Article

Two Years Later: A Qualitative Assessment of Youth Well-Being and the Role of Aftercare in Outdoor Behavioral Healthcare Treatment

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Abstract

This study evaluated youth well-being 24-months after the conclusion of outdoor behavioral healthcare (OBH) treatment and explored how youth transition to a variety of post-treatment settings. OBH treatment involves integrating clinical treatment approaches with wilderness expeditions that average over 50 days. Transition from OBH treatment often requires that youth and family utilize aftercare services, which are typically: (a) outpatient services, which are comprised of individualized, group or family therapy, or (b) residential services, which are comprised of residential treatment centers, therapeutic boarding schools, and others. The results suggest that 80% of parents and 95% of youths perceived OBH treatment as effective, the majority of clients were doing well in school, and family communication had improved. Aftercare was utilized by 85% of the youths and was perceived as a crucial component in facilitating the transition from an intensive wilderness experience to family, peer and school environments. Results also indicated that many continued to use alcohol and/or drugs to varying degrees, had legal problems, and still had issues forming friendships with peers. OBH treatment was perceived as being a necessary and effective step in helping youths address, and eventually overcome, emotional and psychological issues that were driving destructive behavior prior to OBH treatment.

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... In addition, researchers such as McKenzie (2000) recommend increases of literature in the Australian context as most AT research explores US-based programs. This study offers a look into how AT programs can address the common factors that contribute to positive outcomes, such as comprehensive follow-up support, and the relationship, or therapeutic alliance, built between the practitioner and client (Hubble, Duncan, & Miller, 1999;Russell, 2001Russell, , 2005. practitioners (GPs) for various behavioural and emotional concerns. ...
... By understanding the family context, practitioners can address how family members and external resources such as school counsellors, can support the participant's positive changes and goals for returning home (Draper et al., 2013;Gass et al., 2012;Harper, Russell, Cooley, & Cupples, 2007). Staying with this family context, the sustainability of outcomes in AT should be interconnected with parental involvement (Harper, 2007;Mulholland & Williams, 1998;Russell, 2005), a supportive family environment welcoming the child home (Draper et al., 2013), and hope and optimism exhibited by the parents (Hubble et al., 1999). ...
... The survey provided tick boxes, numerical scales, and room for open-ended responses allowing participants to write freely. Questions were designed to explore areas of change common in AT literature such as family relationships, school performance, peer relationships, self-concept, coping skills, and overall behaviour (Davis-Berman & Berman, 1994;Gass et al., 2012;Neill, 2003;Russell, 2000Russell, , 2001Russell, , 2003Russell, , 2005Russell, , 2008Russell & Gillis, 2010;Russell & Hendee, 2000). ...
Article
This paper presents an account of a research project that explored the experiences of adolescents struggling with behavioural and emotional issues, who participated in a 14-day adventure therapy program in Australia referred to by the pseudonym, ”Onward Adventures.” All participants of this program over the age of 16 who completed within the last two years were asked to complete a survey. Additionally, the parents of these participants were invited to complete a similar survey. The qualitative surveys were designed to question participants’ and parents’ perceptions of the program (pre- and post-), the relationships (therapeutic alliance) built with program therapists, follow-up support, and outcomes of the program. Both participants and parents reported strong relationships with program leaders, stressed the importance of effective follow-up services, and perceived positive outcomes when it came to self-esteem and social skills, seeing comparable improvement in self-concept, overall behaviour, and coping skills.
... Subsequent studies from Russell showed significant social and emotional change as measured by the Y-OQ (Youth-Outcome Measure) at discharge as well as maintenance of change at 12 months post-intervention (Russell, 2003). A two-year follow-up to wilderness therapy treatment showed 'aftercare' (e.g., residential treatment) was very common, most youth and parents perceived wilderness therapy as effective, although reports of continued substance use as well as social and legal problems persisted (Russell, 2005). A single-program wilderness therapy case study found positive outcomes in youth's home-life behavior although negative deterioration was found in some aspects of family functioning (Harper, Russell, Cooley, & Cupples, 2007). ...
... The rationale for family involvement in residential treatment is necessary to reduce the pain of separation and loss of child identity and self-concept when removed from home and community, as well address guilt and feelings of failure experienced by parents (Jenson & Whittaker, 1989). In the cases where residential treatment has become the last alternative, OA programs need to ensure the highest levels of care are taken to bring a youth into wilderness therapy in the least harmful manner, to maintain meaningful levels of family involvement, and to ensure quality aftercare (Harper & Russell, 2008;Russell, 2005;Tucker et al., 2015). ...
... Needing to firmly establish its place in a 'system of care' model, wilderness therapy in general, and predominantly the work of Outdoor Behavioral Healthcare, considerable effort has been taken to address questions of effectiveness (e.g., Combs et al., 2016) through an active research agenda. Additionally, questions of quality of care and efficacy are deemed equally important and needing further attention to locate wilderness therapy in the broader service to children, youth and families (Becker & Russell, 2016;Russell, 2005;Tucker et al., 2014). ...
Article
Background and objectives: Credible empirical support for the therapeutic potential and positive outcomes associated with outdoor adventure approaches for children, youth and families has grown in the past decade. Historically, child and youth care practice has included therapeutic camps, adventure sport and outdoor recreation although this reality is not reflected in the training and education of practitioners. The purposes of this scoping review were to identify and articulate the extant literature of outdoor adventure programs and approaches found in child and youth care literature between January 1997 and March 2017. Method: Periodical selection and subsequent publication selection were conducted within Ulrichsweb utilizing specific inclusion/exclusion criteria, search words and abstract reviews. As a scoping review, study type and quality were not used for inclusion criteria thereby opening the review up to peer-reviewed English language publications of research, conceptual development, and program evaluations and descriptions. Results: Out of a total of 9731 periodicals identified in the first selection phase, only 25 met the inclusion criteria and are presented herein as home to child and youth care literature. Of 291 publications found within the child and youth care literature in the first selection phase, only 63 empirical and conceptual publications met the final inclusion criteria for review. Three thematic areas of practice and research emerged from analysis of included publications: (1) wilderness and adventure therapy, (2) therapeutic camping, and (3) adventure education and physical activity. These three content areas are explored and discussed in consideration of child and youth care context and practice, providing the basis for a synopsis and recommendations for practice and future research. Conclusions: This review identifies a need to more clearly identify and articulate outdoor adventure practices as they relate to child and youth care practice. Considering child and youth care's historical linkages to therapeutic camps and outdoor adventure activity, findings of this review suggest these approaches are underrepresented in the field's literature outside of the United States, potentially underappreciated in practice, and as an area requiring specific training and research. While research outcomes in outdoor adventure approaches to child and youth care appear positively robust, ethical concerns in wilderness therapy practice are identified and deserve further attention.
... Of the seven included studies (see Table 1), four (Russell, 2000;Russell & Phillips-Miller, 2002;Russell, 2005;Davis-Berman & Berman, 2012) had a general focus in terms of investigating the wilderness therapy process as a whole rather than selected elements of the treatment. Two of these studies were longitudinal in nature interviewing a sample of clients two years (Russell, 2005) and two decades (Davis-Berman & Berman, 2012) post-treatment. ...
... Of the seven included studies (see Table 1), four (Russell, 2000;Russell & Phillips-Miller, 2002;Russell, 2005;Davis-Berman & Berman, 2012) had a general focus in terms of investigating the wilderness therapy process as a whole rather than selected elements of the treatment. Two of these studies were longitudinal in nature interviewing a sample of clients two years (Russell, 2005) and two decades (Davis-Berman & Berman, 2012) post-treatment. ...
... The final three studies were more targeted per se, specifically investigating attachment relationships (Bettmann, Olson-Morrison, & Jasperson, 2011), treatment effects on selfevaluation (Cook, 2008), and backpacking as a physical component of a wilderness therapy program (Caulkins et al., 2006). Most of the studies had small sample sizes ranging from four to thirteen participants, with the exception of Russell (2005), who included 47 adolescents. ...
Article
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Despite considerable progress within wilderness and adventure therapy research over the last decade, researchers are still unable to precisely answer why, how, and for whom this treatment modality works. There is also a need for more knowledge regarding the circumstances under which the treatment does not appear to be effective. In this realist synthesis, we attempt to unpack this “black box” of wilderness therapy more specifically, defined as a specialized approach to mental health treatment for adolescents. Through a focused review of the primary qualitative wilderness therapy studies, empirical findings are used to test and refine a key program theory. The synthesis results in a proposed wilderness therapy clinical model and offers informed implications for future theory development, research, and practice.
... Outcomes had been maintained at 12-months post-treatment. [30,31]. Russel [31] evaluated youth well-being 24-months after the conclusion of outdoor behavioural healthcare (OBH) treatment and explored youth transition to various post-treatment settings. ...
... [30,31]. Russel [31] evaluated youth well-being 24-months after the conclusion of outdoor behavioural healthcare (OBH) treatment and explored youth transition to various post-treatment settings. The results suggest that 80% of parents and 95% of youths perceived OBH treatment as practical, the majority of clients were doing well at school, and family communication had improved. ...
... Although the idea of OBH and wilderness therapies is remarkable and the study by Russell [29][30][31] yields positive results, he admits that OBH and wilderness therapy's effectiveness reveals a consistent lack of theoretical basis, methodological shortcomings and problematic results difficult to replicate [31]. Therefore, we have focused on the primary tool for influencing attitudes and behaviour: remedial educative programmes [52] based on Shinrin-yoku, observational learning and forest pedagogy methods. ...
Article
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This paper evaluates the impact of the forest environment on aggressive manifestations in adolescents. A remedial educative programme was performed with 68 teenagers from institutions with substitute social care with diagnoses F 30.0 (affective disorders) and F 91.0 (family-related behavioural disorders), aged 12–16 years. Adolescents observed patterns of prosocial behaviour in forest animals (wolves, wild boars, deer, bees, ants, squirrels and birds), based on the fact that processes and interactions in nature are analogous to proceedings and bonds in human society. The methodology is based on qualitative and quantitative research. Projective tests (Rorschach Test, Hand Test, Thematic Apperception Test) were used as a diagnostic tool for aggressive manifestations before and after forest therapies based on Shinrin-yoku, wilderness therapy, observational learning and forest pedagogy. Probands underwent 16 therapies lasting for two hours each. The experimental intervention has a statistically significant effect on the decreased final values relating to psychopathology, irritability, restlessness, emotional instability, egocentrism, relativity, and negativism. Forest animals demonstrated to these adolescents ways of communication, cooperation, adaptability, and care for others, i.e., characteristics without which no community can work.
