Action Sports Reach Troubled, Resistant Youths

By Brandon Stogsdill, LMHC, CMHS, CDP

At first sight, Mikayla fits the profile of a quintessential teen. She’s got stylish clothes; short, dyed hair; and a shy smile. However, something atypical happened to her years earlier: Someone close to her committed suicide. As a result, she became depressed and counteracted her pain by cutting, abusing substances, and engaging in other destructive behaviors before coming to Sound Mental Health in Washington State.

Therapists are tasked with reaching youths such as Mikayla and helping them work through challenges. For some youths, however, traditional counseling models may be seen as authoritarian and rigid, making action sports a potentially successful alternative.

Skepticism Toward Counseling
If you ask teens what they think about traditional therapy, many have a strong reaction: It’s a waste of time. “I don’t want to be judged or brainwashed,” they add.

For others, it’s simply too boring. They may wonder, who wants to sit in a room with a stranger under artificial light talking about feelings, things they do wrong, and painful events in their past? Add that to the fact that often their parents or some authority figure forces them into counseling to get “fixed.” It really should be no surprise then that many youths have a strong reaction against counseling.

Teens, Mental Health, and Risk
Yet counseling is exactly what some youths need. Reports have shown that almost one-half of high school students will smoke, drink alcohol, and/or use illegal drugs by the time they graduate (Mann, 2011). We know substance use in adolescents is “correlated with other psychiatric diagnoses including dysthymia and major depression, conduct disorder, ADHD, eating disorders, and psychosis.” (Shrier, Harris, Kurland, & Knight, 2003). In fact, one in five youths has a diagnosable mental disorder, according to the National Institute of Mental Health, but the good news is the majority of counseling effectively treats mental illnesses (Eisen, Pallitto, Bradner, & Bolshun, 2000).

The developmental phase of adolescence is challenging on its own, but add a traumatic event and/or a mental disorder and someone can only imagine the multifaceted challenges youths and families face. In addition to these challenges, the adolescent phase is a time to push boundaries, which may lead to disastrous consequences (Siegel, 2014).

It is well known that “during adolescence there is an increase in the activity of the neural circuits utilizing dopamine, a neurotransmitter central in creating our drive for reward ... This enhanced dopamine release causes adolescents to gravitate towards thrilling experiences and exhilarating sensations ... and can give adolescents a powerful sense of being alive when they are engaged in life.” (Siegel, p. 67). But pushing back, Siegel says, also can “set the stage for the developmental core character traits that will enable adolescents to go on to lead great lives of adventure and purpose” (p. 2).

Our challenge then as mental health professionals is to adapt new, fresh ways for youths to push their boundaries within a therapeutic framework that does not promote devastating repercussions. For those seeking to accomplish this, there is an emerging area that holds great promise.

FAST Approach
Sound Mental Health has a therapeutic approach to address this dilemma head-on: functional action sports therapy, or the FAST approach, which constructively channels adolescent risk-taking behaviors through action sports in addition to individual mental health and substance abuse therapy. Research shows that physical activity for youth decreases depression and anxiety symptoms (Monshouwer, Have, Poppel, Kemper & Vollerbergh, 2001).

Action sports are a group of individually fueled activities on a progressive continuum, ranging from casual activities to extreme, adrenaline-pulsating sports such as skateboarding, snowboarding, and surfing. Because any skill level can participate in action sports, therapists may find these activities powerful and virtually limitless methods for individual engagement.

Research has shown that people seriously involved in action sports have lower anxiety, are more independent and self-assertive, and have a higher sense of reality (Brymer & Schweitzer, 2013). We can honor the dopamine-driven trajectory of adolescent risk taking by guiding youth in an appropriate and meaningful way (Siegel). “In fact, it could be that the only thing more dangerous than taking risks in adolescence is not taking them,” according to Naterson-Horowtiz and Bowers (2012).

