Wilderness Therapy for Youth-at-Risk - Helping troubled teenagers
Wilderness Therapy is an emerging field that utilizes aspects of the outdoors to promote change in adolescents with behavioral problems. Although this is not the only group that can benefit from the outdoors, wilderness therapy is most often used with youth-at-risk (Davis-Berman & Berman, 1993; Tippet, 1993; Miles, 1987). Staff in the field come from different backgrounds and schools of thought. Thus far, there is not a degree that prepares individuals to work specifically in this field and more and more, outdoor leaders find themselves in the position of a therapist dealing with emotionally and behaviorally troubled teenagers (Berman & Davis-Berman, 1993).
Recently, researchers have started to look at the competencies and skills required of wilderness therapists, since these individuals work with high-risk populations and are confronted with high-risk situations and challenges (Nadler, 1993; Gray & Yerkes, 1995). The purpose of this research update paper is to identify those skills and competencies that have been deemed important by researchers and wilderness therapy professionals who work with youth-at-risk.
Wilderness programs stem from Outward Bound programs formed by German educator Kurt Hahn during World War II (Kimball & Bacon, 1993). Hahn's original purpose was to prepare British seamen to survive the rigors of war. After the war, Outward Bound came to the United States, where it became very popular and expanded rapidly. It was soon discovered that such programs greatly benefitted youths with various kinds of emotional, psychological, and behavioral problems (Davis-Berman & Berman, 1994). According to Kimball and Bacon (1993), Outward Bound's curriculum and philosophy are based on the assumption that people learn best while doing. The program is thus experience-centered, and usually takes place in the wilderness as opposed to indoor centers and hospitals. The main philosophy is that wilderness provides the best learning environment, because it is unfamiliar to the students, and total immersion in the wilderness milieu is necessary to achieve maximum impact.
At this point it is important to point out that the origins of the therapeutic component stems from early `tent therapy' programs. Davis-Berman and Berman (1994) explain that these programs originated in hospitals at the beginning of the century with tuberculosis patients. It became necessary to separate sick patients from the healthier ones, by placing them in tents set up outside on hospital grounds. The improvement in their health was detected immediately, both physically and psychologically. The same was tried with other patients with similar results. The therapeutic benefits of having patients spend time in the outdoors was noted, and today, is the basis of wilderness therapy programs for youth-at-risk (Davis-Berman & Berman, 1994).
The need for outdoor programs for youths became more apparent after World War II. Kimball and Bacon (1993) elaborate on this point in more detail. One hundred years ago youths were important to the economic survival of the family unit. They worked up to 10 hours a day, and thus contributed a significant role in the family, but that all changed with urbanization. In the urban setting children were not required to ensure the everyday functioning of the family, and thus spent most of their time in passive situations. School became compulsory and took most of their day. However, school taught passive learning, since information flowed one way: from the teacher to the student. Today teens "... find themselves at the onset of puberty facing a vast array of challenges and opportunities; however, they are frequently deficient in many of the basic life skills, such as self-confidence, self-discipline, judgment, and responsibility, which are necessary to prosocially manipulate the world around them" (p.17).
Teenagers today face many problems. Our western culture lacks significant roles for teens, and they often find themselves confused and lost in this world, trying to fit somewhere between adulthood and childhood (Kimball & Bacon, 1993). To add to the confusion, television has become a major influencing factor, and "children as watchers of TV may become hyperactive, have a reduced attention span, be weak in verbal ability, and perform poorly in reading. Their values, too, may become corrupted because they see so much violence and immorality" (LaRossa & Mulligan-LaRossa, 1981, P.57).
Wilderness therapy approaches adolescents as individuals who have not had the opportunity to develop, to be challenged, and to develop pro-social values (Gass, 1993). Wilderness programs are designed to attack helplessness, passivity, and feelings of low worth (Miles, 1993; Kimball & Bacon, 1993). Their purpose is to leave the student with feelings of empowerment, perseverance, and confidence. Wilderness trips with youth at risk last anywhere from one day to a year. Groups consist of 6-14 individuals and the number of wilderness leaders/therapists varies between 3-5.