... NATSAP Practice Research Network (PRN), established in 2007, was created to respond to the call for research on program effectiveness of private residential treatment centers (NATSAP, n.d.). These initiatives, as well as other independent projects, have created a research corpus that suggests that OBH is a promising treatment for adolescents (Behrens, Santa, & Gass, 2010; Gass, Gillis, Russell, 2012; Hoag, Savicki, & Burlingame, 2001; Lewis, 2007; MagleHaberek, Tucker, & Gass, 2012; Russell, 2003 Russell, , 2005). OBH literature shows promising outcomes over the course of treatment. ...
... A variety of wilderness therapy outcome studies have provided initial evidence of efficacy (Behrens, Santa, & Gass, 2010; Behrens & Satterfield, 2007; Hoag, Burlingame, Reedy, Parsons & Hallows, 1999; Hoag, Savicki & Burlingame, 2001; Lewis, 2007; Russell, 2003 Russell, , 2005 Russell, , 2007 Young & Gass, 2010). These studies have shown a sharp reduction in symptoms for adolescents during the time they are in wilderness therapy, as well as continued improvement in mental health over the course of the year following therapy. ...
... These studies have shown a sharp reduction in symptoms for adolescents during the time they are in wilderness therapy, as well as continued improvement in mental health over the course of the year following therapy. While symptoms fluctuate post-treatment, the mean scores do not return to pre-treatment levels and may even continue to show improvement two years after clients complete wilderness programs (Russell, 2005). Despite these gains, OBH research lacks post-discharge data, methodological sophistication, and representative samples (Russell, 2007; Scott & Duerson, 2009;). ...
Research
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A National Association of Therapeutic Schools & Programs publication. Focus: residential and wilderness treatment for teens & young adults.
... While these studies suggest potential benefits of family involvement in the WT process, limitations in methodology and the need for further research to understand the phenomena has been expressed. Current literature describes the need for further investigation of WT theory and process to inform effective family involvement (see Burg, 2001;Russell, 2005;Russell & Phillips-Miller, 2002). ...
... Basic definitions of treatment models in OBH were established in efforts to distinguish these clinical treatment models from other wilderness experience programs (Russell & Hendee, 2000). An outcome study was conducted in which a cohort was followed for twelve and twenty-four months and outcomes reported included qualitative and quantitative results (Russell, 2003b(Russell, , 2005Russell & Phillips-Miller, 2002 , 1994). Of note, YOQ score reductions were greater in continuous flow expedition programs (i.e., 8 weeks in duration) than shorter programs. ...
... Russell continued the study with a 24-month follow-up (Russell, 2005). Parents and adolescents were contacted to identify (a) how well the adolescents were doing, (b) what was the role of aftercare, and (c) whether the OBH experience was worthwhile. ...
Thesis
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Adolescent wilderness therapy (WT) programs profess to operate from a family systems perspective. However, few studies have empirically examined the nature and extent of family involvement and the role it plays in facilitating treatment outcome. To address this research need, this study sought to illuminate the theoretical basis, processes and outcomes of family involvement in WT. A mixed-methods research approach was utilized to capture the lived experiences of families in WT as well as measure outcome through assessment of family function, adolescent social and psychological well-being and child-therapist/leader and parent-therapist therapeutic alliances. A case-study of two WT programs included fourteen families in the qualitative phase which included interviews, observation and review of archival materials. WT program filed staff, therapists and administrators were also interviewed and observed to further explore family involvement. Qualitative findings revealed significant family crisis being stabilized by the WT intervention, the majority of families participating actively in mandatory educational treatment processes and an increasing awareness of family system dynamics. A longitudinal repeated-measures design was utilized with one hundred and fifteen adolescents and eighty-five parents in the quantitative phase. Measures were administered to assess change in adolescent outcomes, family functioning, and working alliances. Results of quantitative analysis showed significant improvements in a number of adolescent and family function indices. Further analysis demonstrated change occurring inconsistently across several client and program-level variables. Measures were not correlated on outcomes and age and gender combined as pre-treatment demographics, provided a six percent explanation of outcome. Adolescents reported perceiving significant improvements in general family functioning. Triangulation of qualitative and quantitative findings provided both complimentary and contradictory understandings of family involvement. Measures of family functioning and adolescent outcomes provided a picture of a general improving trend, as did qualitative findings of stabilized family crisis and the recognition that further treatment and support was needed. Measures of family function did not demonstrate significant change within the family system, qualitatively however, families expressed a strong positive impact from their involvement in WT.
... They have clarity, wisdom, confidence, and vision. However, they have not yet internalized that vision into reliable action (Russell 2005). In starting the descent, it becomes more challenging to maintain that vision and confidence, and adolescent clients are at risk of relapse (Russell 2005(Russell , 2007. ...
... However, they have not yet internalized that vision into reliable action (Russell 2005). In starting the descent, it becomes more challenging to maintain that vision and confidence, and adolescent clients are at risk of relapse (Russell 2005(Russell , 2007. The need for an intentional and comprehensive aftercare plan is paramount for clients transitioning out of residential treatment programs and is well documented across disciplines (Nickerson et al. 2007;Priestley 2014;Russell 2005). ...
... In starting the descent, it becomes more challenging to maintain that vision and confidence, and adolescent clients are at risk of relapse (Russell 2005(Russell , 2007. The need for an intentional and comprehensive aftercare plan is paramount for clients transitioning out of residential treatment programs and is well documented across disciplines (Nickerson et al. 2007;Priestley 2014;Russell 2005). ...
Article
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Despite substantial gains adolescents and families can make in the intensely therapeutic and structured environment of wilderness therapy, regression is still a significant risk at the time of discharge. Accordingly, intentional and comprehensive aftercare planning is crucial to support adolescents and families internalize the changes begun in wilderness therapy. Wilderness therapy is a powerful and focused intervention, but it is not the solution. This article describes why most adolescents leaving wilderness therapy programs transition to longer-term, residential therapeutic schools and programs upon discharge. Although intentional separation of parents and children might appear counterintuitive, these settings often provide the least-restrictive environment. Their therapeutic benefit is explained using Bowen theory and the trans-theoretical model of change. Considerations for a successful aftercare plan are identified, including the importance of the family therapeutic process in supporting adolescent clinical growth, and when going home upon discharge is recommended. Lastly, suggestions are offered for treatment providers to support families making difficult aftercare decisions.
... Over the last 20 years, OBH has improved in clinical sophistication and begun to build a base of evidence. A number of OBH outcome studies demonstrate that clients enter OBH Child Youth Care Forum 123 programs with high clinical dysfunction, make dramatic improvements in emotional and behavioral functioning while in OBH treatment, and maintain improvements up to 6 and 12 months post-OBH treatment (Behrens et al. 2010;Bettmann et al. 2013;Hoag et al. 2013;Lewis 2013;Magle-Haberek et al. 2012;Norton et al. 2014;Russell 2003Russell , 2005Tucker et al. 2014). ...
... This study showed that clinically and statistically significant improvements were made during OBH treatment, and that clients maintained these positive results 1 year after discharge (Russell 2003). Two years later, the researcher interviewed a random selection of participants and found that 83 % reported to be doing better, 58 % said they were doing well or very well, and 81 % rated OBH treatment as effective (Russell 2005). ...
... Recent OBH literature continues to support that OBH is effective for a wide range of presenting problems and complex issues (Behrens et al. 2010;Lewis 2013;Hoag et al. 2013;Norton et al. 2014;Russell 2003Russell , 2005Tucker et al. 2014). In 2013 Lewis conducted a study with 190 participants from three OBH programs using growth curve modeling. ...
Article
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Background Outdoor Behavioral Healthcare (OBH) has arisen to fill a gap in mental health treatment. While research shows large positive changes in adolescent self-reports, little is known about predictors of change, longitudinal outcomes, and parent-reports of change. Objective This study sought to identify treatment outcomes up to 18 months post-discharge and predictors of change for parents of adolescent clients in OBH treatment. Methods Parents of 659 adolescents from four OBH programs were invited to complete questionnaires at intake, discharge, and 6 and 18 months post-discharge. A regression was conducted to examine change during treatment, and a multilevel model to examine trajectories of change post-treatment. Results OBH participants entered treatment with clinically significant levels of emotional and behavioral dysfunction, made significant change during the program, and discharged within the “normal” range of functioning. Post-discharge scores indicated that clients remained in the “normal” range of functioning 6 and 18 months post-discharge. The regression analysis found that parent intake scores and attachment disorders were predictive of in-treatment change. The MLM found that parent perceptions of treatment gains and adoption status were significant predictors of functioning post-discharge. Conclusions Results are in-line with previous research suggesting that OBH may be helpful to adolescents experiencing a wide range of presenting problems, and adds new insights as well. Parent-reports parallel the dramatic changes in adolescent self-reports documented throughout OBH literature; data up to 18 months post-treatment shows healthy functioning per the parent perspective; and adoption and attachment appear to play a role in outcome trajectories.
... However, because group processes are central to WT programs, these programs generally do utilize the group therapeutic factors of universality, imparting information, corrective recapitulation of family experience, socialization, imitative behavior, interpersonal learning, and group cohesiveness (Yalom and Leszcz 2005). While the WT literature has not addressed most of these group therapeutic factors explicitly, some qualitative research into these programs has begun to address these issues (Russell 2000(Russell , 2005. ...
... Our results indicate that private pay WT shows mediumsized effects for its clients within the areas of self-esteem, locus of control, behavioral changes, personal effectiveness, clinical symptomology, and interpersonal skills. Previous studies showed the effectiveness of specific private pay WT programs (Bandoroff 1992;Clark et al. 2004;Davis-Berman and Berman 1989;Eikenoes et al. 2006;Harper 2009;Harper and Russell 2008;Harper et al. 2007;Pawlowski et al. 1993;Ronalds and Allen-Craig 2008;Russell 2003Russell , 2005Russell , 2007, but no meta-analyses to date have drawn definitive conclusions about the treatment type as a whole for private pay clients. ...
Article
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Wilderness therapy is becoming a more widely used intervention for adolescents, but there have not been any meta-analyses focused solely on its clinical effectiveness for private pay clients. This study’s objective was to conduct outcome-based meta-analyses of private-pay wilderness therapy programs, benchmark primary features of this approach, and educate the clinical community as to its effectiveness. The authors conducted a review of all available databases, as well as manual searches. Searches resulted in a meta-analysis based on 36 studies, totaling 2399 participants receiving wilderness therapy. Our meta-analyses found medium effect sizes for all six constructs assessed: self-esteem (g = 0.49), locus of control (g = 0.55), behavioral observations (g = 0.75), personal effectiveness (g = 0.46), clinical measures (g = 0.50) and interpersonal measures (g = 0.54). Subgroup analyses included age of participants, duration of program, open or closed model, presence of a mental health practitioner, and publication year.
