Effects of a Low-Element Challenge Course on Abstinence Self-Efficacy and Group Cohesion

Abstract

Substance abuse researchers identify self-efficacy and group cohesion as important components in alcohol and other drug-dependency treatment. Objectives: The purpose of this single-group, pretest–posttest study is to explore the therapeutic value of a challenge course intervention on the self-efficacy and group cohesion of nine chemically dependent, adult females. Methods: Data were collected using two validated outcome measures administered before and after the intervention. Focus groups provided insight into the experiences of participants and were examined using manifest and latent theme analysis. Results: Findings indicate statistically significant improvements on both outcome measures with medium to large effect sizes. Several themes were identified including group unity, trust, interpersonal growth, and self-confidence. Conclusions: Suggestions for practice and future research are provided.

Keywords

addictions mixed methods group work women

The treatment of individuals with substance abuse disorders is a critical practice in which social workers are greatly engaged (National Association for Social Workers [NASW], 2006). According to the Substance Abuse and Mental Health Services Administration (SAMHSA; 2003), as many as 26 million Americans suffer from an alcohol or other drug dependency, indicating a substantial need for substance abuse treatment services. Furthermore, as the social and economic consequences of substance abuse continue to weigh heavily, it has been projected that social work’s involvement in such treatment services may actually grow (Smith, Whitaker, & Weismiller, 2006). Despite this increasing involvement, however, there continues to be a gap in treatment services (McAuliffe & Dunn, 2004); and, due to their unique needs, women may be differentially affected by this gap (Gerolamo, 2004).

Rooted in the traditions of experiential learning theory, wilderness adventure therapy (WAT) utilizes both natural obstacles and crafted activities in order to bring to life traditional therapeutic pursuits. WAT aims to facilitate total sensory engagement while acting as a catalyst for group-and individual-level processing (Joplin, 2008). Such adventure-related treatment modalities are being embraced as effective approaches to enhancing interpersonal growth and ameliorating maladaptive behavior (Gillis & Speelman, 2008). In addition, research supports the use of WAT, in conjunction with other treatment services, to increase self-efficacy (Aubrey & Mcleod, 1994; Faulkner, 2002b; White, 1998) and build group cohesion (Bronson, Gibson, Kishar, & Priest,1992; O’Bannon, 2000) among participants. Both self-efficacy and group cohesion have been linked to successful substance abuse treatment outcomes (Faulkner, 2002a; Gillaspy, Wright, Campbell, Stokes, & Adinoff, 2002; Stark, 1992). For these reasons, the exploration and evaluation of novel practices proves to be an important duty for social work research (Magura, 1994).

Literature Review

A challenge course is a type of WAT designed to engage participants both physically and psychologically as they navigate through a series of obstacles made from cables, logs, and ropes. Challenge courses enhance interpersonal growth through building positive social interactions, stretching personal limits, and strengthening group cohesion (Faulkner, 2002a). Obstacles in a challenge course can be categorized as either low or high element. Low-element obstacles focus on group development through the application of therapeutic games and problem-solving activities and generally take place less than 10 feet off the ground. High-element challenge course obstacles, however, are designed for individual development and take place at least 15 feet off the ground (Rohnke, Wall, Tait, & Rogers, 2003). The primary goal of a challenge course is to provide the opportunity for participants to transfer skills and feelings they learn and apply them to their everyday lives (Haras, Bunting, & Witt, 2005). Today, challenge courses are used as corporate training tools, with students in schools, as recreation, and in therapeutic settings such as hospitals, wilderness camps, and in substance abuse treatment facilities (Gillis & Speelman, 2008).

Although research in the area is limited, initial evidence supports the use of challenge course interventions for certain populations (Gillis & Speelman, 2008). Today, challenge courses are used to enhance team functioning within corporate groups (Bronson et al., 1992; Kelly, 1996), to assuage psychiatric symptomatology among persons with mental or emotional disorders (Chakravorty, Trunnell, & Ellis, 1995), and to increase positive health behaviors in college students (Kanters, Bristol, & Attarian, 2002; Witter, 2005).

Further evidence suggests that participation in a challenge course may have a range of positive effects. Several studies demonstrate that participants who were involved in a challenge course experience improvements in both self-esteem and self-efficacy as indicated on self-report efficacy measures (Davis, Ray, & Sayles, 1995; Rastall, 1998). A recent meta-analysis of studies on the use of a challenge course as a therapeutic tool found that the most frequently examined outcome constructs were self-esteem and self-concept (Gillis & Speelman, 2008), indicating the potential to impact these constructs.

