This article explores the experiences of families that have sent struggling adolescents to therapeutic wilderness programs. We employ a modified case study approach, in which
we, the participants, are also observers of the experiences of our entire families. The article begins by explaining what wilderness therapy is and offering an overview of research that has examined the effectiveness of therapeutic wilderness programs. We delineate the process of seeking, selecting and participating in wilderness therapy as well as the role of an educational consultant in facilitating this.
We describe our experiences from (1) the time we realized and accepted that our children were struggling and suffering to (2) considering sending our children to wilderness therapy to (3) the stresses of the decision making process to (4) what the experience was like for us including participating in a parent workshop to (5) planning the next steps and discharge, and finally to (6) seeing and living the results over the next few years. Areas of growth and struggle are noted. Our children’s perspectives on our families’ development over time and the interactions among us are also discussed.
The Family Throughout the Therapeutic Wilderness Process: Our Stories
“Every time the phone rings, I still think it is the police”
- Spoken by a parent several years after his son first went to a therapeutic wilderness program despite his son’s success in college and graduate school.
“I finally taught myself to stop answering the phone with ‘What’s the matter?’ whenever my son called. Instead I learned to accept that all was well and he was living his life independently with strength. I realized that he was handling things competently and I taught myself to see things going well, working out, and to reinforce the image of my son succeeding. I even realized that if he were anxious about something, like writing a paper, I didn’t need to fall apart.”
-CC
Introduction
The incidence of mental health issues is rising in the United States, as indicated by various sources. The National Center for Children in Poverty found that 20% of adolescents in the United States have a diagnosable mental disorder (Schwarz, 2009). According to the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2012 an estimated 2.2 million adolescents aged 12 to 17 in the U.S. have had at least one major depressive episode, and there were an estimated 9.6 million adults aged 18 or older in the U.S. with serious mental illness (SAMHSA, 2013). Environmental challenges that result from school and learning disabilities, turbulent households, lack of community absence of support for mental health treatment, and stigma of mental health issues and illness all exacerbate the problems faced by American youth. At the same time, prevention and intervention programs are not easy for families to access. Lack of mental health services that support the unique needs of adolescents and young adults, together with emerging data confirming the therapeutic value of wilderness environments have led to the spread of wilderness therapy. Wilderness therapy combines nature and outdoor activities with psychotherapeutic practices that address participants’ psychological problems, emotional distress, failure to thrive and launch, lack of motivation, and substance abuse in a wide range of populations. Recent years have seen increasing sophistication and diversity among wilderness therapy programs.
Though the use of wilderness therapy traces back to 1874 (Hoven, 2014), it is only recently that common terminology and theory have been established. During the 1990s, lack of information on the efficacy of wilderness therapy treatments and associations with boot-camp style programs that tried to break people down in order to build them up gave rise to serious misgivings about the ethics of wilderness therapy (Russell, 2007). In recent years, a rising movement of mental health specialists, researchers, wilderness program leaders, and university administrators have worked to ground wilderness therapy in scientific evidence and standardize best practices. In particular, a shift in practice has taken place from behavioral approaches, including aggressive physical and emotional confrontation, to relationship-based practices, focusing on skill-building to engender confidence and foster intrinsic motivation (Russell and Hendee, 2000). Self-determination theory, positive psychology, attachment theory, Arbinger Institute philosophy as described in The Anatomy of Peace (2015), and adventure-based programming all became more significant theoretical foundations for wilderness therapy.
Along with these theoretical shifts, and a proliferation of programs, new common standards for wilderness therapy and evidence of its effectiveness have arisen. In the article What is Wilderness Therapy? Dr. Keith Russell (2001), a leader in outdoor behavioral healthcare and wilderness therapy theory outlines the key characteristics of wilderness therapy programs. Being licensed by a state agency, having regular visitations from a licensed mental health practitioner (clinical therapist), addressing clinical goals, establishing individualized treatment plans, and pursuing formal evaluations of treatment effectiveness are all typical characteristics of wilderness programs (Russell, 2001). The importance of family involvement in the process of growth and change for adolescents is also beginning to be documented. For example, DeMille and Montgomery described a case study of family therapy in a wilderness program (COFT, 2015).
