5
Mar

Wilderness Therapy: The Basics

In this post I want to discuss some of the unique aspects of wilderness therapy.  I often use the analogy of being a crew member on a sailing ship when I explain how wilderness therapy works.  Most people can see how on a sailing ship the entire crew is interdependent upon each other.  Generally you have someone navigating, someone might be piloting the ship, and you have various people in charge of different sails and other components.  Ultimately, the crew is completely interdependent upon every other crew member.

Such is the case in wilderness therapy.  Group members must rely upon each other for the most basic tasks.  If one participant is depressed and decides they've had enough and they are going to sit down and sulk on the trail, the entire group is held up.  This might result in arriving at the campsite late and not having enough time to gather firewood to cook dinner.  While a hot dog roast might have been planned for that night, as a consequence the entire group now must eat a cold dinner of trail mix.  It is also possible that the group didn't have time to put up tents that night, so they huddle under a tarp only to get rained on.

This is the beauty of wilderness therapy, that each group member is utterly interdependent upon every other group member.  Participants quickly see that consequences are not these made up arbitrary things that authority figures place upon them.  They are the natural consequence of your attitude and corresponding behaviors.  They are final and cannot be negotiated out of.

The group becomes the surrogate family for each participant.  A participant in wilderness therapy might start off defiant, oppositional, and unwilling to buy into the treatment process.  More experienced participants will help out the newcomer as they know the actions of this new participant will have direct consequences upon the entire group.  As the newcomer becomes more experienced, they will then mentor incoming participants.  Due to the rolling admissions nature of wilderness programs, each participant has the experience of being this newcomer and also the mentor.

Wilderness is meant to be a total reset from both family and pure relationships.  Communication is generally done by letter writing which serves to take the emotionality and manipulative communications out of the conversation.

And other unique aspect of wilderness is that therapists are hiking and living with a group participants.  In this regard, therapist can be there in the moment with the campers an offer feedback and try out new coping skills with the participants in real time.  One of the difficulties in working with a child with oppositional defiant disorder in an outpatient setting is that they feel resistant to the treatment process.  They feel like they are in trouble for something they've done, and seeing the therapist is their punishment.  As a result, they come into the therapy office with a defensive mindset and generally a story as to why they are justified in their behaviors.

If wilderness therapy we can leave this behind for the time being.  The child will undoubtedly bring their cognitive distortions, that is, the lens through which they see the world, into our treatment milieu.  The other advantage is that even if the child was 100% honest and forthright with their past indiscretions, they are probably not attuned to the subtle nuances of their behavior which is contributing to their negative interactions.  With wilderness therapy, we can see all aspects of their behaviors and beliefs about the world.

In terms of treatment orientation, there is really nothing entirely unique or special about wilderness therapy.  That is to say, therapeutic interventions are going to be your best practice, gold standard interventions such as CBT and DBT.  What is unique is the setting in which these therapies are performed.  The child is going to get much more therapy than they ever could in an outpatient setting, and they're going to be part of an interdependent community which leads to emotional investment and increased levels of participation as compared to other treatment formats such as therapeutic boarding schools or residential treatment centers.

If you need assistance in determining if wilderness therapy is right for your child, please call me directly at 813-454-1050.