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Posted January 3, 2005


By Larry Stednitz

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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