The Use of Wilderness Therapy in the Addiction Treatment Process

A therapist’s office can be a healing space. Here, surrounded by books, magazines, and richly colored walls, people can discuss the issues that have held them back in the past, and with the help of the therapist, people can use these individual, indoor sessions to plan for the future.

But there is another, completely different, way to heal. It is called wilderness therapy, and it could be a key part of the therapeutic process for people dealing with entrenched, longstanding mental health issues.

Unlike other forms of therapy, which were developed long ago and have been codified with years of research, wilderness therapy is a relatively new field that has been created somewhat spontaneously. That means there is no real consensus of what the therapy entails.

For example, in a study of the field published in 2001 in The Journal of Experiential Education, the authors attempted to come up with a definitive definition by examining four published studies on the issue. Many of these studies had conflicting definitions and mandates for the therapy.

That confusion has not been entirely eradicated in the years that have followed. However, experts are a little closer to defining what the therapy is and what it is not, based on the successes they have seen and the in-depth programs they have developed.

What Is Wilderness Therapy?

patients walking over a bridge during a hike for wilderness therapyIn general, experts agree that wilderness therapy programs involve introducing a small group of troubled people to an experience in the outdoors. The group is led by a trained professional who can provide guidance on basic outdoor survival and therapeutic growth. This professional ensures that the group stays safe while outdoors, and this professional works to ensure that each participant comes away from the experience with insights about both the past and the future.


rope course activity in wilderness therapyHow Does It Work?

The USDA Forest Service suggests that there are two types of wilderness therapy programs. The first type, known as an expedition program, involves staying in the wilderness with no breaks until the program is complete. The second type, known as a structured base camp program, involves daily excursions with a return to the same place each night.

Some programs are long, and others are short. All of them involve spending time in the outdoors, but the activities the team might encounter can vary. Those activities include:

  • Hiking
  • Camping (seasonal)
  • Building fires
  • Rock climbing
  • Canoeing
  • Games
  • Cooking
  • Searching for edible food
  • Swimming

patients camping in a tent  for wilderness therapyIn one program highlighted by ABC News, the participants start the day at 7 a.m., and they spend the rest of the day hiking in single file. They are expected to carry their own supplies and keep pace with the group. In the evenings, the group stops to set up camp, and all the participants sit down for group therapy. At some point, the participants also have a solo expedition in the wilderness.


patient sitting on luggage while camping during wilderness therapyThis is just a rough outline of one program, meaning that others can be quite different. People who run wilderness therapy programs often discuss the meaning that participants can glean from the simple acts they perform while they are out in the wilderness.

Camping is a wonderful activity that encompasses many teachable moments. Participants are taught (by experienced therapists) how to choose a great site that provides shelter and access to firewood and water. They’re also taught how to set up their tents for the night,” he says. “They are also taught fire craft, cooking, water purification, and basic survival skills in the backcountry. These are all transferable skills that build confidence, awareness, and self-sustainability.

W. Troy Young, M.Ed., M.A., N.C.C., clinical/wilderness therapist at The Oxford Center

A camping experience done in wilderness therapy is very different than a standard camping experience a person might have alone. Young says,

The difference really is that there is a method to the madness, and participants are made aware through immediate feedback and encouragement.

In wilderness therapy, the therapist and the wilderness work together to create a learning environment in which participants are faced with challenges both inside and out.

… And, they are given the opportunity and encouragement to overcome issues or barriers that have hindered them in the past.

How Does It Help?

A major benefit is self-awareness that comes from being confronted with challenges outside of one’s comfort zone and learning how to face them. To engage and do battle regardless of the outcome is powerful.

male patient walking a log on a hike for wilderness therapyLife is full of challenges, both large and small. There are jobs to hold down, bills to pay, neighbors to deal with, and children to raise. Health problems appear, money is tight, and losses are right around the corner. In order to handle these challenges, people need what therapists call self-efficacy.

A person with self-efficacy has the inner sense that he or she can handle difficult situations when they appear. This is a person who has confidence, as the person has handled problems effectively in the past. This is knowledge based on experience.

People who do not have self-efficacy and self-esteem can experience deep mental health issues. For example, in a study of 100 people, published in Schizophrenia Research, researchers found a link between low self-esteem and a relapse to psychosis. These people did not trust their ability to handle life’s challenges, and that made their schizophrenia symptoms worse.

