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THE THERAPIST IN THE WILDERNESS:
A NEW PARADIGM
By Larry Stednitz
larry@woodbury.com
My involvement in the treatment of kids grew out of a passion
to develop the “perfect” program, the one program that would
make a difference in a kid’s life. At Capistrano by the Sea
where I was the clinical director during the '80s, many clinicians
and clinical administrators prided ourselves in providing
research-based, clinical programming, including our own research,
to help us develop “best practices” treatment modalities.
Unfortunately, by the late '80s, our length of stay was
down to two months due to reduced insurance coverage. Although
we thought we could effectively help a young man or woman
over several months of treatment, we believed 60 days was
almost a waste of time and money.
During this time, Mark Hobbins came into my office at Capistrano
excited about another 60-day program in Utah called the Achievement
Foundation, later changed to Aspen Achievement Academy. This
program cost only $10,000 for the same length of stay, which
was
significantly
less than hospital treatment. Mark was looking for investors
to help support the program through rough financial times.
He invited me to visit the program which I quickly did. I
went into the field to spend some time with Doug Nelson,
the program founder, and I was thrilled by what I saw. The
experience these students were going through was much more
powerful and hopeful than any I had experienced in some time;
maybe this wasn’t the perfect program, but it inspired
me. The students looked refreshed; they were talking to staff
and their peers openly and honestly. I spent time with a
couple
of the students who volunteered to tell me how much they
had progressed in the two months they were in this vast wilderness
area of Utah. They talked about how they had manipulated
other programs, how they had conned therapists, while never
having to face reality. For them, the wilderness was different;
thus it produced a different result.
I took my stories of the wilderness back to the many clinicians
at Capistrano by the Sea. The vast majority of these fine
and well educated clinicians and administrators looked upon
wilderness programs with a skeptical eye. This was my first
experience of a split between traditionally trained practitioners
and experiential/ adventure “therapists.” Doug Nelson is
known as the first person to integrate clinicians into a
wilderness
program; however, he would quickly tell you that the real
therapist in the back country is in fact Mother Nature. During
the early development of wilderness programs, well trained
clinicians would tell you that there are really no changes
in kids who have gone through a wilderness program, especially
since a clinician is not performing traditional insight oriented
treatment. The territorial battle between clinicians and
wilderness field staff raged on for years and continues to
do so in some programs. The wilderness treatment movement
was the first significant move away from traditional therapeutic
practices.
Times have changed since the clinicians and wilderness “purists”
have had the opportunity to work together over the past several
years. For specific purposes, clinicians by and large have
accepted the value of wilderness programming. The wilderness
staff has learned to appreciate and accept the role of the
therapist. Now, programs are vigorously competing to provide
the highest level of clinical competency in their wilderness
programs.
In the last few years, clinicians took on a major role in
the delivery of wilderness treatment programming. The vast
majority of programs now have therapists, providing a wide
variety of services. These services vary from program to
program. Included among those services are individual, group
and family therapy, case management, program administration
and the administration of psychological testing. More often
than not, their functions include individual, group and family
therapy coupled with the role of communicating with parents
and consultants. In this role, the clinicians become the
voice of the wilderness experience, assisting youth to transition
home or to another placement. The therapist’s involvement
with the students and staff in their group also varies, such
as some therapists spend the majority of their time on the
trail. Some operate as one of the staff with little differentiation
between the therapist and field staff. Another common practice
is to have therapists join the wilderness program early in
the morning, spending the evening with the group, and leaving
late the next day, thus spending two of the seven days in
the field.
Working intimately with the parents and consultant, the
therapist plays an important role in identifying the specific
objectives that brought about the enrollment. For example,
one of my students enrolled in a wilderness program. He was
a bright, manipulative 17-year-old involved with drugs and
alcohol. He had also encountered problems with the legal
system. It was clear from the beginning that he needed at
least a year of post wilderness aftercare, but the critical
issue was to gain a greater understanding of how this boy
thought and responded to peers and staff. The implication
of this issue was that post wilderness, depending upon the
findings, he would either go to a highly structured program,
or perhaps a more insight oriented therapeutic school. Was
he diagnosable as a conduct disordered young man, void of
empathy who learned little from mistakes and had serious
thinking errors that would lead him to further illegal activities?
On a weekly basis, the therapist and wilderness treatment
team focused on his substance abuse issues, trying to understand
the depth of these problems. The therapist also alerted the
team to watch for behavioral and thinking patterns the boy
may demonstrate. Did his words match his actions? Were his
perceived improvements genuine or manipulative? Week in and
week out, the therapist and team stayed focused on these
key issues. The therapist received feedback weekly from
staff, explored their thinking about the boy, and spent two
hours
a week
exploring these very issues with him.
In the above scenario, it turned out that the boy continued
to demonstrate manipulative behavior, lied, showed no remorse
for others and did not reflect upon his part in the problems
that he faced. He is now successfully receiving treatment
in a structured program that holds students tightly accountable
for their behaviors. Without the close relationship and skillful
focus of the therapist, wilderness field staff, family and
the consultant, the boy’s future would be less optimistic.
A therapist plays a vital role in the treatment of students
in the wilderness. They serve as the eyes and ears and orchestrate
the information that unfolds on the trail.
Ironically, clinicians are now finding personal and professional
opportunities in the parent choice industry. Where once
they were skeptical, the new generation of therapists are
seeing alternative and powerful ways to treat adolescents.
This industry offers clinicians a wealth of opportunities.
Equally important, therapists bring a wealth of experience
to wilderness treatment programming. In south Orange County,
located in Southern California, there are well over one hundred
clinicians who offer 20-40 years of experience in treating
adolescents in both outpatient and residential programming.
These groups of clinicians, as well as others throughout
the country, have the clinical and administrative experience
to
contribute hugely to this industry. Hundreds of therapist
have already discovered exciting new challenges in wilderness
treatment programs as well as other schools and programs
for troubled teens.
The next generation of therapists needs to be clinically
well trained, but they also need to have additional training
in experiential/ adventure therapy and be open to exploring
various creative and new approaches to the treatment of adolescents.
None of us have found the answer, and therapists, as well
as field staff, need to be open to new developments.
This article addresses the role and opportunities for clinicians
in wilderness programming. I would be remiss in not acknowledging
the wilderness experts, the field staff. These are the people
who carry the yeoman’s work load. They are a bright, creative
and adventurous group of highly educated and well rounded
people. Most have at least a bachelor’s degree in widely
varied areas, including literature, science, history and
various other fields. These are committed people, who provide
near perfect role models for the young men and women who
so desperately need people to emulate competency. During
the time I ran a wilderness program in Montana, I was truly
humbled
by their idealism, values, dedication and competence. It
is in these people that troubled teens trust and believe.
That is because the line staff also believe in their students
and what they can become.
The next generation of clinicians and wilderness professionals
are perfectly poised to work together to find solutions for
adolescents and their families. Woodbury Reports, Inc. salutes
this partnership of therapists and back country staff, and
looks forward to continuing to work with them. Copyright © 2005,
Woodbury Reports, Inc. All Rights Reserved.
(This article may not be reproduced without written approval
of the publisher.)
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