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Posted: Jun 1, 2005 12:26

MAKING IT LAST

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Transition Services Following Wilderness Treatment
Scott Bandoroff, PhD
scott@peakexperience.org
www.peakexperience.org

[This article continues the discussion of Wilderness Family Therapy: A winning combination, which appeared in The Woodbury Reports™ May 2005, #129, as part one of a two-part essay. Scott is a psychologist specializing in the treatment of challenging teens and families through adventure therapy.]

Readers of this publication are no strangers to the power of wilderness therapy. Perhaps there is no other intervention able to achieve such dramatic changes in so short a time. Although the research is not available to support such bold claims, those who work in the field and many whose families have benefited from the services would not consider this an overstatement.

Transfer of Skills
What we often don't do as well is help those teens and families to integrate the changes back into their home environments. As a result, wilderness treatment programs are sending more and more students on to therapeutic boarding schools. Granted, some of these students were destined for residential treatment before even setting foot in the wilderness; the program was only preparation for long-term treatment. Programs also see more and more challenging teens, many of who require long-term care. However, if given the proper support, a vast number of students could potentially make it at home. Some of these don't get the chance and others go home without adequate resources, only to fail.

Many have criticized the wilderness therapy model for operating from an individual bias, perpetuating the notion that the problem lies within the child. Most programs today recognize the importance of a systemic perspective and involve the family to some degree. It is routine for therapists to call parents on a weekly basis. Most programs include families in their graduation process as well, with some providing family interventions by trained systems therapists. Those programs that truly recognize it is critical to impact the family system, and those that make this a priority in their work, should be commended.

The reality is it is a challenge for programs to provide adequate family intervention. They face the logistical obstacles of working with clients from all over the country, parents on tight schedules and the increased cost of hiring specially trained staff to carry out such an intervention. The dilemma is the family system needs an intervention comparable to the one that the student has experienced to maintain the changes once the teen arrives home. Otherwise, the homeostatic mechanisms of the family system will predictably operate to return the system to its former state, and much of the change will be lost in the process. In other words, the family will not be adequately equipped to support the changes that the student has accomplished.

Wilderness Family Therapy
The exciting news is that the intervention needed to meet this challenge does exist. Just like wilderness therapy, it is short-term, intensive and highly impactful. Wilderness Family Therapy (WFT), described in last month's column, offers an environment free from distractions, providing a milieu ideal for family bonding and emotional reattachment, and affords many teachable moments for skill development. WFT can take a variety of forms from primitive living to high adventure. The critical elements are the natural environment and a therapist skilled in family systems work and adventure therapy. This strength-based approach affords families the opportunity to harness their resources and rediscover their sense of family.

WFT is an ideal intervention following a wilderness treatment program because the teen has transformed from a family liability to a valued asset. The program graduate has achieved a degree of mastery in the wilderness, learning how to manage the challenges of outdoor living and access the therapeutic value of the environment. The family arrives in the wilderness disoriented and anxious and looks to their adolescent for guidance. Providing the family an opportunity to experience the youth in a new light of competence is especially helpful in establishing a foundation for a new family structure.

Rising to the Challenge
It is easy to understand why a WFT intervention is such a natural fit for a wilderness treatment program. Besides sharing similar philosophical and theoretical perspectives, the wilderness program has the resources, e.g., equipment, field, logistical support and the 'know-how' to launch a WFT intervention. It is a perfect marriage, needing only a therapist trained in family systems work and adventure therapy to facilitate the therapeutic process.

So why aren't more programs capitalizing on their unique position to effect family change? Some of the obstacles to integrating WFT interventions appear above. However, the overriding reason, in my opinion, is that the field has not been willing to take full responsibility for systemic change. Traditionally, wilderness programs saw themselves as responsible for treatment in the field; what happens after the student leaves the wilderness was another's domain. Very few private wilderness programs have offered any aftercare despite strong research support for follow-up services. Unfortunately, community mental health resources, e.g., outpatient programs, private therapists, etc., are generally not familiar enough with wilderness treatment to take full advantage of the gains achieved. Consequently, they drop the proverbial ball. Simply stated, the message that most wilderness programs communicate to students and families is, "goodbye and good luck." While this position may be defensible considering the obstacles, it is hardly ideal, and as a field, I believe that we can do better. The reality is "fixing the kid" is not enough to create lasting change. To maximize fully the impact of our work, we must set our sights higher and attempt family system change.

WFT is not a new idea but one whose time has come… a powerful intervention that could help many teens and families. As a field, we have the capacity to effect deeper change that will be more lasting. It is incumbent upon us to rise to the challenge and find ways to integrate such programming into our work. WFT is an exciting intervention that can help families to heal and ensure that the gains achieved in wilderness treatment are supported and maintained.

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