Because studies suggest that participation in a challenge course improves self-esteem, such interventions may be especially suitable for chemically dependent individuals (Bennett, Cardone, & Jarczyk, 1998; Faulkner, 2002a). Significant research looks at self-esteem and efficacy as important components in the addiction and recovery process, and many consider them to be central to theories on addiction (Marlatt & Witkiewitz, 2005). Studies demonstrate that self-efficacy toward abstaining from one’s substance of choice can help predict future drug use, relapse rates, and recovery success (Carbonari & DiClemente, 2000; Ilgen, McKellar, & Tiet, 2005). In a study by Stephens, Wertz, and Roffman (1995), researchers examined the role of self-efficacy in marijuana cessation. Participants who reported feeling more able to abstain had lower rates of relapse than their less-efficacious counterparts. Likewise, abstinence self-efficacy has also been shown to significantly predict future lowered alcohol use. In a study on the abstinence self-efficacy of individuals involved in substance use disorder treatment, researchers found that confidence in abstaining from use was the single strongest predictor of relapse at a 1-year posttreatment follow-up (Ilgen et al., 2005).

Additional research reveals that use of WAT as a therapeutic intervention enhances social interactions and increases group cohesion and alliance (Faulkner, 2002a; Gillaspy et al., 2002; Griffin & Penscott, 1991; Stark, 1992). For our purposes, group cohesion is defined as a group members’ relationship both to the facilitator and to the other group members. Research demonstrates that group cohesion may impact group productivity and psychotherapy outcomes by fostering a climate that promotes the development of therapeutic processes (Brown & O’Leary, 2000; Budman et al., 1989; Johnson, Burlingame, Olsen, Davies, & Gleave, 2005). In fact, group cohesion has been conceptualized as a key aspect of group development and a major component in successful group treatment participation (Griffin & Penscott, 1991; Yalom, 1995).

In a study of adolescents participating in a 1-day, low-elements challenge course, researchers found that individuals who participated in this WAT treatment reported significantly higher rates of group alliance after completion of the intervention (Glass & Benshoff, 2002). While this is the only study to report on the use of a challenge course specifically to improve group cohesion, other evidence exists on the importance of group cohesion to general group development, maintenance, and outcomes (Brown & O’Leary, 2000; Conners, Carroll, DiClemente, Longabaugh, & Donovan, 1997). In another study on adult males participating in an inpatient substance abuse treatment program, researchers aimed to examine the effects of group alliance on a variety of outcome indicators at 30 days posttreatment. Results from this study reveal that participants who reported increased group alliance also reported significantly less psychological distress related to substance use than those who reported decreased group alliance (Gillaspy et al., 2002).

Strong group alliance may also be associated with increased retention in mental health and substance abuse treatment (Stark, 1992); and many studies have found that increased retention in treatment significantly predicts substance abuse treatment success (Greenfield, et al., 2007; Lash, 1998; Moos & King, 1997; Simpson, Joe, & Brown, 1997).

Study Rationale

Because the majority of research on challenge courses has traditionally focused on adolescent populations (Aghazarian, 1997; Davis et al., 1995; Glass & Benshoff, 2002; McDaniel, 1999; White, 1998), little is known about the use of challenge course interventions with an adult sample (Bettmann & Jasperson, 2008), and no literature exists on their use with a chemically dependent, all-female sample (Bennett et al., 1998). In addition, most studies have concentrated on measuring outcomes rather than processes. Because of this predominately narrow focus, researchers suggest that the literature could be improved upon through the use of translational work with different populations (Haras et al., 2005).

While evidence exists supporting the use of WAT interventions with chemically dependent populations to enhance interpersonal growth, there is a distinct lack of evidence supporting their efficacy in reducing substance use. In order to isolate why WAT interventions have yet to yield long-term reductions in alcohol and drug use, new methodologies including mixed method and qualitative designs must be employed (Wolfe & Dattilo, 2007). Through the careful examination of the experiences of participants engaged in a challenge course intervention, we may be better able to unravel WAT’s mechanisms of action. Without a deeper understanding gleaned from such research, it proves impossible to realize WAT’s deficits and adapt it to effectively serve clients.

This study employed the use of two well-studied outcome measures on self-efficacy and group cohesion. Further, this study used qualitative focus groups to answer the following questions: (a) What are the experiences of individuals who participate in a challenge course? and (b) Can challenge course activities be implemented successfully, in conjunction with other services, with an adult sample of chemically dependent females?