Required to Change Life Patterns
Wilderness therapists play a significant role in helping students identify and replace self-destructive behaviors with productive ones (Davis-Berman & Berman, 1994; Gass, 1993). This is not a small task. In their book, "Wilderness Therapy: Foundations, Theory & Research," Davis-Berman and Berman (1994) explain that wilderness therapists are required to change life patterns and confront some of the issues that have been unresolved up to the point when the youths begin the program. Furthermore, competencies needed to work in the field of wilderness therapy with youth-at-risk require knowledge of psychotherapy (Davis-Berman & Berman, 1994; Nadler, 1993), and thus differ from competencies needed to work with mainstream populations. Ultimately, it is the wilderness therapist who will facilitate and invest him/herself in the growth of the students, and in the transformations that will occur. It is important that wilderness therapists be equipped with the proper skills and competencies in order to work with this type of population. Many times these programs are the last chance before the individual is incarcerated. Therefore the importance of therapists possessing full range of skills and competencies to work with these adolescents is absolutely vital (Davis-Berman & Berman, 1994).
The remainder of this paper will look at the research done on skills and competencies needed of outdoor leaders in the field of wilderness therapy who work with youth-at-risk, and summarize its findings. The paper will link some of the previous research to the current research, look at the implications of research for the field of wilderness therapy and provide recommendations to professionals in the field, as well as provide a summary of the findings and future areas that need more research.
Most previous research examines the competencies needed to work in the field of "outdoor recreation" as opposed to wilderness therapy with youth-at-risk (Loewen, 1990-91; Priest, 1987, 1988, 1995; Garvey and Gass, 1997; Clement, 1997; Peterson, 1997; Brackenreg, Luckner & Pinch, 1994; Ford, 1987-88; Bartley, 1989). However, there has been steady growth in research done that specifically examines the competencies and skills needed to work with troubled teens [Crisp, 1998; Ringer, 1994, 1996; Berman & Davis-Berman, 1993; Davis-Berman & Berman, 1993, 1994; West-Smith, 1997; Curtis, 1994). In order to present all the competencies needed of staff to work in the field of wilderness therapy, it is important to examine not only the competencies needed of outdoor leaders but also the competencies needed to work with youth-at-risk. The reason is simple: "in order to be a skilled primary adventure therapist, a leader needs to have all of the competencies required by a recreational leader plus specialist competences in therapy" (Ringer, 1994, p. 30).
Research has identified three kinds of competencies and skills needed of wilderness therapists: technical skills, soft skills, and advanced skills. In terms of technical skills (also known as hard skills) an outdoor leader must possess technical competencies, such as map and compass skills, rock-climbing, canoeing, kayaking, fire-building, first-aid, nutrition, tent assembly, minimal-impact camping, and other skills necessary to survive in the wilderness (Curtis, 1994; Crisp, 1998; Bartley, 1989). In addition to this group of skills, Ford (1988-89) places importance on knowledge (activities, nature, people), skills (leadership, outdoor, group, social interaction, supervision, discussion) and attitudes (concern for the environment, love of people, regard for social priority).
The second group of skills mentioned are soft skills. Bartley (1989) has termed soft skills as competencies needed for effective interpersonal helping skills. Current research has identified the need for outdoor leaders to be good listeners and communicators (Bartley, 1989), be flexible and have the ability to empathize with the client (Pickard, 1997), have common sense under stress (Ford, 1987-88; Ringer, 1996; Clement, 1997), be able to process adventure-based learning experiences with groups (Brackenreg, Luckner & Pinch, 1994), and be able to adjust their own leadership style in order to be supportive and not domineering (Peterson, 1997). Furthermore, outdoor leaders must possess the ability to be genuine, concrete, and confrontive when necessary (Bartley, 1989).
The third set of skills are the advanced skills needed of wilderness therapists. Advanced skills include knowledge in psychotherapy and counseling techniques (Davis-Berman & Berman, 1994; Ringer, 1996), crisis intervention, ability to analyze complex issues and make use of a systems approach to intervention (Crisp, 1998), conducting a debriefing session, an assessment of the group, teaching transference techniques (Curtis, 1994), and the use of therapeutic communication (West-Smith, 1997).
