challenge Kit (contains props and other materials for conducting adventure-based activities with up to 15 youth) $1,600 each No
4-day, on-site level 1 facilitator training $6,000 for up to 16 participants, plus travel expenses for consultant Yes
4-day, on-site level 2 facilitator training $6,000 for up to 16 participants, plus travel expenses for consultant Yes
4-day, on-site level 3 facilitator training $6,000 for up to 16 participants, plus travel expenses for consultant No
8 days of on-site consultation and support (includes initial telephone-based assessment) $12,000 per site, plus travel expenses for consultant Yes
Additional on-site consultation and support $1,500 per day, plus travel expenses for consultant No
Quality assurance process and report (includes assessment instruments) Cost varies depending on site needs Yes
Evaluation process and report (includes assessment instruments) Cost varies depending on site needs No
Replications

No replications were identified by the developer.

Contact Information

To learn more about implementation, contact:
Peter Aubry
(978) 524-4608
paubry@pa.org

To learn more about research, contact:
Michael A. Gass, Ph.D.
(603) 862-2024
mgass@unh.edu

Consider these Questions to Ask (PDF, 54KB) as you explore the possible use of this intervention.

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