Through wilderness therapy, students develop accountability, motivation, boundary setting abilities, stronger family relationships, and self-efficacy. Heightened self-efficacy comes about through actual accomplishments. These can include mastery of hiking or primitive skills like fire building without implements, adventures like rock climbing or mountain biking, self-understanding through participating in initiatives designed to teach insight and new ways of approaching things, and interacting better with peers and adults. Furthermore, living in an outdoor environment helps clients leave their familiar culture behind in order to have a unique experience that will facilitate meaningful growth.
Research examining the effectiveness of therapeutic wilderness programs is growing. Increasingly, literature on wilderness therapy and long-term outcome studies reveal evidence that positive development is taking place. In a study looking at changes in psychosocial health after wilderness therapy, Norton (2008) found a 35% decrease in the prevalence of depression in the youth sampled. Along with a reduction in depression, this study found improvements in school performance, family relationships, and performance in social settings. Similarly, Paxton and McAvoy (2008) detected a significant increase in self-efficacy of students in their study exploring social and psychological benefits of wilderness therapy programs. Through a qualitative assessment of youths’ wellbeing 24 months after their participation in wilderness therapy, Russell (2005) has shown that 80% of parents and 95% of youths perceived outdoor behavioral health treatment as effective. The majority of clients were doing well in school, and family communication had improved. The importance of family involvement in the process of growth and change for adolescents is also beginning to be documented. For example, DeMille and Montgomery described a case study of family therapy in a wilderness program (2015). Partridge et al (2001) explored the importance of family involvement in treating young people in the juvenile justice system. Atwood and Scholtz (2008) talked about the role of the family in affluent young adults’ approach to participating in society.
Wilderness therapy has emerged as a necessary and effective step in helping youths and their families address, and eventually overcome, educational and life struggles. Nevertheless, the process of seeking, finding, going through, and moving on with life after wilderness therapy remains a challenge for both families and professionals.
What is an Educational Consultant?
Educational consultants work to guide families and students in finding appropriate educational and/or therapeutic placements – schools, boarding schools, colleges, and therapeutic programs. Therapeutic educational consultants, as they are called in this context, help families identify alternative educational and therapeutic programs for young people who are not doing well following traditional routes. They travel nationally or internationally, visiting and assessing these programs. Then they work as part of the treatment team alongside educators, clinicians, and parents to help families select the most effective path for their young person. They work closely with therapists and educators to understand what is going on for each individual—the history of the case, what has worked and what hasn’t worked, the concerns of the family and therapist, the student’s strengths and interests, etc. They then work together with the therapist to help the family navigate the maze of possibilities. The leadership of the team is ideally shared, with the consultant leading the discussion of placement and the therapist leading the discussion of the client’s needs. The collaborative process works differently for different people, so these roles may vary in different situations. The bottom line, of course, is that the parents make the decision—the consultant can only make recommendations.
Purpose The purpose of this article is to share with clinicians some aspects of the experiences of families whose children go to wilderness therapy. My perspective, as that of an educational consultant who has also experienced wilderness therapy as a parent, is unique, and provides a broader and deeper lens through which to view issues families face, enabling a better understanding of their responses and reactions. Sometimes families feel comforted to know that I have experienced what they are going through, and it helps alleviate some of the loneliness and pain that people often feel when they are facing a struggling and suffering child. They are more likely to believe that there is hope when they hear that I have also felt that despair.
In addition, both young men in our case study worked as part-time educational consultant interns during college. This chance to visit programs and work with prospective clients has deepened their perspectives as well. All of these experiences have enhanced our understanding of the process of wilderness therapy.