Method

The effects of a low-element challenge course intervention were studied on a small number of women in residential substance abuse treatment. Activities were designed to provide physical and emotional therapeutic challenges and manualized using Rohnke, Wall, Tait, and Rogers’ (2003) Complete Ropes Course Manual and Yalom’s (1995) work on stages of group development. Master’s level clinicians led twelve 90-minute weekly sessions that took place at the facility’s existing challenge course. Only those who participated in at least 75% of the activities were considered to have received a full dosage.

Of the 18 clients participating in treatment at the facility at the time of recruitment, 15 agreed to participate and 9 completed 75% or more of the intervention activities. The remaining 6 participants did not complete 75% of the activities as they were not present during some part of the intervention for reasons including discharge from the program and being unable to attend group sessions. The majority of the study participants was Caucasian between 18 and 34 years old (M = 28, SD = 5.6). Due to the facility’s use of rolling admissions, the length of time in treatment ranged from 14 days to 7 months, with an average length of stay of 90 days (SD = 72.5). Five participants were diagnosed with drug and alcohol dependency, three reported a drug-only dependency diagnosis, and one reported an alcohol-only dependency diagnosis. Participants reported having used their substance of choice for at least 1 year and at the longest for 20 years (M = 12.6, SD = 6.2), and the average age of first use was roughly 17 (SD = 6.1).

Measures

Abstinence self-efficacy

For this study, participants’ abstinence self-efficacy was measured using both the Alcohol Abstinence Self-Efficacy scale (AASES) and the Drug Abstinence Self-Efficacy scale (DASES). Participants were asked to rate on a 5-point Likert-type scale (not at all to extremely) how confident they feel that they could abstain from using their substance of choice in 20 high-risk situations. Scores were summed with high scores indicating strong confidence in abstaining from using alcohol or drugs and low scores indicating low confidence in abstaining (DiClemente, Carbonari, Montgomery, & Hughes, 1994).

Group cohesion

To measure group cohesion, the Group Climate Questionnaire–Short Form (GCQ-SF) was used. It is a multidimensional, 12-item self-report instrument that measures perceptions of group cohesion. Participants were asked to rate on a 6-point Likert-type scale (not at all to very much) how strongly they feel the group is working together or getting along. High scores on the GCQ indicate a high level of perception of group cohesion with low scores indicating the opposite (MacKenzie, 1983).

Design

This study employs the use of a single-group pretest–posttest design. With permission from our Institutional Review Board, participants were administered a consent form, demographics and drug history questionnaire, the AASES, the DASES, and the GCQ before beginning the intervention (pretest at Week 1) and after completion of the intervention (posttest at Week 12). Similarly, participants took part in short qualitative focus groups at 5 times: before beginning the intervention (Week 1) and coinciding with the end of each of four modules: listening (Week 3), teamwork (Week six), trust (Week 9), and problem solving (after completion of the entire intervention at Week 12).

Module 1: listening

Weeks 1–3 began with introductions and “getting-to-know-you” games. Activities included warm-up exercises. For example, participants provided their names and adjectives to describe themselves using the first letter of their name. Participants also engaged in activities such as identifying objects on a nature walk to illustrate their personalities; and “Like me, Not like me” where participants were asked to state whether a given adjective described them.

Module 2: teamwork

Activities during Weeks 4–6 centered on group alliance or teamwork. Participants took part in exercises including a group juggle, where members utilized each other to juggle an increasing number of balls. Another activity, “Eyes, Body, Voice,” required participants to adopt roles—the eyes, the body, or the voice—and accomplish a series of tasks using the help of other group members.

Module 3: trust

Activities during Weeks 7–9 increased in difficulty as they began to focus on building trust. Participants took part in blindfolded exercises, in which participants led each other through a maze or gave direction to achieve a goal. Other activities included a low-level trust fall and “feet off the ground,” in which participants held or carried one another to a desired point.

Module 4: problem solving

The final module on problem solving occurred during Weeks 10–12. Participants took part in activities that required them to work as a group in order to successfully solve puzzles and riddles. Activities included, for example, silently arranging themselves on a log in different formations and getting the entire group across a tight rope with limited resources.

Data Analysis

This study employed a mixed-method analytic strategy. Due to the small sample size and subsequent lack of data normality, we used the nonparametric Wilcoxon’s signed ranks procedure in order to determine the pre- and postintervention differences in abstinence self-efficacy and group cohesion. In addition, researchers conducted five short focus groups throughout the study—before beginning the intervention at Week 1 and again at Weeks 3, 6, 9, and upon completion of the intervention at Week 12—in order to answer the following questions: (a) What are the experiences of individuals who participate in a challenge course and (b) Can challenge course activities be implemented successfully, in conjunction with other services, with an adult sample of chemically dependent females?

