If you’re new to the adolescent therapeutic world, you know that the number and variety of treatment options for young people is dizzying. One category that is often misunderstood or confused with other treatment categories is wilderness therapy. This article provides a brief overview of the nature and function of quality wilderness therapy programs for parents considering that option for their teen.
Classic wilderness therapy is a short-term residential style of treatment that leverages certain features of the wilderness to accelerate the treatment process. Typical wilderness programs utilize a brick and mortar base camp for initial intake, preparation and family therapy, and then take clients “on course,” meaning into the back country for an extended therapeutic backpacking experience. The wilderness context is so different from most teens’ normal day to day environment that it creates a sense of disorientation. This mild disorientation can be highly therapeutic because it creates a temporarily heightened state of vulnerability and openness. Young people become more dependent on others in an unfamiliar environment, especially when many of their normal coping tools—television, computers, peer groups, i-phones, etc.—are absent. This creates a window of vulnerability that allows field staff and wilderness therapists to engage the teen in therapeutic process very quickly.
Many parents initially confuse wilderness programs with other types programs such as boot camps or extreme survival-based programs. Boot camps tend to be punitive in nature and include an intense behavioral approach to treatment—an approach that does not work with many, if not most, diagnostic profiles. Even when this approach does work in the controlled setting of a behaviorally-based program, results are difficult to sustain once the young person leaves that setting. Survival oriented programs are more focused on extreme experience and hard skill building than wilderness treatment programs. This approach can be effective with certain populations—such as adult substance abusers—when coupled with quality therapy and strong safety protocols, but may not be suitable for adolescents, trauma victims or other soft or fragile diagnostic profiles.
Wilderness programs, by contrast, are treatment focused, staffed by qualified wilderness staff and therapists and non-punitive. A good wilderness program strikes a balance between the intensity of the wilderness setting and a nurturing, team-oriented, safety-first approach.
In selecting a program it’s important to remember that good credentials are the hallmark of a good wilderness program. This pertains to staff members and the program itself.
The clinical team should be made up of qualified, master’s or Ph.D. level and/or licensed therapists. Field staff should have strong wilderness medicine and rescue training (CPR, first aid, wilderness first responder) as well as extensive outdoor experience. The extended team should include on-call members with strong medical and psychiatric credentials. All staff should be subject to a background check as a routine part of the hiring process. Look for a safety plan that includes highly accessible evacuation and emergency services and a reliable field communications system (e.g. satellite phones, tracking devices).
Wilderness program accreditations vary, so it’s best to check and compare accreditations by referring to the accreditation standards of each specific accrediting body. Typical wilderness program accreditations include: JCAHO, BBB, and AEE. JCAHO is likely the most rigorous therapeutic accreditation that a wilderness program can have. Reputation is, perhaps, the most important credential a program can have. Talk to parents, educational consultants, residential programs and/or mental health professionals who have had direct experience with the programs you are considering.