The combination of our first-hand knowledge of wilderness therapy with the things we have observed other families experiencing has allowed us to develop a richer and deeper understanding of the process. These explorations, of both difficulties and satisfactions, will provide insights for clinicians and educators working with struggling and suffering students and their families, who may often feel frustrated or even hopeless as they begin to contemplate sending an adolescent or young adult to wilderness therapy. Our transparency about the kinds of struggles that families often have in sending their children to therapeutic wilderness programs can make the process less intimidating for families. It can provide therapists with more specific knowledge to support parents experiencing pain as well as relief (both of which parents often feel at different times during this process.) My perspective as an educational consultant and parent can help therapists and parents learn how to navigate the path through therapy, which will not be a straight line, without excess worry over every blip in progress.
Our Modified Case Study
We have done a modified case study to describe our own experiences as participant-observers in this process. Case studies are used in the study of psychology to provide in-depth investigation of a single person or small group. They are useful for examining processes and development in detail and over a significant period of time. Case studies use interviews and observations to elucidate complex phenomena. For example, Bettman et. al. (2011) studied the narratives of 14 adolescents in wilderness therapy to understand their attitudes toward parents. Russell (2000) studied four cases to examine how the wilderness therapy process related to outcomes. Norton (2008) studied one adolescent in wilderness therapy to assess the effects of the program on mood. Case studies like this depict trends.
Through our work as educational consultants, we are aware of the universality of some of the experiences we had as family participants. Parents and even siblings share in the experience of young people who participate in wilderness therapy. We explain our experiences here in order to offer therapists and families additional insight into some of what may happen. We also hope to normalize some of the fears and struggles that are part of the process as well as an effort to honor the positive effects of wilderness therapy for the whole family.
Two Families’ Stories
We now describe various aspects of the experiences of two families, through the eyes of the mothers of two adolescent boys who were struggling, unhappy, doing poorly in school, and using poor coping strategies. Adam CC and Lian Z both went from Northeastern urban centers to wilderness programs, where they developed motivation, accountability, self-confidence, enhanced relationships and the capacity to flourish. They have become successful young men who are able to push through any challenges and are thriving in all areas.
Struggling and Suffering
C and Adam
My son, Adam, was struggling during high school - he explains now that in elementary school he began to feel bad about himself, especially in school - he had borderline learning issues and some problems with attention that we didn’t address adequately. He explains how alone he felt in his lack of success. Then, when he was in middle school, his father and I got divorced - he explains that he became angry then. These feelings continued to develop, and by ninth grade, he ended up being arrested with two friends who were selling marijuana. Although he was unable to take action at that point to change his situation, he now sees that incident as pivotal - a wakeup call. After the arrest, he left his high school and attended two others in New York to complete ninth grade and half of tenth. The last of these schools was a great place, but while Adam always attended class, he was not very involved. The interesting, progressive education and caring teachers were not enough to draw him in. He was unable to follow through on any interests and kept quitting activities like theater (he had been a successful actor, singer and dancer in community and children’s theater). He was also using/abusing marijuana, though we didn’t realize the extent of this at the time.
Considering the Options
After a year, filled with frustration, feelings of helplessness and quantities of contradictory advice, we finally sent him, at age 15, to a therapeutic wilderness program. My considerable experience in public health, including in leadership positions in mental health and educational fields, had not led me to knowledge of alternative therapeutic and educational programs at that point. In fact most of my colleagues, experts in their fields, cautioned me about the dangers and ineffectiveness of such weird interventions, quite far off the grid of Ivy League psychiatry. We were referred to an educational consultant who seemed to see all of what we were going through as minor. She thought Adam was a “soft” kid thought wilderness would be good for him. Nevertheless, we didn’t act for several months.
The final impetus for us to intervene was Adam’s despondence on a family vacation - something that had always been positive for him before. Thus, we sent him off to wilderness treatment in the heart of winter. He did not, however, go willingly. One day Adam had expressed some concern about himself saying “I don’t know why I’m not more motivated.” I suggested he consider attending one of the therapeutic wilderness programs that have demonstrated effectiveness in helping kids with these issues. He said “No way.”
