Military Veterans and the Use

of Adventure Education Experiences

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in Natural Environments
for Therapeutic Outcomes

Alan Ewert members have deployed to Iraq or Afghanistan, or both, over 3.3
million times with nearly 800,000 soldiers deploying multiple times
Environmental Health/Recreation, Park and Tourism Studies, (Tan, 2009). One of the hallmarks of post-9/11 warfare is that for
Indiana University, Bloomington, Indiana. every US soldier killed, seven soldiers are wounded, either physically
or psychologically, with psychological injuries such as posttraumatic
stress disorder (PTSD) and other military-related issues such as de-
Abstract pression and anxiety much more numerous than physical injuries
This paper describes a study investigating the application and effect (Department of Defense, 2009). Westwood, McLean, Cave, Borgen,
of an Adventure Education (AE) program on the restoration and reha- and Slakov (2010) report that approximately 80% of military per-
bilitation of redeploying military veterans. More veterans are now sonnel diagnosed with PTSD are also subject to significant comorbid
surviving and returning from combat missions with more physical, issues such as depression, anxiety disorders, and substance abuse.
mental, or emotional injuries than from any previous military conflict. These statistics coupled with an upward trajectory of negative vari-
Statistical reports indicate record levels of long-term emotional trauma ables, such as suicide rates among redeployed military veterans, have
(e.g., posttraumatic stress) and suicides from redeployed veterans. While sparked national interest in providing support for this population.
traditional therapies can be helpful to veterans, many soldiers have The extent of the psychological issues experienced by our military
turned to nontraditional support programs, such as the Outward Bound personnel often go underreported for several reasons (a) these injuries
Program for Vets (OB4V), as a useful intervention in the healing process. are not easily observed, (b) they are usually not reported until several
This study found support for the effectiveness of the OB4V on 9 of the 11 months after redeployment (returning home), and (c) the military
personal constructs studied and on the variable of resilience for a se- climate can stigmatize the admission of psychological health-related
lected group of redeployed military veterans. Supporting theories and problems often present among returning veterans, thus reducing the
research findings from recent studies are described within the context of likelihood of reporting these issues (Kim et al., 2011). Documented
specific attributes of AE programs that appear most effective in ad- manifestations of these issues include a broad range of health-related
dressing these types of challenges. Key Words: Adventure education— problems including PTSD, substance abuse, destructive marital and
Military veterans—Natural environments—Outward Bound. family issues, domestic violence, suicide, depression, anxiety, and
other mental illnesses (Resnik & Allen, 2007). Studies estimate that

N
o one comes home from war unchanged, and for many of between 19% and 44% of soldiers returning from Operations
our redeploying veterans, these changes can often be Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Op-
characterized as debilitating psychological wounds (Ta- eration New Dawn theaters meet the current criteria for a mental
nielian & Jaycox, 2008). Since 2001, American service health diagnosis including PTSD (14–28%) and depression (13–14%)

