Evidence Based Research:
-Christine Lynn Norton, PhD, LCSW
*”The sample for this study consisted of adolescent participants in Outward Bound’s youth-at-risk program, a 28-day wilderness canoeing and camping program called Intercept (N=21). By using a mixed methods research design, this study collected data via pre- and post-tests using the RADS-2 and the MPD. These measurements were administered one week prior to the wilderness program and one week following the program. Quantitative data was analyzed by generating descriptive statistics and running statistical analyses, utilizing the SAS program. This researcher tested for relationships and statistical significance among various aspects of the data while controlling for potential confounding variables that may have called into question the sole attribution of any change to the wilderness therapy intervention. Qualitative data was also collected via pre-course paperwork and three month, post-course phone interviews. Qualitative datawas subjected to multiple levels of coding and narrative analysis. Additionally, this study included survey research to assess the importance of various components of the wilderness therapy intervention. The results of this survey were correlated with the outcomes on the pre- and post-tests to understand which had the greatest impact on adolescent depression and psychosocial development. Overall, this study demonstrated that wilderness therapy helped to decrease rates and prevalence of depression and helped to increase rates and prevalence of psychosocial development. This study showed an average improvement of -4.3 points on the RADS-2, which, based on other RADS-2 pre to post studies, is seen as a clinically meaningful level of change (Reynolds, 2002). Likewise, there was an average improvement of 6.1 points on the MPD, which reflected a large shift from low levels of psychosocial development to normal levels (Hawley, 2005). These changes were statistically significant at the 0.0006 level (RADS-2) and at the <.0001 level (MPD). Utilizing a Repeated Measures ANOVA to control for moderating variables, further statistical analysis revealed that the change in the rates of depression and psychosocial health were significant at the 0.022 level (RADS-2) and at the 0.0009 level (MPD). Utilizing a Categorical Repeated Measures ANOVA, this study showed a 33.5% decrease in the prevalence of depression, significant at the .0012 level, and a 52% increase in the prevalence of positive psychosocial development, significant at the <.0001 level. This study also demonstrated a negative correlational relationship between adolescent depression and psychosocial development significant at the 0.0023 level, paving the way for consideration of the efficacy of psychosocial interventions such aswilderness therapy in the treatment of adolescent depression. The qualitative data analysis triangulated these findings, reaffirming that participants experienced decreases in depression and increases in psychosocial health, immediately following the intervention, as well as three months after. Likewise, based on data gathered from qualitative sources before and after the intervention, the study showed a 47.5% decrease in family conflict, significant at the <.0001 level; a 28.6% % decrease in substance abuse significant at the <.0001 level; and a 61.9% decrease in school problems significant at the <.0001 level. These emergent dependent variables are important to consider because they reflect concrete behavioral change. Lastly, regression analysis of the survey of course components revealed the importance of a positive group experience on psychosocial health, significant at the 0.012 level, as well as the role that positive communication with family members played in decreasing depression, which was nearly statistically significant at the 0.08 level. Both of these components reaffirmed the literature in this area. The qualitative data related to treatment-relevant components of wilderness therapy revealed that participants identified being in nature, challenge and adventure, and contemplation as other important aspects of the change process.”
*“the therapeutic approach in wilderness therapy does not appear to force change, but instead allows the environment toinfluence client response through natural consequences (Russell, 2001, p. 74)
*Unsurprisingly “natural environments offer unbelievable benefits for our health” (Selhub & Logan, 2012, p.6).
*Research has found that interaction with nature, domains of contact including animals, plants, landscapes, and wilderness experiences can providebenefits for one’s mental health as well as one’s physical health (Frumkin, 2001)
*exposure to nature-based environments is associated with lower blood pressure and reduced levels of the stress hormone cortisol (and other objective markers of stress)” (Selhub & Logan, 2012, p.7).
*“on the clinical level, this may have implications for patient care. Perhaps we will advise patients to take a few days in the country, to spend time gardening, or adopt a pet” (Frumkin, 2001, p.239)
*Other research about the benefits of nature on physical and mental health lends some support to implementing wilderness therapy approaches. Selhub & Logan, (2012)
*“Scientific researchers are investigating nature’s role in mental health at a time when humans are more distanced from the natural world than ever before” (p.5)
*“walking in gardens, exposure to rooms filled with light, staying close to water, and other nature-based activities were effective components of standardized plans to improve mental health and sleep” (Selhub & Logan,2012, p.13).
*Therapy and rehabilitation, changing delinquent behavior, chemical dependency recovery, acceptance and adjustment to disabilities and loss, spiritual renewal, team building, physical challenge, and character building are potential aims of wilderness experience programs which use the healing and inspirational elements of challenging opportunities of wilderness experience to accomplish these goals (Friese et al., 1998, p. 3)
*In regards to a wildreness programme “Here they faced their vulnerabilities, and consequently deepened their self-awareness through facing trust, fear,and control issues” (Mason, 1987, p.91).
“The wilderness setting was mentioned as a high point of the experience by all theinterviewees” (Davis-Berman & Berman, 2012, p. 333).
