Out-Of-Office Experiences

An Online Course:
Out-Of-Office Experiences: Ethical & Clinical Considerations for Encounters Outside The Office

Out of Office Experiences - Walk & Talk Therapy - Incidental or Chance Encounters - Attending Weddings, Ceremonies and other Celebrations Outside The Office Walls

• Out-of-Office Experience: When crossing office boundaries and engaging in dual relationships is clinically beneficial and ethically sound
• Home Visits, Adventure Therapy, Incidental Encounters and Other Out-Of-Office Experiences
• Walk and Talk Therapy Exercise is good for the body and the mind. It may improve psychotherapy sessions, too.
• A natural fit: Therapy and exercise needn’t be mutually exclusive
• Incidental Encounters
• Crossing the Boundaries of Privacy in Accidental Encounters: Interpretative Phenomenological Analysis of Therapists’ Experiences
• Honoring Clients’ Accomplishments, Rituals and Life Transitions:
• ACA 2014 Code of Ethics On Out Of Office Experiences
  

  A.6.b. Extending Counseling Boundaries
  Counselors consider the risks and benefits of extending current counseling relationships beyond conventional parameters. Examples include attending a client’s formal ceremony (e.g., a wedding/commitment ceremony or graduation), purchasing a service or product provided by a client (excepting unrestricted bartering), and visiting a client’s ill family member in the hospital. In extending these boundaries, counselors take appropriate professional precautions such as informed consent, consultation, supervision, and documentation to ensure that judgment is not impaired and no harm occurs.

  Dr. Zur’s Comments on ACA Code: ACA code of 2014 has outlined several high-level precautions regarding out of office experiences, such as “attending a client’s formal ceremony (e.g., a wedding/commitment ceremony or graduation), purchasing a service or product provided by a client (excepting unrestricted bartering), and visiting a client’s ill family member in the hospital.” It imposes unnecessary restrictions when it says “In extending these boundaries, counselors take appropriate professional precautions such as informed consent, consultation, supervision, and documentation to ensure that judgment is not impaired and no harm occurs.” Some of these out of office experiences are normal (and healthy) and are often daily parts of small and rural communities.

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Adventure Therapy, Wilderness and Outdoor Therapy

• What is Adventure Therapy
• Legacy Outdoor Adventures
• Adventure-Based Therapy: Theory, Characteristics, Ethics, and Research
• Adventure Therapy - Terminology
• Outdoor Wilderness Resources
• Outdoor Education
• Definitions
• Bibliography
• Significant Events in Adventure Therapy
• Adventure-Based Counseling with Adolescents: Lessening Racial Effect on Group Cohesion
• A healthier course
• Therapy Gone Wild: More psychologists are using the wilderness as a backdrop and therapeutic tool in their work

Bibliographies:

• http://reviewing.co.uk/research/adventure-therapy-bibliography.htm
• http://leegillis.com/AT/pubs_LG_03_2005.htm
• http://eric.ed.gov:80/ERICWebPortal/custom/portlets/recordDetails/detailmini.jsp?_nfpb=true&_&ERICExtSearch_SearchValue_0=ED399110&ERIC ExtSearch_SearchType_0=no&accno=ED399110
• http://wilderdom.com/projectadventure/pabibliography.htm

