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Scott Webb: Adventure therapy is a form of experiential psychotherapy in which participants complete challenging activities within a safe and closely supervised environment. Sounds like fun, right? Rope courses, problem solving activities, outdoor experiences and trust-based activities are all examples of adventure therapy. And joining me today to tell us more are Dr. Chris Sharp and Joanne Mikovich, and they're both from Sierra Tucson. This is, let's talk mind to Body Spirit by Sierra Tucson. Sierra Tucson ranked number one best addiction treatment Centers 2021 in Arizona by Newsweek.

I'm Scott Webb, so I wanna thank you both for joining me Today we're gonna talk about adventure therapy, and as I was just sort of confessing, I haven't heard of this. I don't know anything about adventure therapy, so it's great to have you both here have your expertise. And Chris, I'll send this one your way. What's your experience in adventure therapy or leading up to your experience here at Sierra Tucson?

Dr. Chris Sharp and Joanne Mikovich: Yeah, so it's been a long road for me. I started back in the late eighties as. It outward bound and that was a transformational experience for me. Spending a month in the woods doing a lot of outdoor skills and leadership process. And really helped identify who I was gonna be as a young adult in the pathway that I took in my life choices going forward. There's been a few turns and, steps in there, but I first got involved with the professionally with Project Adventure, in the Northeast United States doing ropes course programming and school-based programming that was really focused on leadership and communication, through adventure.

And that was kind of where I got started with that. I took a few side steps, got involved in emergency medicine and backcountry care for a long time, but I came back to the field after my own life-changing experience where I sustained a significant injury, significant head trauma, and had to go through recovery for a long time. So I, started at Sierra Tucson about seven years ago, working specifically on their ropes course and doing the high adventure components there.

And then over the last couple of years I've taken more of a Management role and, doing much more of the clinical programming with the adventure therapy. But it's, something that I live, it's been essential for my whole life trajectory. And so getting to share that with people is a really, rewarding process for me.

Scott Webb: I'm sure it is. It sounds, really exciting and if you pardon the pun, Adventurous. I love it. I can't wait to learn more. So, Joanne, what's the purpose and mission of adventure therapy? What are some of the foundational concepts?

Joanne Mikovich: Adventure therapy, it's just an opportunity for residents to kind of just be mindful and help them develop a deeper sense of self-awareness and insight about themselves and just see what comes up for them organically when we face them with different types of challenges, whether it's going on a mindful hike or potentially something on our low ropes course. Just seeing what comes up for them and then we take the opportunity to kind of process that with them.

Dr. Chris Sharp and Joanne Mikovich: It's very much a laboratory for us that we get to create a scenario or situation that is both safe but also activated. Allowing them to be present in a challenging situation. And then role play or, problem solve or game theories themselves into their own best. And so there's an opportunity to be meeting people when they're activated, when their adrenaline is up, when their experience and familiarity, is not engaged. This isn't asking people to do something they're familiar with. It's really asking to do something they're unfamiliar with. And so what comes out organically a lot is people's default modes. What is their go-to? What is their safe space? And if possible, can we challenge that and expand their safe space?

Scott Webb: Yeah. And Chris, maybe you can give us some examples of the therapeutic experience, you know, a and a resident life experience that they may be working through that brings them to adventure therapy.

Dr. Chris Sharp and Joanne Mikovich: It's fantastic modality because it can really be applied to anybody in every sort of level that's willing to step into this process. One of the things I find most significant is clients that are working on, , How they're interacting with the world, how they're interacting with peers, how they're interacting with loved ones, so to affect their communication style. And so one of the things that we get to do in this process is to challenge what their default is in communication style. If you're somebody who's used to being authoritative, used to being listened to, or used to following directives, this is one of these great opportunities for people to challenge that and see wait, what if I were to use a more collaborative approach?

What if I were to use something that was consensus building? What if I were to step into my own voice and have people hear me as an authority or as a, you know, as someone wanting to direct it and let them actually challenge whatever it is from their whole life experience, trauma experience, family of origin, to turn some of that on its head. And see if there's an opportunity to step into something a little bit different.

Joanne Mikovich: Yeah. We have a lot of residents that have suffered from significant trauma, and this is an opportunity for them to kind of rediscover themselves, rediscover that leadership role that they might have once had. Or sometimes we have residents that were athletes in one point of their life and then something happened and it's almost like a piece of themselves is missing. And so,, we try to provide a safe space for them to, challenge that and again, rediscover themselves.

Okay

Scott Webb: Yeah, that word does seem to be a common thread here, Joanne. The c. Really challenge themselves to sort of be their best selves, either who they are normally or to change that up and do something organically and do it differently. So it's really exciting. Very cool. Wondering, Joanne, what are some of the goals, that are set while working with residents? Do you set them? Do they set them? Do you do them in collaboration? How's that work?

