If conventional substance use disorder treatment programs prove to be ineffective, wilderness therapy may be the answer. Wilderness therapy involves removing individuals from their problem environment and providing treatment in an outdoor environment that promotes self-improvement and skill development during recovery.
Wilderness therapy combines nature and survival experiences with rehabilitative therapy techniques that address substance use disorders, mental health problems and behavioral issues. The therapy places individuals into an unfamiliar outdoor environment to focus on self-improvement and overcoming problem behaviors with coping skills. The overall goal is to foster personal and social responsibility while encouraging emotional growth.
The majority of wilderness therapy programs assess the client’s specific needs and develop an appropriate treatment plan to address any behavioral health issues. Clients live in the wilderness and develop life skills by overcoming activities that are physically and mentally demanding.
The program length and amount of time spent in the wilderness can vary. The programs generally consist of group living, individual and group therapy, education therapy and nature and survival skill experiences. Licensed mental health professionals lead the therapy sessions, and other trained staff members teach basic survival skills and self-care. Common activities include hiking, preparing campsites and building fires.
Wilderness therapy programs come in two forms: expedition and base camp. In expedition programs, clients live in the wilderness throughout the entire treatment process. Base camp programs offer treatment activities at a structured base camp. Clients leave the camp for expeditions and return for processing and post-expedition activities.
The structure of expedition programs can be contained or continuous flow. In contained programs, clients and the treatment staff stay together for the entirety of the trip, which usually lasts three weeks. For continuous flow programs, treatment staff and therapists rotate in and out of the field as new clients join the program. Continuous flow programs usually last up to eight weeks.
Wilderness therapy programs are for individuals and families who are experiencing a crisis related to substance abuse, mental health disorders or both. The average client is 12 to 17 years old, but many young adults benefit from these programs as well.
According to an article by researchers with the University of Idaho and the Outdoor Behavior Healthcare Research Cooperative, good candidates for wilderness therapy include those with substance use disorders, attention-deficit disorder, depression or behavioral problems.
Individuals who do well in wilderness may have tried conventional therapy and experienced poor results. Most clients are resistant to wilderness therapy at first, but they eventually buy into the program as they participate in more treatment activities.
Wilderness therapy programs are built on positive therapeutic relationships between clients and treatment staff. These relationships are characterized by care, empathy, compassion and patience.
Therapists do not force change. They allow clients to work through any resistance or anger related to treatment. They use the wilderness environment as a treatment tool to influence a client’s actions and let the natural consequences of his or her behaviors promote accountability.
Many people who participate in wilderness therapy do not respond well to traditional authority roles. But staff members do not have to impose rules or accountability on clients. The unfamiliar environment does that for them. The wilderness setting creates distress and gets clients out of their comfort zone.
Wilderness leaders act not only as therapists and treatment supervisors but also as role models. Clients who see their leaders as mentors instead of authority figures are able to connect with them in a more profound way.
Generally, wilderness therapy programs incorporate cognitive behavioral therapy and other traditional addiction treatment therapies. Many wilderness experience programs are modeled after Outward Bound, which has served as an alternative to incarceration or treatment for delinquent teens since the late 1960s.
Most wilderness therapy programs require the client’s family members to be heavily involved in the treatment process. Therapists hold family sessions to rebuild damaged relationships and restore family stability.
Wilderness therapy programs also incorporate aspects of Native American rituals and ceremonies. Such rituals may include sending clients into the wilderness alone to reflect on their actions and find inspiration to move forward in recovery.
Learn more about wilderness therapy.
Wilderness therapy programs usually consist of three phases with specific goals. Each stage of treatment builds on previous phases to support growth and self-improvement.
The cleansing phase is the first phase of wilderness therapy programs. The goal is to help clients build healthy habits by removing them from environments that fuel their substance use disorders. During the cleansing phase, clients maintain a rigorous physical exercise regimen and learn survival and self-care skills. Their diet is minimal but healthy.
During the cleansing phase, the treatment staff steps back and lets clients adjust to wilderness living. This phase prepares them for more strenuous recovery work later in the program.
After the cleansing phase, clients begin the personal and social responsibility phase. In this part of treatment, peer interaction and natural consequences teach clients that they are accountable for their actions. Clients must choose to take responsibility for their choices or suffer the consequences. This experience helps teach them that self-care and personal responsibility are necessary for their well-being.
“If it rains and they choose not to set up a tarp or put on rain gear, clients get wet, and there is no one to blame but themselves.”— Researchers with the University of Idaho
“If it rains and they choose not to set up a tarp or put on rain gear, clients get wet, and there is no one to blame but themselves,” researchers with the University of Idaho and the Outdoor Behavior Healthcare Research Cooperative wrote in an article explaining the wilderness therapy process. “If they do not want to make a fire or do not learn to start fires with a bow drill or flint, they will eat raw oats instead of cooked.”
The goal of this phase is to help clients realize that their actions have consequences outside of treatment and to make them understand that the cause-and-effect relationship applies to everything they do.
The final phase of treatment aims to ease the transition from wilderness treatment back to the client’s routine environment. Treatment staff work with clients to help them process the lessons they’ve learned during wilderness therapy and apply those lessons to their everyday life. Many people enter a recovery living program after wilderness therapy to continue building a strong foundation for recovery.
The goal of wilderness therapy is to give clients new skills, knowledge and perspective that they can apply to their lives outside of treatment.
Completing a wilderness therapy program is an accomplishment for clients. The satisfaction they feel from improving their thoughts and behaviors can be a foundational building block that motivates them to continue their self-improvement. Clients leave in better physical health. Their mental well-being also improves as they develop skills for properly expressing their emotions and dealing with issues that contribute to substance abuse or problem behavior.
Clients should leave wilderness therapy with a plethora of skills that can help with issues related to substance abuse, relationships, stress and more. They develop personal and interpersonal skills, improved communication skills and better decision-making skills. These skills help clients navigate adverse situations outside of treatment and prepares them for the challenges of long-term recovery.
The time spent in a wilderness therapy program helps clients reflect on their life path and figure out what they need to change to be happy and healthy. Becoming more familiar with their needs and how they want to change serves as motivation to continue their own personal growth.