Project Title
The Impacts of COVID-19 on Adventure Therapy Substance Use Disorder Treatment
Faculty Mentor(s) Name(s)
Dr. Lee Gillis
Abstract
In March 2020, the world shut down due to the COVID-19 pandemic, which is still affecting the global population (Xiong et al., 2020). Alongside the pandemic, the epidemic of substance misuse has continued to affect the population of North America (Lipari, 2017). To combat this, there are many routes one can take for substance use disorder (SUD). Adventure Therapy (AT) is a type of treatment that incorporates the outdoor environment and utilizes individual therapy along with group therapy to generate a sense of belonging among the clients. One Adventure Therapy program is Enviros Shunda Creek, an outdoor residential treatment center located in Alberta, Canada, for men ages 18 to 24 who are dealing with SUD. COVID-19 has had a community-level impact on these treatment centers, particularly seen in the day-to-day processes in substance use disorder care facilities (Ekqvist et al., 2022). At Shunda Creek, belonging to a community is a major component in the client’s recovery journey, helping them grow personally and collectively around those going through the same treatment as them. Shunda Creek adopted the “we-all” mindset, or “group-as-a-whole", which puts the collective groups’ needs over the individuals (Crumbley, et al, 2021). In addition to the community-level impact COVID-19 has had, recent research suggests there may be an individual-level impact too (C. Blithikioti, 2021). COVID-19 has caused individuals to suffer mentally from isolation and separation from those close to them (C. Blithikioti, 2021). This separation from loved ones, and experience of loneliness could have influenced an individual's mental health (Ramos, K., 2022). In this research, we analyzed alumni data in hopes to better understand the impact COVID-19 has had on community and mental health post-treatment. If there is a difference in psychosocial health for individuals undergoing SUD treatment pre- and post- COVID-19, it might be notable for Shunda Creek and other residential treatment centers dealing with SUD to understand how they could better follow these individuals who went through this stressful time. The instruments utilized in this testing were the Outcome Questionnaire 45.2 (OQ 45.2), and the Follow-Up Assessment Inventory (FAI). The Outcome Questionnaire (Lambert et al., 1996) was utilized to assess the Shunda Creek clients as to how they are doing during treatment. The OQ 45.2 consists of three subtypes: Symptom Distress (SD), Interpersonal Relationship (IR), and Social Role (SR). A high score in these subtypes indicates that there are some concerns in those areas, and a low score indicates that there is an absence of symptoms or problems, or denial of said symptoms or problems (Lambert et al., 1996). The Follow-Up Assessment Inventory (FAI), created by staff at Shunda Creek, was utilized to gather quantitative data and qualitative comments from the clients, which aids in understanding how post-treatment is going for them. The FAI is a survey consisting of 22 questions that are ranked from one to ten on a Likert Scale, with ten being the strongest level of agreement. In addition to the Likert Scale, there is a space to add a comment on each of the 22 questions to describe their feelings in more detail. We analyzed and compared the OQ 45.2 scores and FAI data to understand the impact that COVID-19 has had on individuals leaving treatment at Shunda Creek - whether that was negative or positive on their psychosocial health. We pulled our samples from a deidentified database in which alumni of Shunda’s program reported quantitative and qualitative data on their well-being post treatment. A t-Test: Two-Sample Assuming Equal Variances, was implemented to evaluate the difference of means between pre and post COVID-19 FAI questions. Note that M1 represented pre-COVID- 19 and M2 represented post-COVID-19. Two questions yielded notable differences: Question 3: “How has COVID-19 affected how you are currently doing?” t(20) = -2.15, p = .04, (M1 = 4.82, M2 = 7.27) a mean difference of (M = 2.45), and Question 8: “How would you rate your mental health in the past month?” t(20) = -2.24, p = .04, (M1 = 5.09, M2 = 7.09) with a mean difference of (M = 2.00). The positive difference in means between pre- and post-COVD-19 responses shows that alumni attitude post-recovery improved after leaving treatment post-COVID-19 when compared to pre-COVID-19.
