Each week we ask parents and their adolescent children to communicate by writing letters. Letter writing can be one of the most powerful tools you have to establish new ways of relating and communicating hopes and feelings. Letter writing can be seen as an opportunity to re-author your relationship with your child. It also provides a forum for you to assess and consider patterns your child engages in when communicating with you through letters.
Last month I presented at the National Association for Therapeutic Programs annual conference about a relatively new profile called Pathological Demand Avoidance (PDA). PDA has been studied over the last 40 years by psychologists and mental health providers. Elizabeth Newson, a British developmental psychologist, and her colleagues, were some of the first to explore the profile of these young people referred for assessment, diagnosis, and treatment who reminded referring professionals of autism but differed in important ways (e.g., sociability and imaginative play) (Newson, Le Marechal & David, 2003). It became clear to Newson and her colleagues that these young people did not fit into traditional Autism or Autism Spectrum Disorder (ASD) type diagnoses, and they proposed a separate diagnosis (PDA) within the general diagnostic category of pervasive developmental disorders.
At Evoke we strive for and look to be creative; not just engaging in the "treatment as usual" approach. Often when we meet as a clinical team, we find ourselves discussing challenging cases or processes with families. Mental health is messy. It is tough. We are often working with families and young people during some of their worst moments, on some of the most challenging days of their lives. We provide support and care; often in an emergency and often quickly when people are in crisis. The importance of compassion and thoughtfulness cannot be overstated.
So, you have just enrolled your teenager in a wilderness therapy program. You eagerly await that first call, waiting to hear how they are doing, wondering how they are settling in. You get the initial update, and it sounds like they are still repeating many of the same behaviors from home. You get the next few weekly updates, and they are still being __________ (fill in the blank with the concerning behavior). You start to wonder when the change will begin to occur, and when the magic of the wilderness will impact your child. You grow impatient and question, “Why isn’t this working?”
We all grieve! Yes, I used an exclamation point to draw attention to this idea. We all grieve; sometimes we grieve small things, sometimes we grieve significant losses in our lives. Grief and depression are common and “normal” responses to loss. Dr. Elizabeth Kübler-Ross’ book, On Death and Dying, describes a cycle of emotional states that are often characterized as the Grief Cycle. At some point in our lives, each of us faces the loss of someone or something dear to us. The grief that follows such a loss can seem unbearable, but grief is actually a healing process. Grief is the emotional suffering we feel after a loss of some kind.
One of the best parts about working with adolescents is the significant role they play in the change process for each other. Many parents question how other young people, typically with similar challenges and difficulties, could be helpful to their child in the wilderness. The wilderness group is like a microcosm of the social dynamic at home, with an overlay of therapeutic support and intention. This therapeutic support assists with supporting young people as they navigate making changes in their lives.
Wilderness treatment began as an intervention where the identified patient, typically an adolescent or young adult, left their home to go and receive therapy in an outdoor setting. Yet, the patient’s challenges occurred within a family setting and dynamic, so wilderness therapy has evolved to include the parents in the treatment process, rather than just their child. Evoke has taken the lead in involving parents in Wilderness Treatment, as family systems and dynamics have increasingly become emphasized and explored. We offer the following interventions:
I am often asked about the things that set Evoke Therapy Programs apart from other Wilderness programs. One of the answers that I share is regarding the quality of our staff. I think many programs speak about the quality or skill level of their staff, and at Evoke we really mean it. As the Clinical Director, I interview people from other programs, and as a researcher, I present with a variety of clinicians from other Wilderness and Treatment programs. I am struck by how differently we engage and utilize our Field Instructors compared to other programs. Our investment with regard to time and energy pays off as we watch staff develop in some incredible ways. Here are some of the strengths that stand out to me:
Many people hear words like research, statistics, and outcome and quickly become disinterested or stare blankly into space! Others get excited to hear about MANOVAS or degrees of freedom or significance levels. Research in psychology tends to be a bit more interesting, especially since it relates to human conditions that many of us can identify within our own lives.
It was a perfect spring evening as we sat around the glowing campfire. We welcomed the occasional wisps of cold, memories of winter’s frozen march, as the days grew longer under the sun’s gaze. It would not be long before the stubborn sunburnt evenings reminded us to be more grateful for a night like tonight.