References on Adventure Therapy, Wilderness and Outdoor Therapy

• Albright, R. L. (2016). The Qualitative Impact of Adventure Based Counseling on Sixth Grade General Education Students. Journal of School Counseling, 14(8), n8.
• Banaka, W. H., & Young, D. W. (1985). Community coping skills enhanced by an adventure camp for adult chronic psychiatric patients. Hospital and Community Psychiatry, 36, 746-748.
• Barton, J., Griffin M., & Pretty, J. (2011) Exercise, Nature and Socially Interactive Based Initiatives Improve Mood and Self-esteem in the Clinical Population, Perspectives in Public Health, 132/2, 89-96.
• Berger, R. (2006) Beyond Words: Nature-therapy in action Journal of Critical Psychology, Counseling and Psychotherapy, 6 (4) 195-199.
• Berger, R. (2007). Nature Therapy: Developing a Framework for Practice, [Unpublished Ph.D. Dissertation] School of Health and Social Sciences, University of Abertay, Dundee.
• Berger, R. & McLeod, J. (2006) Incorporating nature into therapy: A framework for practice, Journal of Systemic Therapies, 25 (2) 80-94.
• Berger, R. & Lahad, M. (2013) The Healing Forest in Post-Crisis Work with Children: A Nature Therapy and Expressive Arts Program for Groups. London: Jesica Kingsley.
• Berman, J. & Berman, D. (1994). Wilderness Therapy: Foundations Theory and Research. Iowa: Kendall Hunt.
• Bowen, D. J., Neill, J. T., & Crisp, S. J. (2016). Wilderness adventure therapy effects on the mental health of youth participants. Evaluation and Program Planning, 58, 49-59. https://doi.org/10.1016/j.evalprogplan.2016.05.005
• Carpenter, C., Norton, C., & Pryor, A. (2015). Adventure therapy around the globe: International perspectives and diverse approaches. Champaign, IL: Common Ground Publishers.
• Christian, D. D., Perryman, K. L., & Portrie-Bethke, T. L. (2017). Improving the Parent–Adolescent Relationship With Adventure-Based Counseling: An Adlerian Perspective. Journal of Child and Adolescent Counseling, 3(1), 44-58. http://dx.doi.org/10.1080/23727810.2017.1281693
• Davis-Berman, J. & Berman, D. (2009) The Promise of Wilderness Therapy. Association of Experiential Education.
• Davis-Berman, J., & Berman, D. S. (1994). Wilderness therapy: Foundations, theory & research. Dubuque, IA: Kendall/Hunt.
• DeDiego, A. C., Wheat, L. S., & Fletcher, T. B. (2016). Overcoming Obstacles: Exploring the Use of Adventure Based Counseling in Youth Grief Camps. Journal of Creativity in Mental Health, 1-13. http://dx.doi.org/10.1080/15401383.2016.1191403
• Dobud, W. (2017). Towards an Evidence-Informed Adventure Therapy: Implementing Feedback-Informed Treatment in the Field. Journal of Evidence-Informed Social Work, 1-11. http://dx.doi.org/10.1080/23761407.2017.1304310
• Eckstein, F., & Rüth, U. (2015). Adventure-based experiential therapy with inpatients in child and adolescent psychiatry: an approach to practicability and evaluation. Journal of Adventure Education & Outdoor Learning, 15(1), 53-63. http://dx.doi.org/10.1080/14729679.2013.844573
• Gass, M. A., Gillis, H. L., & Russell, K. C. (2012). Adventure therapy: Theory, practice, & research. New York, NY: Routledge.
• Glass, J. S., & Shoffner, M. F. (2001). Adventure-based counseling in schools. Professional School Counseling, 5, 42-47.
• Greenway, R. (2009). The Wilderness Experience as Therapy: We’ve Been Here Before, in L. Buzzell, & C. Chalquist (eds), Ecotherapy – Healing with Nature in Mind, San Francisco: Sierra Club
• Hegarty, J. (2010). Out of the consulting room and into the woods? Experiences of nature- connectedness and self-healing, European Journal of Ecopsychology, 1, 64-84.
• Herbert, J. T. (1996). Use of adventure-based counseling programs for persons with disabilities. Journal of Rehabilitation, 62, 3-9.
• Hoag, M. J., Massey, K. E., & Roberts, S. D. (2014). Dissecting the wilderness therapy client: Examining clinical trends, findings, and patterns. Journal of Experiential Education, 37(4), 382-396. https://doi.org/10.1177/1053825914540837
• Hoag, M. J., Massey, K. E., Roberts, S. D., & Logan, P. (2013). Efficacy of wilderness therapy for young adults: A first look. Residential Treatment for Children & Youth, 30(4), 294-305.http://dx.doi.org/10.1080/0886571X.2013.852452
• Jeffery, H., & Wilson, L. (2017). New Zealand occupational therapists’ use of adventure therapy in mental health practice. New Zealand Journal of Occupational Therapy, 64(1), 32-38.
• Jordan, M. (2009). Nature and Self: An ambivalent attachment? Ecopsychology,1(1), 26-31.
