by Gail Curran, MS, MBA, of Optimal Edu Options
Therapeutic wilderness or outdoor behavioral health is the sometimes controversial and
often misunderstood treatment option for children, adolescents, and young adults
whose emotional and behavioral struggles cause significant disruption to their well-
being and ability to function. For the layperson not familiar with private treatment options
outside of traditional insurance in-network therapeutic interventions, think of wilderness
as like Outward Bound, but with clinically sophisticated therapies.
Within this treatment option, there are research-informed best practices and highly
effective treatments. As a professional independent educational consultant, my direct
experience comes from recommending wilderness therapy to the right person and
seeing firsthand its transformational power.
Emotionally wounded kids who are overwhelmed with anxiety, depression, technology,
substance use addictions, and other issues aren’t equipped to face environmental
demands such as COVID and isolation. These children often have yet to develop the
resilience to withstand these distresses in life or our fast-paced culture where success is
measured by external markers of achievement and prestige. The good news for a lot of
our distressed kids is that wilderness works. It’s an excellent place to build confidence
and resilience, the prerequisites to life’s foundational skills – to be well-adjusted and
independent in adulthood.
There are some poor programs out there claiming to be therapeutic, but they are not up
to the standards needed for quality intervention. They are less expensive and claim to
do what the more costly and accredited programs actually accomplish. But there are
dozens of highly effective wilderness programs in the United States. Wilderness
programs, also called Outdoor Behavioral Health, is the prescriptive use of wilderness
experiences by licensed mental health professionals to meet students’ therapeutic
Wilderness programs are often used as an intervention to disrupt negative patterns
established in a young person’s life. Young people attend wilderness programs for a
variety of emotional, behavioral, and addictive behaviors. Being in nature for 60 to 90
days helps disrupt the negative patterns that have contributed to adolescents’ or young
adults’ inability to engage in age-appropriate development. Often, parents are aware
that their child is not making age-appropriate progress toward adulthood and the goal of
achieving independence. This process can be overwhelming for families.
In General, Outdoor Behavioral Health Care Programs Consist Of:
- Extended backcountry and wilderness living experiences long enough to allow for
clinical assessment, establishing treatment goals, and a suitable course of treatment not
to exceed the experience’s productive impact.
- Active and direct use of clients’ participation and responsibility toward their therapeutic
- Continuous group living and regular formal group therapy sessions to foster teamwork and social interactions.
- Individual therapy sessions supported by the inclusion of family therapy.
- Adventure experiences utilized to enhance treatment by fostering the development of
stress that is beneficial, i.e., the positive and appropriate use of stress as a valuable
element of the experience.
- The use of nature as a metaphor within the therapeutic process.
- A strong ethic of care and support throughout the therapeutic experience.
The Proof Is In The Outcomes:
Some of the most recent and increasingly prolific research on wilderness may help
professionals effectively reassure parents that these treatment programs are safe, that
they work, and they are worth the cost. The Outdoor Behavioral Healthcare Council has
implemented industry standards to assure quality care is being provided at OBHC
Outdoor Behavioral Health Center scientists, led by Dr. Michael Gass with the University
of New Hampshire, are researching the effectiveness of outdoor behavioral healthcare
programs in North America. These programs are run by licensed mental health
professionals and include wilderness experiences such as hiking, climbing, and more.
Recently, UNH received $2.7 million in grants for the research. They are leading the
charge to answer questions of safety, efficacy, and value by looking at incidents of
injuries, illness, therapeutic holds, and runaways. They also are studying the
longitudinal outcomes, the impact on family functioning, the value-added of adventure
experience to therapy, and whether psychosocial maturity occurs, among other topics.
The findings are so compelling that insurance companies are starting to take notice.
There’s nothing more energizing that the emerging mass of validated studies to help
mainstream a treatment option that previously has only been available those who can
Not All Wilderness Programs Are The Same:
There are different models for outdoor programs, including Nomadic, Adventure,
Basecamp, Hybrid, and everything in between. Wilderness programs are located across
the United States and beyond. It is important to assess which model is the best option
when working with families to match their needs and wants. No family is the same, and
every child is different.
