Wilderness Therapy

bigstock-151921973Wilderness therapy, often referred to as adventure and wilderness therapy, is a type of experiential therapy.
 
An experiential therapy is designed to manufacture experiences that result in participants experiencing certain feelings, attitudes, and beliefs that are normally below their immediate level of awareness. The stimulation of these experiences is therapeutic.

There are a number of different types of experiential therapies. All of these therapies have their origin in the experiential schools of psychology that include Gestalt therapy and the humanistic paradigm in psychology. These paradigms encourage change in individuals by having them examine their emotions, intuitions, and other tendencies regarding certain types of situations.

How Does Wilderness Therapy Work?

couple in therapyWilderness therapy uses a more hands-on approach than more traditional forms of psychotherapy. In wilderness therapy exercises, people participate in a number of outdoor activities, such as team games, zip line excursions, outdoor expeditions, and other outdoor activities. It is important to understand that wilderness therapy is performed under the direction of a trained and licensed therapist. Just going on an outdoor expedition or doing a zip line is not engaging in formal therapy, even though individuals doing these activities without formal therapeutic guidance may find them useful in their own recovery programs.

Despite the particular activity being used, the aim of wilderness therapy is to use the experience of participating in these events to reach some therapeutic goal. Individuals learn to interact or cooperate with others in situations that carry some type of risk. The particular type of risk used in wilderness therapy is not designed to be dangerous or potentially harmful, but instead designed to challenge the person to examine and gain insight into their own feelings and beliefs as they relate to the particular issue at hand. For example, many individuals with substance use disorders are isolated, believe they have to rely on themselves, and do not trust or know to communicate with other people. Wilderness therapy can be used to challenge these individuals to cooperate with others to reach a goal, such as working with a team to engage in moderate-level survival skills on a camping trip. By actually experiencing group cooperation, trust, and the need to confide in others, the individual can also address their issues with substance abuse in the therapeutic environment.
It is important to note that wilderness therapy is not designed to be a primary therapy or a standalone treatment for serious psychological issues, such as substance use disorders.

Instead, wilderness therapy is a complementary form of treatment designed to assist in a more traditional type of treatment (e.g., formal Cognitive Behavioral Therapy for substance use disorders).

It is typically part of a multidisciplinary team approach to the treatment of an individual where the individual participates in traditional individual psychotherapy, may participate in group therapy, may participate in social support groups, and participates in wilderness therapy.

Wilderness therapy is delivered by a person trained in this type of therapy.

Wilderness therapy offers a number of potential avenues to get people involved in self-discovery. For the most part, wilderness therapies are delivered to younger individuals, most often adolescents and young adults. In some cases, adults will participate in wilderness therapy. Wilderness therapy is often an excellent mode of intervention to get individuals with substance use disorders to open up and freely express themselves.

Some of the different types of activities that are used in wilderness therapy include:

  • High adventure activities: These are often termed adventure therapies and include activities like rock climbing, hiking, zip line courses, and rope courses. When individuals are engaged in these activities, the goal is to instill confidence by having them overcome some challenging obstacle that they may find to be difficult or taxing.
  • Expeditions: Activities in this category include survival expeditions and exploratory or discovery expeditions. These activities are performed in groups, and participants are challenged to overcome some obstacle or task. This fosters communication and the development of trust and self-esteem.
  • Problem-solving games: These interventions often consist of games or activities that require group cooperation. They are designed to develop a sense of teamwork, trust, and cooperation in individuals.
  • Outdoor pursuit activities: These interventions consist of recreational activities that can instill a sense of leadership or group cooperation.

When the activity is completed, each participant meets with their therapist in either an individual or group session and discusses aspects of their experience. These aspects of the individual’s experience are related to the person’s issues (e.g., having a lack of trust, being suspicious of others, etc.). The discussion is designed to foster the therapeutic end of the experience for the client. The actual activities are a means to self-discovery; they are not an end in their own right. Without the therapeutic application and reflection of the experience, wilderness therapy would not qualify as a formal form of therapy.

Specific Benefits of Wilderness Therapy

mormons in sobrietyA good portion of the success for wilderness therapy should be attributed to the general target audience. Many children or adolescents who develop substance use disorders have a tendency to feel isolated and alone. They often feel that they lack support and do not readily confide in others. Using the techniques of wilderness therapy, the intervention can help the person to:

  • Develop goals
  • Create a plan to reach their goals
  • Develop insight into their own motivations, feelings, and beliefs
  • Work with and communicate with others
  • Build self-confidence
  • Deal with disagreements with others in a positive manner

The key to the therapeutic intervention in wilderness therapy is the therapist’s ability to help the client reflect on aspects of their experience and directly apply them to other areas of life, such as their substance use disorder. This type of intervention requires specific training and focus. In addition, wilderness therapy is not often viewed as “therapy” by those that participate in it. Instead, they often view it as a break from therapy, when in fact it is a form of therapeutic intervention that is designed to help individuals experience themselves and engage in self-discovery.

Wilderness therapy may not be appropriate for certain individuals, however.

  • Individuals with severe cognitive deficits require very strict monitoring and supervision if they engage in wilderness therapy. Some types of activities are not well-suited for this group.
  • People who have experienced significant trauma, or have a trauma- or stress-related disorders such as posttraumatic stress disorder, may not be appropriate for wilderness therapy. Their inclusion in wilderness therapy should be strictly supervised by a trained therapist.
  • Individuals with attention deficit hyperactivity disorder and co-occurring substance use disorders are often not good candidates for wilderness therapy unless they can be strictly supervised.
  • People who have formal diagnoses of anxiety disorders may not respond well to wilderness therapy. Individuals with social anxiety disorder, certain types of phobias, or a general anxiety disorder that is comorbid with a substance use disorder may not be appropriate candidates for wilderness therapy.
  • People who have a co-occurring diagnosis of obsessive-compulsive disorder and a substance use disorder may not be good candidates for wilderness therapy.
  • Individuals who have active psychotic tendencies should never be allowed to engage in wilderness therapy.
  • Certain types of physical limitations may limit an individual’s participation in wilderness therapy. It is important to make sure that the particular mode of intervention is appropriate for the individual’s capabilities.
  • People with co-occurring eating disorders and substance use disorders are often difficult candidates for wilderness therapy.
  • Care should be taken with individuals who have issues with impulse control, hostility, or aggression. These individuals may not be appropriate for wilderness therapy, or they would require very strict and close supervision if they are to participate in this form of therapy.
  • Any individual who does not wish to participate in this type of intervention should not be forced to engage in wilderness therapy. Instead, it is more appropriate to find some alternate form of treatment for the individual.
Research on the effectiveness of adventure and wilderness therapies is generally positive. It has indicated that the severity of mental health problems that were displayed by adolescence were reduced when wilderness therapy was added to traditional forms of psychotherapy (e.g., Cognitive Behavioral Therapy). Issues with delinquency appear to be particularly responsive to the use of wilderness therapy techniques along with traditional treatments.

Conclusions

Wilderness therapy is an adjunctive therapy that may be extremely useful in the treatment of substance use disorders in certain types of individuals, particularly young people or adolescents who are isolated and uncooperative in their treatment. Wilderness therapy attempts to challenge individuals to achieve goals and work together. This fosters communication, openness, and self-examination.

While wilderness therapy can be a useful complementary treatment, it is not designed to be a standalone treatment or the sole focus of treatment for an individual with a substance use disorder or other psychological problem.

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