... More relevant to therapeutic outfitting are the prescriptively therapeutic programmes which have demonstrated clinical improvement in social and psychological well-being of adolescents (see Clark, Marmol, Cooley & Gathercoal, 2004;Crisp & Hinch, 2004;Russell, 2003). Definitions of practice (Russell & Hendee, 2000), evaluation of outcomes (Russell, 2003(Russell, , 2005, and the detailed monitoring of risk-related incidents (Russell & Harper, 2006) demonstrate the level of professionalism and therapeutic intent of these licensed and accredited mental health organisations. Clark et al. (2004) have completed the most clinically significant research in wilderness therapy to date. ...
... Ongoing contact with programme staff during the post-expedition phase of the intervention is critical for the successful transfer of learning. Aftercare has been described in a recent study as a crucial step in the change process following therapeutic wilderness interventions (Russell, 2005) and yet is relatively unavailable in current adolescent mental health or justice related wilderness-based programmes in Canada. The therapeutic outfitting model provides the collaborating mental health practitioner with intermittent opportunities to bring the group back together for single-day experiential and adventure activities (e.g. ...
Article
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This paper presents an innovative approach designed to meet the needs of conventional mental health service providers in serving adolescents with a range of mental health needs. The collaborative effort between an experiential wilderness education programme and multiple adolescent community and mental health agencies is here described as therapeutic outfitting. This service delivery model addresses the need for innovative programme designs at a time when many adolescents experiencing mental health distress in Canada may not be receiving the services they need. Implications for practice and the need for research in this multi-agency, multidimensional setting will be discussed.
... A variety of wilderness therapy outcome studies have provided initial evidence of efficacy (Behrens & Satterfield, 2007;Behrens, Santa, & Gass, 2010;Hoag, Burlingame, Reedy, Parsons & Hallows, 1999;Hoag, Savicki & Burlingame, 2001;Lewis, 2007;Russell, 2003Russell, , 2005Russell, , 2007Tucker, Zelov, & Young, 2011;Young & Gass, 2010). These studies have shown a sharp reduction in symptoms for adolescents during the time they are in wilderness therapy, as well as continued improvement in mental health over the course of the next year. ...
... These studies have shown a sharp reduction in symptoms for adolescents during the time they are in wilderness therapy, as well as continued improvement in mental health over the course of the next year. While symptoms fluctuate post-treatment, something that seems typical as clients reintegrate into society, the mean scores do not return to pre-treatment levels and continue to show improvement two years after finishing the wilderness program (Russell, 2005). ...
... Individuals must take on an awareness of their context and responsibility for their actions in an outdoor setting to a higher degree than typically required in other settings (Walsh and Golins 1976). General effectiveness research on OBH has provided promising evidence of positive outcomes for struggling adolescents who receive treatment, indicating that adolescents with emotional, behavioral and substance related disorders improve during the course of treatment and these improvements are maintained post discharge (Bettmann et al. 2012; Clark et al. 2004; Lewis 2013; Magle-Haberek et al. 2012; Norton 2008 Norton , 2010a Russell 2003 Russell , 2005a Russell , b, 2008 Russell and Farnum 2004; Russell and Sibthorp 2004; Tucker et al. 2011 Tucker et al. , 2014 Zelov et al. 2013). Positive physiological outcomes have also been found (DeMille et al. 2014). ...
... Positive physiological outcomes have also been found (DeMille et al. 2014). In addition, OBH appears to be effective for a variety of populations and problems, including adolescents in the Juvenile Justice system (Jones et al. 2004; Russell 2005a; Wright 1983), adolescent sex offenders (Gillis and Gass 2010; Lambie et al. 2000), and adolescents with various diagnosable disorders (Clark et al. 2004; Russell 2006, Russell 2008). Many residential treatment programs for individuals claim to improve family functioning, In OBH, the family has received some research attention which has supported this claim. ...
Article
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Adolescent mental health is a significant societal concern in the United States. Diagnosable mental health disorders have been reported at rates of 10–20 % among children and adolescents and this does not include adolescents experiencing personal and interpersonal distress not meeting diagnostic criteria. Adolescents who do not respond to traditional mental health services are often placed in residential treatment centers or other out-of-home treatment programs. Outdoor Behavioral Healthcare (OBH) is growing as a viable treatment option for adolescents who struggle with emotional, behavioral or substance related problems; however, questions have been raised about how to integrate the family into an OBH treatment setting. This article describes a case study illustrating how techniques from Narrative Family Therapy can be used to accomplish this integration, and offers a view of using Narrative Family Therapy to further involve families in the treatment and post-treatment process in an OBH program.
... OBH programs aim to build success-oriented identities for clients by increasing self-concept, internal locus of control, selfconfidence, and improved interpersonal and social skills (Hill, 2007;Russell et al., 2008). Russell (2005) conducted a mixed-methods study on wilderness therapy outcomes 2 years postdischarge and found that 80% of parents (n = 88) and 90% of adolescent clients (n = 47) believed that OBH was effective. A noted limitation regarding these findings is that the adolescent sample surveyed 2 years postdischarge represented only 33% of the original study sample size (N = 188). ...
... We also know that a relationship exists between growth, function, and overall wellness when individuals are connected with nature (Reese & Myers, 2012;Tucker et al., 2013). We are beginning to elucidate OBH effects in general (Bowen & Neill, 2013) and outcomes with adolescents in particular (Russell, 2003(Russell, , 2005Tucker, Smith, & Gass, 2014). What we do not yet know are the OBH outcomes for young adults over time, because results to date have been reported (Hoag et al., 2013) for a small number of young adults (N = 10). ...
Article
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This article details a 3-year outdoor behavioral health care outcome study. Hierarchical linear modeling was used to analyze data from 186 young adults in a wilderness therapy program. Participants completed the Outcome Questionnaire–45.2 (Lambert et al.,) 6 times from Week 1 to 18-month postdischarge follow-up. Results indicated that clinically and statistically significant change occurred in treatment. Rates of change varied, and posttreatment scores remained stable, thus demonstrating that in-treatment gains were maintained. Implications and recommendations for future research are discussed. © 2017 by the American Counseling Association. All rights reserved.
... While growing in prevalence, OBH has also increased in clinical sophistication and built an evidence base demonstrating that it is effective for a wide range of presenting problems and complex issues in adolescents. Numerous outcome studies demonstrate that clients enter OBH programs with high clinical dysfunction, make dramatic improvements in emotional and behavioral functioning while in OBH treatment, and maintain improvements up to 6 and 12 months post-OBH treatment (Behrens et al. 2010;Bettmann et al. 2013;Combs et al. 2015;Lewis 2013;Magle-Haberek et al. 2012;Norton et al. 2014;Russell, 2003Russell, , 2005Tucker et al. 2014). The most thorough metaanalysis to date on adventure therapy concluded: "adventure therapy programs are moderately effective in facilitating positive short-term change in psychological, behavioral, emotional, and interpersonal domains and that these changes appear to be maintained in the longer-term" (Bowen and Neill 2013, p. 41). ...
... While there is some promising evidence of maintenance of change after OBH treatment, post-discharge data has been a weakness in the literature. Research by Russell (2003Russell ( , 2005, Bettmann et al. (2013) and Lewis (2013) show maintenance of OBHtreatment effects, and this study affirms and contributes to those findings. This study's ability to look 18 months posttreatment, and to examine diagnostic and demographic factors influencing outcome six months post-treatment is original. ...
Article
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Outdoor behavioral healthcare is an increasingly popular treatment modality for adolescents, and evidence suggests that it is effective for a wide range of complex issues. The outdoor behavioral healthcare literature still faces major limitations though, and one of these limitations is that outcomes are primarily measured at only admit and discharge. This study sought to explore the trajectory of change throughout treatment, and investigate outcomes up to 18 months post-discharge. Of the 659 adolescent participants from four outdoor behavioral healthcare programs, 29 % were female, 18 % were adopted, and the average age was 16 years old. Participants were invited to complete questionnaires four times during treatment, and at 6 and 18 months post-discharge. We used multilevel modeling to explore trajectories and predictors of change during treatment, and a regression and an ANOVA to examine outcomes post-discharge. Results of the multilevel modeling supported that adolescents make significant changes during outdoor behavioral healthcare, and also contributed new findings on demographic and diagnostic predictors. Gender and the presence of a mood or anxiety disorder predicted greater rates of change during treatment. Analysis of post-discharge data at six and 18 months post-discharge suggested that clients maintain treatment effects and that gender persists in influencing outcomes. This study is the first to examine trajectories of change in outdoor behavioral healthcare, to find diagnostic variables to be relevant, and to examine self-report outcomes past 12 months post-discharge.
... Depending on the population being studied and length of stay, WT programmes have been shown to facilitate positive client outcomes (e.g. Bettmann, 2007;Bettmann, Gillis, Speelman, Parry, & Case, 2016;Cason & Gillis, 1994;Hattie, Marsh, Neill, & Richards, 1997;Roberts et al., 2017;Russell, 2000Russell, , 2005Wilson & Lipsey, 2000). Examples of positive outcomes include the development of a positive therapeutic alliance (Harper, 2009); increased self-evaluation and positive sense of self (Cook, 2008); lasting self-reported positive impact on a client's life (Davis-Berman & Berman, 2012); reduced symptom distress and improved perceptions of social role and interpersonal performance (Roberts et al., 2017); and overall positive outcomes related to client wellness, both during adolescent and young adult stages of development (e.g. ...
... Examples of positive outcomes include the development of a positive therapeutic alliance (Harper, 2009); increased self-evaluation and positive sense of self (Cook, 2008); lasting self-reported positive impact on a client's life (Davis-Berman & Berman, 2012); reduced symptom distress and improved perceptions of social role and interpersonal performance (Roberts et al., 2017); and overall positive outcomes related to client wellness, both during adolescent and young adult stages of development (e.g. Harper, Russell, Cooley, & Cupples, 2007;Russell, 2005). ...
Article
Wilderness Therapy (WT) programming has been criticized for underutilizing nature as an active co-facilitator in treatment. Although some concept models in the field take into account nature’s contributions in WT, an abundance of multidisciplinary research suggests that nature contact and connection could be of greater emphasis. The purpose of this article is to introduce the EcoWellness model as one empirically based approach for facilitating intentional nature connection in WT. The state of WT research and supporting theory are reported. The EcoWellness framework is overviewed and embedded within the multidisciplinary literature. A case example is presented and implications for integrating EcoWellness into WT practice, training, and research are discussed.