DOI: 10.1089/eco.2013.0035 ª MARY ANN LIEBERT, INC.  VOL. 6 NO. 3  SEPTEMBER 2014 ECOPSYCHOLOGY 155
 EWERT

and for alcohol and drug use disorder (3–5%) (Seal et al., 2009; increasingly different and challenging tasks (Gass et al., 2012). More-
Zinzow et al., 2012). Moreover, there is considerable evidence that, over, through effective facilitation and reflection they may emerge
when compared to the general population, redeployed veterans are at more resilient and capable of dealing with uncertainty, stress, and other
higher risk for other health-related issues such as obesity and tobacco potentially adverse issues (Sibthorp, 2003). Within AE, facilitation and
use (Nelson, 2006; Smith et al., 2009). reflection imply a systematic effort to help the participant draw
A traditional approach for treating symptoms related to PTSD and meaning out of the experience, with these meanings often intended for
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similar disorders has been pharmacological (Olfson et al., 2002). use by the individual after the experience (Gass et al., 2012).
However, the risks often associated with pharmacological manage- The Outward Bound Program for Vets (OB4V) is specifically de-
ment and poor clinical outcomes have prompted the need to develop signed for military veteran populations and is an example of a type of
other treatment options. These options have included cognitive be- intervention utilizing components of adventure-based activities in
havior therapy (Forbes et al., 2013), exposure-based interventions remote outdoor settings and conducted within small groups of vet-
(Goodson & Helstrom, 2011), supportive counseling, prolonged ex- erans. Typically, the OB4V is a five-day Outward Bound course that
posure therapy, emotional debriefing, and collaborative care (For- involves one day of preparation that includes a series of small group
neris et al., 2013). Similarly, Landres, Garovoy, and Burkman (2013) exercises designed to develop trust and cooperation within the group,
report that stage-based treatment approaches can be effective par- three days of purposive and structured adventure-based experiential
ticularly for complex trauma among veterans. However, veterans, activities, and a fifth day of debriefing the experience. Considered an
especially those that have been exposed to combat, tend to under- important component of the overall experience (Tannenbaum &
utilize health care services, in particular those associated with mental Cerasoli, 2013), this debriefing period is a time during which the
health (Hunt & Rosenheck, 2011; Ruzek et al., 2011). This underuti- veterans develop personal ‘‘action plans’’ and reflect on how they will
lization by some veterans has prompted the need to develop alter- use the information and incorporate the changes realized during
native treatment modalities and interventions. the course with respect to their future endeavors. Experiential tasks
One such intervention, Adventure Education (AE), has evolved as a typically include some combination of hiking, camping, rock climbing,
promising therapeutic tool used with redeployed (returning) military ropes course, and/or white-water or ocean kayaking. Each course
veterans in ameliorating postdeployment health issues such as de- usually has 2–3 professional staff and involves 6–12 veterans. The
pression and feelings of isolation (Gass et al., 2012). This paper de- courses are carefully planned with activities sequenced to produce a
scribes a recent study measuring the effect of a specific AE program ‘‘scaffolding’’ effect whereby each course member has specific re-
(Outward Bound) upon 11 different psychologically based variables sponsibilities, leadership positions are rotated among all the partici-
and levels of resilience of redeployed veterans from the Iraqi and pants, and it is expected that all participants will actively support each
Afghanistan theaters. other and provide accurate and honest feedback to one another. Thus,
group decision making, collective goal setting, and constructively
Adventure Education and Military Veterans resolving internal differences are integral to the OB4V experience.
Following the Vietnam War, under the rubric of AE, programs using Military veterans report that participation in an OB4V creates a
natural environments and adventure-based activities began to appear sense of camaraderie and feeling part of a team (Frankel & Ewert,
as either an alternative or adjunct to more traditional psychological 2009). In turn, this sense of teamwork can provide for mutual respect,
counseling approaches (Hyer et al., 1996). One of the forerunners of the communication, and development of trust ( Johnson et al., 1994). In
AE approach, and still the most widely emulated program model, is addition, postwar structural social support (i.e., number of friendships
Outward Bound. Developed in 1941 as a training program to increase and complexity of social attachment) appears particularly important to
the likelihood of survival for sailors whose ships were sunk by German male veterans, while functional social support (i.e., perceived emo-
submarines during World War II, Outward Bound has since expanded to tional support and assistance) is deemed important to both female and
more than 30 schools worldwide. While the locations of the various male veterans (Palmer, 2008). As an inherent component of the pro-
Outward Bound schools vary, the goals and philosophical underpin- gram, groups formed during an OB4V are encouraged to provide both
nings of all the schools are similar and involve the Outward Bound emotional and physical support to each other.
Process Model first developed by Walsh and Golins (1976). Using this The logic underlying this type of intervention is that when vet-
model as a framework, participants are placed into unique social and erans successfully complete the OB4V, their course outcomes may
physical settings in which they need to form a team and are faced with include enhanced perceptions of their personal abilities such as

156 ECOPSYCHOLOGY SEPTEMBER 2014

 MILITARY VETERANS AND ADVENTURE EDUCATION
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Fig. 1. Examples of OB4V intervention and outcome variables.

