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Wilderness therapy is a subset of adventure-based therapy, which in turn is under the Outdoor Behavioral Healthcare Industry. It is the use of experiential education, individual and group therapy in a wilderness setting to treat clients for a range of emotional, developmental and relational struggles. Clients range in age from 10-17 for adolescents, and 18-28 for adults. There are a variety of different types of wilderness therapy programs, with the most common models being sustained expedition or base camp models with a typical stay of 8–12 weeks, other single expedition style models involve single 25-35 day trips. Some grow out of a survival approach and others out of an Outward Bound approach. Their aim is to guide participants toward self-reliance and self-respect.
Contents
Overview
The New York Asylum and the San Francisco Agnew Asylum played an early role in the development of wilderness therapy, drawing upon the philosophies of Kurt Hahn. Although the therapy is often used for behavior modification by the families of young people, the aims and methods of wilderness therapy do not center on behavior modification. Many wilderness therapy programs avoid what they view as manipulations, contrived activities, psychological games, and contrived consequences. Most programs employ no force, confrontation, point or level systems, or other overt behavioral modification techniques or models, but stress assertiveness, open communication between staff and students, and are very group-oriented. There is no one standardized model for the therapy, since many models of wilderness therapy are reflective of different programs, although most usually contain the following principles: a series of tasks that are increasingly difficult in order to challenge the patient; teamwork activities for working together; the presence of a psychiatrist or therapist as a group leader; and the use of a therapeutic process such as a reflection journal or self-evaluation.
Michael G. Conner of the Mentor Research Institute states that "wilderness therapy programs trace their origins to outdoor survival programs that placed children in a challenging environment where determination, communication and team efforts were outcomes". Alternately, some programs are derived from a more ecopsychological perspective, according to the director of the wilderness therapy program at Naropa University, "through contemplative practice and the experiential outdoor classroom, students gain further self-awareness and the ability to respond to whatever arises in the moment." The founders of ANASAZI Foundation concluded that "we learned that whenever we adopted what we have come to call 'contrived' experiences, the overall impact often diminished for the participants."
Pioneers in the Industry
The pioneers in the field of wilderness therapy include Larry D. Olsen and Ezekiel C. Sanchez at Brigham Young University; Nelson Chase, Steven Bacon, and others at the Colorado Outward Bound School; Rocky Kimball at Santa Fe Mountain Center and others. Madolyn M. Liebing, Ph.D. (of Aspen Achievement then, and currently of Journey Wilderness) was the first clinical psychologist to integrate clinical therapy with wilderness programming.
Controversy
Given the proliferation of such programs, lax regulation, and absence of research setting uniform standards of care across programs, advocates have called on increased accountability to ensure programs are capable of providing care that is consistent with their marketing claims.
Some programs which advertise as "wilderness therapy" are actually boot camps in a wilderness environment. 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.
One of the major differences between 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). Additionally, most wilderness therapy programs have highly trained clinical staff either on the expedition or in active and ongoing consultation with the team. Boot camps may have no clinically trained staff working in the programs. Some staff members are from a correctional or military background. Among the most controversial programs have been those run by Steve Cartisano. or former Cartisano associates. Nevertheless, incidents of alleged and confirmed abuse and death of youth, have been widely reported across many wilderness programs claiming to provide a less coercive environment than that of boot camps.
The industry reports that, as with any type of treatment program, abusive situations have been reported and accidental deaths have taken place in some of these programs, but that compared with similar outdoor adventure activities deaths are extremely rare. These assertions cannot be independently verified due to inadequate regulation, poor monitoring, and a pattern of unreported deaths and state failure to prosecute offenders.
There is also controversy over whether parents should be allowed make their child attend a wilderness therapy program by force, as is often the case. Apart from the thousands spent on the actual program (around $500/day), some parents pay a teen escort company thousands to ensure their child gets to the program by any means necessary, without the child's consent or foreknowledge. Generally the "transfer" occurs at night, when children are disoriented. 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.
Accountability
October 2007 and April 2008, the United States Government Accountability Office convened hearings to address report of widespread and systemic abuse. In relationship with the hearing, they have issued a report about the wilderness therapy industry. The Federal Trade Commission has published a list of questions for parents to ask when considering a wilderness program.
Programs seeking additional accreditation and certification often pursue partnerships and memberships with associations such as;
After the program
The industry reports many teens in wilderness programs report the experience as being positive, beneficial, and enjoyable. They claim youth learn independence, patience, assertiveness, self-reliance, and maturity. Outcome studies have been completed and the industry reports they show continued improvement in behavior one year after attending wilderness therapy and new outcome studies are currently underway. However, independent researchers have called into questions such claims, criticizing the industry's use of 'bad science' due to methodological flaws in the research and ethical concerns.
After a wilderness therapy program, students may return home or may be transferred to a therapeutic boarding school, young adult program or an intensive residential treatment center. Some estimate that 40% of children enrolled in wilderness programs are later sent to long-term residential behavioral care facilities.