• Jordan, M. (2009). Back To Nature, Therapy Today, 20(3), 26-28.
• Jordan, M. (2009c) The living mountain: attachment to landscape and its importance in regulating emotions, Journal of holistic healthcare, 6(3) 14-17.
• Jordan, M. (2012) Did Lacan Go Camping? Psychotherapy in search of an ecological self in M.J. Rust, & N. Totton (eds), Vital Signs: Psychological Responses to the Ecological Crisis, London: Karnac.
• Jordan, M. & Marshall, H. (2010) Taking Therapy Outside: Deconstructing or reconstructing the therapeutic frame? European Journal of Psychotherapy, Counselling and Health, 12(4), 345—359.
• Kaplan, R. & Kaplan, S. (1989). The Experience of Nature, A psychological perspective.Cambridge: Cambridge University Press.
• Kearney, M. (2009). A Place of Healing: Working with Nature and Soul at the End of Life. New Orleans: Spring Journal Books.
• Koperski, H.; Tucker, A.; Lung, M.; & Gass, M. A. (2015). The Impact of Community Based Adventure Therapy on Stress and Coping Skills in Adults. The Practitioner Scholar: Journal of Counseling and Professional Psychology, 4(1), 1-16.
• Lee J, Park BJ, Tsunetsugu Y, Kagawa T, Miyazaki Y. (2011) Physiological benefits of forest environment: based on field research at 4 sites. Nihon Eiseigaku Zasshi, 66(4): 663-669.
• Lowry, T. (1974). Camping therapy: Its uses in psychiatry and rehabilitation. Springfield, IL: Charles C. Thomas.
• Mabey, R. (2008), Nature Cure, London: Vintage.
• Moore, T. & Russell, K. (2002) Studies of the Use of Wilderness for Personal Growth, Therapy, Education, and Leadership Development: An Annotation and Evaluation. University of Idaho Wilderness Research Centre, College of Natural Resources, University of Idaho, Moscow, ID USA.
• Mutz, M., & Müller, J. (2016). Mental health benefits of outdoor adventures: Results from two pilot studies. Journal of adolescence, 49, 105-114. https://doi.org/10.1016/j.adolescence.2016.03.009
• Newes, S. L. Adventure-Based Therapy: Theory, Characteristics, Ethics, and Research. A paper written to fulfill the comprehensive examination requirement. Doctoral Candidate, The Pennsylvania State University.
• Nicholls, L. (2008) ‘Touching the Void’ Mountains as transitional objects: Climbing as a defence against anxiety. Psychodynamic Practice 14(3), 249-262.
• Norton, C. L., Tucker, A., Farnham-Stratton, M., Borroel, F., & Pelletier, A. (2017). Family Enrichment Adventure Therapy: A Mixed Methods Study Examining the Impact of Trauma-Informed Adventure Therapy on Children and Families Affected by Abuse. Journal of Child & Adolescent Trauma, 1-11. doi:10.1007/s40653-017-0133-4
• Russell, K., & Gillis, H. L. (2017). The Adventure Therapy Experience Scale: The Psychometric Properties of a Scale to Measure the Unique Factors Moderating an Adventure Therapy Experience. Journal of Experiential Education, 40(2), 135-152. https://doi.org/10.1177/1053825917690541
• Russell, K. C., Gillis, H. L., & Heppner, W. (2016). An Examination of Mindfulness-Based Experiences Through Adventure in Substance Use Disorder Treatment for Young Adult Males: a Pilot Study. Mindfulness, 7(2), 320-328. doi:10.1007/s12671-015-0441-4
• Sahlin, E., Matuszczyk, J. F., Ahlborg, Jr. G. and Grahn, P. (2012) How do participants in nature-based therapy experience and evaluate their rehabilitation? Journal of Therapeutic. Horticulture 22(1), 9–22.
• Schimmel, C. J., Daniels, J. A., Wassif, J., & Jacobs, E. (2016). Learning the Ropes: A Creative Orientation Approach for Counseling Students. Journal of Creativity in Mental Health, 11(1), 27-38. http://dx.doi.org/10.1080/15401383.2015.1095663
• Schoel, J., Prouty, D., & Radcliffe, P. (1988). Islands of healing: A guide to adventure based counseling. Hamilton, MA: Project Adventure.
• Tucker, A. R., Javorski, S., Tracy, J., & Beale, B. (2013). The use of adventure therapy in community-based mental health: Decreases in problem severity among youth clients. In Child & Youth Care Forum (Vol. 42, No. 2, pp. 155-179). New York, NY: Springer.
• Tucker, A. R., Smith, A., & Gass, M. A. (2014). How presenting problems and individual characteristics impact successful treatment outcomes in residential and wilderness treatment programs. Residential Treatment for Children & Youth, 31(2), 135-153. http://dx.doi.org/10.1080/0886571X.2014.918446
• Tucker, A. R., Norton, C. L., Itin, C., Hobson, J., & Alvarez, M. A. (2016). Adventure Therapy: Nondeliberative Group Work in Action. Social Work with Groups, 39(2-3), 194-207. http://dx.doi.org/10.1080/01609513.2015.1048416