The Impacts of COVID-19 on Adventure Therapy Substance Use Disorder Treatment
In March 2020, the world shut down due to the COVID-19 pandemic, which is still affecting the global population (Xiong et al., 2020). Alongside the pandemic, the epidemic of substance misuse has continued to affect the population of North America (Lipari, 2017). To combat this, there are many routes one can take for substance use disorder (SUD). Adventure Therapy (AT) is a type of treatment that incorporates the outdoor environment and utilizes individual therapy along with group therapy to generate a sense of belonging among the clients. One Adventure Therapy program is Enviros Shunda Creek, an outdoor residential treatment center located in Alberta, Canada, for men ages 18 to 24 who are dealing with SUD. COVID-19 has had a community-level impact on these treatment centers, particularly seen in the day-to-day processes in substance use disorder care facilities (Ekqvist et al., 2022). At Shunda Creek, belonging to a community is a major component in the client’s recovery journey, helping them grow personally and collectively around those going through the same treatment as them. Shunda Creek adopted the “we-all” mindset, or “group-as-a-whole", which puts the collective groups’ needs over the individuals (Crumbley, et al, 2021). In addition to the community-level impact COVID-19 has had, recent research suggests there may be an individual-level impact too (C. Blithikioti, 2021). COVID-19 has caused individuals to suffer mentally from isolation and separation from those close to them (C. Blithikioti, 2021). This separation from loved ones, and experience of loneliness could have influenced an individual's mental health (Ramos, K., 2022). In this research, we analyzed alumni data in hopes to better understand the impact COVID-19 has had on community and mental health post-treatment. If there is a difference in psychosocial health for individuals undergoing SUD treatment pre- and post- COVID-19, it might be notable for Shunda Creek and other residential treatment centers dealing with SUD to understand how they could better follow these individuals who went through this stressful time. The instruments utilized in this testing were the Outcome Questionnaire 45.2 (OQ 45.2), and the Follow-Up Assessment Inventory (FAI). The Outcome Questionnaire (Lambert et al., 1996) was utilized to assess the Shunda Creek clients as to how they are doing during treatment. The OQ 45.2 consists of three subtypes: Symptom Distress (SD), Interpersonal Relationship (IR), and Social Role (SR). A high score in these subtypes indicates that there are some concerns in those areas, and a low score indicates that there is an absence of symptoms or problems, or denial of said symptoms or problems (Lambert et al., 1996). The Follow-Up Assessment Inventory (FAI), created by staff at Shunda Creek, was utilized to gather quantitative data and qualitative comments from the clients, which aids in understanding how post-treatment is going for them. The FAI is a survey consisting of 22 questions that are ranked from one to ten on a Likert Scale, with ten being the strongest level of agreement. In addition to the Likert Scale, there is a space to add a comment on each of the 22 questions to describe their feelings in more detail. We analyzed and compared the OQ 45.2 scores and FAI data to understand the impact that COVID-19 has had on individuals leaving treatment at Shunda Creek - whether that was negative or positive on their psychosocial health. We pulled our samples from a deidentified database in which alumni of Shunda’s program reported quantitative and qualitative data on their well-being post treatment. A t-Test: Two-Sample Assuming Equal Variances, was implemented to evaluate the difference of means between pre and post COVID-19 FAI questions. Note that M1 represented pre-COVID- 19 and M2 represented post-COVID-19. Two questions yielded notable differences: Question 3: “How has COVID-19 affected how you are currently doing?” t(20) = -2.15, p = .04, (M1 = 4.82, M2 = 7.27) a mean difference of (M = 2.45), and Question 8: “How would you rate your mental health in the past month?” t(20) = -2.24, p = .04, (M1 = 5.09, M2 = 7.09) with a mean difference of (M = 2.00). The positive difference in means between pre- and post-COVD-19 responses shows that alumni attitude post-recovery improved after leaving treatment post-COVID-19 when compared to pre-COVID-19.