|By Langlois, Krista|
But the irresponsible caregivers and tragedies of the giil^íg^doiáíífy Ne^a
The abuse and neglect that preceded his death sparked national outrage. Scores of publications, including
Yet the public scrutiny was also a wake-up call - a "kick in the butt" for reputable programs to band together and promote a more compassionate approach, says
But despite years of working to redefine wilderness therapy as legitimate treatment, the tragedies of the past continue to haunt even practitioners who never endorsed
Now wilderness therapy may have reached a turning point. At the 2013 Wilderness Therapy Symposium in
ildemess therapy" is a nebulous term, and even those who practice it have a hard time agreeing what it means. But they do agree on what it is not: Militaristic programs try to break kids down to build them back up - a practice psychologists say can scar already-struggling teens.
Ideally, wilderness therapy combines traditional counseling with healthy living and outdoor skill-building. For teenagers and young adults struggling with eating disorders, substance abuse, mental illness, trauma and other challenges, it's often a last resort after conventional therapy or rehab have failed. Yet while programs often teach survival skills like building fires without matches and sleeping under tarps in inclement weather, Outward Bound they are not. Staff are trained to restrain violent outbursts, and students are sometimes put on suicide watch. At night, their shoes are collected so they can't run away.
Yet proponents believe that the confidence and resilience gained in the wild can inspire transformations that weekly therapy sessions under fluorescent lights cannot. The idea was first popularized by a 1968 course at
"In the beginning, it just seemed like a good idea," says Hallows. "Take kids into the woods with competent, caring adults, and good things would happen."
Regulation was scant, however, and programs operated in remote places far from public view. Some were run by sincere, well-trained staff, but others were little more than moneymaking schemes that preyed on parents' fears. Desperate parents had little way to know which was which.
In 1997, hoping to revive their battered industry, a handful of companies formed the
Most early programs were expeditionstyle, sending groups of kids deep into the wilderness for seven to 10 weeks and relying on nature - not therapists - as the primary catalyst for growth. Today, nature is just one tool among many. Between shorter trips in the backcountry, students meet with licensed therapists and follow individual treatment plans. At
Some fear the changes have caused the industry to lose its soul. "It's not wilderness therapy," says
At the root of wilderness therapy's struggle for mainstream legitimacy is its cost. Without insurance or public funding, most of today's 88 programs require parents to pay
Expanded insurance coverage could give more teens access, as well as help companies stay viable. Yet though new federal healthcare regulations afford mental and behavioral health treatment the same status as other types of medical care, insurance providers still dismiss wilderness therapy as experimental.
"It is not experimental," insists
To convince insurance agents - and others - that wilderness therapy is legitimate, a group of researchers connected with the industry began seeking solid data on its effectiveness. Relying heavily on exit surveys filled out by parents and participants and information collected from the field, the
Many in the industry believe that before long, major providers will be compelled to insure licensed providers. "We've got the outcome data," says Frazer. "The next piece is (national, third-party) accreditation, then cost-benefit analysis. In the next three to five years we'll have everything in place to be able to go to insurance companies, and they'll have a much more difficult time refusing us."
Insurance may be wilderness therapy's last major hurdle, but it also threatens to create more upheaval in an industry still getting back on its feet. If more families are able to send their children to wilderness therapy, companies used to working with the privileged and welleducated may have to adapt to a different demographic: Teens bom to drug-addicted mothers and raised in foster care, for example. That could affect the industry's success rate: 92 percent of participants currently complete treatment, compared to 42 percent of residential patients, and many go on to college.
That's not to say that wilderness therapy works for everyone or solves all problems. "Having a mental illness is like having cancer or diabetes," says Elizondo. "(Many) kids who go to wilderness therapy are going to need long-term care." Nor is it risk-free. Though there hasn't been a death in eight years, suicides and accidental deaths have occurred in even the most well-regarded programs. The decision to send one's child to an unforgiving, unfamiliar environment is not made lightly.
"There's risk in everything," she says. "But there's greater risk in not doing anything. These kids take pills (without knowing) what's in them. They drink until they black out. They're not ever where they say they're going to be. My kid was doing things more dangerous every day than Summit would ever try. Ever." ?
*name has been changed.
Most early programs relied on nature - not therapists - as the primary catalyst for growth. Today, nature is just one tool among many.
Disclaimer: HCN editorial fellow
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