Wilderness therapy has had many definitions, typically involving the use of traditional therapy techniques mixed with group therapy out in a wilderness setting, approached with therapeutic intent. Wilderness therapy has been described as "challenge courses", "adventure-based therapy", and "wilderness experience programs". A variety of theoretical orientations are used in wilderness therapy, including and cognitive . According to Russell 2003, Wilderness Therapy is a program for individuals who have not had success in psychiatric hospitals, rehabilitation programs, and out-patient treatment. These programs typically consist of 8-12 members that run on a 7-8-week schedule where licensed mental health professionals take clients out into the wilderness. Interventions may consist of individual, group, or family therapy sessions, and can also include individualized treatment plans, medication management, and milieu-based care. Participants are encouraged to create reflections that make them in tune with themselves and nature. The price of a wilderness therapy program is expensive, sometimes averaging $325 dollars per day with only 40 percent of clients receiving financial assistance from medical insurance. More clients may receive co-pay assistance in the future if Wilderness Therapy programs receive accreditation from national agencies and then receive recognition from insurance companies.
History
Madolyn M. Liebing, Ph.D. was the first clinical psychologist to integrate clinical therapy with wilderness programming. The New York Asylum and the San Francisco Agnew Asylum played an early role in the development of wilderness therapy.
Controversy
Independent researchers have called into question the wilderness therapy industry's claims, expressing ethical concerns and criticizing its use of 'bad science' due to methodological flaws in the research. Given the proliferation of such programs, lax regulation, and absence of research setting uniform standards of care across programs, advocates have called for increased accountability to ensure programs are capable of providing care that is consistent with their marketing claims. Some programs which advertise as "wilderness therapy" are actually boot camps similar in style to military recruit training in a wilderness environment. These can sometimes be distinguished from other wilderness therapy by such programs promising behavior modification for troubled teens, but it is hard to tell just from the ads. One of the major differences between military style boot camps and wilderness therapy is the underlying philosophical assumptions. Incidents of alleged and confirmed abuse and deaths of youths have been widely reported across many wilderness programs, despite claims that these programs provide a less coercive environment than that of boot camps. Abusive situations have been reported and accidental deaths have taken place in some of these programs. The industry reports that deaths are extremely rare compared with similar outdoor adventure activities. These assertions cannot be independently verified due to inadequate regulation, poor monitoring, and a pattern of unreported deaths and state failure to prosecute offenders. There is also controversy over whether parents should be allowed to make their child attend a wilderness therapy program by force, as is often the case. Apart from the thousands spent on the actual program, some parents pay a teen escort company thousands to ensure their child gets to the program by any means necessary, without the child's consent or foreknowledge. Generally the "transfer" occurs at night, when children are disoriented. Due to the trauma and alleged harm reported by former wilderness program residents who have been forcibly escorted into placement, psychologists have heavily criticized this approach as inappropriate, and grossly inconsistent with establishing the necessary trust required for building a therapeutic relationship between youth and providers.
Accountability
In October 2007 and April 2008, the United States Government Accountability Office convened hearings to address reports of widespread and systemic abuse. In connection to the hearing, they issued a report about the wilderness therapy industry. The Federal Trade Commission has published a for parents to ask when considering a wilderness program. Programs seeking additional accreditation and certification often pursue partnerships and memberships with associations such as:
After a wilderness therapy program, clients may return home or may be transferred to a therapeutic boarding school, young adult program, or intensive residential treatment center. Some estimate that 40% of children enrolled in wilderness programs are later sent to long-term residential behavioral care facilities.