leadership, teamwork skills, effective communication, resilience, and compared to a more traditional counseling model, the Outward Bound
self-efficacy (see Fig. 1). In addition, the small-group context pro- experience had neither a positive nor negative impact on alleviating
vided by the intervention promotes a level of social support that psychological symptoms related to PTSD. Using open-ended inter-
facilitates the veteran’s making positive attitudinal and behavioral views, however, indicated that the participants of the Outward Bound
changes in his or her personal life, at home or at work. The overall courses were overwhelmingly positive in terms of increasing trust,
goal of many AE programs such as the OB4V is to transfer the out- feeling that they were more in control of their behaviors and depres-
comes realized at the end of the course to situations that may occur sion, enjoying the outdoors, and being able to do more physically.
later in an individual’s life. The concept of transference, or the ap- In a related work, Lundberg, Bennett, and Smith (2011) studied 18
plying of course outcomes to situations later in life, is considered a veterans who participated in one of three week-long therapeutic and
critical component in many AE programs (Goldenberg et al., 2005). adaptive sports programs in Sun Valley, Idaho. Similar to the OB4V, the
Through this transference of course outcomes to applications later programs offered through Higher Ground seek to improve a veteran’s
in life, the overall goal of the OBVP is to address or mitigate a variety quality of life and personal relationships and to decrease negative
of disorders (usually psychology-based) experienced by the veteran mood states such as stress and depression through the use of winter and
by providing immersive wilderness-based courses that draw heavily summer adventure camps. Results from this study identified significant
on the therapeutic aspects of the natural world, teamwork, and and positive pre- and posttest differences in a variety of mental health
challenge-based activities. Specific issues that the OB4V seeks to issues including reduction in levels of stress and depression, increased
address include reducing a sense of isolation, improving the veteran’s psychological health, and higher reported levels of quality of life.
ability to trust others, promoting a more physically active lifestyle, A number of other studies have utilized an AE format as a thera-
instituting a reaffirmation of self, along with a heightened sense of peutic setting with veterans. For example, Gelkopf, Hasson-Ohayon,
empowerment and more effective relational skills. Bikman, and Kravetz (2013) found significant improvements in both
functioning and symptomatology of veterans who were diagnosed
Review of the Literature with PTSD, as well as other forms of combat-related stress, after they
A developing body of research has now investigated the effect of participated in a one-year Nature Adventure Rehabilitation program.
outdoor-based programs such as AE on many of the mental health– Likewise, Duvall and Kaplan (2013) investigated the outcomes of four
related issues faced by redeployed military veterans (Krasny et al., AE programs that worked with veterans and found that study par-
2014). Veterans have reported experiencing feelings of courage, bond- ticipants reported significant improvements in psychological well-
ing with others, increased self-determination, responsibility to self and being, social functioning, and life outlook. The data also indicated
others, and a sense of competence in times of uncertainty and challenge that these improvements persisted one month following the com-
while engaged in their military duties (Cox, 2008). Through the use of a pletion of the various courses. The four programs studied by Duvall
series of structured and challenging experiences designed to facilitate and Kaplan included Higher Ground, Wasatch Adaptive Sports,
change while participants are engaged in a novel (often wilderness) Wilderness Inquiry, and Women’s Wilderness Institute.
setting, these feelings can often be emulated through participation in Van Puymbroeck, Ewert, Luo, and Frankel (2012) examined the
programs such as the OBVP (Driskell et al., 2001; Sheard & Golby, 2006). effect of participation of redeployed veterans in a number of Outward
For example, Hyer et al. (1996) investigated the effects of Outward Bound courses upon levels of sense of coherence. Using a repeated-
Bound programs as an adjunct to specialized inpatient treatment on measures pre-, post-, and one-year follow-up design, they found
Vietnam and Korean War veterans. Their findings indicated that, when significant changes in sense of coherence between the pre and