... Once a family decides to seek out-of-home treatment, various options are available. Parents may decide to place their child directly in residential treatment, wilderness therapy, or a sequential combination of the two, generally with wilderness therapy preceding a longer term residential placement (Russell, 2005;Young & Gass, 2010). Thus, the client demographics of such programs are quite similar including guardian's socioeconomic status, the client age, previous history of substance abuse, previous therapeutic treatment, and psychiatric medication use for mental health issues (Bettmann et al., 2011;Young & Gass, 2010). ...
... Notably, adolescents frequently cycle from one type of these programs to another, such as from a wilderness therapy program to a therapeutic boarding school or residential treatment program (Russell, 2005). To investigate whether these adolescents differed based on their placement, a series of between-subject tests were conducted. ...
Article
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Adopted children are disproportionately represented in residential treatment programs in the United States. Adopted children in the United States constitute only 2% to 3% of the U.S population. Nevertheless, they comprise approximately 16.5% of the population in residential care. This descriptive study evaluated a sample of 473 psychological evaluations of adolescents in wilderness and residential treatment centers. Results indicated that, compared with nonadopted youth, adopted youth had greater histories of recent trauma, higher rates of suicidal tendency and biological parents’ mental illness, and poorer academic achievement. However, there were no significant differences between adopted and nonadopted youths in terms of defiant behaviors, IQ, substance use/abuse, reasons for referral, impulsivity, anxiety, or depression. Study results suggest that wilderness and residential programs may need to target programmatic elements specifically to meet the special needs of adopted adolescents who comprise a significant percentage of their client population.
... While qualitative research in OBH exists, most of the literature focuses on the experiences of OBH practitioners (e.g., Karoff et al., 2019;Marchand et al., 2009). Russell (2005) interviewed parents and adolescent participants two years after the adolescent completed OBH. The study found that despite youths and parents deeming OBH as necessary and effective, the results "also indicated that many continued to use alcohol and/or drugs to varying degrees, had legal problems, and still had issues forming friendships with peers" (p. ...
... Such practices deserve urgent and rigorous attention. Parents considering OBH should be cautioned about the potential for lifelong effects as the result of secure transport services and potential for deterioration in family conflict (Russell, 2005). ...
Article
Often synonymous with wilderness therapy, outdoor behavioral healthcare (OBH) is a residential treatment in the United States for young people, more than half of whom are sent via secure transport services. While empirical evidence suggests the secure transport of adolescents to OBH does not impact quantitative outcomes, limited research exists exploring client voice and the lived experience of OBH participants. This qualitative study, utilizing narrative inquiry, builds knowledge on experiences of secure transport services from nine past OBH adolescent participants. Findings are analyzed, interpreted, and discussed through a social work and trauma-informed lens. Recommendations for ethical practice, linking with human rights, and future research are provided.
... More specific information (quantitative and qualitative) could be collected from the participants as to have a more intimate understanding of how the camps affect the families. Follow-up surveys at various times after the conclusion of the camps, such as one year later, could test the sustainability of change for camp participants, which has been demonstrated in the wilderness therapy literature (Russell, 2005), but not as often with programs for families. It is important to ask questions about how the program could help support the families to maintain change after the conclusion of camp, much like aftercare support provided in wilderness therapy programs (Russell, 2005). ...
... Follow-up surveys at various times after the conclusion of the camps, such as one year later, could test the sustainability of change for camp participants, which has been demonstrated in the wilderness therapy literature (Russell, 2005), but not as often with programs for families. It is important to ask questions about how the program could help support the families to maintain change after the conclusion of camp, much like aftercare support provided in wilderness therapy programs (Russell, 2005). ...
Article
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The program described in the present article focused on service member parents and their teenage children participating in camps together. The scope of the project was to provide an opportunity for military personnel who recently returned from deployment to reconnect with an adolescent after an extended absence due to deployment. The camps used the Campfire Curriculum, which included experiential learning, team-building experiences and nightly campfire programs from the Blue to You curriculum for military families. Open-ended responses from parent participants suggested that time together with their children, interacting with fellow service members and their kids, sharing stories, and opportunities for camaraderie were especially important and meaningful.
... Findings were that group adventure, reflection, nature, and challenge, as experienced within a wilderness therapy context are theorized as active components of OBH. Research investigating the effectiveness of wilderness programming has grown exponentially over the past two decades (Norton et al., 2014) and the convergence of literature suggests that participants evidence marked symptom remission (Russell, 2003(Russell, , 2005 and maintain symptomatic improvements throughout follow-up assessment periods (Lewis, 2013;Russell, 2005). ...
... Findings were that group adventure, reflection, nature, and challenge, as experienced within a wilderness therapy context are theorized as active components of OBH. Research investigating the effectiveness of wilderness programming has grown exponentially over the past two decades (Norton et al., 2014) and the convergence of literature suggests that participants evidence marked symptom remission (Russell, 2003(Russell, , 2005 and maintain symptomatic improvements throughout follow-up assessment periods (Lewis, 2013;Russell, 2005). ...
... Longitudinal data indicate that significant symptomatic reductions were maintained at six months post-treatment (Harper et al., 2007) and had even improved by the 12-month follow-up (Russell, 2003b). Qualitative interviews with youth and parent informants have reported that most participants still perceived the intervention to be effective at 24 months post-treatment (Russell, 2005). ...
Article
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Despite the rich traditions of outdoor life in the Scandinavian countries, structured nature-based therapeutic interventions remain underexplored in adolescent mental health services. We suggest that wilderness therapy is an age-appropriate and effective group treatment that may hold particular appeal for at-risk youth who are less responsive to conventional forms of treatment. Although more widespread in other parts of the world, wilderness therapy may also be a viable treatment modality for the Scandinavian region. Our overall aim of this state-of-knowledge article is to provide an overview of wilderness therapy with regard to conceptualization, practice and research, and to discuss current challenges. Based on the available knowledge, we suggest that the addition of this nature-based group treatment could increase the diversity of treatment options in adolescent mental health services in Scandinavia and recommend rigorous intervention studies exploring what works, for whom, and in what circumstances.
... Researchers involved in evaluating adventure therapy programs have highlighted the importance of follow-up or aftercare systems that involve participants after the initial immersive outdoor experience has been completed 84, 85 . Introducing post-OALE programming is a future opportunity worth exploring, especially for younger males (ages 12-14), because their resilience scores decreased more dramatically from T2 to T3 (Fig2). ...
Article
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It is imperative that we improve the mental health of Aboriginal youth in Canada. From an Aboriginal worldview, mental health must be approached in concert with the promotion of spiritual, physical, and emotional health. This holistic approach is concordant with the processes implicit in programs using outdoor adventure and experiential education (OAEE). Programs using OAEE have proven effective in improving the mental health of youth at risk in other populations; yet there is little evidence of their effectiveness on the resilience and well-being of Aboriginal youth. We used a three-phase study design that began with a community-based participatory approach to develop an outdoor adventure leadership experience within one Aboriginal community in Canada (Phase 1). We then applied culturally reflexive strategies in the context of a mixed-method research design to evaluate the program’s effect on the resilience and well-being of youth using both quantitative methods (Phase 2), and qualitative methods (Phase 3). This paper describes the methods and the sample, and offers initial findings from the qualitative analysis. The qualitative results suggest that the outdoor adventure leadership experience had a positive effect on resilience. These initial findings are encouraging, since the program has been fully accepted and endorsed by the community.
... Similar to the improvements in research with children and adolescents in general (Kazdin, 2004;Weisz, Weiss, Han, Granger, & Morton, 1995), research with wilderness therapy programs has improved significantly over the past 10 to 15 years. A clear definition of wilderness therapy and its methods have been established (Russell, 2001(Russell, , 2003b, and outcome studies have begun to provide some evidence of efficacy (Behrens, Santa, & Gass, 2010;Behrens & Satterfield, 2007;Hoag, Burlingame, Reedy, Parsons, & Hallows, 1999;Hoag, Savicki, & Burlingame, 2001;Russell, 2003aRussell, , 2005Russell, , 2007Young & Gass, 2010). Even with this growth of research, the evidence and literature within this field still lacks depth and methodological sophistication, and has been limited in the scope of what it has examined. ...
Article
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Over the last decade, wilderness therapy research has increased substantially in both quality and quantity and has begun to establish a base of evidence and literature. However, there is still much to be learned about the clients served and their clinical profile. The authors examined diagnostic data from discharge summaries of 929 clients (192 young adults and 737 adolescents) who enrolled in wilderness therapy at four sites across the nation. We explored trends and differences in primary diagnosis and overall prevalence of disorders according to gender and age. Central themes emerged such as the pervasiveness of substance issues, the overwhelming impact of Mood Disorders, and the clinical complexity of wilderness therapy clients. How these findings fit in with industry trends are discussed, as well as the conceptualization of behavioral issues from adolescent to adult populations, variances between adults and adolescents, and gender differences.
... Similarly, Paxton and McAvoy (2000) detected a significant increase in self-efficacy of students in their study exploring social and psychological benefits of wilderness therapy programs. Through a qualitative assessment of youths' well-being 24 months after their participation in wilderness therapy, Russell (2005) has shown that 80 % of parents and 95 % of youths perceived outdoor behavioral health treatment as effective. The majority of clients were doing well in school, and family communication had improved. ...
Article
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This article explores the experiences of families that have sent struggling adolescents to therapeutic wilderness programs. We employ a modified case study approach, in which we, the participants, are also observers of the experiences of our entire families. The article begins by explaining what wilderness therapy is and offering an overview of research that has examined the effectiveness of therapeutic wilderness programs. We delineate the process of seeking, selecting and participating in wilderness therapy as well as the role of an educational consultant in facilitating this. We describe our experiences from (1) the time we realized and accepted that our children were struggling and suffering to (2) considering sending our children to wilderness therapy to (3) the stresses of the decision making process to (4) what the experience was like for us including participating in a parent workshop to (5) planning the next steps and discharge, and finally to (6) seeing and living the results over the next few years. Areas of growth and struggle are noted. Our children’s perspectives on our families’ development over time and the interactions among us are also discussed.
... Over the last fifteen years, wilderness therapy has improved in clinical sophistication and begun to build a base of evidence. Wilderness therapy as an intervention has been more clearly defined (Russell, 2001(Russell, , 2003(Russell, , 2007, and evidence of efficacy has been demonstrated with a number of studies among adolescents (Behrens & Satterfield, 2007;Behrens, Santa, & Gass, 2010;Hoag, Savicki, & Burlingame, 2001;Lewis, 2007;Magle-Haberek, Downloaded by [74.120.37.94] at 09:05 16 December 2013 Tucker, & Gass, 2012;Russell, 2003Russell, , 2005Russell, , 2007Tucker, Zelov, & Young, 2011;Young & Gass, 2010). Unfortunately, outcome data on young adults in wilderness therapy are largely nonexistent in the current literature. ...