Mindy and Lian
It was a stressful time in the family before deciding to send Lian to wilderness, according to Mindy C, his mom. “After moving to a new area and putting him in a new school, issues began to arise that we had not expected - he was disconnecting, changing friend groups, selling and abusing pot, and demonstrating large levels of frustration with school. Simultaneously, there were other tensions in the family with other brothers and my relationship with my husband was not its best. It was not until we moved Lian out of the school he was in that we were able to uncover what was actually going on. It was hard on everyone. As well, our older son had struggled when he was younger but we felt we waited too long with him to get help, especially after learning with him that there are key windows for interventions. So for Lian we decided to address the issues openly and we were able to talk about the process of going through a program.”
Lian explains, “I was confused about the process but willing to trust my parents/listen to them. However, before going I think I had a skewed view of what I was going into that made it seem more appealing. I had a love for nature and adventure already so the thought of going on big trip was appealing, even though I was wrong about how long I would be going for (I thought I would be gone for a month). Once I got there, my first few letters were hateful - bashing and ranting about how unhappy I was. It was good for my parents to have my therapist explain why I might be sending letters like that because their response was always very considerate and written with conviction.
Getting There
C and Adam
When we were about to send Adam, he refused to consider wilderness even though he had expressed frustration with his lack of motivation. We felt stuck, but proceeded to hire transporters - the process made me so anxious I couldn’t make any of the arrangements or speak with the staff in advance. Our educational consultant remained cheerful throughout all of this - our waking Adam early in one morning and handing him over to transporters, his being in wilderness for the winter, working together with his wilderness therapist - a number of things that seemed overwhelmingly difficult for me to handle. Most overwhelming of all was figuring out how to help and support Adam through the process.
I was very surprised that once the transporters arrived, I felt supported in a way I had not in years - we were embarking on a path in which we would have help figuring out how to help Adam develop a sense of well-being by dealing with his challenges and embracing his strengths. Adam told us later that he was angry about what was happening, and considered fighting back briefly, but then acceded. Eventually, Adam came to terms with being taken somewhere against his will. He realizes there was no other way other than for him to have gone to wilderness therapy and that the experience was so important in creating a positive direction in his life and allowing him to push through his challenges. He has at times pointed out the moral dilemma inherent in expecting someone to develop intrinsic motivation to grow and change in the context of being sent somewhere against their will. Although I acknowledge the validity of this point, parents of teenagers sometimes have no better way to set a limit and let their children know that what is going on is not working and that they expect more. It is nevertheless helpful to see the paradox rather than assume that there are no issues inherent in taking such a step.
The Program Begins
Though I felt relieved that Adam was safe, I remained heavy hearted in his absence for several weeks, participating in every webinar that was available, eagerly reading every suggested resource, anything to feel more connected. I began to feel appreciative that there was someone - a whole entity - taking over the role of “nag” and replacing it with an approach that would help Adam develop motivation and agency. As parents, we had been unable to do that, and now there were people who were able to reach him—a thoughtfully developed program with a history of success. Gradually, Adam became accountable for his behavior and open to growth.
His sister, five years older and in college was reassured that we had taken this step. She had been at home during winter break when Adam left and we gave her and a friend a “gift’ of a night in a hotel, so they wouldn’t be home when Adam left. When we explained what we had done, she was reassured that we had finally taken action to make a difference in her brother’s life. School had always come easily to her; she sailed through largely untroubled (until our divorce, which was traumatic for her as well). However, she recounted to me that she often experienced inadequate attention from us during times when we were preoccupied with how to help her brother. Adam’s treatment in wilderness therapy allowed us to refocus on his sister as well.
Adam was required to remain outside of his peer group of students when he arrived at the wilderness program, until he told his life story. His dad and I agreed to speak together with his therapist on weekly calls, something I thought I would never do since we had divorced. We were able to learn to parent together more effectively. We wrote impact letters and read his story. He struggled to be engaged in the process until after a number of weeks. His therapist suggested that he act as if he were engaged and succeeding. This seemed to help him get unstuck.
He hiked miles every day, made shelters with his tarp, packed and carried his backpack, had to chance to “bust” a fire - skills he hadn’t had before, though we had spent extensive periods at our country house with him and visited natural settings around the world. He developed connections with the field staff and his peers, as well as participating actively in therapy. His therapist and her intern were continually and increasingly helpful to us and to him—the process became reassuring and hopeful. Communication by letter was satisfying - as he says, it allowed us to consider our interactions and to respond thoughtfully rather than react immediately.
