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The objectives of the review were:
Following approval by the Tusla Independent Research Ethics Committee to conduct the research, convenience sampling was used to recruit ABTS providers, young people aged 14-17 years, and parents/foster carers.
Four case study sites were selected, in collaboration with the Tusla Research Oversight Group. These included one site that provides art and play therapy (creative therapies), two that provide adventure therapy, and one that provides equine-assisted (animal-assisted) therapy.
For the most part, the review focuses on young people aged 14-17 years, apart from one case study site which caters for children aged 7-12 years.
Interviews and/or focus groups were carried out with 40 participants across the four case study sites, including 16 staff/ABTS providers, 10 parents/foster carers, 12 young people, a former service user and their parent.
Data were analysed using a deductive thematic approach. Deductive thematic data analysis uses an existing framework or theory to examine and understand interpersonal and intrapersonal narratives, process and meanings (Fife & Gossner, 2024).
Data from each case study site were analysed separately in the first instance by two members of the CES review team to prepare the individual case studies. Findings from the two adventure therapy providers were combined.
The data was analysed according to 4 themes:
The overall findings were then synthesised.
The overall conclusion of this review is that there is significant value in the provision of ABTS to young people. The results confirm and add to the growing body of literature building evidence to inform policy and practice in the provision of ABTS for children and young people.
The case studies showcase three different models of therapeutic support and the positive impact that they can have on the lives of children, young people, and their parents and foster carers. The fact that the supports are community-based, locally accessible and delivered by qualified, committed and passionate staff are key enablers of success.
The findings show that the therapeutic supports are relational, enjoyable, and grounded in relevant therapeutic theories. The importance of ABTS as an alternative to more traditional therapies was noted, along with the value of being outdoors.
"You get to express yourself while you're having fun, so your mind is in a good place.”
– Young person
“Rather than sitting in a stuffy room, you're out and then you’re doing stuff you enjoy too.”
– Young person
Funding was cited as a common barrier to the provision of ABTS. Staff retention is also a challenge for some providers. Inconsistency of attendance was also cited as a barrier to ABTS provision and the challenge of working outdoors was noted.
The benefits cited for children and young people include increased self-esteem and self-confidence, enhanced social skills and relationship building, and emotional regulation. There are also signs of benefit for parents/foster carers and the wider community.
“I always find that when I’m sad, I end up really happy at the end.”
– Young person
“It really helped my confidence, my anxiety, my mental health.”
– Young person
There was consensus among providers that ABTS provision should be increased. There is scope for further study to understand the value and fit of ABTS in the broad suite of supports available to children and young people. More measurement of intervention outcomes was suggested as necessary by some ABTS providers.
Marian Brattman, National Manager at Tusla said:
"The review shows that Activity Based Therapeutic Supports can offer children and young people a meaningful route into helping relationships. For some children, creative, adventure or equine-assisted therapeutic interventions may be the first type of support that is accessible to them.
The learning from this review will support Tusla to consider how these services can be best integrated into broader therapeutic planning.
Tusla worked collaboratively with CES throughout the review process and valued the positive and constructive working relationship established over the course of the project. Tusla was satisfied with the final report and the way in which the findings and learning from the review were reflected in the final publication."
You can read the final report here.
To speak to our team about this work contact us here