Article
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There has been considerable growth in outcomes research with adolescent clients in wilderness therapy. However, data on young adults are largely absent from the literature. This pilot study investigated the effectiveness of wilderness therapy for 297 young adult participants. The 3-year study found clinically and statistically significant change from intake to discharge on the Outcome Questionnaire-45.2. It also found significant change on measures of life effectiveness, motivation for therapy, therapeutic alliance, and dysfunctional attitudes. This article discusses when change occurs in the wilderness, factors that influence outcomes, differences between genders, and post-discharge outcomes for young adults.
... The eight-week treatment intervention is similar to other published descriptions of wilderness therapy interventions (Bettmann and Tucker 2011;Russell 2003Russell , 2005. In this model, adolescents live in a wilderness environment on a continuous expedition with primary care staff and receive individual, group and milieu treatment that is supervised and delivered by licensed clinicians. ...
Article
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Background Considering the sensitive ethical issues related to involuntary treatment of adolescents, research investigating youth transport practices and treatment outcomes is clearly needed. Youth transport is common practice in many private pay programs, including wilderness therapy programs. Objective This study of 350 adolescents in wilderness therapy sought to answer the following questions: (1) did youth who were transported to wilderness therapy present differently at intake than youth not transported in terms of both readiness to change and functioning? (2) Were there different outcomes for participants who were transported to the program compared to those who were not? (3) Were transport use and readiness to change predictors of overall improvement in the program? Methods In this exploratory non-equivalent groups quasi-experimental study, youth self-report pre- and post- mean scores of the YOQ and URICA, as well as parent YOQ reports, were compared between transported and non-transported groups. Regression analyses were performed to see if transport use was predictive of overall improvement. Findings Results suggested that youth improved significantly regardless of transport use; however, transported youth were more likely to have larger decreases in mental health symptomatology than non-transported youth, suggesting that being transported did not have a negative impact on treatment outcomes. Discussion While these are encouraging findings, the results represent the evaluation of a single wilderness therapy program and are limited by the research design; hence, future research is needed to increase confidence that transport does not negatively affect treatment effectiveness.
... This study is limited by its racially homogenous sample. It is likely that the predominantly White sample is reflective of the larger population of young adults in NATSAP programs, because this racial/ethnic make-up has been repeatedly found in the body of research related to NATSAP programs (e.g., Behrens, 2011;Bettmann et al., 2016;Russell, 2005;Tucker et al., 2016a;Tucker et al., 2016b). Therefore, it is important to bear in mind that these findings (as well as the population of clients served in NATSAP programs) apply primarily to white young adult clients. ...
... Similarly, Paxton and McAvoy (2000) detected a significant increase in self-efficacy of students in their study exploring social and psychological benefits of wilderness therapy programs. Through a qualitative assessment of youths' well-being 24 months after their participation in wilderness therapy, Russell (2005) has shown that 80 % of parents and 95 % of youths perceived outdoor behavioral health treatment as effective. The majority of clients were doing well in school, and family communication had improved. ...
Chapter
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This chapter explores the experiences of families who have participated in wilderness therapy through a modified case study approach in which we, the participants, are also observers of the experiences of our entire families. We delineate the process of seeking, selecting, and participating in wilderness therapy, as well as the role of an educational consultant in facilitating this. We talk about our own experiences before, during, and after wilderness. We describe (1) the recognition of the adolescent’s struggles and suffering; (2) our introduction to the concept and possibility of wilderness therapy; (3) the decision-making process with its inherent difficulties and stresses; (4) the ongoing nature of the families’ experiences, including family and parent participation in workshops; (5) identifying, understanding, and accepting the need for ongoing support post-wilderness and the team effort involved in planning the next steps and discharge ; and finally, the (6) observation of the results for both participants and families over the next several years. Areas of growth and struggle are noted. The children’s perspectives on our families’ development over time and the interactions among us are also discussed. We conclude by discussing a collaborative path forward for everyone involved and interested in alternative therapeutic and educational placements.
... Proponents of wilderness therapy, an adventure-based approach in which adolescents and young adults are immersed in remote natural settings for weeks or months at a time, utilize the natural environment as a backdrop when facilitating therapeutic groups (Beringer, 2004). Wilderness therapy has been shown to decrease client symptoms (Roberts et al., 2017), improve perceptions of wellness (Russell, 2005), and expand sense of self (Cook, 2008). Interestingly, nature tends to be an underemphasized therapeutic factor within wilderness therapy . ...
Article
Group counselors who facilitate groups in and around natural environments may benefit from a clear conceptual model that delineates the underlying theorized elements of therapeutic change in such settings. We sought to develop a theoretically grounded model of change for developing and evaluating nature-based groups, which we call the Group EcoWellness Model of Change (GEMC). The purpose of this article is to describe the theoretical underpinnings of the GEMC and explore one application of the framework in articulating the Fishing for Wellness therapeutic group. Implications for group counseling practice and research are discussed.
... Available follow-up data indicated that significant symptomatic reductions were maintained at six months (Harper et al., 2007) and had even improved at 12 months post-treatment (Russell, 2003). Qualitative interviews with adolescent and parent informants reported that most participants still perceived the WT treatment to be effective at 24 months post-treatment (Russell, 2005). Regarding efficacy, the most thorough meta-analysis concluded: "adventure therapy programs are moderately effective in facilitating positive short-term change in psychological, behavioral, emotional, and interpersonal domains and that these changes appear to be maintained in the longer-term" (Bowen & Neill, 2013, p. 41). ...
Thesis
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This is a doctoral dissertation for the degree of PhD in Health Sciences at the University of Agder, Norway. It is an article-based thesis, which means that the main work of this PhD is three published scientific articles and a fourth article that has been submitted. The thesis provides the introduction, summary and overall discussion of these four substudies, which can also be found separately on my ResearchGate profile.
... A small subset of these out-of-home placements are adventure therapy (AT) programs such as outdoor behavioral healthcare (OBH) programs. To date, relatively little research has been able to link specific program components to the successful client outcomes being reported in OBH programs (Behrens & Satterfield, 2011;Roberts, Stroud, Hoag, & Massey, 2017;Russell, 2003Russell, , 2005Tucker & Rheingold, 2010;Tucker, Smith, & Gass, 2014). Since many OBH programs identify as wilderness therapy programs, a closer evaluation of wilderness therapists using the conceptual mapping task (CMT) (Impellizzeri, Savinsky, King, Leitch-Alford, 2017) could provide a mechanism for therapists to voice their unique understanding of what they do in practice. ...
Conference Paper
Review of the Literature While the mentor/mentee relationship has been associated with traditional teacher education apprentice models (Ambrosetti & Dekkers, 2010; Feiman-Nemser,1996; Little, 1990), it is increasingly reported as integral for experiential education (EE) and leisure instructor training programs (Propst & Koesler, 1998). Moreover, prominent experiential education and leisure programs have asserted the primacy of mentoring as part of their field instructor programs (Divine, 2016; Outward Bound, 2006). The literature, practitioners, and students seem to agree that the mentor/mentee relationship is a critical component of effective experiential education and leisure programming (Cain, 1989; Galloway, 2002; Shooter, Sibthorp, & Paisley, 2009), yet there remains no detailed investigation into the operational definition of mentoring in these contexts and the desirable characteristics of mentoring programs as identified by practitioners to foster the interpersonal relationships essential to the learning of implicit knowledge in these contexts. Closer examination of the mentor/mentee relationship in experiential education and leisure contexts reveals troubling issues. An inherent problem in the fields of experiential education and leisure is that while the mentor/mentee relationship is both a necessity and an proffered methodology, there is little conceptualization of the terms and definitions comprising the mentor/mentee relationship. For example, if authors insert the words mentor, apprentice, or protégé into an article’s conclusion or recommendation section and do nothing to conceptualize that term, they assume the requisite experience of the reader to do that for themselves. However, if the reader does not have the requisite experiences to conceptualize what is meant by these terms, there is no structure by which to guide them to an appropriate use of this concept within the context of the authors’ recommendations. As an example, Morrison-Shetler and Heinrich (1999) state “Given the interdisciplinary nature of experiential teaching and the notion of ‘group as mentor,’ the idea of an interdisciplinary faculty group that mentors members around experiential teaching approaches makes sense” (p. 5). While the authors reference formal mentor/mentee programs, they do not define or conceptualize the components of a mentor/mentee relationship. The purpose of this study is to determine the amount as well as thematic relation and focus of literature on the topic of the mentor/mentee relationship within the fields of EE and leisure. Second, this study sought to provide a potential structure for conceptualization of the terms encapsulating the mentor/mentee relationship. We consider the present review to be timely, as recent advances in EE and leisure, coupled with anecdotal evidence, provide contemporary practitioners and researchers with increasingly clearer insight into the mechanisms by which field instructors and experiential educators exhibit fundamental skills and implicit knowledge, such as that required for decision-making and risk management, leading to effective functioning in a variety of situations. The gains derived via specific types of the mentor/mentee relationship may be of importance for field instructors and experiential educators as effective behavior is guided by both intrapersonal and interpersonal factors related to the mentor/mentee relationship. Methods A systematic review of papers published prior to March 2017 was undertaken using experiential education and leisure peer-reviewed journals currently in publication (n=12; see Table 1). Each journal was searched using three search terms in four search fields (see Table 1). Database searches, screening, and eligibility of records were performed independently by two authors at two different institutions. Figure 1 shows the identification, screening, and selection of the final full text articles included the qualitative analysis, resulting in a full review of 19 papers and final inclusion of 19 papers. After the initial database search and the removal of duplicates, records that were screened (n = 30) contained at least one of the three search terms (mentor*, apprentice*, or protégé*) in at least one of the search fields (All, Keywords, Abstract, Title). At this point, records were excluded (n = 11) because they were book reviews and thus did not meet inclusion criteria. Next, full text articles (n = 19) were assessed for eligibility included in the qualitative synthesis. Qualitative synthesis will be performed using NVivo software to analyze keywords-in-context to identify