Therapeutic wilderness or outdoor behavioral health is the sometimes controversial and often misunderstood treatment option for children, adolescents, and young adults whose emotional and behavioral struggles cause significant disruption to their well-being and ability to function. For the layperson not familiar with private treatment options outside of traditional insurance in-network therapeutic interventions, think of wilderness as like Outward Bound, but with clinically sophisticated therapies.

Within this treatment option, there are research-informed best practices and highly effective treatments. As a professional independent educational consultant, my direct experience comes from recommending wilderness therapy to the right person and seeing firsthand its transformational power.

Emotionally wounded kids who are overwhelmed with anxiety, depression, technology, substance use addictions, and other issues aren’t equipped to face environmental demands such as COVID and isolation. These children often have yet to develop the resilience to withstand these distresses in life or our fast-paced culture where success is measured by external markers of achievement and prestige. The good news for a lot of our distressed kids is that wilderness works. It’s an excellent place to build confidence and resilience, the prerequisites to life’s foundational skills – to be well-adjusted and independent in adulthood.

There are some poor programs out there claiming to be therapeutic, but they are not up to the standards needed for quality intervention. They are less expensive and claim to do what the more costly and accredited programs actually accomplish. But there are dozens of highly effective wilderness programs in the United States. Wilderness programs, also called Outdoor Behavioral Health, is the prescriptive use of wilderness experiences by licensed mental health professionals to meet students’ therapeutic needs.

Wilderness programs are often used as an intervention to disrupt negative patterns established in a young person’s life. Young people attend wilderness programs for a variety of emotional, behavioral, and addictive behaviors. Being in nature for 60 to 90 days helps disrupt the negative patterns that have contributed to adolescents’ or young adults’ inability to engage in age-appropriate development. Often, parents are aware that their child is not making age-appropriate progress toward adulthood and the goal of achieving independence. This process can be overwhelming for families.

In general, outdoor behavioral health care programs consist of:

  • Extended backcountry and wilderness living experiences long enough to allow for clinical assessment, establishing treatment goals, and a suitable course of treatment not to exceed the experience’s productive impact.
  • Active and direct use of clients’ participation and responsibility toward their therapeutic process.
  • Continuous group living and regular formal group therapy sessions to foster teamwork and social interactions.
  • Individual therapy sessions supported by the inclusion of family therapy.
  • Adventure experiences utilized to enhance treatment by fostering the development of stress that is beneficial, i.e., the positive and appropriate use of stress as a valuable element of the experience.
  • The use of nature as a metaphor within the therapeutic process.
  • A strong ethic of care and support throughout the therapeutic experience.

The Proof is in the Outcomes

Some of the most recent and increasingly prolific research on wilderness may help professionals effectively reassure parents that these treatment programs are safe, that they work, and they are worth the cost. The Outdoor Behavioral Healthcare Council has implemented industry standards to assure quality care is being provided at OBHC accredited programs.

Outdoor Behavioral Health Center scientists, led by Dr. Michael Gass with the University of New Hampshire, are researching the effectiveness of outdoor behavioral healthcare programs in North America. These programs are run by licensed mental health professionals and include wilderness experiences such as hiking, climbing, and more.

Recently, UNH received $2.7 million in grants for the research. They are leading the charge to answer questions of safety, efficacy, and value by looking at incidents of injuries, illness, therapeutic holds, and runaways. They also are studying the longitudinal outcomes, the impact on family functioning, the value-added of adventure experience to therapy, and whether psychosocial maturity occurs, among other topics. The findings are so compelling that insurance companies are starting to take notice. There’s nothing more energizing that the emerging mass of validated studies to help mainstream a treatment option that previously has only been available those who can afford it.

Not all wilderness programs are the same

There are different models for outdoor programs, including Nomadic, Adventure, Basecamp, Hybrid, and everything in between. Wilderness programs are located across the United States and beyond. It is important to assess which model is the best option when working with families to match their needs and wants. No family is the same, and every child is different.

Learning self-reliance, collaboration, and teamwork comes naturally for many children as they navigate the intricacies of adolescence or adulthood through sports, school involvement, and other social interactions. But for some teens and tweens, the rocky path of adolescence is strewn with boulders. That’s when alternatives to traditional schools can be beneficial.