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post scores ( p = .001, d = .51) but not between the post and one-year conclusion of the course (Lam & Bengo, 2003; Sibthorp et al., 2007).
follow-up. The authors noted that this was one of the first examples Additional independent variables included gender, age, combat status,
of an intervention demonstrating a significant change in the vari- and ethnicity. Combat status was determined by two questions asking
able of sense of coherence, and they ascribed this change to the high whether the veteran had been engaged in actual combat and the du-
level of challenge inherent in the AE program. ration of that combat during his or her most recent deployment. Two
More recently, Scheinfeld (2013) used a quasi-experimental de- review processes were used in the study: A traditional IRB through
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sign to study 159 male veterans participating in an OB4V-type Indiana University and an institutional review process through Out-
program. Using a pre-, post-, and one-month follow-up approach ward Bound. Veterans signed an Outward Bound form indicating their
with a wait-list as the control group, results indicated statistically agreement to participate. Data were collected from veterans who re-
significant improvements in the variables of mental health status, turned from OEF or OIF theaters within one year and had attended one
personal growth, attitudes toward seeking professional psychological of 32 different OB4V courses. Course length was typically five days
help, restriction on emotions, and subjective well-being. No differ- and involved a group size of 6–10 veterans with two course instructors.
ence was noted on the variable of psychological mindfulness.
Using the above literature as a guide, this research study utilized Resilience
two Research Questions (RQ): The concept of resilience has changed in the psychology literature
RQ1: When comparing pre-course and post-course levels of from being primarily considered a deficit-based paradigm to that of
agreement, what effect does participation in the OB4V have on se- something focused more on positive, personal-based qualities such as
lected personal constructs and resilience? adaptability (Lam & McBride-Chang, 2007). Described as a phenom-
RQ2: What effect do the variables of age, sex, ethnicity, and level of enon or process reflecting positive adaptation despite experiences of
combat status have on self-reported levels of personal constructs and significant adversity or trauma, resilience represents an individual’s
resilience? capacity for maintenance, recovery, or improvement in mental health
following challenges in one’s life (Luthar, 2006). Accordingly, in this
Methods study, resilience was conceptualized as experiencing growth through a
Personal constructs disruptive event. Moreover, a number of authors suggest that AE
In this current study, two major variables were examined: personal programs can be effective in enhancing levels of resilience because of
constructs and resilience. Personal constructs included the follow- (a) spending extended time in natural environments, (b) separation
ing: self-confidence, self-actualization, compassion, healthy and from normal life, (c) social support from a small group setting, and (d)
balanced lifestyle, goal setting, group collaboration, effective com- the intensity and challenging nature of the adventure experience
munication, conflict resolution, problem solving, social responsibility, (D’Amarto & Krasny, 2011; Ewert & Yoshino, 2008).
and environmental responsibility. These constructs were mea- An increasing body of research has emphasized pre- and post-
sured using the Outward Bound Outcomes Instrument (OBOI) (Frankel deployment factors related to resilience that might have implications
& Ewert, 2009). Each construct was measured by two items, with for the long-term well-being and health of military personnel and
the OBOI consisting of 22 items using a 0–10 Likert scale with veterans (King et al., 2006). Within the military context, certain as-
0 = strongly disagree and 10 = strongly agree. The items were selected pects of military life, such as field training, unit cohesiveness, and
on the basis of their ability to measure the individual construct and are physical fitness, can be beneficial to fostering resilience (Gifford,
similar to many items used in previous work on the effects of partic- 2006). Resilience to adversity, however, relies more on personal en-
ipation in Outward Bound programs (Hattie et al., 1997; Shore, 1977). ablement rather than simply on environmental protectiveness, and it
In the initial development of this instrument, Frankel and Ewert re- is this enablement that equips the veteran with personal resources
ported Cronbach’s alphas ranging from .75 to .89. Using the OBOI, the that enhance his or her competencies in order to successfully adapt to
11 constructs were measured throughout the summer season of 2010 adverse situations (Benight & Bandura, 2004). Interventions, such as
using a retrospective pretest format. A retrospective pretest method the OB4V, can provide both challenging situations and supporting
was used to adjust for changes in participant self-knowledge (i.e., re- group structure that can be particularly useful in developing levels of
sponse shift). With this approach, researchers asked the respondents to resilience (Britt et al., 2001; Hattie et al., 1997). Thus, interventions
recall their status for each construct at the beginning of the OB4V that provide support along with the challenge of accomplishing
course and then report how they felt about each construct at the difficult goals and providing feedback, such as that provided through