Joanne Mikovich: We really leave it open to their own interpretation. When it comes to the word challenge, I think a lot of residents, they try to step into that physical role and put a lot of pressure on themselves and be like, oh my gosh, it's a challenge. So I have to get up on this ropes course and I have to, climb to the top of the rock wall. But we also try to let them know that, A challenge is, different for everybody. So that could mean simply just practicing being present. Maybe a challenge for you is you have racing thoughts and you need to practice breathing and take a step back.

And we really try to leave it open for residents to kind of have that mindful check-in moment with themselves and discover like, what is that challenge and how can I move forward with that? And we're just kind of there to help guide them along through that process.

Scott Webb: Yeah. And I'm sure Chris, the most important thing that you mentioned earlier, role playing, right? So sort of stepping out of their normal lives, their normal selves, and kind of doing something different or maybe that they used to do or used to be, or wish they were, or any, all of the above. But I'm sure one of the, essential things here is helping residents to carry these goals and experiences back into. actual lives, their daily lives. So how do they do that, and how do you help them do?

Dr. Chris Sharp and Joanne Mikovich: Yeah, I think that really is the nut to crack in this whole process because if it's not about the transference, if it's not about what they take home, then really we're just kind of playing games and, seeing beautiful sights. Which to be honest, Is a real perk of the job, but there is some real, transference goals in the overall process. And so, to build on, there is this laboratory kind of idea that they're getting to practice some of these things, in real time. And hopefully that practice then carries on to practical applications so much. What we talk about in psychoeducation has these, very big sounding words like mindfulness, like grounding, That sort of thing.

And it's amazing to actually practice it because the practice of it is both incredibly simple and the impact incredibly profound. So the big thing for us is that opportunity to practice something, especially when you don't know the outcome or you aren't comfortable. So whether it's the group dynamics, whether it's the level of the challenge that the adventure programming is giving you, you're in a space where you're fully able to outline everything you're gonna do and check the back chapter for how, exactly to do this.

You're really stepping into it. And then what that does is it, builds a foundation for them to either go back and learn more, , or really to apply it to what's important to them and see themselves in that situation. So much of what we do on a ropes course or something like that is a made up adventure. And so we ask them to refer this to visualize, to connect with the real challenge they face, so that it's not so much walking on a cable as that metaphorical journey that they're taking in their life from dis-ease and unwellness to, wellness and to anticipate some of the problems along the way.

And, if you can connect the physical challenge that you're experie. and the goal that you're going for in a very real time piece there. Then the idea is, when they actually are in that process, they have that mental reference. Yeah, I struggled and I grip down and I breathed into the moment and maybe I asked for help. And those are all metaphorical experiences, but they actually then apply to the real opportunity. So it's this wonderful, wonderful place to, play act, to role play, to test that, and if they walk away with just remembering to breathe when they're stressed, man, we've gotten ahead of the curve on so many things there.

Joanne Mikovich: We're really lucky because we're really just planting seeds is how I see it. And we see a lot of aha moments because it's so simple to say, like, breathe. Right? But we constantly forget it. Like when we're stressed, I mean, I find myself holding my breath all the time and , so we see a lot of aha moments with people like, oh my gosh, like, wow, that actually did reduce my anxiety or asking for a shoulder to lean on while going across this traverse wasn't that big of a deal. It was okay to reach out for help. And like Chris was saying, that transference piece, being able to take that into the real world and ask for that metaphorical han d is huge.

Dr. Chris Sharp and Joanne Mikovich: And it takes practice, right? Yeah. And so that's what we are, we're the practice room . I like that.

Scott Webb: Yeah, definitely. My watch is always reminding me to breathe, you know? And I used to ignore it, you know, the mindfulness, the breathing, and I started listening and I was like, you know what? I'm gonna trust you. Watch. If you believe it's time for me to breathe, then I need to make some time to breathe. And it's like you say, it's such a simple thing, you just, hey, just breathe. Yeah. But most of us have trouble with that, not the literal, like, life sustaining, breathing. But the metaphorical, the psychological breathing, the taking a breath, taking a moment, taking a beat, and it really sounds like this adventure therapy program really helps folks do that.

And Joanne, I'm wondering, when we think about the relationship between you and the residents while they're working through things like trauma and anxiety, maybe you can tell us about that, maybe share a story, but at the very least, what's that relationship like and why is it maybe so gratifying for you?

Joanne Mikovich: Yeah, gratifying is a great word because I'm very grateful for what we do. I think we're really lucky because we get to see a more playful side of residents. What we do is a little bit less rigid than maybe some other sort of therapeutic modalities. And so I think that we provide a safe space where residents feel like they can let their guard down and we just simply, we're going on a hike and residents are, practicing being mindful, or maybe this is an opportunity for them to talk about their trauma and process a couple things and they don't even realize that that's what they're doing.

And it's pretty cool, like even when we're on the rock wall residents get the opportunity to kind of, to let loose and have a little bit of what we call mindful fun, and I'm super grateful that we get to be a part of that.