Researchers asked open-ended questions, took field notes, and transcribed participants’ responses. These field notes were then uploaded into Atlas.ti qualitative analytic software and subjected to iterative analysis by two independent researchers.

Atlas.ti is used extensively in qualitative research in the social sciences. In this study, the software was used to identify salient words or codes that emerged from an iterative examination of the transcribed field notes. Codes were then separately reviewed by independent researchers and grouped together to form constructs or themes. Once the constructs were created, researchers reunited to evaluate congruency. Only the themes which both researchers agreed upon were retained for analysis.

First, qualitative data were collected via short (roughly 30 min) focus groups with all participants at 5 points during the study: before, 3 times during (Weeks 3, 6, and 9), and after completion of the intervention (Week 12). At these points, participants were asked to openly discuss their experiences. While the purpose of these focus groups was to allow free discussion, specific questions designed to engage this discussion were gleaned from research in similar areas. Questions centered on the expectations, goals, and perceptions of benefits and limitations of participation in the challenge course. Field notes were taken on these focus groups by an observer and later transcribed by a research assistant for open-coding analysis. Open-coding analysis allowed us to identify manifest content—the information that was physically present in the data—and to develop codes out of this content (Miles & Huberman, 1984).

Focus groups were initially analyzed by session in order to examine the group development process and the different experiences of participants throughout the intervention stages. First, two independent researchers performed a line-by-line analysis of the transcribed focus groups. In order to accurately capture participants’ thoughts and feelings, we used in vivo coding or the exact words of participants to create codes. The codes were generated by the qualitative analysis software. Once generated, the codes were highlighted in the margins of the transcript to allow a visual examination of the textual patterns. Researchers looked for patterns in word usage and grouped similar verbiage together. Patterns were determined if at least three participants used similar words to express an idea. Once the word patterns were identified, researchers then came together to compare notes on these patterns and reach a consensus on each one. Only codes that both researchers agreed upon were retained and highlighted by the software program in the transcript. After determining the most salient codes, researchers discussed the implications of these codes and looked at the data—this time by phrases or expressions rather than line by line—all in order to explore larger, latent themes. Latent themes are deeper ideas conveyed by participants (Holsti, 1969). The development of such themes, in conjunction with identification of manifest codes, can help provide a better understanding of the similarities and differences among participants’ experiences (Berg, 2001).

Results

Quantitative Analyses

Results from the Wilcoxon’s signed rank procedure revealed a significant difference in mean scores on the pre- and posttest on the AASES and DASES as well as on the GCQ. In addition to determining whether differences in pre- and posttest scores existed, the standardized mean difference statistic, or the effect size, was calculated and interpreted using Cohen’s (1969) accepted thresholds of magnitude. A small-to-medium effect was found for drug abstinence self-efficacy (d = 0.30, p < .05), and large effects were found for alcohol abstinence self-efficacy (d = 0.86, p < .05), and group cohesion, respectively (d = 1.89, p < .01; Table 1 ).

Table 1.

Effect of a Challenge Course on Abstinence Self-Efficacy and Group Cohesion

	Pre Mean	Pre SD	Post Mean	Post SD	Z	Cohen’s d
Alcohol abstinence self-efficacy	73.22	21.79	88.78	13.57	2.37^*	0.86
Drug abstinence self-efficacy	79.00	23.56	85.56	19.44	2.40^*	0.30
Group cohesion	54.67	9.86	72.33	8.85	2.67^*	1.89

^*p < .05.

Qualitative Analyses

Throughout the 12 weeks, participants reported a progression of thoughts. Several themes emerged that related to group development. During the initial focus group, participants articulated expectations regarding the intervention and reported feeling somewhat anxious and nervous. By the second group, however, participants expressed feelings of safety and enjoying their experiences both within the group and on the challenge course. As the intervention continued, participants related activities to the recovery process and expressed a sense of trust. Finally, participants reported experiencing self-awareness and personal growth as a result of participation in the challenge course.