His dad and I flew west to attend a parent seminar at which we met field staff, therapists (not his), and other parents. Somehow it felt okay to be near Adam but not to see him. We learned communication exercises that he was learning. These entailed dialogues like “ I feel XXX when YYY happens,” followed by reflective listening “I hear that you feel...” They involved expressing our hope for ourselves, which is within our control - and our hope for the other person, which is out of our control. We felt camaraderie with other parents - they were intelligent, thoughtful and caring, interesting people. It was significant to me to feel part of a group that was “okay.” At home, despite the presence of understanding friends, it was easy to feel alone, as though no one else had been through any difficulties like this. Avoiding the trap of wallowing in isolation is crucial. Over the years, meeting many other parents and attending parent seminars as both a parent and an educational consultant, processing the teachings of Arbinger Institute (2002, 2015) materials and many other books and articles, I have continued to learn as an active parent among the many active parents doing the best we can to help our children flourish.
Determining What Was Next
The process of figuring out what would follow wilderness therapy was difficult and brought more uncertainty and anxiety about how to help Adam effectively. I missed him incredibly but believed the people who insisted that he needed to stay away from home after wilderness. It certainly would have been traumatic for me to bring him home - I would have worried constantly - but it still surprised me a couple of years ago when Adam himself explained that he believes it is best for teenagers not to come home after wilderness therapy because the old triggers are still there in place. I had been sure he would have said he would have preferred to come home and would have handled it well. I have seen a number of students return to settings against advice and they eventually do well – some have struggles and seem to muddle through but they often arrive in a positive place.
For Adam, even though he went to boarding school, it was difficult for me to figure out whether and how to limit his relationships with his old friends, some of whom were stuck in old, self-destructive patterns but who are good people. Adam and his friends all wanted the best for each other, but I worried about the effects of them spending too much time together. By now, however, Adam has worked it out on his own and he is able to be caring, connect with, and see old friends at the same time as he pursues his own life. The friends he has made along the way are also caring, as well as motivated and focusing on developing active, productive, interesting lives.
When we were visiting and reviewing follow-up programs (we went to each one suggested), the one we liked the best did not have a space for him. Nothing we saw felt right, and eventually we selected the place closest to home. At that point we were able to plan Adam’s graduation from wilderness.
Completing the Program
After 93 days, we came to wilderness to stay overnight, for his graduation. It was a wonderful, very touching couple of days. We were impressed with the field staff running the experience and the other two kids. There were three of us - all families whose children were graduating and we spent two days together, experiencing some of the wilderness program and participating in transitional rituals and ceremonies to honor our children’s work and success. Even writing about it now brings back the intense pride in Adam, appreciation for the opportunity to do some of our own work, and our gratitude to the staff and program. Even the experience of sleeping outside in the now warmer winter - 16 degrees Fahrenheit - was amazing. We were impressed with Adam’s confidence and easy competence setting up tarps and living in the harsh Utah outdoor winter. The love and caring we all felt toward one another was profound.
The initiatives we participated in were effective in creating situations that we could use to develop insights into our behaviors and responses. The exercise of telling one another things we regretted, respected, and requested was extremely moving and now, five and one half years later, I still remember and continue to work on at least some of my behaviors that I learned could be difficult for my son. It seems often that parents change more slowly than their children. Kids in wilderness have the opportunity to have 24 hours a day of repatterning while we have only a couple of hours a week working with the wilderness therapists. Over the years, Adam has persisted in reminding me, almost always in a caring and connected way, about some “better” ways of interacting and responding at those times when I am in old patterns.
After Wilderness
We left to spend a few days together, and then traveled with Adam across the country to drop him off at the therapeutic school we had selected. It was scary to leave him there, but he helped the separation by telling us, as he met the other students, “These are my friends.” He was clearly comfortable with meeting new peers and ready to develop relationships with them.
