Efficacy of an adventure therapy program for brain injury survivors and caregivers


  • James Newman, CTRS
  • Elizabeth Newstadt




TBI, adventure programming, caregivers, ropes course


The Adventure Therapy Program for Traumatic Brain Injury Survivors and Caregivers at Radford University is a recreation therapy program that uses adventure-based activities to decrease the stress, approach, and understanding of the traumatic brain injury survivor and caregiver relationship and individual experiences. There is empirical support for the use of inclusive outdoor recreation programs, in bringing about positive social behavior changes. The specific benefits reported in this area are as follows: increased group cooperation, increased individual and group socialization, reduction of maladaptive behaviors, increased acceptance and quality of life for individuals with disabilities, and increased social adjustment and inclusion. These benefits coincide with the needs of the study population, and the results of this study suggest that further development in this area have potential for increasing the success of community transitions.

Author Biographies

James Newman, CTRS

Assistant Professor, Waldron Clinical Fellow, and Recreation Therapy Coordinator, Department of Recreation, Parks, and Tourism, Radford University, Radford, Virginia.

Elizabeth Newstadt

Student, Radford University, Radford, Virginia.


Charters J, Murray S: Design and evaluation of a leisure education program for caregivers of institutionalized care recipients. Top Geriatric Rehabil. 2006; 22: 334-337.

Miller K, Schleien S, Brooke P, et al.: Community for all: The therapeutic recreation practitioner’s role in inclusive volunteering. Ther Recreation J. 2005; 39: 18-31.

Anderson L, Kress C: Inclusion: Including People With Disabilities in Parks and Recreation Opportunities. State College, PA: Venture, 2003.

Anderson L, Schleien S, McAvoy L, et al.: Creating positive change through an inclusive outdoor adventure program. Ther Recreation J. 1997; 31: 214-229.

Herbert JT: Therapeutic effects of participating in an adventure therapy program. Rehabil Counsel Bull. 1998; 41: 210-217.

McAvoy L, Schatz C, Stutz M, et al.: Inclusive wilderness adventure: Effects on personal and lifestyle traits of persons with and without disabilities. Ther Recreation J. 1989; 23: 50-64.

Robb G, Ewert A: Risk recreation and persons with disabilities. Ther Recreation J. 1987; 21: 58-69.

Schleien S, Light C, McAvoy L, et al.: Best professional practices: Serving persons with severe multiple disabilities. Ther Recreation J. 1989; 23: 27-40.

Rotondi A, Sinkale J, Balzer K, et al.: A qualitative needs assessment of persons who have experienced traumatic brain injury and their primary family caregivers. J Head Trauma Rehabil. 2007; 22: 14.

Mannell R, Kleiber D: A Social Psychology of Leisure. State College, PA: Venture, 1997.

Cziksentmihalyi M: Flow: The Psychology of Optimal Experience. New York: Harper Perennial, 1990.

Mannell R: Evolution of cross-cultural analysis in the study of leisure: Commentary on ‘culture, self-construal, and leisure theory and practice’. J Leisure Res. 2005; 37: 100-105.

Csikszentmihalyi M, Csikszentmihalyi I: A Life Worth Living: Contributions to Positive Psychology. New York: Oxford University Press, 2006.

Peterson C, Stumbo N: Therapeutic Recreation Program Design. 3rd ed. Englewood Cliffs, NJ: Prentice Hall, 2000.

Schleien S, Ray T, Green R: Community Recreation and People With Disabilities: Strategies for Inclusion. 2nd ed. Baltimore: Brookes, 1997.

Hawkins B, Ardovino P, Hsieh C: Validity and reliability of the leisure assessment inventory. Mental Retard. 1998; 3: 303-313.

O’Reilly M, Cannella H, Sigafoos J, et al.: Communication and social skills interventions. In Luiselli J (ed.): Antecedent Assessment and Intervention. Randolph, MA: May Institute, 2006.

Lefebvre H, Pelchat D, Levert M: Interdisciplinary family intervention program: A partnership among health professionals, traumatic brain injury patients, and caregiving relatives. J Trauma Nurs. 2007; 14: 100-112.

Barnes E, Frank E, Motgomery A, et al.: Factors predicting rehabilitative service provision in adults with traumatic brain injury. J Speech-Language Pathol. 2005; 13: 69-84.

Degeneffe E, Lynch R: Correlates of depression in adult siblings of persons with traumatic brain injury. Rehabil Counsel Bull. 2006; 49: 130-142.

Hoss M: Therapeutic Recreation Activity Assessment. Ravensdale, WA: Idyll Arbor, 1993.

Burlingame J, Blaschko T: Assessment Tools for Recreation Therapy and Related Fields. 3rd ed. Ravensdale, WA: Idyll Arbor, 2002.

Maslow A: Toward a Psychology of Being. 2nd ed. Toronto, ON: Van Nos Reinhold, 1968.



How to Cite

Newman, CTRS, J., & Newstadt, E. (2009). Efficacy of an adventure therapy program for brain injury survivors and caregivers. American Journal of Recreation Therapy, 8(2), 31–37. https://doi.org/10.5055/ajrt.2009.0012