Wilderness works

Wilderness therapy “gave me my son back — and better,” says Stephen Mace. His son, Christian, age 15, participated in the wilderness program at SUWS of the Carolinas in Old Fort last year. SUWS is one of several local and regional organizations that use wilderness therapy. Sarah “Salli” Lewis, an Asheville-based clinical scientist, has conducted several research studies demonstrating the effectiveness of wilderness therapy.

But first, why wilderness therapy, also known as Outdoor Behavioral Healthcare?

In the wild

In a wilderness setting, students have fewer distractions and the opportunity to detach from technology, says Shawn Farrell, executive director of SUWS of the Carolinas. “The result,” he says, “is that they are able to sit with themselves and begin to ask themselves who they are, what they want to be and what they want to do differently.”

At the same time that students are exploring themselves, they are able to “connect with each other on a deeper level, forming authentic relationships based on emotional investment,” says Farrell. He reports that many students say it’s the first time they’ve had friends. “It’s not about what you’re wearing or who you’re dating,” says Farrell. “Students take emotional risks, make themselves vulnerable and respect each other for it.” He adds that breaking students into small groups of no more than eight avoids cliques and helps students learn better communication skills through listening, speaking up and giving constructive feedback.

Wilderness therapy is different from traditional treatment, such as individual or group therapy because of the inherent challenges of living outdoors, Farrell explains. The challenges of doing difficult things such as crossing a creek or starting a fire with sticks help kids develop a sense of competency. “Hiking up a mountain gives kids a sense of accomplishment. If kids are not allowed to struggle with challenges, they don’t experience failure, but they’re also robbed of self-esteem and emotional development. Helicopter parenting has great intentions, but it goes too far and stunts development.”

The main activities at SUWS are backpacking and learning primitive living skills such as making cordage out of tree bark and constructing a Paiute deadfall trap (which are never actually used to trap animals). Other activities include yoga, therapeutic drumming, journaling, a ropes course, art therapy and equine-assisted therapy with Horse Sense of the Carolinas.

SUWS of the Carolinas and similar programs are geared toward helping struggling families, much like the Maces. Farrell says that kids often come to SUWS as a last resort, after previously meeting with two or three outpatient therapists. “The program provides a high-impact intervention that gives families … respite, while at the same time giving kids the opportunity to develop new coping mechanisms,” he says. “The program is designed to use wilderness skills to drive more important life skills such as frustration management, effective communication and solving complex problems by breaking them down into steps.”

Case study

The Maces report that Christian’s problems began as he was transitioning from a small private middle school to a local high school. Christian’s grades went down, he became depressed and spent most of his time in his room. He also refused to go to school or participate in the swim program he had previously excelled in. Christian began to act out, punching holes in walls and breaking things.

His father, Stephen, says he knew they had to do something. They had already involved the police and a crisis intervention specialist, both to no avail. Stephen had seen an episode of the Dr. Phil show that featured a kid sent to SUWS. “It was the hardest decision we ever had to make,” Stephen said about sending Christian to the program. “It felt like we were a failure as parents. And I felt horribly guilty about his being in the cold, sleeping on the ground, when I was in a bed in a warm house.”

Christian spent 50 days in the woods, entering the program just before Christmas. Much of the experience was miserable, says Christian, especially a five-day stint in the rain. In the midst of adversity and challenge, however, he says, “I learned that there are some things you can’t change, so you need to stay positive and do what you can to better yourself. We said the serenity prayer every day, and it really meant a lot to me and stuck with me.”

Christian describes himself as “a completely different person” after the program. “I’m more active. I socialize. I’ve gotten a lot more popular and have good friends. I’ve learned to find outlets such as working out and biking instead of using drugs. I’m happy.” He attends Alcoholics Anonymous meetings and has been sober for 14 months. He notes that his relationship with his parents has improved also. “My dad and I never had a good relationship. Now he’s like a best friend, and I can tell him anything.”

Research

Wilderness therapy has proliferated over the past few decades as an alternative treatment modality for treatment-resistant youth. Research is confirming the effectiveness of wilderness therapy. Lewis, director of the Research Division of CReATE (Center for Research, Assessment, and Treatment Efficacy) has done studies that establish wilderness therapy as an effective treatment modality.

Lewis was the principal investigator of a landmark study conducted in collaboration with the Arkansas Institute of Developmental Science and begun in 2006. The study looked at 200 adolescents in three programs in the U.S., one of which was SUWS of the Carolinas. Results showed a significant reduction in psychological problems such as anxiety, depression, ADHD, substance use and suicidality. Participants also demonstrated improvements in emotion regulation skills and overall healthy coping strategies. “The outcome data indicate very robust therapeutic effects, even for adolescents who returned home following program completion,” says Lewis. “The effects of treatment appear to persist even when treatment is over.” Therapeutic gains were maintained for a full year after graduation, Lewis points out.

Lewis recently completed another study, in collaboration with Four Circles Recovery Center and the Intervention Sciences Laboratory at the University of Arkansas, comparing wilderness therapy to traditional drug treatment programs for young adults (ages 18-28). Lewis reports that preliminary data support the use of the wilderness model. She adds, “Wilderness treatment may actually be more appealing to young adults because it’s designed around the developmental needs of this particular age group, so participants are more likely to go and stay.”

Lewis was motivated to research the effectiveness of wilderness therapy because of the significant gap she saw between the empirical understanding of treatment effectiveness and the provision of services.

Results

At SUWS, wilderness therapy works, says Farrell, concurring with Lewis’ findings. He says that 70 to 85 percent of kids do really well and that every kid gets something out of it. “It’s awe-inspiring to watch kids grow, learning to believe in themselves and like themselves. I personally believe that every person can learn from group experience with time in the woods.”

Farrell recounts watching graduation exercises and “seeing families reconnect in an open, authentic way, full of joy. What we’re doing with these families is so rewarding,” he says.

Christian Mace’s experience at graduation reflects the joy that Farrell describes. “I saw my parents walking up, and I ran and hugged them,” he says. “It was the most emotional experience of my life, reconnecting with them.”