Observation 1: unease, anticipated difficulty

When asked open-ended questions regarding intervention expectancies prior to beginning the intervention, several themes emerged from the data. The first major theme identified was “unease.” The majority of participants reported feeling “nervous” or “uneasy” about participation in the intervention. None reported previous experience with challenge or challenge courses, and only one stated that she knew what a challenge course was. Because of the lack of knowledge and experience with similar activities, the majority of participants reported some apprehension. Two, however, of them expressed excitement at the possibility of health benefits. “I’m excited because I love the outdoors. Plus, I feel like I’ve gained weight since I’ve been [at the program]. I want to lose weight.”

The second major theme identified was “anticipated difficulty.” When asked, “What do you think this experience will be like?” several participants expressed worry due to the perceived difficulty of the activities. Participants reported that they rarely exercise and were worried that they would be unable to physically complete the obstacles. One stated, “I can’t do this.” Another said, “I don’t know what to expect. This sounds hard.” Two members of the group also vocalized concerns regarding the outdoor environment, “I don’t like being outside when it’s hot. I’m already dreading being hot and sweaty.” Despite hesitation, all agreed to maintain a positive attitude and stated they were “willing to try.”

Observation 2: fun, relating activities

Participants were asked open-ended questions at the end of Week 3 regarding their experiences with the challenge course. During this focus group, one salient theme emerged. Participants generally responded that they were having “fun.” One explained she “loved [the activities]” and thought “they were really fun.” Another participant said that while at first she was hesitant because she is “not usually good at this type of thing,” she found herself laughing often which was “unusual.”

I didn’t think I could do it, but I did. It was fun. I laughed a lot, which is nice. We don’t really just cut loose, and I feel like we did today …. It was good to be out of the [facility] today too.

The next theme that emerged was participants’ ability to relate the challenge course activities to their recovery process. Several members agreed that participating in activities that required the use of their entire bodies (opposed to talk-therapy alone) allowed them to see things differently. One individual explained that the activities highlighted the group’s message, “At least we’re not just inside talking to each other … I can really see what you mean now.” When asked specifically how the obstacles related, another elaborated.

I can relate this to my recovery because you have to learn to drown out the wrong voices and only listen to yourself and the people who want to help you … I had to ignore the people who didn’t want me to succeed …. But at first, I couldn’t tell which voice to listen to. I had to tune out the other ones.

Observation 3: unity, connectedness

The group continued to participate in focus groups at the end of Week 6. The primary theme that emerged here was “unity.” During one activity that required all group members to work collectively, a participant stated, “We can do this together” and several agreed. When discussing a certain activity that required interdependence to complete a complex task, one participant said, “I needed her to pick up my slack, and then I helped her … It was a team effort.” Through working together to complete obstacles, participants shared a sense of connectedness. The group provided and received feedback and guidance both during the activities and focus groups; and members reported feeling “close” to one another.

Observation 4: trust

Following the intervention session on Week 9, participants again engaged in a short focus group in order to discuss experiences. The most salient theme to emerge here was trust. Participants were asked to take part in various activities that required them to be blindfolded and heavily rely on another group member to successfully accomplish a goal. While many expressed apprehension before beginning, several women reported positive experiences after participation.

I didn’t want to trust my partner at first but I finally did…. You can’t do everything on your own. That’s how we got here. I’ve tried to be superwomen, and I just can’t do it. I have to rely on my mom and my sister for help sometimes too.

Observation 5: self-awareness, confidence

At the end of the Week 12, participants were again interviewed as a group and asked open-ended questions regarding their experiences over both the preceding 3 weeks and the intervention as a whole. At this point, several themes emerged including, “self-awareness” and “growth.” When asked about her thoughts regarding an activity where participants were led around a maze, one explained, “Even though some of the activities were scary, I found out something new about myself.” Participants reported that by stepping outside of their typical comfort zone, they gained insights about themselves. Another individual used an analogy of a rollercoaster to express her feelings.

At first it’s scary and your adrenaline is pumping … then you do it and you are a stronger person for it.

The second theme that emerged was “self-confidence.” Participants reported successful navigation of difficult obstacles allowed them to recognize that they were “good at something.” After completing a complex group puzzle, one participant explained, “I enjoy sharing my opinion and figuring things out. We usually don’t get to talk through problems like this.” Finally, another individual explained that she gained self-confidence through participating in the challenge course.

It feels good to get out and do something sometimes …. I can be helpful. I give good advice and encourage other people when they’re doing something hard for them … I learned to proud of myself.

Discussion and Application to Practice

The findings of this study reveal that there were statistically significant improvements on measures of abstinence self-efficacy and group cohesion. Effect sizes were calculated in order to determine the magnitude of such improvements. Analyses demonstrate a high effect for alcohol abstinence self-efficacy and group cohesion, and a medium effect for drug abstinence self-efficacy (Cohen, 1969). Similar effect sizes have been found in related literature.

