Keith C. Russell

What Is Wilderness Therapy

Despite a growing number of programs operating in the United States under the guise of “wilderness therapy,” a consistent and accepted definition is lacking. Rehabilitative, outdoor-based approaches, such as “challenge courses,” “adventure-based therapy,” or “wilderness experience programs,” are often used interchangeably to describe “wilderness therapy.” This paper attempts to shed light on this issue by presenting an integrated and consistent definition of wilderness therapy to guide program design and future research efforts. Three trends in the industry are also explored which support the notion that wilderness therapy programs are searching for recognition by state agencies, national accreditation agencies, insurance companies and mental health professionals. These trends support the idea that consistent wilderness therapy practices may be emerging which support the use of a consistent definition.

Perspectives on the Wilderness Therapy Process and Its Relation to Outcome

This study examined the wilderness therapy process in order to better understand how the intervention effects change in problem behavior of adolescent clients. A review of literature reveals multiple definitions of wilderness therapy, numerous studies evaluating treatment outcomes, and a need to focus research on how the process facilitates change. This study investigated four established wilderness therapy programs using a multisite case study approach and a variety of qualitative data collection methods to carefully examine the wilderness therapy experience of 12 clients in four wilderness therapy programs. Findings indicate that physical exercise and hiking, primitive wilderness living, peer feedback facilitated by group counseling sessions, and the therapeutic relationship established with wilderness guides and therapists were key change agents for adolescents. These factors helped adolescents come to terms with their behavior and facilitated a desire to want to change for the better.

Exploring How the Wilderness Therapy Process Relates to Outcomes.

Wilderness therapy is seen as a treatment option for seriously troubled adolescents not being reached by traditional forms of treatment. The research shows that wilderness therapy can improve self-perceptions, increase social adjustment, and reduce recidivism of adolescent participants. However, research on wilderness therapy has not been specific in describing how presenting problems are assessed by wilderness therapy and how therapeutic approaches relate to target outcomes. This article examines the wilderness therapy process in context to illustrate how the process related to specific outcomes for four client case studies in four wilderness therapy programs. Trends emerged from qualitative data analysis illustrating the importance of alone time and opportunity for reflection and a non-confrontive and caring approach that helped clients establish a trusting relationship with staff. Three outcomes were common across all four client case studies in the form of proposed changes: (a) a better relationship with their family, (b) abstinence from drugs and alcohol, and (c) a desire to try harder and complete school. Four-month follow-up interviews revealed clients doing well, though three had used drugs and alcohol to varying degrees, which underlines the importance of structured aftercare services.

A Nation-Wide Survey of Outdoor Behavioral Healthcare Programs for Adolescents with Problem Behaviors.

Outdoor behavioral healthcare (OBH) is an emerging intervention and treatment method in mental health practice which helps adolescents overcome emotional, adjustment, addiction, and psychological problems. OBH programs apply wilderness therapy as a treatment approach, which involves immersion in an unfamiliar environment, group living with peers, individual and group therapy under the supervision of licensed professionals, and educational curricula. The goal of OBH treatment is to reveal and address problem behaviors, foster personal and social responsibility, and enhance the emotional growth of adolescent clients. A nation-wide survey of 86 OBH programs that annually serve over 10,000 clients and their families showed that over 80% of all OBH programs are licensed by state agencies. Results also showed that there are more private placement than adjudicated programs by nearly five to one, and that less than 25% of client treatment costs are covered by insurance payment. OBH program models vary and are often used as an alternative treatment for adolescents not reached by traditional counseling services.

A Five-Year Follow-Up of a Survey of North American Outdoor Behavioral Healthcare Programs.

This study reports the results of a five-year follow-up survey of private-pay outdoor behavioral healthcare (OBH) programs operating in the United States and Canada. A total of 65 of 102 programs identified as meeting certain characteristics responded to the survey and identified themselves as an OBH program that utilizes a clinical treatment model that primarily uses wilderness expeditions. The goal of the study was to determine industry trends by comparing the results of this study to results generated in a 2001 survey of OBH programs. An additional goal of the study was to discuss the findings in the context of recent reports on OBH and related programs concerning program management and practice. Key findings indicate that the number of OBH programs operating appears to have increased since 2001, and that the clear majority of these programs are state-licensed and half are accredited. Family involvement in programming has decreased, as has the number of families receiving co-pay to help alleviate the costs of treatment. Field instructor training and qualifications, supervision, and oversight of daily treatment and program operation, and drug detoxification practices at admission are all issues that warrant further investigation. A conclusion is made that care should be taken by policy makers and others when making broad generalizations that implicate all OBH treatment programs, when it appears that most programs are licensed, have licensed clinicians on staff, and adhere to best practices in treatment as identified by a variety of agency and association standards.