Researchers have responded to the issue of competency requirements by focusing their research on these additional advanced or specialized skills needed to work with at risk adolescents who have complex social, behavioral, and psychological problems. The focus of the remainder of this article is to identify the advanced skills and to summarize current research findings about them.
One of these advanced skills is a knowledge of psychotherapy (Davis-Berman & Berman, 1994). The authors ascertain that since wilderness therapy involves the use of psychotherapy, the credentials required of wilderness therapists should not be any different from those professionals working in mental health centers. In their research study, Davis-Berman and Berman (1994) examined 31 wilderness therapeutic programs serving youth-at-risk. They conducted a 30-minute phone interview with the administrator from each program and analyzed the program material. One of the areas examined involved looking at staff credentials. From their survey it was concluded that staff credentials were lacking, and that the "... majority of programs are not utilizing professionally trained, Master's level staff ... furthermore, ... most programs call themselves therapeutic, but few offer psychotherapy" (p. 52).
Two more authors (Ringer, 1996; Curtis, 1994) emphasize knowledge in mental health training. Ringer (1996) found the need for a University-based program to prepare adventure therapists to be important and necessary. His respondents felt it was necessary for adventure therapists to possess skills in counseling, therapy, psychotherapy, group processes, and group dynamics. Knowledge in this area received attention because wilderness therapists deal with adolescents with various emotional, psychological, and behavioral problems that may appear at some time in the course of the trip, and the staff must be able to deal with the issues as they arise. When asked which discipline adventure therapy should associate itself with, the most common answer was psychology; however, many mentioned a need for a multi-disciplinary approach. Twenty-five subjects were contacted to examine the field of adventure therapy in Australia and list the essential elements needed for university-based courses in adventure therapy. Ringer used three sources to collect his data: questionnaires, literature, and anecdotal data (unstructured interviews, e-mail, and personal conversations).
Importance of a Group Skills Workshop
Curtis (1994) goes into detail to discuss the importance of providing a group skills workshop. One of the concepts that should be taught includes debriefing, which consists of self-disclosure and personal reflection. Another is assessment, which requires the leader to assess the state of the client and group, and to be able to use an appropriate leadership style at any given moment. Leaders must also be taught to act as facilitators, in other words must be able to provide effective group interaction. Curtis also stresses the importance of learning transference techniques to help the client take what he/she has learned, and transfer that to the home environment.
Another skill was identified by West-Smith (1997) and refers to therapeutic communication. This skill is closely tied to soft skills, however it is mentioned for the sole reason that it specifically focuses on communication that is therapeutic. This is an important skill, the author continues, because it helps to build trust between the client and the leader. The author defines basic therapeutic communication skills as "... one way to facilitate both empowerment of the participant and to help establish the climate of interpersonal trust between participants and leader that is necessary for a sense of physical and emotional safety" (p. 69). The use of reflection and clarification by the leader communicates to the client that they are being heard and understood. These skills are the basis of counseling and when employed properly can lead the client and the leader to potential solutions.
Make Use of Systemic Systems
In terms of therapy skills, Crisp (1998) believes that practitioners in the field need to be qualified and to understand the clinical frameworks. They need to be familiar with crisis intervention skills, and be able to analyze complex issues that arise within the group and the individual. Furthermore, he identified that some of the key elements of best practice in wilderness and adventure therapy require that programs make use of systemic systems, that is, taking into account family, friends, class, culture, and ethnicity for better intervention. Programs also need to offer staff training, so that learning remains an ongoing process. The author studied 14 wilderness and adventure programs in the United Kingdom, United States, and New Zealand in order to identify those issues. He compiled his data through interviews, literature, direct observation, and participation in training programs, and found a great deal of diversity among the various programs, especially in the use of terminology.
Current research confirms and adds to previous research done in the area of wilderness therapy, in that it separates wilderness therapy from adventure therapy (Crisp, 1998), focuses on the development of a training program for wilderness therapists (Ringer, 1996), and re-emphasizes the need to hire staff trained in mental health (Davis-Berman & Berman, 1993-94).