Over the next few months, I was not sure that the fit was right. I did not connect with his therapist, the education seemed too elementary, and there did not seem to be enough activities. Nevertheless, I did not trust myself - my old tendency to rescue might be resurfacing. I finally decided to hire another consultant to assess the situation. She decided that the program was fine but that our son did not need a therapeutic school, that a traditional supportive boarding school would be good. Adam’s dad eventually agreed to go along with the plan to find a new situation for him.
We relied on our new consultant’s suggestions completely, as we had with the previous person. The path through the therapeutic world remains unclear to the uninitiated. It is scary to make decisions about what to do because there is no black and white route to wellbeing. We rely on those who say they know what to do – and I have seen many children and young adults get to better places - but that reliance is a bit tentative because the world is so unfamiliar. But I learned much from our experience, and that of so many others I have talked with about the variety of effective approaches to helping young people. As a result, I have developed some ideas about which parts of the process are significant and what aspects of programs are the cornerstones of change.
Adam went to another wilderness program, with a different philosophy and different approach, as a transition situation- he was able to leave it for days at a time to visit boarding schools. He selected a boarding school in the West, preferring that part of the country and in order to maintain connection more easily with his wilderness therapist, with whom he continued to work during school. I continued to learn from his therapist - how to identify the ways in which I felt confident in my son’s ability to handle things and how to express that confidence to him. I had the opportunity to practice letting him do “it” whatever “it” was, for himself. I could only be supportive and set some basic limits, which were that he had to do something productive and stay out of trouble.
Senior year he was struggling again, thinking of going back to wilderness, because he knew it would be helpful. But then he got involved with people who were not a good influence and activities that were not positive, so the school asked me to send him back to wilderness. Once again, he was transported against his will, but he accepted it. Nevertheless, we both felt upset by the transporters lack of warmth and caring this time.
Looking Back from a Successful Present
Adam has said that this last trip to wilderness was the most meaningful. I remember I met him there shortly after he arrived. His previous therapist, with whom he had been working on an outpatient basis while in boarding school, was away. The program’s clinical director pitched in and in a meeting of the three of us, called me on my unspoken desire to rescue Adam. For one thing, she wanted to make sure everyone knew and saw his strengths. The therapist said to Adam and me, “this is serious. If we don’t want Adam to be in a similar place of uncertainty and lack of commitment in his mid-twenties, Adam needs to take responsibility for his situation moving forward.” We were able to listen, and Adam worked hard. I let him embrace the strength within himself to move forward and to find and pursue his own path. I asked only one thing – that he be productive in some way. He has developed into a person whose values I respect immensely, a leader, able to express his caring and sensitivity in very positive ways to his friends and family. He has also found his academic and intellectual strengths, becoming a very successful student and a deep thinker.
Over the past few years, Adam has worked with me, visiting and assessing programs, consulting with families, suggesting placements. We have spent many hours discussing the wilderness treatment, specific programs, specific clients and families. His insights are invaluable. He understands the process and can elucidate it in helpful ways.
In wilderness therapy, students become motivated to find a new perspective. They come to understand and accept themselves, and know their own boundaries and needs. Wilderness therapy enables young people to become stronger in who they are, and therefore more able to hold their own and establish healthy, positive relationships with their parents.
Regarding family involvement, Adam has noted the following: parents who participate in as many activities and programs as possible are likely to be more invested in the process and make the experience more powerful for everyone. Students learn about who their parents are and how to deal with that reality, both the positive and the negative. On the other hand, when parents are not interested or able to make changes, their children have to work through a more difficult process by themselves.
Adam believes that the lack of involvement of his sibling at the time he was in wilderness made it harder to communicate about it. Though he and his sister have a satisfying and close relationship, he sees that her lack of direct participation in the process created a disconnect. He wishes his sister had been able to participate in a family program. Even she, who is glad she didn’t have to go to wilderness herself but sees how wonderful an experience it was for Adam, admits that a family intensive would have been helpful.