Dr. Chris Sharp and Joanne Mikovich: Joanne's a ninja therapist. That's what she's talking about here. She sneaks up on you.

Scott Webb: It just feels like something out of a movie, sort of like going back in time and getting to be a kid again a little bit. And it sounds like you both really love your jobs and get to play a lot and have fun a lot. Do I have that right?

Joanne Mikovich: Definitely.

Dr. Chris Sharp and Joanne Mikovich: Yes, absolutely. And that's, there's a reason why, you know, why we do this, because Yes, it's fun and, the real impact, the change that it, you know, that we see with people, I think is, huge. There's so much of this that really is playful and fun. There is an underlying method to our madness that absolutely comes out in this process. So there's a few components that we're. aware of for it to be adventure therapy. , adventure therapy is, an aspect or a component of experiential therapy. And experiential therapy is really that existential holistic, living in your own skin, being present kind of piece. And then the adventure therapy is really looking at that stepping outside your comfort zone.

And so that's the thing that we have to facilitate. And that is, yes, a lot of fun most of the time, you know, but it's also, hard, we know it's hard for our clients to step outside their comfort zone and we try and sequence things. So it's a small step and a small step before they realize that they've taken some really big steps. So the sequencing is kind of critical to us, but the idea of moving towards discomfort, moving towards dis disease in the sense of comfortable in the process. That's the method to our madness. That's the part there.

And yeah, we laugh and we have some fun with it, but also there's a trust component to everything that we facilitate. We don't pretend that something isn't happening in front of us. We really have to kind of dive into the reality that we're facing.

Joanne Mikovich: Yeah. Yeah. I like what you're saying about the uncertainty and just learning how to navigate through that uncertainty and that uncomfortable situation that might be coming because there's no way we can really avoid those things. It's about learning how to regulate ourselves, how, we are as people, how do we act in these certain situations, and then how can we navigate and move forward?

Scott Webb: Yeah, it's so fascinating and it does sound so fun, but as you're sort of pointing out there is work involved and really, really helping residents and clients, to do things literally, metaphorically and so on. It makes me wonder like, can we do some of this stuff at home? Like, what are some of the ways, Chris, that we can practice adventure therapy at home with a family member or friend or maybe our dog, somebody? It sounds like this would be really fun to do at home.

Dr. Chris Sharp and Joanne Mikovich: Yeah, and I think there is a. whole host of activities that one can do intentionally that really are gonna bring benefit for you. If we want to talk specifically within kind of the, framework of, adventure therapy, it comes back to that idea of pushing your comfort zone. So a hike isn't gonna be adventure therapy if you're going o n familiar ground and with people that you already know super well, or you've got all your, tools and GPSs and all that lined up. If you can step outside that comfort zone, in some little way, then you're stepping into that process.

And every time we challenge our comfort zone, we expand it. Even if we choose not to add that activity or those people or that awareness into our day-to-day life. If we can challenge some little or big thing. So adventure therapy doesn't need to be a practice in the wilderness. It doesn't need to have a ropes course or white water or rock climbing those are great because they're very, efficient at bringing you outta your comfort zone, or at least bringing me outta my comfort zone.

But what you practice on your own, that mindful awareness of, just stepping outta your comfort zone so it can be going t o a restaurant and ordering something that you've never thought of ordering before. That sort of awareness of taking you outta your comfort zone informs your processes, and if you look at that mindfully, yeah. So it can be something simple, but let's not discount the value recreation either. Recreation is, hugely significant in our lives, and any opportunity for recreation is gonna be beneficial.

Again, if you apply some of those mindfulness components to it, do it intentionally. Think about what you're getting out of it. Think about what the outcome for you is. Those can be deeply beneficial without risking too much in the process.

Scott Webb: Hmm.

Joanne Mikovich: Yeah. And I think, like we were saying before, another big goal that we have is just this idea of being present, being in the here and now, and identifying what that means for you and what is your niche, what's that thing that allows you to be present? So for a lot of people, it could be hiking, but for others it could just be like those adult coloring books or maybe some yoga or, I don't know, talking in your plants. But just what allows you to be present and, ground yourself in moments of stress. Easy thing to practice at home.

Scott Webb: Yeah. That's so interesting. And I'm glad I've been present for this conversation today to learn more about adventure therapy, so, I hear everything that you're saying and I loved it today. So thank you both, and you both stay well.

Joanne Mikovich: Thank you. Thank you, Scott.

Dr. Chris Sharp and Joanne Mikovich: Thank you. Good to talk.

Scott Webb: And if you'd like to learn more about adventure therapy at Sierra Tucson, go to sierra tucson.com/therapies/integrative/adventure. And if you find this podcast to be helpful, please share it on your social channels. And be sure to check out the full podcast library for additional topics of interest. This is Let's Talk: Mind, Body, Spirit from Sierra Tucson. I'm Scott Webb. Stay well.