Wilderness Therapy Programs have recently become a formal alternative treatment for adolescents with emotional and behavioral disorders (Hinkle, 1999; Russell & Hendee, 1999; Russell, Hendee, & Phillips-Miller, 2000; Russell, 2003a, 2003b). Adolescent populations are unique in that traditional forms of psychotherapy, including “talk-therapies,” are often inadequate for adolescents' stage of development. Despite improvements in mental health awareness, there continues to be barriers to service, including a lack of education and awareness about psychological concerns of children and adolescents, stigma associated with mental health issues, and a staggering rise in health care costs (Department of Health and Human Services [DHHS], 1999; National Advisory Mental Health Council Workgroup, 2001; Russell, 2003a, 2003b). An extraordinary number of children and adolescents in need of psychological services are not being adequately treated (Bryson, 1997; Davis-Berman, & Berman, 1994a; DHHS; Harris, Leiberman, & Marans, 2007; National Advisory Mental Health Council Workgroup, 2001; Reid & Eddy, 2002; Russell, 2003a). With growing rates of mental health issues among children and adolescents, this population in particular needs access to quality and appropriate therapeutic treatments. Wilderness Therapy has become a popular alternative because various components that are unique to this therapeutic intervention are particularly effective with adolescent populations, and notably less stigma is attached to this form of treatment (Crisp, 1998; Davis-Berman & Berman, Gass, 1995; Hinkle; Russell, 1999; Russell & Farnum, 2004; Russell & Hendee; Russell, Hendee, & Phillips-Miller; Russell, 2003a; 2003b).
Wilderness Therapy Programs have successfully improved qualities in adolescents. Historically, however, these programs are used as a final treatment option, mostly because of the lack of familiarity of programs, sensationalized boot camp views of the programs, and the inaccurate assumption that these programs are more expensive than traditional treatment (Russell, 2003b; Russell & Farnum). Wilderness Therapy Programs offer children and adolescents an experience that challenges dysfunctional beliefs and coping skills, provides them with a stronger skills set, and improves their ability effectively communicate with others. Wilderness Therapy Programs developed for healthy populations have demonstrated an increase in overall personal enhancement (Crisp, 1998; Davis-Berman & Berman, 1994a; Ewert, McCormick, & Voight, 2001; Fletcher & Hinkle, 2002; Gass, 1993; Gillis & Thomsen, 1996; Kelley et al., 1997). These positive effects found in wilderness therapy programs could be adapted and used in a preventative form for youth at risk of developing emotional and behavioral disorders.
One difficulty inherent in studying the effectiveness of wilderness therapy programs is the lack of strong empirical support for its use. Although the field of wilderness therapy has campaigned for clearer definitions and descriptions of interventions categorized under the umbrella of adventure or recreation therapy, barriers still exist for gathering empirical data Wilderness therapy occurs with a wide variety of populations and settings, and there continues to be a lack of validated measurement tools and control groups making empirical studies flawed. These methodological flaws limit the few studies in existence into general anecdotal reports with ungeneralizable results. Recently, the works of Michael Gass, Jennifer Davis-Berman, Dene Berman, and Keith Russell have progressed the field towards gathering more qualitative and quantitative data. Over the past two decades, their works have outlined theoretical foundations and the process of change that guides wilderness therapy programs. The work of these authors have laid the foundation for this dissertation and without their contributions to the field, this dissertation would not be possible.
The purpose of this dissertation is to examine the research on wilderness therapy programs in order to outline the therapeutic process of change, identify various components, and highlight the current understanding of these programs. A comprehensive review of the literature will also identify areas of growth and need in the field of wilderness therapy, which will be included in developing this program. Simultaneously, current research on prevention programming will be examined to understand and incorporate programming guidelines. By combining effective wilderness therapy program components with modified program needs and best practice in prevention programming, a model prevention program for youth will be developed. In doing so, a model wilderness therapy prevention program for at-risk youth will be generated, in the hopes of providing a base model from which future models may elaborate, and researchers may empirically study across various settings and populations. (Abstract shortened by UMI.)