Parents change more slowly than their young people who are in wilderness and experiencing 24 hours a day of repatterning. Our daughter thinks that as a result of our experience with wilderness, we changed somewhat in the way we parented her brother, but not a huge transformation. Children can help parents see certain things, and possibly even change certain behaviors, but they cannot be responsible for creating the change in their parents. It is okay for kids to say to parents “this is what I need from you in our relationship” but it’s not appropriate for them to be responsible for their parents changing themselves.
At this time, Adam is nearing the completion of a very successful college experience. I have seen how he found ways of calling forth his strengths, of showing up in the arena to push forward, of handling his challenges. At the same time, I have seen how he has been able to enjoy the things that come easily to him – his great social skills, sensitivity and responsibility toward others, his deep and meaningful relationships. I feel close to him and grateful for our relationship.
Lian and Mindy
Lian has also succeeded socially, emotionally and academically. He too has developed strong relationships, pursues solid and good values, and has found academic success. His mother, Mindy, reflects on their family’s experience, “As a family we continued to seek out ways to become stronger. The landmark forum and yoga retreats are things we did to continue the process of family growth and strengthening. The concrete evidence that we have seen as a family is love, positive communication, and continuous growth. Since our son went to wilderness we have made major milestones as a family, such as having three kids right now succeeding in college, passionate children, and Paul and I thriving in our professional endeavors. We feel blessed and privileged to be where we are.
Lian went to a boarding school and has now graduated college, and is pursuing global mental health as a career. He too is succeeding socially and academically.
Working with an Educational Consultant-Enhancing Support for Families and Referring Therapists
There is often urgency for families exploring wilderness therapy. Educational consultants can assist both families and clinicians with access to more accurate information about programs and facilitate the process of identifying appropriate choice for a child or adolescent.
I have been able to continue to appreciate the many benefits of wilderness therapy. It was my experience with Adam that motivated me to become a therapeutic educational consultant in the first place. Over the past few years, I have been able to work with my son and other young people who have had wilderness experiences, review programs, and help place clients’ children in appropriate environments. I have seen many people go through the process and have a clear understanding that there are ups and downs along the route to flourishing. I know that the problems are not usually a sign to go back to square one but rather can be a part of the process of healing and growth.
There are divergent opinions about what is the most effective residential treatment. From our experiences and my knowledge I believe that the most effective growth and development results when an internal locus of control is the focus of change – that each person must change from within, knowing and accepting themselves and their own boundaries. I also believe that the best programs are those that model, as an organization and among staff, the path they want their clients to take – personal growth leading to a sense of wellbeing and flourishing. Positive psychology is important to create strength-based programs. Of course, sometimes people have great success at programs that follow other approaches. There is no single right answer and people can follow their intuition, once they survey all the information.
Some particularly effective interventions for us as parents were: learning to express difficult sentiments in “I feel” statements involving reflective listening – “I hear that is hard for you, but not solving the problem.” Assisting adolescents and young adults, with the help of wilderness therapists, I have learned that three things are needed: each young person has to do “it” himself or herself, while at the same time parents need to set limits. Parents have to expect their child to be productive in some way – and parents need to help young people feel confident in themselves by pointing out their specific successes in handling challenging situations.
Part of wilderness therapy is exploring what leads to growth and change for each person in the family. For the child, is it the therapy, the time in wilderness itself, the field staff, the theoretical approach - intrinsic vs. extrinsic locus of control - the activities, adventure or primitive skills, or mastery projects? All of these may be significant. For families, is it the break, the therapy, the change in the dynamics of the family system as the person in wilderness changes, the clarity that something needs to be different, learning new strategies or exploring more deeply into one’s persona, the psychoeducation – (as discussed in Brene Brown’s books like The Gifts of Imperfection (2012, 2013) or Arbinger Institute ( Leadership and Self Deception 2002, 2015) materials)? These are all questions about the mechanisms of change that are important to clarify.