158 ECOPSYCHOLOGY SEPTEMBER 2014

 MILITARY VETERANS AND ADVENTURE EDUCATION

the OBVP, can be particularly useful in developing levels of resilience season, out of 333 veterans participating in the study, 310 returned
and thereby reducing the risk for redeployment issues and disorders. completed questionnaires (93%) using the retrospective pretest format.
To measure resilience, a 10-item instrument modified from the Of these, 262 were male (84%), and 48 were female (16%). Age ranged
Multidimensional Relationship Questionnaire (MRQ) was admin- from 20 to 62 years with a mean of 34.1 years (SD = 9.1 years). Of the
istered. The MRQ is a 37-item instrument developed from well- questionnaires returned, approximately 258 were from participants
established resilience inventories (Barton & Pretty, 2010; Connor & that classified themselves as being White (98%).
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Davidson, 2003; Wagnild & Young, 1993) and tested in several ad- Using t tests with a Bonferroni correction, data analysis indicated
venture-specific studies (Ewert & Yoshino, 2011; Kaplan & Berman, that when compared to scores generated before the Outward
2010). As with the Personal Construct variables, the retrospective Bound course, post-course scores, 9 of the 11 personal constructs
pretest approach was utilized with the 10 items selected on the basis of statistically improved at the p < .01 level, with an effect size range of
being most appropriate for the specific OBVP course experience. Stu- 0.36–0.77 (see Table 1). Given the homogeneous nature of the sam-
dents were presented with stem statements such as ‘‘when I make plans I ple, it is not surprising that the independent variables of sex, eth-
follow through with them’’ or ‘‘I feel proud that I have accomplished nicity, and age did not make significant contributions to the analysis.
things in my life.’’ After reading the statements, the students were asked In addition, no significant differences were noted on the variable of
to place a tick mark on a 100 mm line anchored by strongly disagree (0) combat status.
and strongly agree (100). Based on the distance from zero, these re- In a similar fashion, for the aggregated resilience scores, a mean
sponses were then assigned a number between 0 and 100. The pre and difference value of 0.56 between the pre and post scores resulted in a t
post scores of the individual 10 items were aggregated and compared value of 8.19, which generated a p < .001 with an effect size of 0.54
using a repeated-measure t test with a Bonferroni correction. and an overall Cronbach’s alpha of 0.93. Similar to the analysis on
personal constructs, the independent variables of age, sex, ethnicity,
Results and combat status did not result in any significant differences be-
The results from this study provide a picture that is both positive and tween the pre and post scores. In sum, the data suggest a beneficial
consistent relative to the variables examined. Over the 2010 summer effect from participation in the OB4V when comparing the pre- and

Table 1. Personal Construct Analysis

CONSTRUCT MEAN DIFFERENCE SD t p
Self-Confidence 1.45 2.06 4.33 0.000

Self-Actualization 1.34 2.18 3.79 0.001

Compassion 0.87 1.70 3.17 0.003

Healthy & Balanced Lifestyle 1.47 2.10 4.35 0.000

Goal Setting 0.91 0.24 3.77 0.001

Group Collaboration 0.84 2.12 2.44 0.019

Effective Communication 1.24 1.76 4.33 0.000

Conflict Resolution 1.41 2.14 4.04 0.000

Problem Solving 1.08 1.75 3.81 0.001

Social Responsibility 0.82 1.89 2.67 0.011

Environmental Responsibility 1.13 2.36 2.95 0.005

Total Constructs: 13.26 15.49 5.28 0.000

Note. Based on a Likert scale, where 0 = strongly disagree and 10 = strongly agree. Alpha level based on a Bonferroni correction, adjusted mean, with p = .005.

