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Jong MC, Stub T, Mulder E, Jong M. The Development and Acceptability of a Wilderness Programme to Support the Health and Well-Being of Adolescent and Young Adult Cancer Survivors: The WAYA Programme. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12012. [PMID: 36231313 PMCID: PMC9566286 DOI: 10.3390/ijerph191912012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
Detailed descriptions of theory, structure, and activities with causal links to specified outcomes of wilderness programs are lacking. Addressing this gap, the present qualitative study gives a thorough description of the development of the Wilderness programme for Adolescent and Young Adult (AYA) cancer survivors (WAYA). WAYA is adapted to the individual needs of AYA cancer survivors. It was conceived around Næss's ecosophy and the Positive Health Model, and refined based on findings from a scoping review and patient/public involvement. Programme aims were to increase physical activity, self-confidence, personal growth, joy, safety within nature, meaningful relationships, and self-efficacy. The programme was an eight-day expedition followed three months later by a four-day base-camp. Activities included hiking, backpacking, kayaking, rock climbing, mindfulness and bushcrafting. Evaluation of the programme through focus group and individual interviews with 15 facilitators and 17 participants demonstrated that a diverse group of participants, challenging activities, and mindfulness-based practices were found to positively influence group bonding and the learning process. Furthermore, including an expedition and base-camp component was found to be beneficial in supporting the development of participants' own personal outdoor practices. In conclusion, this study demonstrated that the WAYA programme is safe and well accepted by AYA cancer survivors.
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Affiliation(s)
- Miek C. Jong
- National Research Centre in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, The Arctic University of Norway, UiT, Hansine Hansens veg 18, 9019 Tromsø, Norway
- Department of Health Sciences, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden
| | - Trine Stub
- National Research Centre in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, The Arctic University of Norway, UiT, Hansine Hansens veg 18, 9019 Tromsø, Norway
| | - Eric Mulder
- Department of Health Sciences, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden
| | - Mats Jong
- Department of Health Sciences, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden
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The role of burn camp in the recovery of young people from burn injury: A qualitative study using long-term follow-up interviews with parents and participants. Burns 2022; 48:1139-1148. [PMID: 34607728 DOI: 10.1016/j.burns.2021.09.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 09/19/2021] [Accepted: 09/21/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Children and adolescents recovering from burn injury are at heightened risk of psychosocial problems. An integrative form of psychosocial intervention is burn camp. However, evidence about burn camp effectiveness is equivocal. OBJECTIVES This study examined the role of therapeutic camp experiences in the recovery journeys of children and adolescents who had experienced burn injury and been treated in a tertiary pediatric hospital in Brisbane, Australia. METHODS Retrospective semi-structured interviews were conducted with youths and parents. Inductive reflexive thematic analysis was used with pooled interview data. RESULTS The participants were eight youths who attended at least one burns camp (between 2009 and 2019) and 15 parents of youth campers. An overwhelming majority (96%) reported a positive experience of camp, that they would return, and that they recommended the camp to other youth with burns. The four strengths of the camp experience were fun, adventurous activities; social relatedness (friendships, socializing); camp setting and experience; and acceptance. The four impacts of the camp on youth campers were normalizing ("I'm not the only one", shared experience); social support (making new friendships, social confidence, mentoring others); psychological recovery (happier, mentally stronger, more resilient, independence building); and confidence (increased self-confidence, increased social confidence, leadership development). CONCLUSIONS Although this is the first known research about burn camp in Australia, the findings are similar to a handful of other qualitative studies about burn camp experiences and impacts. Recommendations include future research on aspects of camp experiences that contribute to targeted outcomes, the role of staff and previous camp participants as mentors, and comparisons with other psychosocial interventions for youth burn survivors.
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Stea TH, Jong MC, Fegran L, Sejersted E, Jong M, Wahlgren SLH, Fernee CR. Mapping the Concept, Content, and Outcome of Family-Based Outdoor Therapy for Children and Adolescents with Mental Health Problems: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105825. [PMID: 35627364 PMCID: PMC9141554 DOI: 10.3390/ijerph19105825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/06/2022] [Accepted: 05/07/2022] [Indexed: 02/06/2023]
Abstract
Outdoor therapy and family-based therapy are suggested to be promising interventions for the treatment of mental health problems. The aim of the present scoping review was to systematically map the concept, content, and outcome of combining family- and outdoor-based therapy for children and adolescents with mental health problems. The Joanna Briggs Institute methodology and PRISMA guidelines were applied. Eligible qualitative and quantitative studies were screened, included, and extracted for data. Seven studies were included. Findings from these studies indicated that family-based outdoor therapy programs have a positive impact on family- and peer relationships, adolescent behavior, mental health, self-perceptions (self-concept), school success, social engagement, and delinquency rates. However, participant characteristics, study design, and content and mode of delivery of the interventions varied substantially, hence preventing detailed comparison of outcomes across studies. In addition, most of the studies included few participants and lacked population diversity and comparable control groups. Although important ethical concerns were raised, such as non-voluntary participation in some of the programs, there was a lack of reporting on safety. This review indicates that a combination of family- and outdoor-based therapy may benefit mental health among children and adolescents, but due to the limited number of studies eligible for inclusion and high levels of heterogeneity, it was difficult to draw firm conclusions. Thus, future theory-based studies using robust designs are warranted.
