Defining Wilderness Therapy
Recently, a reputable Wilderness Therapist presented on the effectiveness of Wilderness Therapy at the American Psychology Association conference. Upon his return he shared his presentation was grouped in the same category as dance therapy! This is an amusing illustration of the confusion in defining Wilderness Therapy. A growing number of behavioral healthcare professionals are asking what should and shouldn’t be considered “Wilderness Therapy.” With interpretations ranging from boot camp to adventure trips there is an obvious need for a clear definition of Wilderness Therapy. A clear definition provides universal understanding of what Wilderness Therapy is and the extensive benefits gained from it.
While the field of Wilderness Therapy is relatively young, the past 20 years has seen an increase in research in the theory and effectiveness of Wilderness Therapy. This research shows Wilderness Therapy as a highly effective treatment model, creating significant clinical change in its participants.[i] And contrary to most assumptions, there is also research showing that adolescents in a Wilderness Therapy program (OBHIC member programs) are nearly three times safer than living at home.[ii]
A great deal of investigation and research has gone into Wilderness Therapy. The book “Adventure Therapy: Theory, Practice, & Research”, provides comprehensive details of Wilderness Therapy’s present practices as well as outcomes. In this book, Dr. Will White gives an extensive history of adventure therapy, which includes the rise of Wilderness Therapy. Adventure therapy and Wilderness Therapy are frequently used synonymously, and in most general aspects are very similar. In the book, “Adventure Therapy: Theory, Practice, & Research” Gass, Gillis, & Russell define Adventure therapy as, “the prescriptive use of adventure experiences proved by mental health professionals, often conducted in natural settings that kinesthetically engage clients on cognitive, affective, and behavioral levels.”[iii]
According to this definition, Wilderness Therapy is adventure therapy. Ropes courses, nature walks, rock climbing, etc. may also be included as adventure therapy. It is important to recognize all these programs are valuable and each have their place and purpose. However, it is crucial to distinguish that while Wilderness Therapy is adventure therapy, not all adventure therapy is Wilderness Therapy. They are not equal in experience, nor are they equal in clinical effectiveness.
To further distinguish Wilderness Therapy from adventure therapy and ultimately provide a clear definition there are three additional key elements. These elements are: wilderness environment, the therapeutic experience and primitive living. All three of these crucial elements are necessary for Wilderness Therapy to occur.
It should be obvious that the wilderness environment is essential in defining Wilderness Therapy, yet too often wilderness is partially or completely removed from the experience. The result is that a significant portion of the overall experience is taken out with it. One reason Wilderness Therapy is effective is because the wilderness environment is constant and impartial. Wilderness is unadulterated, it is unrelenting, it cannot be bargained with or controlled, and the results of actions or inactions are unfiltered and inescapable. To benefit from the remoteness and isolation of Wilderness the experience needs to be void of modern conveniences such as electricity, plumbing, and housing. Even the smallest interruption of wilderness experience can have a substantial effect on the overall experience. To spend the day in the wilderness, and then return to a cabin for the evening is removing an essential element of the necessary experience of Wilderness Therapy.
The therapeutic experience comes in multiple direct and indirect forms. Professional clinicians work with the participant/s to provide individual therapy sessions every week, personalized treatment plans and a program structure driven by clinical intentions. These are all primary and necessary elements of the therapeutic experience in Wilderness Therapy. Additional necessary therapeutic elements come in the form of intentional therapeutic processes, daily group therapy sessions, consistent communal interaction, teaching communication skills and drawing on the uninterrupted Wilderness experience to highlight the metaphors between experiences in Wilderness and at home.
Primitive living is the third necessary element of Wilderness Therapy. It too should be uninterrupted and parallel wilderness and therapeutic experiences. Fulfilling basic expectations of self-care and teamwork while living in the wilderness is a primary process that creates the eustress[iv] of Wilderness Therapy experience. Primitive living provides an unavoidable setting for observation and assessment, leading to insight and understanding and directly contributes to the therapeutic process for the therapist and participant/s. The use of certain survival or primitive skills is also necessary and contributes to the eustress, metaphor and therapeutic experiences. Cooking, sleeping, hygiene and other basic living skills in the wilderness are all necessary experiences in order to fulfill the complete Wilderness Therapy experience.
So, what is Wilderness Therapy?
Wilderness Therapy is the use of complete, uninterrupted, primitive living in a wilderness environment within a clinically-driven program structure that provides weekly in-person professional clinical treatment while drawing on Wilderness experience, to provide safe intervention and stabilization, individual assessment, education, and therapy.
Rick Heizer is the program director and an onsite partner for Second Nature Entrada. He has been in the field of wilderness therapy for 18 years. As the Program Director, Rick oversees all operations of the program, ensures program policies and safety procedures are followed and actively participates in staff training and development.
[i] Using the Youth Outcome Questionnaire® (YOQ), both parents and students reported significant change over the course of treatment. http://evoke.designkh.com/why-evoke/proven-results.
[ii] “OBHRC incident report 2011 9-18-12.PDF”. Retrieved from http://www.obhrc.org/risk-management. Retrieved March 25, 2013