Effectiveness of wilderness therapy programs

The setting is far from the madding crowd and the peace and spectacular beauty of the outdoors is inspirational and awe-inspiring. It is the ideal place for a teen to begin the process of turning their life around. Then there is the therapy aspect of the curriculum. Sure there is a great deal of physical activity using the outdoor setting but the program involves serious sessions with trained counselors.

The goal is to match the needs of the teen with the appropriate therapist. Sessions include the opportunity for teens to discover their potential, their inner self and their true personality. They are not distracted by worldly attractions or other unreliable teens. They have the time and place to boost their self-esteem and take stock of their life. Then comes the development of friendship and teamwork when in the outdoors and having to fend for yourself.

A challenge is a great way to grab the attention of anyone and particularly a troubled teen. Suddenly they are in the great outdoors and have to climb a mountain or cross a river. Adolescents in such programs today have access to doctors as needed and regularly see a therapist — typically a psychologist or social worker. In many cases, they move through a level-based program that gradually grants them increasing privileges.

And once a wilderness therapy program is completed, adolescents are often moved to other private therapy waypoints before eventually returning home.

This is the industry — the new, reformed industry — that Erin and Mike Gibbons encountered when concern for their daughter reached its apex. The parents of several children who died in residential wilderness therapy programs testified before Congress in A bill bringing the industry under more scrutiny was passed in the House, but never cleared the Senate.

She would line her toys up while the family watched Notre Dame football and push the cats, dressed in baby clothes, around in a stroller. But things got harder in high school. As she spent more time using social media on her smartphone, she began to isolate herself. She was pulled over on the approach to Columbus for driving over miles per hour. After she returned home, she and her family recall, a therapist diagnosed Katherine as bipolar. Over the next few months, Katherine was in and out of treatment programs, but in July, she attempted the drive to Ohio again.

She switched therapists and medications multiple times. She was drinking excessively, and the family called several times. Between the calls, Erin met another mother at a yoga studio who had struggled with her own child. Such consultants, who are often former school counselors or administrators with mental health-related degrees, are typically the first contact that worried parents have with the industry. Most wilderness therapy program websites strongly recommend parents hire a consultant, though they stop short of requiring it.

Nearly all of the families that spoke to Undark used one. These advisors often become intimately involved not just in finding programs for troubled teens, but in coaching parents about wilderness therapy and related programs, planning transitions, and helping to handle other steps in the treatment process. Erin says she called her consultant a day or so after being given her number. They made plans for Katherine to be sent away for treatment at the end of that week — in the wee hours of Friday morning — but when Katherine was blacking out drunk at school on Thursday, Erin called the consultant back from the hospital.

It has to happen today. A few hours later, two transporters arrived — a man and a woman in plainclothes, one of them a former Marine. Katherine had been sedated, so they had the Gibbonses draft handwritten letters for when she woke up, explaining that they loved her and that the strangers were taking her to get help.

Departures for treatment often move that quickly. Undark spoke to 18 families who sent their children to wilderness therapy and further residential treatment. For many, the turnaround between when they called a consultant — often referred by a friend or acquaintance in their network — and when they sent their child away was a matter of days or weeks. For Katherine, the transition was abrupt. At the program, Katherine was given hiking clothes and outdoor gear, which all fit into a pack she would carry for the next several months.

She was then driven to the high desert near Bend, Oregon. There, she joined a small group of teen girls with matching supplies and guides who rotated in and out on weeklong shifts. While athletic, Katherine was not an outdoors person, and her early letters home were full of curses, declarations of how she hated camping, and anger at being sent away without warning. Fuck you. Fuck this. Fuck that. Her letters got shorter and angrier when she learned she would not be going home after wilderness but to a therapeutic boarding school.

The Gibbonses planned early on to send Katherine to therapeutic boarding school after wilderness therapy, but not all parents are aware when they send their child away that the wilderness therapy program is just the start.

You quickly learn that wilderness is just triage. Visits — with the parents traveling to these programs, or the child coming home for brief stays — add up as well, and can involve a dozen cross-country flights over the course of a year. Why am I bothering with wilderness? She returned home last October. McDonald, Erin Gibbons, and the Massachusetts mother are part of Facebook groups for parents whose children have gone to wilderness therapy and residential treatment.

Members share experiences, support, and recommendations for consultants, insurance reimbursement services, and more. For the Gibbons, that online community has been vital. Staying afloat with a child inside this system can be difficult for anyone but the well-heeled. Insurance coverage is rare, though parents can sometimes get their local school district to help cover care of a special needs child. Getting that funding may require another consultant.

James, the former guide, recalled that most of the families she encountered were fairly wealthy. Families are known to have tapped college funds, taken out second mortgages, or dipped into inheritances to cover costs. One such service based in Utah, Denials Management , has been leading the charge to increase insurance coverage for wilderness therapy.

Run out of a suburban office park near Salt Lake City, with a view of the Wasatch mountains, the person appeals company has filed thousands of wilderness therapy insurance appeals since She has partnered with the industry and industry-tied researchers on the campaign and has been working with lawyers since to bring lawsuits, many of them class action, for insurance coverage of wilderness therapy around the country.

They argue that insurance companies must cover wilderness therapy under the federal Mental Health Parity and Addiction Equity Act, as amended by the Affordable Care Act, to provide coverage for mental health care comparable to the medical coverage of a plan.

Blue Cross Blue Shield of Massachusetts, Aetna and Cigna have also been sued for a lack of coverage of wilderness therapy, though the companies have countered in those cases that such treatment was specifically excluded in the plans the plaintiffs were covered by.

Still, some cases have been decided against insurers or have resulted in settlements. Two years later A qualitative assessment of youth-well-being and the role of aftercare in outdoor behavioral healthcare treatment. A longitudinal assessment of treatment outcomes in outdoor behavioral healthcare.

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