This study reports the results of a five-year follow-up survey of private-pay outdoor behavioral healthcare (OBH) programs operating in the United States and Canada. A total of 65 of 102 programs identified as meeting certain characteristics responded to the survey and identified themselves as an OBH program that utilizes a clinical treatment model that primarily uses wilderness expeditions. The goal of the study was to determine industry trends by comparing the results of this study to results generated in a 2001 survey of OBH programs. An additional goal of the study was to discuss the findings in the context of recent reports on OBH and related programs concerning program management and practice. Key findings indicate that the number of OBH programs operating appears to have increased since 2001, and that the clear majority of these programs are state-licensed and half are accredited. Family involvement in programming has decreased, as has the number of families receiving co-pay to help alleviate the costs of treatment. Field instructor training and qualifications, supervision, and oversight of daily treatment and program operation, and drug detoxification practices at admission are all issues that warrant further investigation. A conclusion is made that care should be taken by policy makers and others when making broad generalizations that implicate all OBH treatment programs, when it appears that most programs are licensed, have licensed clinicians on staff, and adhere to best practices in treatment as identified by a variety of agency and association standards.
BermanD.Davis-BermanJ. (2007). The promise of wilderness therapy: Reflecting on the past, projecting into the future. New Zealand Journal of Outdoor Education, 2(2), 24–42.
4.
BurnsB. J.CostelloE. J.AngoldA.TweedD.StanglD.FarmerE. M. (1995). Children's mental health service use across service sectors. Health Affairs, 14, 147–159.
5.
Clark. (2003). The effects of wilderness therapy on the perceived psychosocial stressors, defense styles, dysfunctional personality patterns, clinical syndromes, and maladaptive behaviors of troubled adolescents. Unpublished Dissertation, George Fox UniversityNewburg, OR.
Davis-BermanJ.BermanD. (2008). The promise of wilderness therapy. Boulder, CO: Association for Experiential Education.
8.
Davis-BermanJ.BermanD. S. (1994a). Wilderness therapy: Foundations, theory and research. Dubuque, IO: Kendall/Hunt.
9.
Davis-BermanJ.BermanD. S. (1994b). Therapeutic wilderness programs: A national survey. The Journal of Experiential Education, 17(2), 49.
10.
Davis-BermanJ.BermanD. S. (1993). Therapeutic wilderness programs: Issues of professionalization in an emerging field. Journal of Contemporary Psychotherapy, 23(2), 127–134.
11.
DillmanD. A. (2000). Mail and Internet surveys—The tailored design method. New York: John Wiley & Sons.
12.
EdgmonK. J. (2002). Therapeutic benefits of a wilderness therapy program and a therapeutic community program for troubled adolescents. Dissertation Abstracts International: Section B: The Sciences & Engineering, 62(10), 4781.
13.
JohnsonL. D.O'MalleyP. M.BachmanJ. G.SchulenburgJ. E. (2006). Monitoring the future national results on adolescent drug use: Overview of key findings 2005. NIH Publication No. 06-5882): Bethesda, MD: National Institute on Drug Abuse.
HaganJ. D. (2003). An alternative therapy for the behaviorally challenged youth: The efficacy of wilderness therapy programs. Dissertation Abstracts International: Section B: The Sciences & Engineering, 63(7), 3473.
16.
KutzJ. D.O'ConnellA. (2007). Concerns regarding abuse and death in certain programs for troubled youth. U.S. Government Accounting Office, # GAO-08-146T. Report and Testimony to the Committee on Education and Labor, House of Representatives, October 10, 2007.
17.
LambieI.HicklingL.SeymourF.SimmondsL.RobsonM.HoulahanC. (2000). Using wilderness therapy in treating adolescent sexual offenders. Journal of Sexual Aggression, 5(2), 99–117.
18.
LatessaE. (2004). The challenge of change: Correctional programs and evidence-based practices. Criminology and Public Policy, 3(4), 547–560.
19.
LeafP. J.AlegriaM. C. P.GoodmanS. H.HorwitzS. M.HovenC. W.NarrowW. E. (1996). Mental health service use in the community and schools: Results from the four-community MECA study (methods for the epidemiology of child and adolescent mental disorders study). Journal of the American Academy of Child and Adolescent Psychiatry, 35, 889–897.
20.
MarchandG.RussellK. C.CrossR. (in press). An empirical examination of wilderness therapy field instructor job satisfaction. Journal of Experiential Education.
21.
McManusM. A. (2003). Is the health care system working for adolescents?Washington, DC, Maternal and Child Health Policy Research Center, October 2003. Retrieved November 30, 2007 from http://www.mchpolicy.org/publications/adolescents.html.
22.
McNamaraD. N. (2002). Adventure-based programming: Analysis of therapeutic benefits with children of abuse and neglect. Dissertation Abstracts International Section A: Humanities & Social Sciences, 62(7), 2353.
23.
MillerJ.SchneiderC. (2005). Death at youth camp ruled homicide. Atlanta Journal Constitution, June 2, 2005.
24.
MorralA.McCaffreyD.RidgewayG. (2004). Effectiveness of community-based treatment for substance-abusing adolescents: 12-month outcomes of youths entering Phoenix Academy or alternate probation dispositions. Psychology of Addictive Behaviors, 18(3), 257–268.
25.
National Outdoor Leadership School (NOLS). Wilderness Risk Managers Conference. Retrieved January 29, 2008, from http://www.nols.edu/wrmc/.
26.
RussellK. C. (2008). Adolescence substance use treatment: Service delivery, research on effectiveness, and emerging treatment alternatives. In RothJ.FinchA. (Eds.), Approaches to substance abuse and addiction in educational communities. New York: Haworth Press.
27.
RussellK. C. (2006a). Depressive symptom and substance use frequency outcome in outdoor behavioral healthcare. Technical Report 1, December 2006, Outdoor Behavioral Healthcare Research Cooperative, College of Education and Human Development, University of MinnesotaMinneapolis. 62 pp.
28.
RussellK. C. (2006b). Brat camps, boot camps, or….? Exploring wilderness therapy program theory. Journal of Adventure Education and Outdoor Learning, 6(1), 51–67.
29.
RussellK. C. (2005). Two years later: A qualitative assessment of youth-well-being and the role of aftercare in outdoor behavioral healthcare treatment. Child and Youth Care Forum, 34(3), 209–239.
30.
RussellK. C. (2003a). A nationwide survey of outdoor behavioral healthcare programs for adolescents with problem behaviors. Journal of Experiential Education, 25(3), 322–331.
31.
RussellK. C. (2003b). Assessing treatment outcomes in outdoor behavioral healthcare using the Youth Outcome Questionnaire. Child and Youth Care Forum., 32(6), 355–381.
32.
ShuffeltJ. L.CozzaJ. J. (2006). Youth with mental health disorders in the juvenile justice system: Results from a multi-state prevalence study. Research and Program Brief, June 2006. Delamar, NY: National Center for Mental Health and Juvenile Justice.
33.
Substance Abuse and Mental Health Services Administration (2006). Results from the 2005 national survey on drug use and health: National findings. (No. DHS Publication No. SMA 06-4194). Rockville, MD.
WellsL. (2006) Prescription medication and street drug considerations in Outdoor Behavioral Healthcare Programs. Journal of Therapeutic Schools and Programs, 1(2), 61–74.
36.
WhiteD. D.CaulkinsM.RussellK. C. (2006). The role of physical exercise in wilderness therapy for troubled adolescent women. Journal of Experiential Education, 29(1), 18–37.