Learning self-reliance, collaboration, and teamwork comes naturally for many children
as they navigate the intricacies of adolescence or adulthood through sports, school
involvement, and other social interactions. But for some teens and tweens, the rocky
path of adolescence is strewn with boulders. That’s when alternatives to traditional
schools can be beneficial.
Wilderness therapy invites students to participate in interventions and challenges
specific to outdoor behavioral healthcare. It is designed to help students build skills
related to self-confidence, assertive communication, interpersonal relationships, and
coping skill development. It also helps students identify patterns that create barriers to
developing these skills.
Wilderness therapy is particularly popular for teaching children and young adults self-
reliance and a newfound appreciation for responsibility and natural consequences. A
critical aspect of a wilderness intervention is removal from the environment or distractions that allow the continuation of maladaptive or avoidant patterns.
As students engage in emotional, cognitive, or behavioral patterns they utilized at home, they do not have the typical environment or people around to blame. They are confronted with the realization
that their style of thinking or acting often contributes to their difficulties. It allows them to
look deeper into their issues while developing new skills and opening themselves to
more trusting relationships.
Students participate in small group living within a “communication-rich” therapeutic
milieu. Together with their group, students participate daily in therapeutic group,
mindfulness exercises, and camp chores such as setting up or taking down camp,
cooking meals, and caring for group equipment. Students also engage in daily physical
exercise, including backpacking, yoga, and games. Another skill or intervention may
include learning to make a primitive fire using a bow-drill method. This skill requires
technique development and practice along with skills such as persistence, frustration
tolerance, and resiliency.
They learn the “I feel“ statement that allows students to practice identifying feelings, the
beliefs associated with attitudes and skills to better tolerate and regulate intense
emotions. Reflective listening and feedback are also practiced. These activities aid in
developing character traits such as self-control, empathy, persistence, resilience, and
citizenship. Students may learn and practice Dialectical Behavioral Therapy to develop
skills focused on mindfulness, emotional regulation, distress tolerance, and
interpersonal effectiveness. Other models of therapy may include EMDR, Brainspotting, and others.
The general program structure positively impacts many of the treatment areas and
therapists and staff use daily challenges to represent struggles that a student may have
had in their home life such as linking assignments to school, boundaries in the group as
boundaries in the family, and peer and mentor relationships as representing other
Nomadic programs give participants space to work through feelings and thoughts as
they focus on meeting personal and group challenges. Youth are usually responsible for
maintaining their gear as well as setting up and breaking down camp. The group moves
often from location to location to keep everyone engaged in the process. Therapists meet with children in the field and work with them to develop healthy coping mechanisms.
Base Camp Program:
Unlike nomadic programs that immerse participants in wilderness 24/7 for 10 to 12
weeks, in base camp programs, youth return weekly to a safe, reliable space to shower,
meet with a therapist, and replenish their food supplies. The time at base camp
frequently offers a chance to visit with parents via conference call or virtual and
Integrated programs combine the best elements of nomadic and base camp strategies
with more traditional therapy models. This approach often uses wilderness immersion at
the beginning of a longer process, assessing your child’s needs and tailoring their time
outdoors accordingly. An integrated program might be the best option for participants
who need some time to ease into their treatment or those who will not benefit from a
longer stay in nature.
Wilderness, however, is still no silver bullet or panacea. All wilderness programs do not
offer the same level of quality or effectively serve the same demographics – that’s why
seeking the advice of professionals who know these programs is so critical and
worthwhile for parents. For the right young person at the right time in their struggles,
with the right program and therapist, it is a viable and often superior alternative to
traditional treatment and the right initial step on the road back to emotional and
Growing up in today’s world isn’t easy – and neither is parenting young people.
Sometimes the best option is to allow professionals to step in and provide specialized
care to struggling children, teens, and young adults. Optimal Edu Options can help you
navigate the forest of therapeutic options with our team of experts who specialize in
educational and therapeutic placements.
What we can help with at Optimal Edu Options is reviewing the different programs and
helping you and your family choose a wilderness program that best suits your child’s needs. Remember, you aren’t alone. Our team can help – reach out to us today to find
the best support possible for your family.