Focus groups provided insight into the experiences of participants. Initially, the group reported unease or anticipated anxiety regarding intervention expectations. Throughout the study and as the group developed, members reported that they were having fun. Over the next several sessions, participants began to trust one another and receive feedback from or give advice to other group members. Finally, participants reported experiencing personal growth and increases in self-confidence after participation in the challenge course.

Finding ways to motivate clients who have histories of chronic substance abuse to alter their maladaptive behaviors can be a difficult task for practitioners. Some researchers characterize substance abusers as being resistant to change and having unique motivational needs (Sampson, Stephens, & Velasquez, 2009). From this perspective, resistance is believed to be normative and a potential obstacle in treatment. WAT interventions, like the one studied here, are designed to increase treatment engagement. The use of such interventions in conjunction with other services may enhance experiences of participants. An examination of the process experiences of clients participating in the challenge course revealed that clients increasingly became more positively engaged with other group members and with the intervention. Similarly, clients reported a strong willingness to participate because they were “having fun.”

There were several limitations to this study. Because of the small sample size and the absence of a comparison condition, results cannot be generalized, causal inferences are not permissible, and findings may be difficult to replicate. The research design failed to utilize a comparison group; therefore, treatment effects could not be isolated. Additionally, residential substance abuse treatment likely targets self-efficacy and group cohesion as part of its psychoeducational curriculum. This makes it impossible to determine whether the quantitative findings were due to the intervention alone or due to participation in the residential substance abuse treatment program.

Participating in the challenge course and in standard treatment services simultaneously undoubtedly confound results. While our quantitative findings alone do not support causal inference, information gleaned from the focus groups supports and reflects the quantitative findings, giving us comfort in reporting pre- and posttest differences. In order to improve design and generalizability, it would be necessary to compare the treatment group to a similar comparison group with an adequate number of participants in each condition. Future studies would benefit from examining either those who did not receive the full dosage of the intervention or a second group that is also participating in the same residential treatment but not the targeted intervention. This would allow for the comparison of group differences and assist in determining whether the completion of the challenge course, in fact, aided in self-efficacy and cohesion improvements above and beyond the residential program. Additionally, the employment of a randomized design would further illuminate the effects of participation in a challenge course intervention as researchers could isolate outcomes by controlling for threats to internal validity. Another limitation of this study was the lack of control for the varying amount of time participants spent in the program. Because the facility employs rolling admissions, participants differed substantially in the number of days in treatment. It is possible that the simple passage of time influenced outcomes.

Balanced against the limitations of this study are its contributions. This study represents an early effort to empirically explore a novel WAT intervention on a population that has been understudied in the literature (Bettman & Jasperson, 2008). Validated measures were chosen based on their relevant theoretical constructs to the recovery process. The mixed methods design allowed contextualization of the measurement results and provided insight into participants’ subjective experiences. Finally, manualization of any intervention is particularly beneficial as it allows for the possibility of transferring it to other settings as well as providing guidance for inexperienced clinicians and student interns. Ways to improve the study include a randomized design with control or comparison groups. A larger sample size with attention to key demographics will improve generalizability and increase chances of replicating findings. It may also prove advantageous to collect additional observations during the 12-week intervention in order to better understand and predict incremental changes in behavior as they occur.

Social workers have long participated in the prevention and treatment of individuals with substance abuse disorders (Jenson, Howard, & Vaughn, 2004), and many social workers are currently engaged in substance abuse practice (NASW, 2006). Because of social work’s history and capacity to serve such clients, the implementation and evaluation of new techniques should be explored (Magura, 1994). Initial evidence supports the use of WAT as a potential new way to provide services to clients. Participation in a challenge course intervention may increase one’s self-efficacy as it relates to recovery and improve group dynamics by enhancing cohesion among members. In addition, challenge course activities may provide an opportunity for interpersonal growth and act as a source of enjoyment, as individuals in this study reported. While these results do not imply causation nor can they be generalized to other samples, further research is warranted.

Studies like the one reported here are only suggestive and should be interpreted with considerable caution. Findings, however, do suggest that a challenge course, in conjunction with additional services, may provide benefits to individuals participating in substance abuse treatment. Through this study, we have learned more about the process and experiences of participants in a challenge course intervention and have begun to see the benefits of using such an intervention with an understudied sample.

Footnotes

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The authors received no financial support for the research, authorship, and/or publication of this article.

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