Applying the Principles of Group Therapy to the Wilderness Setting

Posted by Matt Hoag, Ph.D. on July 23, 2013

Irvin Yalom¹ identified eleven factors that contribute to healthy functioning in group therapy, which therapists may use to facilitate meaningful and effective interventions. Application of these factors to the Wilderness Therapy experience allows clinicians to both understand Wilderness Therapy on a more sophisticated level and to design interventions that serve to highlight or develop any of the factors.

Group Cohesiveness

Groups form and develop through day-to-day activities by working through challenges together. Difficult hikes, dealing with the challenges of weather, cooking as a group, and initiative activities all lend themselves to strengthening the group dynamic. They provide common experiences that all group members share. Common experiences help to build a sense of solidarity as group members have a goal to work towards and share some of the same challenges.

Universality

Wilderness Therapy utilizes peer mentors to reinforce the shared experience and build empathy. Mentors teach new clients necessary backcountry living skills. The mentor validates the feelings of new clients and often shares her own experiences about her first days in the wilderness. By observing and relating to the experiences of new clients, other clients validate their own early experiences in the wilderness and reflect upon the progress that they have made. This not only generates empathy with new, often resistant, clients, it also provides hope for new clients that change can occur, and that Wilderness can be a positive experience.

Interpersonal Learning

The social microcosm in Wilderness is quite real, because clients not only participate in group therapy together; they hike, cook, sleep, and work through challenges together as well. This provides opportunities to observe and offer feedback on how clients cope with stressful situations. Relationships in Wilderness are built through cooperative work, empathic communication, and conflict resolution. Also, clients that are resistant to emotional exploration may be more open to starting with feedback on seemingly simple tasks like cooking. Successes, such as learning how to make fire from another client, provide corrective emotional experiences. Clients then have a positive emotional experience of success that can be related to challenging emotional work.

Instillation of Hope

The open-ended format of wilderness groups provides for the development of leadership, modeling through successful outcomes, and “peer pressure” wherein older, more established group members facilitate the improvement of younger members. The open-ended group thus provides a built-in social mechanism, which pushes the adolescents and adults to become more engaged in the process with each other. Other clients, group leaders, and therapists provide support and encouragement, which increases hope and engagement.

Imparting Information

In Wilderness, imparting information often involves wilderness living skills and emotional expression tools. Often, clients are resistant to engaging these skills, resist the structure, and provide barriers similar to what they might in a group therapy session. Often, other clients, staff, and therapists play a part in shifting this dynamic. Direct advice occurs early in groups, especially when groups are still forming and prior to developing a therapeutic process. Advice giving is seen as helpful because the client believes if they just tell their peer what to do, then they will do it.

Corrective Recapitulation of the Primary Family Group

Field instructors and therapists often take on roles as parents or other authority figures within the client’s world, while group members take on roles of siblings. Issues that occur in life in a Wilderness Program are issues that occur in the family, and provide an opportunity to work through them. Staff members relate struggles in Wilderness Treatment to difficulties at home. Resistance to program expectations, rules, or assignments, are manifestations of the difficulties with school, respect for parents, or similar processes prior to treatment. Trust issues can also be worked through within the Wilderness Therapy group.

Catharsis

Much of Wilderness is designed to assist with accessing cathartic experiences, through ‘busting’, hiking, or some other ‘hard skill.’ The intensity of the outside world, including weather or dealing with the elements, creates experiences that are often uncomfortable and lead to emotional breakdowns; which likely relate to some repressed or ignored event.

Altruism

Within the wilderness environment, the group functions as a cohesive unit on a daily basis. Group members must learn to take care of each other and offer assistance when needed in order for the group to manage effectively. This is actually necessary in order for the group to achieve the goals needed for the day. Wilderness therapy requires clients to move beyond themselves and work together in a variety of ways, improving self-worth, value, and effectiveness.

Development of Socializing Techniques

Many young people who attend Wilderness Programs have had difficulty establishing and/or maintaining meaningful or healthy relationships. Some clients present as very isolated and lonely, while others have been managing to make friendships through substance abuse or other unhealthy means. These relationships are oftentimes quite superficial and lack of healthy reciprocation. One of the strongest components of the social learning factors described by Yalom that can be utilized in Wilderness Therapy is through healthy interaction and basic “here and now” coaching and feedback about the interpersonal process. The “social microcosm” described by Yalom occurs as members live with the group 24 hours per day for a number of weeks. Processing social interaction through feedback at the moment can aid in understanding how members affect each other interpersonally.

Imitative Behavior

Imitative behavior is effective in Wilderness Therapy, particularly when a client is first enrolled. Clients are introduced to the group in a number of different ways, but they are often assigned a mentor in order to help that client move along and feel a part of the group quickly. These mentors utilize the altruistic therapeutic factor and also aid the client in learning the group culture and expectations faster. Staff and clients utilize common strategies and language within groups in order to aid in the conceptualization of difficulties and means in which to better work through issues.

Existentialism

Wilderness can aid clients in feeling more responsible for themselves and empowered to cope with the environment around them. Clients in Wilderness Therapy are required to take personal accountability for self-care and have natural consequences if they fail to complete tasks and responsibilities. Recognizing personal strength and developing a connectedness with themselves and the environment is a powerful process that is unique to Wilderness Therapy.

1) Irvin Yalom, M.D. is a psychiatrist and writer whose first book, The Theory and Practice of Group Psychotherapy, is a seminal writing and has been used to train therapists in the practice group psychotherapy over the last 40 years. He has also written a number of books on the practice of existential psychotherapy.