Wilderness therapy invites students to participate in interventions and challenges specific to outdoor behavioral healthcare. It is designed to help students build skills related to self-confidence, assertive communication, interpersonal relationships, and coping skill development. It also helps students identify patterns that create barriers to developing these skills.

Wilderness therapy is particularly popular for teaching children and young adults self-reliance and a newfound appreciation for responsibility and natural consequences. A critical aspect of a wilderness intervention is removal from the environment or distractions that allow the continuation of maladaptive or avoidant patterns. As students engage in emotional, cognitive, or behavioral patterns they utilized at home, they do not have the typical environment or people around to blame. They are confronted with the realization that their style of thinking or acting often contributes to their difficulties. It allows them to look deeper into their issues while developing new skills and opening themselves to more trusting relationships.

Students participate in small group living within a “communication-rich” therapeutic milieu. Together with their group, students participate daily in therapeutic group, mindfulness exercises, and camp chores such as setting up or taking down camp, cooking meals, and caring for group equipment. Students also engage in daily physical exercise, including backpacking, yoga, and games. Another skill or intervention may include learning to make a primitive fire using a bow-drill method. This skill requires technique development and practice along with skills such as persistence, frustration tolerance, and resiliency.

They learn the “I feel“ statement that allows students to practice identifying feelings, the beliefs associated with attitudes and skills to better tolerate and regulate intense emotions. Reflective listening and feedback are also practiced. These activities aid in developing character traits such as self-control, empathy, persistence, resilience, and citizenship. Students may learn and practice Dialectical Behavioral Therapy to develop skills focused on mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness. Other models of therapy may include EMDR, Brain Spotting, and others.

The general program structure positively impacts many of the treatment areas and therapists and staff use daily challenges to represent struggles that a student may have had in their home life such as linking assignments to school, boundaries in the group as boundaries in the family, and peer and mentor relationships as representing other interpersonal dynamics.

Nomadic Programs

Nomadic programs give participants space to work through feelings and thoughts as they focus on meeting personal and group challenges. Youth are usually responsible for maintaining their gear as well as setting up and breaking down camp. The group moves often from location to location to keep everyone engaged in the process. Therapists meet with children in the field and work with them to develop healthy coping mechanisms.

Base Camp Program

Unlike nomadic programs that immerse participants in wilderness 24/7 for 10 to 12 weeks, in base camp programs, youth return weekly to a safe, reliable space to shower, meet with a therapist, and replenish their food supplies. The time at base camp frequently offers a chance to visit with parents via conference call or virtual and specialists.

Integrated Programs

Integrated programs combine the best elements of nomadic and base camp strategies with more traditional therapy models. This approach often uses wilderness immersion at the beginning of a longer process, assessing your child’s needs and tailoring their time outdoors accordingly. An integrated program might be the best option for participants who need some time to ease into their treatment or those who will not benefit from a longer stay in nature.

Wilderness, however, is still no silver bullet or panacea. All wilderness programs do not offer the same level of quality or effectively serve the same demographics – that’s why seeking the advice of professionals who know these programs is so critical and worthwhile for parents. For the right young person at the right time in their struggles, with the right program and therapist, it is a viable and often superior alternative to traditional treatment and the right initial step on the road back to emotional and behavioral health.

Growing up in today’s world isn’t easy – and neither is parenting young people. Sometimes the best option is to allow professionals to step in and provide specialized care to struggling children, teens, and young adults. Optimal Edu Options can help you navigate the forest of therapeutic options with our team of experts who specialize in educational and therapeutic placements.

What we can help with at Optimal Edu Options is reviewing the different programs and helping you and your family choose a wilderness program that best suits your child’s needs. Remember, you aren’t alone. Our team can help – reach out to us today to find the best support possible for your family.

Optimal Edu Options is an Arizona-based education consulting agency whose experienced team has the expertise necessary to effectively support your family and child in finding the best educational and therapeutic options to meet your family’s needs. Reach out to us today for more information about our services and how they can help. We offer a free 30-minute consultation. Email or call us at (602) 904-1282.