Pine River Institute is a program that you almost have to see and experience to understand the work they do. I had read their material and thought I had a general understanding of their program, but it took a couple hours of seeing it and listening to get a real feel for the depth of their program.

Arriving at the 200 acre campus, it looked like a typical idyllic program with students who looked and acted much like typical teens, which considering their past indicates an impressive accomplishment. The initial impression is very similar to what I see at other quality therapeutic boarding schools. Part of that impression is an outdoor oriented environment, clean buildings and living quarters, and students busy and engaged in going about their daily activities. There was a healthy buzz about the place.

As the staff explained the program to me, it became apparent that there is much more to it than just what is apparent on the surface. For example, I saw one student involved in a brief discussion with a staff member. It was apparent he was still very fearful and closed off. His eye contact was minimal and he obviously had a lot of healing to do. At first glance, this observation might indicate that his progress in the wilderness was minimal.

Upon further explanation, I understood he had initially been very resistant in the Wilderness, the first phase of the program, exhibiting violent outbursts. It took about three weeks for him to stabilize and reduce his outbreaks to where he completed the wilderness phase successfully. However, when he was transferred to the second phase, the Residential phase, he displayed that change came hard for him, and he began reverting to his initial patterns of angry outbreaks and disrupting the school. He needed to return to the wilderness to stabilize and work specifically to prepare for the change to the residential portion.

When I saw him at the residential program, he had been back for a few days and seemed to be successful at making the transition this time. Although he still had a long way to go, it was obvious that the progress he had already made was almost a miracle considering how troubled his initial behavior indicated he was.

The staff also advised me that recently they had done an analysis of their population, finding that 60 percent of their student body had been abused, some of them sexually, while a third had been cutting on themselves, and many had had suicide ideations. In other words, this program works with a very troubled population whose typical alternative would have been some secure and highly clinical treatment center that was closed off for their own protection. Some students do require intensive stabilization for a short period in a hospital before admission to the program, and some return to the hospital for a brief period of stabilization during the program, so that they are then able to be safely treated in a less restrictive environment. To me, Pine River's option of a healthy, open and natural environment for treatment is a much better alternative.

The campus was initially built as a residential Outdoor Education Centre for Toronto students. Due to a change in governmental policy, the facility was shut down and stood vacant for a couple of years until the school found and leased it. It was ideal for this kind of program since the infrastructure was already there and just required moving in and modifying it for its own needs. Open only two years, they are still building it to their needs. For example, the students are involved in converting one of the outbuildings to a gymnasium, and one of the old cabins had just been moved up next to the main building to serve as a chicken coop--feeding the chickens being one of the chores the students take on.

This coed program serves students ages 13-19 with a primary emphasis on substance abuse. But they don't stop there. They are very strong in working with a multitude of other serious disorders also, to the extent that they often will accept a child who has been rejected by other treatment facilities. When I asked if they would accept a child with violent tendencies, which is a very common reason for other treatment facilities to reject a child, the staff said that they would consider it on a case-by-case basis. While a history of violent aggressive behavior would be an exclusion criterion, this kind of behavior associated with substance use is common, and several children with a short-term history of violent tendencies have enrolled and been successful. Instead of being automatically screened out, each applicant is assessed and considered.

Each child goes through four phases. The first phase is the Wilderness (Outdoor Leadership Experience) which usually lasts from 4-6 weeks. It is designed so they can handle those children going through detoxification. Their wilderness program is heavily expedition based and the goal is to stabilize the child so he/she can make a successful transition to the second phase, which is the residential facility I visited. The usual result for the students is to come out of the wilderness phase physically fit and, to at least some extent, emotionally connected.

The Residential phase normally lasts for five months and operates very much like a therapeutic boarding school. The residential facility has a high staff to student ratio, which according to staff, is necessary to keep the students safe while still maintaining an open facility that is unfenced and unlocked. Initially, there is very strong on-site supervision for the newly arrived students, that lessens as the students progress in taking responsibility for their own actions. The staff consists of highly trained individuals with a multitude of different and helpful credentials and experiences. The staff members were friendly and willingly answered my questions, while at the same time keeping a close eye on the students.

Once a student has progressed to being able to take on more responsibility and act appropriately the student will move into the third, Transition. In Transition, students continue their school and emotional work at the facility, but start emphasizing visits home and working on their plans for the future. The two students who gave me a tour were set to graduate shortly. They knew the day they were going to graduate and had arranged how they were going to transition back into their homes and go on for further education.

Once students formally graduate, they go home and on to school or work. The students are shifted into what they call Aftercare, the fourth phase, in which the program maintains contact with the students, always available any time the graduates need help or support. In all, there is a concept of a continuing flow of progress starting with the impact of the initial wilderness and gradually, step by step, helping the students progress toward living successfully on their own.

Family involvement is a very important element. From the very first, the program works at developing a sense of community among all the parents, starting with a parent/family retreat very early in the program, and continuing on throughout the students' stay and even long into Aftercare. In addition, every six weeks there is a comprehensive team review of the student's progress, the team consisting of the student's mentor, teachers, therapist(s), parents, the student and any others involved in his/her life at the school.

CEO and Founder Karen Minden was inspired to develop this two-year-old program by her experience a number of years ago of placing her child in a program in the States. She gives full credit to how much that program helped her child, who is now an adult and one of the co-founders of the Institute. They went on to learn from the best practices in a number of other US programs, and Pine River Institute was specifically designed to incorporate the best aspects of existing programs and the evidence base available in studies of adolescent development, mental health and addiction treatment. From a brief tour, it appears that they have been very successful at that and it seems that Pine River is getting great results.