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post-course scores for both the variables of personal constructs and Moreover, what seems to be a recurring theme in the success of
resilience. What would explain these findings, and is there something these programs is that being in a small group with other veterans
unique about the OB4V and AE in general? appears to be able to exert a tremendous amount of positive impact to
the individual veteran (Westwood et al., 2010). Perhaps Ray (2006)
most eloquently summarizes this concept:
Discussion
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In discussing how the OB4V and AE may be efficacious in pro- For healing to take place, peacekeepers need to voice their grief
ducing positive benefits for veterans, several explanations should be and love not only for their dead military brothers but the loss of
considered. One explanation may involve the ambiance surrounding innocence, the loss of their band of brothers, their military family
the OB4V. As previously mentioned, typically these types of pro- and their military careers. (p. 18)
grams include a small group atmosphere, a natural/outdoor setting,
Thus, being in a group of other military personnel within a unique
and purposively designed and challenging experiences. These attri-
adventure setting often allows the participants to feel connected with
butes serve to ‘‘scaffold’’ or bridge many of the situations experi-
other soldiers again, and this connection can be clearly beneficial in
enced by veterans returning from their military life to that of being
their recovery.
a ‘‘civilian’’ or at least being a veteran redeployed from a combat
Beyond the comradeship, however, it is suggested that two other
theater of action. Thus, in this study, the OB4V may offer the veteran
phenomenon are also at play, both of which have theoretical im-
certain experiences that are reminiscent of some of the more positive
plications. First is the influence of nature and natural environments
aspects of his or her time in the military.
in exerting a positive effect on military veterans. As Hasbach (2012)
Schiraldi (2000) posits a number of these ‘‘positive’’ aspects re-
suggests, natural environments can provide direct sensory experi-
garding being a soldier, including courage, comradeship, selflessness,
ences, and an interaction with nature can facilitate the optimization
dedication, bonding, and self-confidence. In addition, he suggests
of both mental and psychological development. Numerous studies
that, as military people, many veterans experienced feelings of ac-
have now demonstrated a connection between natural landscapes
complishment and empowerment while dealing with adversity
and human health. Beginning with the seminal work of Ulrich
and challenge. Thus, the OB4V can serve as a bridge to these posi-
(1984), a number of theories have emerged that speak to the in-
tive military attributes by providing for the mastering of outdoor and
fluence of nature upon human health. A sample of these theories
adventure-based challenges as a member of a team and doing so
includes Kaplan and Kaplan’s (1989) work on Attention Restoration
within an emotionally ‘‘safe’’ climate. Veterans are encouraged to
Theory that presupposes natural environments can be restorative to
participate in both the activities and also in the discussion of
human health, Ulrich’s (1981) Psychoevolutionary Theory positing
thoughts, feelings, and past experiences among the group members
that nature can help reduce levels of stress, and E. O. Wilson’s (1984)
within a nonjudgmental and nonthreatening atmosphere. Within
Biophilia Theory that suggests humans have a natural affinity to
this context, military veterans often report a number of beneficial
natural things.
outcomes, including
Not surprisingly, it is increasingly believed that the human/nature
(1) A willingness to trust others again, starting with the other relationship can be an important component in the promotion of
members of the group, who, it should be stated, are usually human health. For example, a number of authors suggest that the
complete strangers at the beginning of the AE course or natural environment can be facilitative in the healing process through
program. a number of mechanisms: as a restorative setting (Hartig et al., 2011), a
(2) A belief that they can change their life for the better. valuable ‘‘cofacilitator’’ in the change process (Taylor et al., 2010), or
(3) An engagement in positive reinforcing activities while being an important component in the social, cultural, and environmental/
‘‘off the grid.’’ ecological context for human well-being (Beringer, 2004).
(4) A reawakening to the energizing effects of nature, physical Beyond the effect of the natural environment is the role specific
activity, and practicing learned skills, particularly as a result adventure programming plays in dealing with veteran-related out-
of being involved in adventure activities that are physically comes. In other words, is there a set of specific attributes associated
demanding and necessitate using these learned skills within a with activities or a sequence of activities and curriculum-related
setting that has consequential and real, rather than abstract, experiences that can be particularly effective in producing positive
outcomes. outcomes for military veterans, and do AE experiences capitalize on

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 MILITARY VETERANS AND ADVENTURE EDUCATION

these in a therapeutic way? McKenzie (2000) attributes these out-

comes to four characteristics common to many AE experiences, in-
cluding (a) the unfamiliar nature of the physical environment; (b) the
incremental and progressive sequencing of the challenges presented
through the adventure education experience; (c) the ‘‘processing’’ of
the experience in order to identify and organize meaning for the
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participant; and (d) the use of small groups to facilitate issues such as
reciprocity, group cohesiveness, interpersonal relationships, and the
balance between group belongingness and individual autonomy.
In addition, Ewert and Voight (2012) suggest that AE experiences
can be beneficial for veteran-related issues because they (a) en-
courage physical activity; (b) facilitate the development of social
contacts; (c) provide opportunities for personal growth; and (d) fa-
cilitate, often through reflection in natural landscapes, the reduction
of stress and attention fatigue.
Westwood et al. (2010) describe a concept known as the thera-
peutic enactment, which consists of a sequence of steps that can
move the veteran along a rehabilitation pathway. Figure 2 depicts
these steps.
While principally constructed around a standard group therapy
model, many of these steps align themselves very closely with the AE
situation where there is a preparation phase when the veteran gets
ready to come to the AE experience (e.g., equipment, clothing, home-
related preparations) followed by an initial contact and group de-
velopment phase (e.g., meeting the other participants, working out
normative behaviors and expectations, and developing a team
identity). This phase is followed by a skills and knowledge training
phase where these newfound skills are then enacted upon by in-
creasingly more challenging tasks and demands, both as a group and
individually. Finally, the AE experience leads to a reconnection and
sharing phase where veterans are given a chance to develop and share
a plan on how they will integrate and transfer this experience into
their lives after the course.
Thus, within AE, the military veteran operates within a context that
includes a variety of outdoor activities that require a skill base, at-
tention to detail, trust, and teamwork to successfully negotiate the
various tasks (Ewert et al., 2010b). Moreover, the adventure context
provides consequences that must be attended to. For example, many
of the experiences in both the OB4V and, more generally, AE include
activities such as wilderness trekking, white-water rafting, rock
climbing, mountaineering, and solo. For example, rappelling down a
cliff face provides a challenge with real consequences and, if done
Fig. 2. Therapeutic Enactment Model. Adapted from Westwood
incorrectly, contains elements of serious risk and danger. On the other
et al. (2010).
hand, if done correctly, these activities can mobilize a host of health-
promoting behaviors including trust building, being able to rely on