thematic convergences among articles. Results Although qualitative analysis has not been performed at this time, preliminary results reveal that the majority of papers published where mentor*, apprentice*, or protégé* appear in the Keywords, Abstract, or Title are qualitative in nature (Bachert, 2007; Bell, 1990; Chand & Shukla, 2003; Coakley, 2006; Colvin & Tobler, 2013; Gladwell, Dowd & Benzaquin, 1995; Gray, 2008; Maxson, 1983), with three quantitative studies (Morgan, Sibthorp, & Tsethlikai, 2016; Norton & Watt, 2014; Propst & Koesler, 1998), and three theoretical papers (Coakley, 2006; Karagatzides et al., 2011; Wheal, 2000). Four papers propose mentor program curricula (Gladwell, Dowd & Benzaquin, 1995; Powell & Sable, 2001; Schaumleffel, 2009; Wittmer, 2001). These papers implement diverse methods, such as case studies (Bachert, 2007; Bell, 1990; Chand & Shukla, 2003; Colvin & Tobler, 2013; Gray, 2008; Pelchat & Karp, 2012; Skalko, Lee, & Godlenberg, 1998) and informal interviews (Morrison-Shetlar & Heinrich, 1999), to assess the effectiveness of the mentor/mentee relationship in the context of faculty and peer mentoring programs. Both informal and formal mentoring contexts are examined in the papers, with few papers describing the effectiveness of a formal mentoring program. No standardized assessment measures are implemented in the research, with informal semi-structured interviews being the dominant assessment measure. Overall, there is little homogeneity in the investigation of the effectiveness of mentoring programs in experiential education and leisure contexts. Limitations of this study were found mainly within the selection criteria themselves. While the selection criteria provided a operationalized definition of the focus of an article, it was found that articles may have included much information on the terms without having included them in any search criteria category. This meant that potentially impactful information on elements of the mentor/mentee relationship that were missing from the results due to the limitations of the search criteria. A second limitation may well have come from the articles themselves. Very few references were made to literature in periods other than the 19th and 20th century, potentially eliminating some beneficial “primary” source material. Discussion Although some articles support the notion that the mentor/mentee relationship is valuable to developing implicit knowledge in EE and leisure contexts (Bachert, 2007; Bell, 1990; Chand & Shukla, 2003, Gladwell, Dowd & Benzaquin, 1995, Maxson, 1983; Morrison-Shetlar & Heinrich, 1999; Morgan, Sibthorp, & Tsethlikai, 2016; Propst & Koesler, 1998; Wittmer, 2001), few papers explicitly conceptualized the defining attributes of the mentor/mentee relationship (Gladwell, Dowd & Benzaquin, 1995; Powell & Sable, 2001; Schaumleffel, 2009; Wittmer, 2001). To further elucidate the conceptualization of the mentor/mentee relationship in EE and leisure contexts, future research directions should include a framework, such as that outlined by Jacobi (1991). Jacobi’s research is particularly relevant to this study because she sought to alleviate the subjectivity of a [mentoring] models’ measurement by a personalized definition of that subject. Jacobi’s lowest common denominators for a mentor/mentee relationship exemplifies a more holistic concept of the term, and therefore, robust model by which to apply that term. For example, a literature review of medical, higher education, and teacher training programs may determine thematic convergences leading to a conceptual model that optimizes learning in EE and leisure contexts. Without such systematic investigation into the conceptualization of the mentor/mentee relationship, the effective characteristics comprising mentoring programs to optimize learning for additional gains in implicit knowledge will remain a challenge. Another future research direction might include a timeline of literature to include greater connections to more primary source literature on which future articles may wish to base their literature reviews of the mentor/mentee relationship. Doing so may add a depth of knowledge previously unknown to many intrigued by these terms. References Ambrosetti, A., & Dekkers, J. (2010). The interconnectedness of the roles of mentors and mentees in pre-service teacher education mentoring relationships. Australian Journal of Teacher Education, 35(6), 42. *Bachert, R. E. (2007). NAAEE virtual mentors: Influencing future environmental educators at Bloomsburg University of Pennsylvania. Applied Environmental Education & Communication, 6(2), 197-197. doi:10.1080/15330150701598288 *Bell, M. (1990). Pathways of emerging practitioners the value of tracing an apprenticeship. Journal of Experiential Education, 13(1), 14-19. doi:10.1177/105382599001300102 Cain, K. D. (1989). A Delphi study of the development, evaluation, and documentation of judgement and decision-making ability in outdoor leadership of adventure education programs. Dissertation Abstracts International, 49(9). *Chand , V. S., & Shukla , S. R. (2003). Biodiversity contests': Indigenously informed and transformed environmental education. Applied Environmental Education & Communication, 2(4), 229-236. doi:10.1080/15330150390256782 *Coakley, J. (2006). The good father: Parental expectations and youth sports. Leisure Studies, 25(2), 153-163. doi:10.1080/02614360500467735 *Colvin, J., & Tobler, N. (2013). Cultural speak: Culturally relevant pedagogy and experiential learning in a public speaking classroom. Journal of Experiential Education, 36(3), 233-246. doi:10.1177/1053825913489104 Divine, A. (2016). Mentoring at NOLS. NOLS Instructor Association. Retrieved from http://nolsinstructorassociation.org/bod/4184711 Feiman-Nemser, S. (1996). Teacher mentoring: A critical review. ERIC Digest. Retrieved from ERIC database (ED397060). Galloway, S. (2002). Theoretical cognitive differences in expert and novice outdoor leader decision making: Implications for training and development. Journal of Adventure Education & Outdoor Learning, 2(1), 19-28. *Gladwell, N., Dowd, D., & Benzaquin, K. (1995). The use of mentoring to enhance the academic experience. SCHOLE: A Journal of Leisure Studies & Recreation Education, 10, 56-65. *Gray, H. J. (2008). " I'm present,'A'please": A case study examining grading issues in a recreation curriculum. Schole: A Journal of Leisure Studies & Recreation Education, 23, 43-61. Jacobi, M. (1991). Mentoring and undergraduate success: A literature review. American Educational Research Association. 61, (4), 505-532. *Karagatzides, J. D., Kozlovic, D. R., De Iuliis, G., Liberda, E. N., General, Z., Liedtke, J., . . . Tsuji, L. J. S. (2011). Youth environmental science outreach in the Mushkegowuk Territory of Subarctic Ontario, Canada. Applied Environmental Education & Communication, 10(4), 201-210. doi:10.1080/1533015X.2011.669684 Little, J. W. (1990). The mentor phenomenon and the social organization of teaching. In C. Cazden (Ed.), Review of Research in Education. Vol. 16 (pp. 297-351). Washington, DC: American Educational Research Association. *Maxson, L. (1983). Mentors. Journal of Experiential Education, 6(1), 7-9. doi:10.1177/105382598300600103 *Morrison-Shetler, A. & Heinrich, K. T. (1999). Mentoring at the edge: A faculty group fosters experiential teaching. Journal of Experiential Education. 22, (1), 5-11. Moher D., Liberati A., Tetzlaff J., Altman D.G., The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(7): e1000097. doi:10.1371/journal.pmed1000097 *Morgan, C., Sibthorp, J., & Tsethlikai, M. (2016). Fostering self-regulation skills in youth: Examining the effects of a mentoring curriculum in a summer recreation program. Leisure Sciences, 38(2), 161-178. doi:10.1080/01490400.2015.1083496 *Norton, C. L., & Watt, T. T. (2014). Exploring the impact of a wilderness-based positive youth development program for urban youth. Journal of Experiential Education, 37(4), 335-350. doi:10.1177/1053825913503113 Outward Bound. (2006). Mentor. In Outward Bound Training Manual. Retrieved from https://www.mountaineers.org/volunteers/leader-resources/shared-branch-resources/gener al-leadership/mentoring/view *Pelchat, C., & Karp, G. G. (2012). Using critical action research to enhance outdoor adventure education instructional practice. Journal of Outdoor Recreation, Education and Leadership, 4, 199-219. *Powell, L., & Sable, J. (2001). Professional preparation of allied health practitioners and special educators using a collaborative, transdisciplinary approach. SCHOLE: A Journal of Leisure Studies & Recreation Education, 16, 33-48. *Propst, D. B., & Koesler, R. A. (1998). Bandura goes outdoors: Role of self‐efficacy in the outdoor leadership development process. Leisure Sciences, 20(4), 319-344. *Schaumleffel, N. A. (2009). Enhanced academic advisement with online learning management systems. SCHOLE: A Journal of Leisure Studies & Recreation Education, 24, 142-148. *Skalko, T., Lee, Y., & Godlenberg, R. (1998). Seeking active collaboration through a comprehensive fieldwork system in therapeutic recreation: A case example. SHCOLE: A Journal of Leisure Studies & Recreation Education, 13, 63-72. Shooter, W., Sibthorp, J., & Paisley, K. (2009). Outdoor leadership skills: A program perspective. Journal of Experiential Education, 32(1), 1-13. *Wheal, J. R. (2000). The agony or the ecstasy? The academy at the crossroads. Journal of Experiential Education, 23(3), 135-142. doi:10.1177/105382590002300304 *Wittmer, C. R. (2001). Leadership and gender-role congruency: A guide for wilderness and outdoor practitioners. Journal of Experiential Education, 24(3), 173-178. doi:10.1177/105382590102400308 *Denotes articles included in systematic review
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This article demonstrates the effectiveness of using traditional family therapy techniques to enhance wilderness therapy, also known as outdoor behavioral healthcare. This article presents the practice of utilizing the narrative family therapy technique of reflecting teams in combination with the experiential family therapy technique of family sculptures. This article discusses the combination of these theoretical models and techniques and introduces a practical approach to the integration of models and theories in an outdoor behavioral healthcare setting.
Article
Wilderness adventure programs have been utilized as an intervention in youth corrections in the United States since the arrival of Outward Bound in the early 1960s. This exploratory study evaluates the effects of a 21-day wilderness adventure program for young offenders called Wilderness Endeavors. The results of the study showed that self-efficacy and hope scores changed significantly and that young offenders who had reported higher levels of hope were less likely to recidivate than those who had reported lower levels. When comparing the treatment group to a control group, no significant differences in recidivism rates, school participation, or employment rates were found. The limitations, challenges, and recommendations for research on wilderness programs for young offenders are also discussed.
Article
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This paper investigates the effectiveness of a Norwegian wilderness therapy programme, Friluftsterapi, which is offered to adolescents within a specialized mental health care setting. This mixed methods study incorporated (1) psychometric pre-, post-, and 12 month follow-up data, (2) executive functioning data, and (3) qualitative data from two rounds of individual participant interviews. The results indicate that group averages remained largely the same between the pre-and post-tests, however that health measures generally improved one year later (Cohen's d effect sizes ± 0.5). Interview data revealed that the processing of the Friluftsterapi experiences takes time and that for many several months are required before the impact is fully internalized and translated into improved daily functioning. In conclusion, the Friluftsterapi experience is perceived as valuable, and it appears to contribute towards improving the mental health of many participants. A refined version of the treatment programme is suggested and briefly presented in the conclusion.
Chapter
Wilderness programs have sought to reduce the risk of problem-oriented teenagers from becoming criminal offenders. Wilderness programs have suffered from a lack of a sound theoretical background, and are subject to limitations, much like many practices in juvenile delinquency. Despite these limitations, an increasing success rate has been apparent in wilderness rehabilitation programs for troubled youth that have successfully aimed to ease the transition for students entering the college lifestyle. These programs have also helped to alleviate interpersonal issues. This entry provides information on the limitations within wilderness programs and the increases in effectiveness for rehabilitation of adolescents that wilderness therapy aims to influence. The entry also outlines increasingly important issues for the future, in order further to evaluate and overcome the shortfalls of wilderness programs.