Codes of Ethics on Interactions/Therapy Outside the Office

Professional Association Codes of Ethics and Guidelines OnOut-of-Office Therapy

CPT Codes for Out of Office Experiences

CPT Codes for Out-of-Office Services

References on Out of Office Therapy

• Adams, M., & Jordan, M. (2016). Growing together: Nature connectedness, belonging and social Identity in a mental health ecotherapy programme. Ecotherapy: Theory, Research and Practice, 122.
• Cipriani, J., Benz, A., Holmgren, A., Kinter, D., McGarry, J., & Rufino, G. (2017). A systematic review of the effects of horticultural therapy on persons with mental health conditions. Occupational Therapy in Mental Health, 33(1), 47-69. http://dx.doi.org/10.1080/0164212X.2016.1231602
• Christie, M., Thompson, M., Miller, P. K., & Cole, F. (2016). Personality disorder and intellectual disability: The impacts of horticultural therapy within a medium-secure unit. Journal of Therapeutic Horticulture, 26(1), 3-17.
• DeMille, S. M., & Montgomery, M. (2016). Integrating narrative family therapy in an outdoor behavioral healthcare program: A case study. Contemporary Family Therapy, 38(1), 3-13.doi:10.1007/s10591-015-9362-6
• Freeman, E. (2017). With nature in mind: The ecotherapy manual for mental health professionals. British Journal of Guidance & Counselling, 1–2. http://dx.doi.org/10.1080/03069885.2017.1317713
• Hart, J. (2016). Prescribing nature therapy for improved mental health. Alternative and Complementary Therapies, 22(4), 161-163. https://doi.org/10.1089/act.2016.29067.jha
• Hawkins, B. L., Townsend, J. A., & Garst, B. A. (2016). Nature-based recreational therapy for military service members: A strengths approach. Therapeutic Recreation Journal, 50(1), 55-74.http://dx.doi.org/10.18666/TRJ-2016-V50-I1-6793
• Hegarty, J. R. (2010). Out of the consulting room and into the woods? Experiences of nature-connectedness and self-healing. European Journal of Ecopsychology, 1(1), 64-84. Retrieved from http://eje.naturalresourceswellbeing.com/v1/EJE%20v1_Hegarty.pdf
• Hinds, J., & Jordan, M. (Eds.). (2016). Ecotherapy: Theory, Research and Practice. London, UK: Palgrave.
• Hooley, I. (2016). Ethical considerations for psychotherapy in natural settings. Ecopsychology, 8(4), 215-221. https://doi.org/10.1089/eco.2016.0008
• Jordan, M, (2013). Talking Therapy Outside – A Narrative Inquiry into Counseling and Psychotherapy in Outdoor Natural Spaces. A thesis submitted in partial fulfillment of the requirements of the University of Brighton for the degree of Doctor of Philosophy.
• Jordan, M. (2014). Nature and therapy: Understanding counselling and psychotherapy in outdoor spaces. New York, NY: Routledge.
• Jordan, M. (2014). Moving beyond counselling and psychotherapy as it currently is–taking therapy outside. European Journal of Psychotherapy & Counselling, 16(4), 361-375. http://dx.doi.org/10.1080/13642537.2014.956773