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others, a sense of competence, teamwork, and a sense of empower- model emulated across the various Outward Bound schools, vagaries
ment (Shellman & Ewert, 2010). such as weather, types of instructors, field conditions, and so on
In addition, as in most AE programs for veterans, each individual preclude us from guaranteeing that all the participating veterans
in the group is expected to participate in all aspects of the experience, received the exact same AE experience. While the research protocol
in part to develop a sense of reciprocity, that is, using the strengths of was similar across the courses, the same cannot be said for all the
individuals within a group to compensate for specific needs of other courses (e.g., weather, instructors).
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members of the group (Van Puymbroeck et al., 2012). Most AE pro- The above limitation notwithstanding, the results of this study
grams for veterans incorporate reciprocity into the group experience suggest that the OB4V, and by extension, the AE experience, can be
as the problem-solving tasks and challenges become increasingly an effective intervention approach in helping veterans achieve a
more difficult. This reciprocity helps develop a sense of trust and number of positive outcomes such as specific personal constructs and
belonging to a team, which many veterans report as missing in their resilience. Because most AE programs do not have licensed therapists
civilian lives. In addition, through facilitation and reflection it is on staff, these programs are often used as ‘‘adjunct’’ therapeutic in-
expected that the veteran will emerge more capable of dealing with terventions. Nevertheless, Beringer (2004) suggests that utilizing AE
stressful situations and be willing to ask for help, if needed. types of programs can provide a new and innovative alternative for
Creating an atmosphere whereby military veterans can consider more traditional therapeutic programs. Thus, regardless of their
and change their behaviors relative to issues such as substance abuse placement in the therapeutic sequence, these types of programs can
and combat-related stress, through the use of debriefings and facil- play a vital role in the restoration and rehabilitation for many mili-
itation, is often critical to the AE experience. When combining many tary veterans primarily through the mechanisms of using natural
of the attributes commonly associated with natural environments, landscapes combined with sequenced and purposely designed ac-
such as real and concrete consequences, with adventure-based tivities developed for individual and group interaction. In addition,
activities that expose the participant to manageable risk and uncer- the AE experience relies heavily on the small group and reflective
tainty of outcome, coupled with the use of incremental and specifi- context where veterans once again can feel part of a team while in a
cally designed activities, veterans often emerge more resilient and physically challenging but emotionally supportive environment. In
capable of dealing with uncertainty, stress, and other potentially ad- considering the potential outcomes from participation in AE pro-
verse circumstances they are experiencing as civilians or as soldiers grams, for many veterans ‘‘emptying out the rucksack’’ is easier and
being redeployed back to the United States (Ewert et al., 2010a). more meaningful in these types of environments than on the clini-
While the data present a fairly positive picture, there are several cian’s couch.
limitations associated with this study. First, as is common with much
of the research done in field-based environments and programs, the Author Disclosure Statement
participants were self-selected in that they volunteered to participate No competing financial interests exist.
in the OB4V. This self-selection presents a confounding variable
(Ewert & Sibthorp, 2009) that points to a conclusion that AE pro-
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Address correspondence to:
Sibthorp, J. (2003). An empirical look at Walsh and Golins’ Adventure Education Alan Ewert, PhD
Process model: Relationships between antecedent factors, perceptions of Indiana University
characteristics of an adventure education experience, and changes in self- 1025 East 7th Street
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