Information for Home Clinicians Working with Families
Referring clinicians usually decide that the person with whom they are working is stuck, not making adequate progress, resistant to outpatient treatment, or part of a family that is unable to change. It can be a great benefit for a therapist to work with a consultant who knows about and has assessed programs that are alternatives to typical outpatient treatment and hospitals. When selecting a consultant, it can be useful for the home therapist to determine the consultant’s philosophical orientation and approach to vetting programs, style of team work, etc. to determine if they are compatible.
The process for suggesting wilderness or other alternative residential therapeutic programs for a therapist starts with the family and the team figuring out the best way to work together. Although each situation is different, in general the home therapist determines what the young person needs together with the family and the family makes a choice.
Meanwhile, the consultant helps everyone navigate the process. The home therapist is the expert on what issues the young person faces, what he or she has responded to in the past, what has not worked, the family relationship, etc. People often feel like they are jumping into an abyss when they are entering the world of residential therapy – it is unknown to many clinicians and educators. More education about how these programs operate, who the staff are, what their training and professional development includes and how wilderness therapy organizations function would be very helpful for clinicians who are advising families. It is also useful for the therapist to help the family define their goals for their child or young adult so the consultant can help them figure out the best way to help the young person attain those goals.
Transporting someone against their will is not anyone’s preferred choice. On the other hand, an angry young person almost always arrives less angry when they have been accompanied by someone they don’t know rather than by their parents. A good interventionist can help a young person understand why they are being sent to a program and how the program will help them. Almost all children who have been transported to programs soon develop an understanding that this was the only way their parents were able to set limits – a young child can have a time out, for a teenager that doesn’t work. They see the benefits of being where they are and understand that there was no other way to get them where they need to be.
Conclusion
Despite the need to pursue more research to deepen our understanding, it is clear that participants in wilderness therapy get their lives back. They become able to embrace their strengths and deal with their challenges, find new motivations and refreshed self-concepts, develop new ways of pursuing their values and handling ups and downs with greater resilience. Families almost always become closer and repair wounds. As therapeutic wilderness programs and other alternative comprehensive residential programs are refined, we are able to pay more attention to the value of ongoing support for both parents and student alumni. Educational consultants have an important role to play in helping families and clinicians navigate the selection that is the best fit from among the hundreds of comprehensive, therapeutic alternative programs that exist. Maximizing dialogue and collaboration within each group and among all involved -“home” clinicians, programs, consultants, parents and participants - can enhance the effectiveness of the work we are all doing.
References
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doi: 10.1177/105382591103400206
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Brown, B. (2012). Daring greatly: How the courage to be vulnerable transforms the way we live, love, parent, and lead. Westminster, UK: Penguin.
Brown, B. (2013). The gifts of imperfection: Let go of who you think you're supposed to be and embrace who you are. Center City, MN: Hazelden Publishing.
Hoven, L. J. Van. (2014). A Systematic Review of Wilderness Therapy : Theory , Practice and Outcomes. Master of Social Work St. Catherine University and the University of St. Thomas St. Paul, Minnesota Clinical Research Papers. Paper 279.
Norton, C. L. (2008). Understanding the impact of wilderness therapy on adolescent depression and psychosocial development. Illinois Child Welfare, 4(1), 166–178.
Paxton, T., & McAvoy, L. (2000). Social psychological benefits of a wilderness adventure program. USDA Forest Service Proceedings, 3(z), 202–206.
Russell & Hendee, J. C., K. C. (2000). Wilderness therapy as an intervention and treatment for adolescents with behavioral problems. USDA Forest Service Proceedings, 6.
Russell, K. C. (2005). Two years later: A qualitative assessment of youth well-being and the role of aftercare in outdoor behavioral healthcare treatment. Child and Youth Care Forum (Vol. 34, No. 3, pp. 209-239). Kluwer Academic Publishers-Human Sciences Press.
DOIL 19.1007/s10566-005-3470-7
Russell, K. C. (2001). What is wilderness therapy? Journal of Experiential Education,September 1, 2013 24, 70–79.
Schwarz, S. W. (2009). Adolescent Mental Health in the United States. National Center for Children in Poverty (NCCP).
Substance Abuse and Mental Health Services Administration (SAMHSA). (2013). Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings. US Patent 1,870,942, 1–63.
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