• Lai, C. K. Y., Lau, C. K. Y., Kan, W. Y., Lam, W. M., & Fung, C. Y. Y. (2017). The effect of horticultural therapy on the quality of life of palliative care patients. Journal of Psychosocial Oncology, 1-14. http://dx.doi.org/10.1080/07347332.2017.1286699
• Lazarus, A. A. & Zur, O. (Eds.) (2002). Dual Relationships and Psychotherapy. New York: Springer.
• Peterson, D., & Boswell, J. N. (2015). Play Therapy in a Natural Setting: A Case Example. Journal of Creativity in Mental Health, 10(1), 62-76. http://dx.doi.org/10.1080/15401383.2014.935545
• Richards, K. & Peel, J (2005) Outdoor Cure. Therapy Today 16(10). 3-8.
• Sahlin, E., Matuszczyk, J. F., Ahlborg, Jr. G. and Grahn, P. (2012) How do participants in nature-based therapy experience and evaluate their rehabilitation? Journal of Therapeutic. Horticulture22(1), 9–22.
• Surgenor, H. (2015). Nature and therapy: Understanding counselling and psychotherapy in outdoor spaces. Existential Analysis, 26(2), 370-374. Retrieved from http://go.galegroup.com/ps/anonymous? p=AONE&sw=w&issn=17525616&v=2.1&it=r&id=GALE%7CA428625373
• Tucker, A. R., Paul, M., Hobson, J., Karoff, M., & Gass, M. (2016). Outdoor behavioral healthcare: Its impact on family functioning. Journal of Therapeutic Schools and Programs, 21-40. doi:10.19157/JTSP.issue.08.01.05
• Tucker, A. R., Widmer, M. A., Faddis, T., Randolph, B., & Gass, M. (2016). Family therapy in outdoor behavioral healthcare: Current practices and future possibilities. Contemporary Family Therapy, 38(1), 32-42. doi:10.1007/s10591-015-9370-6
• Westlund, S. (2014). Field exercises: How veterans are healing themselves through farming and outdoor activities. Gabriola Island, Canada: New Society Publishers.
• Wilson, N. W., Jones, R. J., Fleming, S., Lafferty, K., Knifton, L., Catherine, K., & McNish, H. (2011) Branching Out: The Impact of a Mental Health Ecotherapy Programme, Ecopsychology, 3(1), 51-57
• Wise, J. (2014). Digging for victory: Horticultural therapy with veterans for post-traumatic growth. London, UK: Karnac Books.
• Zur, O. (2001). Out-of-office experience: When crossing office boundaries and engaging in dual relationships are clinically beneficial and ethically sound. The Independent Practitioner, 21 (1), 96-100.
• Zur, O. (2007). Boundaries in Psychotherapy: Ethical and Clinical Explorations. Washington, DC: American Psychological Association - APA Books.
• Zur, O. (2015). Beyond the Office Walls: Home Visits, Celebrations, Adventure Therapy, Incidental Encounters and Other Encounters Outside the Office Walls. Retrieved from https://www.zurinstitute.com/outofofficeexperiences.html
• Zur, O. (Ed.) (2017). Multiple Relationships in Psychotherapy and Counseling: Unavoidable, Common and Mandatory Dual Relations in Therapy. New York: Routledge.

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