*“All the interviewees talked about the wilderness therapy program as having an impact on their lives, even after nearly 25 years” (Davis-Berman &Berman, 2012, p. 334).
*“many wilderness therapy programs emphasize an eclectic approach to working with at-risk youth” (Hill, 2007, p.339).
*”Adolescents are naturally seeking a success identity; however, their progress may be hindered by the lack of experiences of love and worth. The group experience in wilderness therapy provides a medium to experience being worthwhile and valued, while the initiatives and camping provide opportunities to be successful.” (Hill, 2007, p. 340)
*Hill (2007) also identifies that wilderness therapy has been known to integrate tenets of behavioral therapy, Adlerian therapy, and reality therapy. These tenets include but are not limited to the concepts of natural consequences, encouragement, modeling, reinforcement, problem solving, behavior rehearsal, and group work.
*”It is believed that a disruptive event is necessary in order to begin to alter attachment patterns, which for many participants was experienced because they were not informed ahead of time of their required participation in treatment. When using the attachment theory as a framework for wilderness therapy, the authors emphasized small treatment groups with a high staff to client ratio. Additionally, by its very nature, wilderness therapy provides numerous opportunities to observe the many attachment needs through separation, loss and reunion.” – Lindsey Jo Van Hoven
*“In wilderness therapy programs, clients must face regular losses, separations, and reunions with program staff and peers, as students graduate from programs and staff finish their weeklong shifts”, which activates the client’s attachment system (Bettman et al., 2011, p. 185)
*”Semi-structured interviews were conducted with thirteen adolescents between 14 and 17 years old who participated in a wilderness therapy program in southern Utah. This wilderness therapy program ranged from five to twelve weeks and participants spent most of their days hiking to new campsites. Each day also included participation in an academic curriculum, which was based on the wilderness experiences and allowed the clients to receive school credit upon completion of the program. Results of this study found that the wilderness program helped the adolescents to improve their perspectives on parental relationships as well as feelings of trust with in parental relationships. Participants also expressed that the wilderness program had helped them to develop an increased openness and trust.” – Lindsey Jo Van Hoven, St. Catherine University.
*”41 adolescents who were admitted to an eight-week wilderness therapy program in Colorado completed a set of assessments upon admission, discharge and six-month post treatment. During this treatment program, participants lived in a wilderness environment where they received treatment daily. During this wilderness treatment experience participants lived without most modern conveniences such as electricity, plumbing and electronics. Participants were provided a unique opportunity to depend upon each other along with program staff while they learned primitive living skills.It was determined that the adolescent’s readiness to change was not necessary for the wilderness therapy experience to be effective. These findings contradict concerns regarding the usefulness of the motivation to change theory as a framework for wilderness therapy when working with adolescents who might not be prepared to want to change, such as those struggling with substance use and abuse. In addition to finding support for using the motivation to change theory as a part of the wilderness therapy framework, this study also found that wilderness therapy resulted in effective reductions of mental health symptomology in the treatment of adolescents with substance use disorders. Specifically these adolescents reported reduced symptoms in their interpersonal distress, social problems, suicidality, interpersonal relations, and behavioral dysfunction.” – Lindsey Jo Van Hoven.
*“During Lisa’s participation in the wilderness therapy program, she began to face her illusory self by confronting opportunities to attempt and complete tasks that were difficult for her” (Norton, 2010, p.232).
*Harper et al.(2007) found significant positive changes at a two-month follow up of adolescents and their families who participated in wilderness therapy. Family functioning, adolescent behavior as well as mental health issues all showed signs of improvement. These findings suggest that wilderness therapy, specifically the CFWT intervention, may contribute significantly to the stabilization of problem behaviors as well as lasting change for adolescents and their families.
*”Bandoroff & Scherer (1994) found that wilderness therapy participants moved their family functioning from the clinical range at pretest to the normal range at posttest. There were adolescent reported drops in delinquency, an improved parental rating of problem behaviors, a decrease in police and court contact as well as an increase in adolescent ratings of self concept. In addition to these findings, the researchers also discovered that participants found the experiential activities, metaphors, processing sessions, opportunity for family intimacy, relationship skills training, and the opportunity to share their experiences with other families to be especially helpful.” Lindsey Jo Van Hoven.
*”Davis-Berman & Berman (2012) found that in reflecting on their past experience in wilderness therapyseveral years ago, participants found that the trip and the experiences had a lasting impact on their lives including lessons for life, a better relationships with a sibling, lessons to share with a child, self-confidence to persevere through difficult times and the use of a coping skill with journaling.” Lindsey Jo Van Hoven.
*”Bettmann et al. (2011) found that wilderness therapy could support the development of healthy relationships for participants with past attachment relationships that provoke anxiety or distrust. Their findings also suggest that wilderness therapy works for a population of adolescents who have highly conflicted family relationships. Bettman et al.(2013) found that wilderness therapy is effective for treating a wide range of problems with positive changes that are maintained at six months.” Lindsey Jo Van Hoven.
*”Norton (2010) found that wilderness therapy could promote a positive self-image, enhance coping skills and can be an effective intervention for adolescents suffering from depression.” Lindsey Jo Van Hoven.
Evidence Based Research gathered by SAJMRM.