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Affiliation(s)
- Tonje H. Stea
- Department of Child and Adolescent Mental Health, Sørlandet Hospital HE, 4604 Kristiansand, Norway; (S.L.H.W.); (C.R.F.)
- Department of Health and Nursing Science, University of Agder, 4604 Kristiansand, Norway;
- Correspondence:
| | - Miek C. Jong
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT, The Arctic University of Norway, 9037 Tromsø, Norway;
| | - Liv Fegran
- Department of Health and Nursing Science, University of Agder, 4604 Kristiansand, Norway;
| | - Ellen Sejersted
- The Library, University of Agder, 4604 Kristiansand, Norway;
| | - Mats Jong
- Department of Health Sciences, Mid Sweden University, 851 70 Sundsvall, Sweden;
| | - Sophia L. H. Wahlgren
- Department of Child and Adolescent Mental Health, Sørlandet Hospital HE, 4604 Kristiansand, Norway; (S.L.H.W.); (C.R.F.)
| | - Carina R. Fernee
- Department of Child and Adolescent Mental Health, Sørlandet Hospital HE, 4604 Kristiansand, Norway; (S.L.H.W.); (C.R.F.)
- Department of Sport Science and Physical Education, University of Agder, 4604 Kristiansand, Norway
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Jong M, Lown EA, Schats W, Mills ML, Otto HR, Gabrielsen LE, Jong MC. A scoping review to map the concept, content, and outcome of wilderness programs for childhood cancer survivors. PLoS One 2021; 16:e0243908. [PMID: 33406103 PMCID: PMC7787391 DOI: 10.1371/journal.pone.0243908] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 11/30/2020] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES Systematic mapping of the concept, content, and outcome of wilderness programs for childhood cancer survivors. DESIGN Scoping review. SEARCH STRATEGY Searches were performed in 13 databases and the grey literature. Included studies describe participation of childhood cancer survivors in wilderness programs where the role of nature had a contextual and therapeutic premise. At least two authors independently performed screening, data extraction and analysis. RESULTS Database searches yielded 1848 articles, of which 15 met the inclusion criteria. The majority of programs (73%) employed adventure therapy. Five activity categories were identified as components of wilderness programs: challenge/risk, free time/leisure, experiential learning, physical activity and psychotherapeutic activities. A majority of the participating childhood cancer survivors were female, white, aged 8-40 years, with a wide range of cancer diagnoses. Reported outcomes included increased social involvement, self-esteem, self-confidence, self-efficacy, social support, and physical activity. Key gaps identified included the absence of randomized controlled trials (RCTs), lack of studies on long-term effects, lack of information on the multicultural aspects of programs, and missing information on engagement in nature activities after the program ended. CONCLUSIONS This scoping review guides childhood cancer survivors, their families, practitioners, clinicians and researchers in the development and optimization of wilderness programs for childhood cancer survivors. In addition, it informs the utilization of these programs, and identifies gaps in the evidence base of wilderness programs. It is recommended that future study reporting on wilderness programs include more detail and explicitly address the role of nature in the program. Performing RCTs on wilderness programs is challenging, as they occur in real-life contexts in which participants cannot be blinded. Creative solutions in the design of pragmatic trials and mixed method studies are thus needed for further investigation of the effectiveness and safety of wilderness programs in childhood cancer survivors.
