Why Wilderness Therapy Works

A Review of the Latest Research on the Effectiveness of Wilderness Therapy Programs

Mental illness impacts the lives of millions of adolescents, yet the majority are not receiving needed treatment. Some of the barriers preventing teens from getting the help they need are the shortage of adolescent-specific treatment programs and the fact that adolescents tend to be a difficult population to treat as they are more likely to minimize the gravity of their mental health issues and resist intervention.

Adolescents who don’t receive appropriate treatment for their mental health disorders are at increased risk for poor academic performance, dropping out of school, family conflict, substance abuse, violence, and other emotional and behavioral problems.
SUWSCar-2-MOutdoor Behavioral Healthcare (OBH), also referred to as wilderness therapy, has proven to be an effective alternative for treatment-resistant youth. Wilderness programs have evolved over the last five decades, growing into a comprehensive and clinically sophisticated intervention. Most wilderness programs now offer clinical assessments, individualized treatment planning, individual and group therapy, and substance abuse education and treatment.

Recent Research Confirms the Effectiveness of Wilderness Therapy

Until recently, research examining the effectiveness of wilderness therapy programs has been limited. But in 2003, Keith Russell and the Outdoor Behavioral Healthcare Research Cooperative conducted one of the first comprehensive empirical investigations, using a large sample of adolescents who were enrolled in multiple wilderness programs.

Russell and his colleagues examined whether adolescents’ psychological functioning improved as a result of their participation in a wilderness therapy program, and whether improvements were maintained 12 months after graduation. They found that adolescents demonstrated significant improvements in their emotional and psychological functioning as a result of their participation in a wilderness program.

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A second study conducted in 2006, using a large sample of adolescents (774 participants) in OBH programs, focused on rates of anxiety, depression and substance use. The teens reported greater therapeutic engagement and readiness for change upon graduation from the wilderness program. They also reported improvements in levels of stress, anxiety, depression, and substance abuse and dependency, as well as an overall satisfaction with the therapeutic process. Improvements were maintained at the 6-month follow-up assessment.

SUWS-4-MThe study involved 190 adolescents, ages 14 to 17, who were enrolled in three different wilderness therapy programs across the U.S. Ninety percent of the teens had participated in at least one prior therapeutic experience, with 22 percent of adolescents reporting four or more prior therapists.

The researchers collected data upon admission; one week after they started treatment; graduation from the wilderness therapy program; 3 months post-graduation; and 12 months post-graduation. Upon admission, the teens reported impairment in peer relationships and school performance as well as significant symptoms of ADHD, aggressive behavior, substance abuse and dependency, depression and anxiety, sleep disruption, and suicidality. A majority of the teens also reported significant lifetime substance abuse:

  • 48% reported daily tobacco use
  • 47% reported weekly (or greater) alcohol use
  • 60% reported weekly (or greater) marijuana use
  • 12% reported recreational (at least once per month) use of amphetamines (not prescribed by their physician)
  • 11% reported recreational (at least once per month) use of powder cocaine
  • 20% reported binge drinking (consuming 5 or more drinks in one hour) at least five days out of the previous month
  • 40% reported smoking marijuana 10 or more days out of the past month (with 15% acknowledging daily use)
  • 38% reported using substances to manage stress, 15% to regulate negative emotions and 66% to escape boredom

Like Russell’s early findings, teens in the effectiveness study made significant progress during treatment, and maintained these therapeutic gains for a full year. The adolescents demonstrated marked improvements in the following areas:

  • Anxiety and depression
  • Substance abuse and dependency
  • Disruptive behavior
  • Defiance and oppositionality
  • Impulsivity
  • Suicidality
  • Violence
  • Sleep disruption
  • School performance
  • Interpersonal relationships

These results suggest that wilderness therapy programs are teaching important emotion regulation skills and that adolescents are continuing to refine their skills after graduation. Overall findings provide considerable support for the use of wilderness therapy in treating resistant adolescents. 

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