"Raising the Bar," "Best Practice," "Making the Cut," and "Quality Improvement," are all phrases that come to mind when speaking in terms of today's industry performance standards. The outdoor education and healthcare industry is no different, as programs and organizations that utilize the outdoor medium for teaching and counseling special needs groups continue to look for ways to enhance outcomes and manage risk. The National Association of Therapeutic Wilderness Camping (NATWC) is one such organization that was founded in the early 1990's as a result of a tragic incident in a western desert.
In an atmosphere of sparse regulation and emerging, but regional, standards for outdoor programs, NATWC was created to initiate a network of programs that were committed to developing a common language and a foundation for industry wide standards. It was shortly after its inception that NATWC became involved with The Council on Accreditation (COA)
to draft standards for accreditation in Therapeutic Wilderness Camping.
The recent hearings conducted by the Committee on Education and Labor
have fostered a fast and furious debate, specifically the efficacy and safety of some types of outdoor residential programs. As with any healthy debate, multiple perspectives emerge. The expected outcome for a debate is usually more informed consumers and an enhancement of the product, process or participants. However, the outcome of this debate currently remains unresolved.
There are many potential negative outcomes, including: misrepresentation of outdoor programming as unsafe and inefficient and the loss of consumer choice of outdoor programming as an alternative or
complement to traditional education and healthcare. It would be unfortunate if a conclusion was that only federally run programs or traditional hospitals and psychiatric wards were the only safe and efficient milieu and groups of students could no longer experience the outdoors as part of their development unless it was on the athletic field!
NATWC holds the view that many positive outcomes are possible from this debate. In a recent letter to Representative George Miller, Chair of the Committee on Education and Labor, NATWC expressed support for continued oversight for the outdoor education and therapy industry. However the proposed bill on Institutional Abuse as it stands is not the answer. Programs must continue to work harder to insure clients' and their families' physical and emotional safety.
Programs also need to dialog around "Best Practices" to ensure that outcomes are real and sustainable. Many programs, colleges and universities, and groups such as the Outdoor Behavioral Health Care Industry Council (OBHIC)
have undertaken a variety of research objectives to help the interested public understand how the outdoor education and therapy industry has historically employed program improvement initiatives.
Practitioner credentialing, including college or university curriculums specific to outdoor education and therapy; state regulatory mandated training and program-specific staff training are all critical for a best practices foundation. Good training on an ongoing basis should include regulatory, ethical, clinical and programming milieu considerations. Nationally many colleges and universities have added outdoor education and therapy curricula.
Many states have Residential Child Care and Mental Health Care laws that are specific to Outdoor and/or Mobile Programs. These statutes must be continuously reviewed and updated as the works in progress they should be. Regulations should address any differences that may exist between publicly and privately administered programs so efficacy is not compromised and the cost of service is manageable. States that do not have specific regulations need to have good reasons why or get with the times for the sake of safety.
Many programs often serve students from another state or region. The current proposal under the Institutional Abuse Bill maintains that a program that serves an out of state youth and family must follow the regulations of the referring state as well as the home state. This sounds like common sense and a good thing to do until one looks at how incompatible many state and regional regulations currently are. Without some compatibility analysis of these regulations, the rising cost of health care could be accelerated, and many good treatment and education alternatives may be lost.
Program or organizational accreditation is a valuable self-improvement instrument that has been embraced by many in the outdoor education and therapy industry. Many agencies that work under the behavioral health care umbrella face mandatory accreditation as criteria to serve mental health clients. For many of the other private entities, accreditation is an option that may illustrate that program's commitment to quality service. However, the costs for this process are often prohibitive for some smaller programs, while they are undoubtedly passed on in operating costs by those who pursue accreditation.
NATWC collaborated with the Council on Accreditation (COA)
in the early 1990's to create a separate set of standards for Therapeutic Camping. The Association for Experiential Education (AEE)
, the Commission on Accreditation of Rehabilitation Facilities (CARF)
and the Joint Council on Accreditation of Healthcare Organizations (JCAHO)
also offer standards for outdoor education and industry entities.
Regardless of the efforts by the federal government or the industry itself, we must realize that some individual programs as well as some individual program staff, both administrative and direct care, are often not up to those standards, and efficacy is often compromised as a result. It is under this premise that the issues of industry regulation, program accreditation, and practitioner credentialing must be embraced.
Part II of this article will focus on the benefits of certification and the NATWC certification process.
About the Author:
Rick McClintock is Executive Director and Membership Chairman of the National Association of Therapeutic Wilderness Camping, www.natwc.org. For additional information, you can contact him via email at firstname.lastname@example.org, by phone at 724-329-1098, or by mail at 274 Brown Hill Road, Markleysburg, PA 15459.
Watch for future articles regarding Today's NATWC including a review of NATWC's plans for its 15th Annual Training Conference, September 21, 22, 23, in Jekyll Island, GA.