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Affiliation(s)
- Mats Jong
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | - E. Anne Lown
- Department of Social and Behavioral Sciences and Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Winnie Schats
- Scientific Information Service, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Michelle L. Mills
- Department of Social and Behavioral Sciences and Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Heather R. Otto
- See you at the Summit, Portland, OR, United States of America
| | - Leiv E. Gabrielsen
- Department for Child and Adolescent Mental Health, Sørlandet Hospital Health Enterprise, Kristiansand, Norway
| | - Miek C. Jong
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
- Department of Community Medicine, Faculty of Health Sciences, National Research Center in Complementary and Alternative Medicine (NAFKAM), The Arctic University of Norway (UiT), Tromsø, Norway
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[Risk-taking Behaviour and Aspects on Adolescents' Participation in High-risk Sports]. Prax Kinderpsychol Kinderpsychiatr 2020; 69:98-108. [PMID: 32114948 DOI: 10.13109/prkk.2020.69.2.98] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Risk-taking Behaviour and Aspects on Adolescents' Participation in High-risk Sports The age of adolescence represents an enhanced reward sensitivity which is often linked to increased risk-taking behaviour. Peers enhance risk-taking behaviour which is shown through delinquency and substance use. Whereas most research on adolescent risk-taking has been directed towards negative risk-taking, this narrative review tries to highlight adventure and high-risk sport participation as a prosocial form of risk-taking and its potential influence on adolescents' behaviour. Adventure/high-risk sports such as mountainbiking, freeride ski and snowboarding and climbing have grown exponentially in the last years with a high popularity among adolescents. Besides the inherent risk of severe injury in case of a mismanaged accident, which should be minimized by preventive steps such as educative risk-management and protective gear, those sports bear the potential for multiple psychological benefits such as enhanced mood, autonomy, resilience and self-efficacy. Adventure/high-risk sports seem to have the possibility to satisfy the need for rewards, prestige and risk-taking in a socially accepted way. Few research projects have already successfully integrated adventure sport interventions in clinical settings in mental health treatment. The idea of testing adventure/high-risk sport interventions as an addition to the treatment in child and adolescent psychiatry and psychotherapy could be promising and an impulse for future research projects.
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Jong MC, Lown A, Schats W, Otto HR, Jong M. Mapping the concept, content and outcome of wilderness therapy for childhood cancer survivors: protocol for a scoping review. BMJ Open 2019; 9:e030544. [PMID: 31481374 PMCID: PMC6731868 DOI: 10.1136/bmjopen-2019-030544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Long-term childhood cancer survivors are at risk for frailty and have significant health-related issues in adulthood. Various health promotion interventions have been proposed to enhance quality of life including wilderness therapy, which applies the impact of nature on health in a therapeutic context. Previous studies have described positive outcomes linked with various wilderness-related therapies for cancer survivors. However, there is no clarity on the role these therapies play in childhood cancer. The current scoping review aims to systematically map the concept, content and outcome of wilderness therapy for childhood cancer survivors. METHODS AND ANALYSIS This review will be guided by the Joanna Briggs Institute Reviewers' manual for scoping reviews. A systematic literature search using medical subject headings (MeSH) and text words related to wilderness therapy and childhood cancer survivors will be performed in EMBASE, ERIC, Medline, Psycinfo, CINAHL, Scopus, Web of Science, SPORTDiscus and Svemed+, Sociological Abstracts, supplemented by grey literature searches. Eligible quantitative and qualitative studies will be screened, included, assessed for quality and extracted for data by two reviewers independently. Results will be described in a narrative style, reported in extraction tables and diagrams, and where appropriate in themes and text. ETHICS AND DISSEMINATION This study describes a protocol for a scoping review that will undertake secondary analysis of data already published in literature and is therefore exempt from medical ethical review. The scoping review will inform understanding of the benefits and risks of wilderness therapy for childhood cancer survivors, their families, practitioners, clinicians and researchers, and will help elucidate the steps necessary for building its evidence base going forward. Results will be published in a peer-reviewed scientific journal.
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Affiliation(s)
- Miek C Jong
- Department of Health Sciences, Mid Sweden University, Campus Sundsvall, Sundsvall, Sweden
- The Arctic University of Norway, National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT, Tromsø, Norway
| | - Anne Lown
- Department of Social Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
| | - Winnie Schats
- Scientific Information Service, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Mats Jong
- Department of Health Sciences, Mid Sweden University, Campus Sundsvall, Sundsvall, Sweden
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Fernee CR, Mesel T, Andersen AJW, Gabrielsen LE. Therapy the Natural Way: A Realist Exploration of the Wilderness Therapy Treatment Process in Adolescent Mental Health Care in Norway. QUALITATIVE HEALTH RESEARCH 2019; 29:1358-1377. [PMID: 30541381 DOI: 10.1177/1049732318816301] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Wilderness therapy has the potential to meet the specific needs of the current adolescent population by providing a rather unique outdoor group treatment. Wilderness therapy is not a new approach to mental health treatment, but its theoretical basis is not yet clearly delineated, in part because of the diversity found across programs and contexts. This article presents a critical realist exploration of a wilderness therapy program that was recently implemented as part of adolescent mental health services in Southern Norway. In this study, we combine fieldwork and interviews for an in-depth investigation of the treatment process, where the objective was to acquire a deeper understanding of the opportunities that arise in the wilderness therapy setting. The therapeutic mechanisms and influential contextual premises found across the ecological, physical, and psychosocial factors of this multidimensional approach to treatment are presented, and their underlying conditions are briefly discussed.
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