An Exploratory Study of a Wilderness Adventure Program for Young Offenders

Abstract Wilderness adventure programs have been utilized as an intervention in youth corrections in the United States since the arrival of Outward Bound in the early 1960s. This exploratory study evaluates the effects of a 21-day wilderness adventure program for young offenders called Wilderness Endeavors. The results of the study showed that self-efficacy and hope scores changed significantly and that young offenders who had reported higher levels of hope were less likely to recidivate than those who had reported lower levels. When comparing the treatment group to a control group, no significant differences in recidivism rates, school participation, or employment rates were found. The limitations, challenges, and recommendations for research on wilderness programs for young offenders are also discussed.

An Empirical Examination of Outdoor Behavioral Healthcare Field Instructor Job-Related Stress and Retention

The purpose of this study was to collect and analyze demographic characteristics and job related difficulties experienced by field instructors in outdoor behavioral healthcare programs which utilized wilderness therapy as well as other treatment modalities. Three state-licensed outdoor behavioral healthcare programs in the United States provided a sample of 129 field instructors who completed the survey. Results confirmed a high turnover rate of instructors and high challenges experienced with non-work related issues, particularly in sustaining romantic personal relationships. Factor analysis identified three constructs related to difficulty levels experienced on the job: a) time and schedule constraint; b) emotional anxiety and stress-related issues; and, c) physical and mental challenges. Results of this study are of value to field instructors and outdoor behavioral healthcare program administrators to better understand the challenges faced by this group of professionals. Recommendations are presented that suggest ways that the physical and mental health of field instructors can be supported.

Hierarchical Data Structures in Adventure Education and Therapy

Hierarchical linear modeling (HLM) is an approach used in data analysis to better understand how program outcomes are affected by the “nested” nature of data collected in many studies. An outcome can be considered variables such as an individuals self-efficacy, social skills, or more targeted outcomes such as demonstrated reading and mathematical skills. Recent research has suggested that individuals within each “nested structure” may exhibit more similar outcomes than another similar research setting. The purpose of this article is to provide examples of nested data structures and illustrate common approaches to dealing with this type of data often found in adventure education and therapy research. Data available from a study on the wilderness treatment outcomes are then analyzed using HLM to illustrate how the process can increase interpretation of findings and inform future research. Results suggest that many of the variables of interest in research on adventure education and therapy, which might explain why outcomes vary for participants, may be missing from research designs due to nested data structures. Future researchers should consider HLM approaches that may be appropriate for nested data structures common in studies on adventure education and therapy.

Initial Training of Field Instructors in Outdoor Behavioral Healthcare Programs

Currently, the training and education of outdoor leaders has mostly been directed towards instructing technical, educational and relationship skills (Priest & Gass, 2005). This approach often omits critical skills necessary to deal with the job demand stressors that come from working in outdoor education settings, including outdoor behavioral healthcare (OBH) programs that work with challenging youth. Some job demands stressors typically found in OBH programs include: a) psychological and emotional issues of clients, b) demanding work schedule, c) remote work areas and d) certain intervention strategies utilized to successfully help youth overcome their personal issues. (Marchand, Russell & Cross, 2009). Previous research has found that working in OBH requires support at various levels to sustain and help develop the individuals working in this unique area of outdoor education and human services. By assuring that programs provide employees with the specific tools necessary to deal with the unique job demand stressors, they will be better able to fulfill their mission and goals of providing quality outdoor educational and therapeutic services to clients. Improvements should also be made to understand the ideal length and content of these initial trainings (Davis-Berman & Berman, 1994; Russell, Gillis & Lewis, 2008). In the context of a larger study (Marchand, 2009), the initial training of field instructors in OBH was examined for prevalence, length, satisfaction and content. This focus was meant to increase the understanding of this overlooked aspect of OBH, review potential information that may give insight into the management of job demand stressors, and provide information for future studies on the subject.

A Way to Wisdom through Service and Relationships

Youth workers and psychologists alike assert the need to address the development of noncognitive assets in education (Gardner, 1983; Goleman, 1995; Pittman et. al, 2003). This call comes in the wake of recent statistics which indicate that academic success and wellbeing are negatively affected by distrust, disinterest, and isolation in the school environment (CASEL, 2002; CDC, 2006). The effort to evade the escalation of negative attitudes and behaviors has taken a turn for the “positive.” Positive youth development and positive psychology present optimal models of thriving that maximize subjective and objective well-being (Ardelt, 2003; Benson & Scales, 2009). One such model is represented in the construct of Wisdom.