Evidence-Based Components
It may sound like fun and games, but action sports programs should be based on widely practiced evidence-based therapies that will give greater credibility among stakeholders. One such example is a dialectical behavioral therapy (DBT) technique, mindfulness.

In an action sports model, DBT encourages individuals to focus on the here and now of the activity. Mindfulness practices have been shown to convey countless benefits to mental health (Davis & Hayes, 2012). An effective action sports model also utilizes exposure techniques by having clients simply face their anxieties (e.g., fear of heights).

Cognitive-behavioral techniques such as cognitive restructuring encourage youths to reaffirm their thinking that they can accomplish the task. Lastly, simple behaviorism is encouraged with positive praise and reward. Incorporating these and other techniques into programming will not only improve outcomes for clients but establish greater credibility for the program.

Designing a Program
In designing a relevant action sports program, organizations must be willing to create something that will appeal to the youths they serve. They should assess the unique pressures impacting the youths’ lives, the mental or emotional health issues that challenge them daily, and the struggles they have in social settings and families. This understanding provides agencies with a solid foundation from which to build a tailored, adaptable, and responsive program.

Providers looking to develop their own program likely will base their action sports activities in part on factors such as geography and climate. Sound Mental Health, located in an area close to bodies of water, two mountain ranges, urban wooded areas, and an abundance of state and city parks, created programs centered on snowboarding, BMX (bicycle racing/jumping), skateboarding, stand-up paddling, and indoor skydiving

By utilizing these geographically appropriate activities, which also integrate well with individual therapy, the FAST approach introduces youths to counseling and sparks engagement. The critical factor that makes this approach effective is the organic nature of the developing client/therapist relationship, which is the foundation for communication, trust, and respect. Once a relationship is formed, youths naturally share their struggles and know where to turn when they are ready for that next step in counseling.

Possible Challenges
As with any creative and unconventional program, there are challenges. Costs, staffing, organizational culture, and optimal environmental conditions will be the issues that likely stall the creation of an action sports program before it can gain momentum. From the onset, investing time up front to strategize and build a plan to address and overcome these hurdles is recommended.

Culturally, many clinical organizations likely are both unfamiliar with and tentative about the action sports concept as a viable therapeutic tool. As they look to create and sustain this type of program, organizations must be prepared in advance to educate and advocate for a program among management and colleagues alike. Some may ask, “What are the risks associated with permitting youth to engage in risky activities?” while others will inquire, “How much will such programs cost to operate?”

Organizations will need to anticipate these questions, compile their own research to validate the program, and be prepared to tirelessly campaign for it. They will have to possess a strong sense of advocacy, a firm dedication to education, and some persistence to ensure that superiors and colleagues buy in and support the program.

Build From Scratch or Expand?
Trying to build any new program like the FAST approach from the ground up is challenging, especially if staff have burgeoning caseloads. Creating an offshoot or amending an action sports program to an established youth and families department is optimal. Organizations would have an existing potential client base, with trust already established among adolescent clients and their families.

While it is not impossible to build from scratch, having a proven youth/family program with a track record of success greatly reduces many of the growing pains and start-up worry often associated with the venture.

All the Right Staff
Educating upper management and having aligned the program with an existing department, achieve the best results when the right staff is selected, whether from existing staff or hired specifically for the program. Staff, of course, must be certified youth counselors who possess the ability to connect with youths while being credible with parents. A high premium should be put on staff who also possess the unique attributes of high energy, passion for the work, and marketing savvy needed to sell the program to youths, their parents, superiors, and outside partners.

Optimal Resources Needed
For a resource-strapped community mental health agency to launch an action sports program requires less funding than someone may think, but it will take a great deal of out-of-the-box partnering. The key is to cultivate foundations or other funding organizations that place emphasis on engaging youths through innovative, healthy means.