When asked how the therapy helps people in need, Young says this:

wilderness therapy helps teens with low self esteemSimilarly, in a study of teenagers published in the journal Developmental Psychology, researchers found that teens with low self-esteem were more likely to deal with mental and physical health problems, low earning potential, and higher levels of criminal behavior as adults, when compared to teens with high self-esteem. Clearly, a low opinion of the self drives people to make poor choices when they reach adulthood.

Wilderness therapy is designed to provide participants with a challenge, in an environment in which they are likely to succeed. Those who have lived all of their lives in a protected and urban environment, and then thrust into the wilderness, are likely to feel overwhelmed and out of their element. These people might not think they could build a fire, set up a camp, or find food. The therapist helps, and makes the learning experience and lessons clear, so participants find that they really can do things that seem unachievable. They succeed. And with the help of the leader, these people can learn to apply that lesson to other areas of life. The therapist can make individual lessons of the wilderness universal, so it can apply to non-wilderness environments too.

In regards to how Wilderness therapy helps, Young says,

I’ve seen clients overcome high levels of fear and anxiety. They have developed confidence through facing their fears and overcoming their perceptions and emotions. I’ve also been blessed with the opportunity to witness people who said they never could do it, actually do it. Wilderness therapy is a powerful, fast, and effective modality for change and growth.

teens less depressed after taking part in wilderness therapyIt can also provide an experience that might be hard to replicate in another setting. For example, on the surface, wilderness therapy might seem like a quest or a game. People set out on an adventure and overcome a set of challenges. That might seem like a video game. Some might believe they could get the same benefits from playing a game online.

The literature does not bear out this theory. For example, in a study in the journal Cyberpsychology, Behavior, and Social Networking,researchers found that people who spent a great deal of time on the Internet have low self-esteem scores. They spend time online, but they do not walk away from the activity feeling better.

Wilderness therapy is different. A clinical expert supervises the tasks, and the lessons are made explicit and clear. This is the sort of work people can truly benefit from, in a way they might not benefit from other therapy or recreational activities.

In a formal study of the efficacy of wilderness therapy, published by a researcher at Loyola University Chicago, researchers found that 70 percent of teens going through wilderness therapy were less depressed when the therapy was over. Young suggests that similar benefits could be seen in adults, as this form of therapy is appropriate for people of all ages.

Key Considerations

Since there is no formal definition of what wilderness therapy is and how it should work, people interested in this form of healing will need to do some research on the providers they are considering. They should ask about:

  • The length of the program
  • The prescreening and tailoring process
  • The clinical expertise of the team leaders
  • The environment in which the therapy will take place
  • The size of the group
  • How groups are put together

Each facility is likely to answer these questions a little differently, but some red flags may appear. For example, programs that cannot provide an experienced team leader or who do not hold prescreening sessions may be hosting a one-size-fits-all camping program that might be fun but not therapeutic. Programs committed to real healing will have safeguards and screenings in place to ensure that participants truly learn.

Young also suggests meeting with the team leader in person, in order to assess that person’s innate qualities.

In my opinion, the greatest quality in a provider is the heart of a teacher and the compassion of a good parent. The hard skills of programming and facilitating experiences should be evident, but the soft skills of a caring and patient teacher are a must.

These may be qualities families can only assess with a meeting.

Safety issues are also important to consider, Young says. All activities held outside come with some level of risk, both real and perceived, and the facility should have plans in place to deal with those concerns. However, families should remember that risk is part of the therapy too.

The weather and the nature of Nature are always front and center. Dealing with them is therapeutic and enlightening. Activities are programmed to eliminate as much risk as possible, although they may carry a high level of perceived risk…The greatest risk is facing oneself and being courageous enough to look deep inside and push forward.

family happy together after couple takes part in recovery treatmentFamilies should also be prepared to discuss issues of cost. The American Psychological Association points out that programs can cost $20,000-$30,000 for two months, and those costs may not be covered by insurance programs. The therapy might be very beneficial, but the cost might put the program out of reach of some families. That is something to discuss well before therapy begins. Many facilities offer payment plans to make the cost of such care more feasible for clients.

Making a Choice

“Wilderness therapy is great for all ages. The courses and activities can be modified to meet the issues of all stages of life…I’ve seen significant benefits and change in people who have graciously allowed me to guide them through the process of self-discovery and personal growth.”

Families dealing with deep challenges, and who want to tackle those issues in a new way, might benefit from a program just like this. For them, getting outside of the comforts of a therapist’s office could be the best way to find a real and lasting path to healing.

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