Wilderness therapy

Wilderness therapy, also known as Outdoor Behavioral Healthcare, is a treatment option for behavioral, substance, and mental health issues in adolescents.^[1]

Overview[]

Wilderness therapy has been described as "challenge courses", "adventure-based therapy", and "wilderness experience programs".^[2] A variety of theoretical orientations are used in wilderness therapy,^[3] including mindfulness-based therapy and cognitive behavioral therapy. However, in the majority of wilderness therapy programs, teens spend most of their time living in tents in the woods with a group of eight to 12 peers.^[4][5] Participants are accompanied by three staff members who are not trained as therapists and work for minimum wage, who are responsible for their day-to-day activities.^[4]

About half of wilderness therapy participants attend involuntarily and are transported by services specialized for “uncooperative” youth.^[1]

Generally, therapeutic wilderness programs cost upwards of $30,000 or more for a child’s three-month stay.^[4] Few clients receive financial assistance from medical insurance.^[6] Insurance companies have long refused to pay for wilderness therapy, contending that the programs are not covered by insurance policies because they take place outdoors.^[7]

History[]

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Madolyn M. Liebing, Ph.D. (of Aspen Achievement then, and currently of Juniper Canyon Recovery) was the first clinical psychologist to integrate clinical therapy with wilderness programming.^[5]

Backpackers at a wilderness therapy program

Controversy[]

Allegations of Abuse, Deaths, and Lawsuits[]

Abusive situations have been reported and several children have died in wilderness therapy programs. Many participants also say that they are left with lifelong trauma from the experience.^[8]

In 2014, a 17-year-old missing from the North Carolina Trails Carolina wilderness therapy program was found dead in a stream.^[9] The teen wandered away from the group he was with, broke his hip and was unable to move, and died of hypothermia when he was not found.^[9] The North Carolina Department of Health and Human Services (DHHS) report investigating his death shows a deputy sheriff said staff at Trails Carolina waited five hours before calling for help.^[4]

Maia Szalavitz, author of the 2006 book Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids, has concluded that many of the tactics that wilderness-therapy programs use are no different than those used at Guantanamo Bay.^[10] Szalavitz has documented cases of emotional and physical abuse, and the withholding of food, water, and sleep.^[10]

A fourteen-year-old in the Catherine Freer Wilderness Therapy program died in 2003 when a tree fell on the tent that he was sleeping in.^[10]

In 2001, another teen at the Catherine Freer Wilderness Therapy program died of heatstroke and dehydration while on a hike the day after she had arrived.^[10]

Aaron Bacon, age 16, died in 1994, while enrolled in a wilderness program in Utah. He was three weeks into a 63-day wilderness trek when he died of peritonitis and a perforated ulcer.^[11] Several staffers were charged with felony neglect and abuse of a disabled child.^[11]

Also in Utah, two teens died in 1990 while enrolled in wilderness therapy programs.^[11] Both of their deaths were related to heatstroke on hikes.^[11]

Due to the trauma and alleged harm reported by former wilderness program residents who have been forcibly escorted into placement, psychologists have heavily criticized this approach as inappropriate, and grossly inconsistent with establishing the necessary trust required for building a therapeutic relationship between youth and providers.^[12]

Limited and Biased Research[]

Although the wilderness therapy industry has tried for several decades to fill research gaps to bolster its case of effectiveness and reduce the need for legislative intervention, critics say that science still does not support wilderness therapy.^[13]

Independent researchers have called into question the wilderness therapy industry's claims, expressing ethical concerns and criticizing its use of "bad science" due to methodological flaws in the research.^[14] Given the proliferation of such programs, relaxed regulation, and absence of research setting uniform standards of care across programs, advocates have called for increased accountability to ensure programs are capable of providing care that is consistent with their marketing claims.^[15]

Some programs which advertise as "wilderness therapy" are actually boot camps similar in style to military recruit training in a wilderness environment.^[16] These can sometimes be distinguished from other wilderness therapy by such programs promising behavior modification for troubled teens, but it is hard to tell just from the ads.^[17]

One of the major differences between military style boot camps and wilderness therapy is the underlying philosophical assumptions (wilderness therapy being driven by the philosophy of experiential education and theories of psychology, and boot camps being informed by a military model). Incidents of alleged and confirmed abuse and deaths of youths have been widely reported across many wilderness programs, despite claims that these programs provide a less coercive environment than that of boot camps.^[18]

Accountability[]

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In October 2007 and April 2008, the United States Government Accountability Office convened hearings to address reports of widespread and systemic abuse in adolescent treatment facilities. In connection to the hearing, they issued a report about the wilderness therapy industry.^[15][19] The Federal Trade Commission has published a list of questions for parents to ask when considering a wilderness program.^[20]

Programs seeking additional accreditation and certification often pursue partnerships and memberships with non-profit membership and accreditation organizations.

After the program[]

After a wilderness therapy program, clients may return home or may be transferred to a therapeutic boarding school, young adult program, or intensive residential treatment center. Some estimate that 40% of children enrolled in wilderness programs are later sent to long-term residential behavioral care facilities.^{[21][needs update]}

See also[]

• Outdoor education
• Experiential education
• Primitive skills
• Bushcraft
• Therapy
• Intervention (counseling)
• Group psychotherapy
• Educational consultant
• Ecopsychology

References[]

Further reading[]

• Kenneth R. Rosen (2021). Troubled: The Failed Promise of America's Behavioral Treatment Programs. Little A. ISBN 978-1542007887.

External links[]

• Media related to Wilderness Therapy at Wikimedia Commons
• Learning materials related to Wilderness therapy at Wikiversity
• The dictionary definition of wilderness therapy at Wiktionary