Article
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'Green care' overwhelmingly takes place in a social context, yet this element can often appear to be marginalised in comparison both to associated health outcomes and the relevance of the natural environment. Whilst the criticality of these latter factors is acknowledged, this chapter focuses upon social aspects and seeks to argue that they, in fact, underpin the benefits that green care can provide. Consideration is initially given to the nature of the relationship between social factors, health and well-being before subsequently outlining available evidence concerning the contribution that the social element makes to green care activities. The specific processes and outcomes that are identified are then discussed in greater depth and are further illustrated with the support of qualitative material provided by care farm stakeholders in the UK. The chapter concludes by suggesting how and why social, environmental and economic elements (and related outcomes) should all be incorporated to allow a truly holistic understanding of associated value to be identified, presented and indeed celebrated.
Chapter
Adolescent mental health is a significant societal concern with 10–20% of adolescents meeting criteria for a diagnosable mental disorder. Adolescent mental health disorders are concerning as they interfere with the accomplishment of normal development and can lead to poor school performance, dropout, strained family and social relationships, involvement with the child welfare and juvenile justice system , and other disruptive behaviors . Adolescents who do not respond to traditional services are often placed in residential treatment centers or other out-of-home treatment programs. Outdoor Behavioral Healthcare (OBH) is a viable treatment option for adolescents who struggle with emotional, behavioral or substance related problems, and one which flexibly permits an integration of the family into the treatment setting. A case study illustrating how techniques from narrative can be used to accomplish this integration is presented in this chapter, offering a view of how narrative family therapy can be used to involve families in the treatment and posttreatment process in an OBH program.
Chapter
Adolescents with significant externalizing or internalizing behaviors that have been ineffectively treated in traditional clinical settings are increasingly finding support via the intentional family separation that occurs in wilderness therapy programs. Although often counterintuitive to family therapists, the space provided when adolescents are separated from their parents can facilitate a decrease in the chronic anxiety within a family system , thereby enabling each family member to increase his or her differentiation level through an intensive therapeutic process. Healthy levels of differentiation are evidenced through balancing intellectual and emotional functioning (on the individual continuum), and autonomy of self and connection with others (on the relational continuum). When one has a lower level of differentiation, one is prone to emotional dysregulation or suppression, as well as emotional fusion or cutoff in relationships. Though very difficult, one can increase one’s basic level of differentiation through sustained therapeutic engagement and decreased family system anxiety . This chapter explores Bowen’s concept of differentiation of self , in a wilderness therapy context, as it relates to intentional family separation for adolescents with clinically acute symptoms and families with entrenched and unhealthy dynamics.
Chapter
The following chapter explores the theoretical basis for involving family to improve clinical outcomes during wilderness therapy (WT) programming. The chapter describes the history of family involvement in WT, provides a discussion of the need for categorization of the different types of family involvement , and highlights Outdoor Behavioral Healthcare (OBH) developments and research. The limitations of the current research are also illustrated to underscore the need for future research and to provide context for the subsequent discussion about programming. To provide a clear understanding of current programming, different family therapy interventions currently being utilized in OBH are described along with a call to further explore the impact of each intervention on individual and family functioning . A portion of the chapter is also dedicated to demonstrating how one OBH program in particular is attempting to correct past weaknesses in family programming. Recommendations for specific research to further the field are made.
Thesis
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Background: Promoting mental health for Indigenous youth in Canada is a well-documented priority. Indigenous approaches to health promotion share similarities with the holistic process in outdoor adventure and experiential education contexts. The purpose of this study was to develop, implement, and evaluate an Outdoor Adventure Leadership Experience (OALE) for Indigenous adolescents from one First Nations community in Northeastern Ontario, Canada. Methods: Principles of community-based participatory research were used to guide this mixed method study that included three phases. Phase 1 involved the development of a culturally relevant OALE intervention. The intervention was available to adolescents, aged 12-18 years, living in Wikwemikong Unceded Indian Reserve. Phase 2 consisted of a quantitative evaluation of the effectiveness of the OALE, based on participant self-report. It focused primarily on assessing resilience using the 14-Item Resilience Scale (RS-14). Using an ethnographic approach, Phase 3 comprised a qualitative evaluation of the ways in which the OALE promoted resilience and well-being. Results: Phase 1 occurred over a period of 10 months (September 2008 to June 2009), and it resulted in the development of an intentionally designed 10-day OALE program. The program was implemented in the summer of 2009 and 2010 with 73 adolescent participants, aged 12-18 years. Results from Phase 2 revealed that there was a 3.40 point increase in mean resilience for the adolescent participants at one month post-OALE compared to one day pre-OALE (n=46, p=.011), but the improvement was not sustained one year later. Phase 3 results revealed that the OALE facilitated the development of resilience and well-being by helping the adolescents connect to Anishinaabe Bimaadziwin, an Ojibway concept that can be translated as the Good iv Life. Connecting involved an external experiential process of connecting with various aspects of creation and an internal reflective process of connecting within to different aspects of self. Conclusion: The OALE appears to be a program that helped the adolescents: (1) become more resilient in the short-term, and (2) become more aware of Anishinaabe Bimaadziwin (the Good Life) by providing opportunities for connecting with creation and self through a variety of experiences and reflections that were unique for each youth.
Chapter
Given a variety of potential treatments and outcomes in ecotherapy and environmental health approaches, and the dynamic nature of health, it is important to carefully consider your choice of research methods in this area. In this chapter, we discuss three research programs that provide excellent role models: Forestry Scotland's “Branching Out” program; the United States and Canada-based Outdoor Behavioral Healthcare Industry Research Council; and the University of Illinois Landscape and Human Health Laboratory. As the program strategies highlight, attention to the basics of research design and selection of practically useful research outcomes will serve prospective researchers well, along with flexibility and willingness to innovate. The chapter also describes the linkages between environmental psychology and human health and well-being, including the empirical basis for ecotherapy and environmental health approaches. Key factors involved in research design in ecotherapy and environmental health include how to operationalize “nature” as a therapeutic mechanism.
Chapter
Families frequently seek wilderness therapy hoping for a miracle when other treatment interventions have proven ineffective, and these families and their adolescent children frequently do experience powerful shifts during wilderness therapy programs. However, these therapeutic gains are not yet internalized as change, and follow-up treatment is necessary. Navigating the aftercare planning process can be confusing, emotionally fraught, and paralyzing for parents when considering the potential risks associated with not maintaining those gains. This chapter describes why most adolescents transition to longer term residential therapeutic schools and programs post-wilderness, and how that environment can actually be the safest and least restrictive. Many considerations for crafting an aftercare plan are detailed in this chapter, as well as how to safely transition an adolescent to an aftercare program. Situations are discussed in which returning home upon discharge might be recommended. Suggestions are offered for wilderness therapists and home providers regarding how to support parents making difficult aftercare decisions. And lastly, the importance of the wilderness therapy intervention is explained, even in the face of subsequent longer term residential treatment.
Article
The purpose of this study was to collect and analyze demographic characteristics and job related difficulties experienced by field instructors in outdoor behavioral healthcare programs which utilized wilderness therapy as well as other treatment modalities. Three state-licensed outdoor behavioral healthcare programs in the United States provided a sample of 129 field instructors who completed the survey. Results confirmed a high turnover rate of instructors and high challenges experienced with non-work related issues, particularly in sustaining romantic personal relationships. Factor analysis identified three constructs related to difficulty levels experienced on the job: a) time and schedule constraint; b) emotional anxiety and stress-related issues; and, c) physical and mental challenges. Results of this study are of value to field instructors and outdoor behavioral healthcare program administrators to better understand the challenges faced by this group of professionals. Recommendations are presented that suggest ways that the physical and mental health of field instructors can be supported.
Article
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Research on parent–child attachment and parental child rearing practices has been pursued independently. The purpose of the present study was to test whether a secure attachment relationship is related to parental monitoring and child efforts to contribute to the monitoring process. This question was examined in a cross-sectional study of third- and sixth-grade children and their parents. Attachment-based measures were used to tap child and parent perceptions of attachment. Monitoring (i.e., parents' awareness of children's whereabouts and activities) was assessed through phone interviews with children and parents. Child contributions to monitoring were assessed with parent and child questionnaires. A more secure attachment was related to closer monitoring and greater cooperation by the child in monitoring situations, especially at sixth grade. The findings illustrate the importance of embedding attachment within a larger child rearing context. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
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Outdoor behavioral healthcare (OBH) is an emerging treatment that utilizes wilderness therapy to help adolescents struggling with behavioral and emotional problems. The approach involves immersion in wilderness or comparable lands, group living with wilderness leaders and peers, and individual and group therapy sessions facilitated by licensed therapists in the field. OBH also offers educational and psychoeducational curriculum all designed to reveal and address problem behaviors, foster personal and social responsibility, and enhance the emotional growth of clients. The extant studies on the effectiveness of OBH and wilderness therapy reveal consistent lack of theoretical basis, methodological shortcomings and results that are difficult to replicate. This publication reports the results of an outcome assessment for adolescent clients who received treatment in seven participating OBH programs that averaged 45 days in length from May 1, 2000 to December 1, 2000. Adolescent client well-being was evaluated utilizing the Youth Outcome Questionnaire (Y-OQ) and the Self Report-Youth Outcome Questionnaire (SR Y-OQ) (Burlingame, Wells, & Lambert, 1995). Complete data sets at admission and discharge were collected for 523 client self-report and 372 parent assessments. Results indicated that at admission clients exhibited presenting symptoms similar to inpatient samples, which were on average significantly reduced at discharge. Follow-up assessments using a random sample of clients found that on average, outcomes had been maintained at 12-months posttreatment.
Article
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We present a treatment program (The Family Wheel) designed to integrate wilderness therapy interventions with family therapy for the treatment of troubled adolescents. The Family Wheel program was conducted in the high desert of southern Idaho. Participation in this four-day program required parents and their adolescent children to engage in an intensive experiential family therapy while camping and trekking in the wilderness. An evaluation of the program revealed positive outcomes for the programs' participants. The theory, research, and pragmatics of conducting such an innovative program are discussed.