Likewise, the agency must be prepared to identify community-oriented partners and nurture a strong relationship with them. Many youth-oriented businesses, such as snowboarding companies, longboard manufacturers, and skateboard builders, often seek ways to give back to their communities. They also are committed to building brand loyalty among potential customers in creative ways. A partnership with providers serving adolescents may present a dual opportunity. These organizations either can donate or provide the resources needed pro bono or at greatly reduced costs, including facilities, equipment, and classes.

To ensure that the program is sustainable, it is important to be creative and unconventional to create value for an organization. Depending on the actual activity, the organization can estimate that two to three counselors will be needed for the outings, with at least two staff members dedicated to it full time.

FAST Approach in Action
Mikayla, along with a handful of clients at Sound Mental Health, prepared for their first FAST experience at an indoor skydiving facility. Scared and anxious. Mikayla was prepped, outfitted, and instructed. She entered the flying chamber and flew like a bird. She screamed as she blazed to the top of the flying tube with an instructor safely guiding her.

She emerged from the flying tube “buzzing with exhilaration. It took a few minutes to come back to earth” (Spitzer, 2013). She reported that she felt her adrenaline pumping and was “freaking out, but it was the good kind of scared.”

Here is where a therapeutic approach was executed. Mikayla said, “I’m in the air right now and I need to focus on how my body is moving and you don't need to worry about anything else" (Spitzer). She exposed herself to the fearful stimuli of heights, no aversive consequence followed, mindfulness was in full effect, and she received high fives from her counselor and peers. Now she “is actively involved in therapy and is finding new ways to counteract the despair with a physical rush. And this time it’s a healthy channel—through action sports” (Spitzer).

Final Thoughts
If Mikayla’s case serves as an example, then action sports programs hold intriguing potential. As an emerging model, the FAST approach can benefit organizations that serve youth populations. Not only can they be implemented at relatively low cost, but adopting agencies will improve their ability to reach youths who are skeptical and resistant to more traditional models. Simply put, action sports programs can creatively reach youths by offering more novel and exciting options that allow them the opportunity for individual accomplishment.

— Brandon Stogsdill, LMHC, CMHS, CDP, is a clinician at Sound Mental Health’s Child & Family Services.

References
Brymer, E., & Schweitzer, R. (2013). Extreme sports are good for your health: A phenomenological understanding of fear and anxiety in extreme sport. Journal of Health Psychology, 18(4), 477-487.

Davis, D. M, & Hayes, J. A. (2012). What are the benefits of mindfulness? American Psychological Association. Retrieved from http://www.apa.org/monitor/2012/07-08/ce-corner.aspx.

Eisen, M., Pallitto, C., Bradner, C., & Bolshun, N. (2000). Teen risk-taking: promising prevention programs and approaches. Retrieved from http://www.urban.org/UploadedPDF/TeenRiskTaking_2.pdf.

Mann, D. (2011). Nearly half of U.S. teens smoke, drink alcohol, or use drugs. Retrieved from http://teens.webmd.com/news/20110629/nearly-half-of-us-teens-smoke-drink-alcohol-or-use-drugs.

Monshouwer K., ten Have, M., van Poppel, M., Kemper, H., & Vollerbergh W. (2001). Possible mechanisms explaining the association between physical activity and mental health: findings from the 2001 Dutch Health Behaviour in School-Aged Children Survey. Clinical Psychological Science, 1(1), 67-74.

Natterson-Horowtiz, B., & Bowers, K, (2013). Zoobiquity: the astonishing connection between human and animal health. New York: Vintage.

Shrier, L. A., Harris, S. K., Kurland, M., & Knight, J. R. (2003). Substance use problems and associated psychiatric symptoms among adolescents in primary care. Pediatrics, 111(6 Pt 1), e699-705.

Siegel, D. J. (2014). Brainstorm: the power and purpose of the teenage brain. New York: Tarcher.

Spitzer, G. (2013). Therapist uses extreme sports to treat mental Illness. Retrieved from http://www.kplu.org/post/therapist-uses-extreme-sports-treat-mental-illness.