Article
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A group of 13 men and women in substance abuse treatment participated in a 3-day residential program experience based on integrated principles from adventure therapy, therapeutic camping, and relapse prevention. The experimental group is compared to a group of 18 men and women who received the usual and customary relapse prevention program. Both groups completed pre- and postintervention questionnaires. There were no differences in drinking-related locus of control, stress, or problem-solving between groups at postinterview, but there were significant improvements in autonomic arousal, frequency of negative thoughts, and alcohol craving. Participants in both groups were interviewed 10 months after the 3-day intervention. Considering individuals who were unreachable as relapsed, the 10-month follow-up relapse rate was 31% for the experimental group and 58% for the comparison group. These results add to the limited body of research supporting outdoor adventure and therapeutic camping experiences integrated with traditional relapse prevention activities as an adjunct to substance abuse treatment.
Article
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The knowledge base and research gaps of the adolescent drug abuse treatment field are discussed. In addition to summarizing several challenges faced by clinicians treating drug-abusing adolescents, traditional and emerging treatment strategies are described. The treatment outcome literature is seen as having several weaknesses, including that most studies are limited to descriptive designs. The author suggests that the most important research priority for the field is to address meaningfully the issue of which treatment approaches work best for which types of adolescent drug abusers.
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The purpose of this meta-analysis is to examine the effects of adventure programs on a diverse array of outcomes such as self concept, locus of control, and leadership. The meta-analysis was based on 1,728 effect sizes drawn from 151 unique samples from 96 studies, and the average effect size at the end of the programs was .34. In a remarkable contrast to most educational research, these short-term or immediate gains were followed by substantial additional gains between the end of the program and follow-up assessments ( ES = .17). The effect sizes varied substantially according the particular program and outcome and improved as the length of the program and the ages of participants increased. Too little is known, however, about why adventure programs work most effectively. Download: http://www.wilderdom.com/pdf/HattieAdvEdMA1997.pdf
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Inpatient care is expensive and should ideally be provided for children and adolescents with the most serious psychiatric disorders. However, only little is known about inpatient treatment, e.g. the factors influencing hospital admission, the content of care in the hospital, the appropriate norms for the duration of inpatient stays, the inpatient arrangements that result in the best outcomes, or connection with necessary aftercare services. There are many methodological problems with existing research. However, it can cautiously be concluded that psychiatric hospitalisation of children and adolescents is often beneficial, particularly if special aspects of treatment are fulfilled (e.g. good therapeutic alliance, treatment with a cognitive-based problem-solving skills training package, or planned discharge) and aftercare services are available. The continuum-of-care model is promising because it provides opportunities to achieve better integration between inpatient interventions and aftercare services.
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Used quasi-experimental design to assess effects of participation in Outward Bound type program on recidivism of juvenile probationers. Findings indicated one-year delinquency reduction effect confined to youth who successfully completed program. Reduction effects were exhibited for both high- and low-rate offenders but were not found at two-year followup. (Author/NB)
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look at methodological features of qualitative data analysis (QDA) to consider how, and how much, and how well, it can be computerized / give an overview of general-purpose packages that can be used in QDA, and some types of special-purpose QDA packages / discuss how they can be used and how well they work / provide some pointers to future software developments / stimulate methodological debate on computational QDA [start] from the research processes involved in relating data and theory in QDA and the different ways [computer] software might support or distort them / describe and critique a series of types of software [multiple text management uses, building conceptual models, sorting categories, attaching key words and codes to text segments, isolating negative or deviant cases, and creating indices] in terms of purposes and design, examining the implications of the method supported by each (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Examined the validity of the conduct disorder hypothesis of adolescent drug involvement on 2,582 drug clinic-referred Ss (aged 11–20 yrs). Based on self-report data from the Personal Experience Inventory (PEI; K. C. Winters & G. A. Henly, 1989), multiple regression analyses were conducted to predict prior twelve months drug use frequency from psychosocial risk variables. It was hypothesized that the Delinquency factor would account for the most variance in drug use compared to 3 competing factors (Psychological Distress, Nonconventional Values, and Family Distress). The analyses provided support for the hypothesis across gender, age and ethnic groups. The Delinquency factor uniquely accounted for about 50%–60% of the variance in drug use severity. Backward deletion regression analysis of individual scales indicated that Peer Chemical Environment and Deviant Behavior (both part of the Delinquency block) and, to a lesser degree, Psychological Disturbance (part of the Psychological Distress block), were consistently the most predictive of drug use. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Discusses the proceedings of 2 medical conferences on aftercare in chemical dependence treatment. Participants represented 16 VA medical centers from the Pacific Northwest and Southwest. The conferences were held as a mechanism to enhance the quality and long-term continuity of care essential to the treatment of chronic and relapsing conditions, specifically, the care of alcohol abusers. Most representatives conceptualized aftercare as the last phase of a long-term treatment course that may include several primary care modalities such as outreach and emergency services. It became clear to the representatives that clients do not always progress uneventfully through the entire series of primary care modalities and that they are likely to exit the treatment system at any transitional point and from within a component as well. (2 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
This study examined the wilderness therapy process in order to better understand how the intervention effects change in problem behavior of adolescent clients. A review of literature reveals multiple definitions of wilderness therapy, numerous studies evaluating treatment outcomes, and a need to focus research on how the process facilitates change. This study investigated four established wilderness therapy programs using a multisite case study approach and a variety of qualitative data collection methods to carefully examine the wilderness therapy experience of 12 clients in four wilderness therapy programs. Findings indicate that physical exercise and hiking, primitive wilderness living, peer feedback facilitated by group counseling sessions, and the therapeutic relationship established with wilderness guides and therapists were key change agents for adolescents. These factors helped adolescents come to terms with their behavior and facilitated a desire to want to change for the better.
Book
Most writing on sociological method has been concerned with how accurate facts can be obtained and how theory can thereby be more rigorously tested. In The Discovery of Grounded Theory, Barney Glaser and Anselm Strauss address the equally Important enterprise of how the discovery of theory from data--systematically obtained and analyzed in social research--can be furthered. The discovery of theory from data--grounded theory--is a major task confronting sociology, for such a theory fits empirical situations, and is understandable to sociologists and laymen alike. Most important, it provides relevant predictions, explanations, interpretations, and applications. In Part I of the book, "Generation Theory by Comparative Analysis," the authors present a strategy whereby sociologists can facilitate the discovery of grounded theory, both substantive and formal. This strategy involves the systematic choice and study of several comparison groups. In Part II, The Flexible Use of Data," the generation of theory from qualitative, especially documentary, and quantitative data Is considered. In Part III, "Implications of Grounded Theory," Glaser and Strauss examine the credibility of grounded theory. The Discovery of Grounded Theory is directed toward improving social scientists' capacity for generating theory that will be relevant to their research. While aimed primarily at sociologists, it will be useful to anyone Interested In studying social phenomena--political, educational, economic, industrial-- especially If their studies are based on qualitative data.
Article
Adventure programs utilize the outdoors and/or activities to accomplish goals that are recreational, educational, enrichment or preventive oriented, or therapeutic. These programs encourage active manipulation of surroundings and the utilization of pro-active survival skills. In the growing field of Adventure Programming (and within the more specific field of Adventure Therapy), there exists a need to link valuable program characteristics to specific outcomes. Locus of control has been theorized to be a moderator of change in adventure programs, however past research has yielded inconsistent and contradicting results. An attempt was made to replicate the effect size of 0.30 generated within the comprehensive meta-analyses of both D. R. Cason (1993) and J. Hattie, H. W. Harsh, J. T. Neill, and G. E. Richards (1997). A slightly higher effect size of 0.38 was computed, substantiating evidence that subjects across studies became significantly more internal as a result of participation. Investigation of specific outcomes yielded two possible variables as moderators of locus of control effect size: program goal and daily duration.
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Obra en que se presentan ejemplos de casos de estudio ya completados en diversas áreas de aplicación (desde la educación hasta la administración empresarial del cambio), con la finalidad de mostrar la utilización de las técnicas y principios de esta metodología de investigación social.
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This study, guided in part by G. A. Marlatt and J. R. Gordon's (1985) abstinence violation effect (AVE) model, examined whether variability in cognitive and emotional reactions to binges accounts for recurrence of binge eating. Attributional, cognitive, and affective reactions to two successive binges, as well as the latencies between each binge and a subsequent binge, were evaluated through a series of structured phone interviews with 50 nonpurging normal-weight female bingers. Reported mood after binging was unrelated to binge latency. However, when Ss made more intense internal, global, and uncontrollable causal attributions for a binge, a subsequent binge followed significantly sooner. Within-subject variations in AVEs across binges prospectively predicted within-subject variations in the speed with which another binge followed. Analyses suggested that cognitive states (e.g., AVE and guilt) evoked by particular events were better predictors of how quickly binging repeats than were stable differences in attributional style.
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Adherence to aftercare therapy in substance abuse treatment is associated with improved outcomes. Although previous research has established that adherence contracts and orientation to aftercare are an effective method of increasing aftercare attendance, participation levels are often low. We examined whether feedback and prompts are an effective means of further increasing adherence to substance abuse aftercare group therapy beyond that found when orientation and adherence contracts are completed. We randomly assigned 41 substance dependent individuals completing inpatient or intensive outpatient treatment to receive either attendance feedback and prompts to attend aftercare, or no feedback and no prompts. participants who received the feedback and prompts were more likely to begin aftercare, and to attended more weekly aftercare groups, and they were less likely to be readmitted to the hospital. The clinical utility of prompts and feedback are discussed.
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To identify underlying patterns in the alliance literature, an empirical review of the many existing studies that relate alliance to outcome was conducted. After an exhaustive literature review, the data from 79 studies (58 published, 21 unpublished) were aggregated using meta-analytic procedures. The results of the meta-analysis indicate that the overall relation of therapeutic alliance with outcome is moderate, but consistent, regardless of many of the variables that have been posited to influence this relationship. For patient, therapist, and observer ratings, the various alliance scales have adequate reliability. Across most alliance scales, there seems to be no difference in the ability of raters to predict outcome. Moreover, the relation of alliance and outcome does not appear to be influenced by other moderator variables, such as the type of outcome measure used in the study, the type of outcome rater, the time of alliance assessment, the type of alliance rater, the type of treatment provided, or the publication status of the study.
Article
Inpatient care is expensive and should ideally be provided for children and adolescents with the most serious psychiatric disorders. However, only little is known about inpatient treatment, e.g. the factors influencing hospital admission, the content of care in the hospital, the appropriate norms for the duration of inpatient stays, the inpatient arrangements that result in the best outcomes, or connection with necessary aftercare services. There are many methodological problems with existing research. However, it can cautiously be concluded that psychiatric hospitalisation of children and adolescents is often beneficial, particularly if special aspects of treatment are fulfilled (e.g. good therapeutic alliance, treatment with a cognitive-based problem-solving skills training package, or planned discharge) and aftercare services are available. The continuum-of-care model is promising because it provides opportunities to achieve better integration between inpatient interventions and aftercare services.
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