Crisp (1998) helps to distinguish between adventure therapy and wilderness therapy. Recent discussions provide separate definitions for the two professions, and point to some differences between the two: adventure therapy is done indoors, whereas wilderness therapy takes place entirely outdoors and requires overnight trips (Crisp, 1998). Crisp goes on to differentiate a third category called wilderness-adventure therapy and states that this type of program does not extend overnight, but utilizes aspects of the natural environment (caving, rock-climbing, and other outdoor activities), to work with various groups and populations.
Another (Ringer, 1996) stresses the importance of developing a university-based program to train adventure therapists. Initially, his research pointed to areas of staff competencies needed in order to work as an adventure therapist (Ringer, 1994).
Other researchers have concentrated on knowledge in psychotherapy or other mental-health related fields (Berman-Davis & Berman, 1993-94). The authors have studied programs in the United States that use wilderness and group processing as a form of therapy, and found the programs to be run by staff lacking in clinical background. They stress the need for staff to be cross-trained, through which "experiential educators would obtain training in counseling and counselors would gain experiential education training" (Berman & Davis-Berman, 1993, p. 9).
In summary, most previous research has concentrated on presenting competencies required of outdoor leaders. These include technical skills (hard skills) and soft skills. However, recent research has started to concentrate on advanced skills needed of wilderness leaders who work with high-risk adolescents, and has begun to differentiate adventure and wilderness therapy from outdoor recreation. Most authors admit there is a need for more research to analyze the competencies needed by wilderness therapists, as well as the need to create a specific training program which can prepare professionals to better meet the needs of the clients they serve. What has been written on the subject of wilderness therapists' competencies includes the need for individuals to possess strong counseling skills, familiarity of psychotherapy, advanced clinical skills and group therapy, ability to write professional documentation, and the ability to think analytically. It is becoming clear that programs serving high-risk youths need to hire competent individuals.
The implication of the research on wilderness therapy professionals is encouraging. The research thus far has encouraged awareness of the emerging field of wilderness therapy. It has differentiated this field from adventure therapy, and is beginning to identify key qualities needed by wilderness or adventure therapists working with troubled youth. Wilderness therapy is still in its evolving stages, since there is not a university training program or a certification designed to prepare wilderness therapists and unify the diverse concepts and fields into one. However, some researchers have identified the need for a University Program for Adventure Therapy (Ringer, 1996), and others have outlined the curriculum for training College Wilderness leaders (Curtis, 1994). Berman-Davis and Berman (1993-94) have stressed the importance of hiring qualified staff with backgrounds in counseling, psychology or psychotherapy. The research done so far has helped advance the field of wilderness therapy by identifying key elements still lacking, such as certification, training and staff competencies, and has helped bring those needs to the attention of professionals in the field.
One recommendation to help advance this field and create a unified profession is to start a university program which will be able to provide the theoretical and practical knowledge needed for wilderness therapists (Ringer, 1996; Berman-Davis & Berman, 1993). Presently, people working in outdoor programs with youth-at-risk come from various backgrounds and schools of thought (Berman & Davis-Berman, 1993). The same authors state the need for more programs offering training in both mental health and outdoor education. Ringer (1994) points to the need for a definitive set of leadership competencies for adventure therapists across the board, since no such standard exists, and those competencies need to be agreed upon by all parties involved. Crisp (1998) looks at the international models of wilderness and adventure therapy programs in three countries: the United States, Australia, and Britain. He goes on to say that issues and underlying principles among the nations can be shared and discussed. Crisp continues, "a search for principles of best practice is essential to guide the field in developing and refining itself into a true profession with the broad community respect, acceptance, and genuine social benefit" (p. 72). In short, striving to achieve best practice will ensure a strong foundation and will help advance the field. Finally, Gray and Yerkes (1995) discuss the need for documentation of incidents and progress in order to increase the quality of programs and to decrease the risk of liability claims. They urge professionals to document because "... documentation of clinical incidents can serve as a guiding light that produces insight and information sharing about our methods" (p. 101).
In conclusion, the field of wilderness therapy was examined in terms of its historical background and its philosophical orientation in helping youth-at-risk take responsibility for their actions and start making positive changes. Most researchers looked at the competencies and skills required of outdoor leaders, which included technical skills, soft skills and advanced skills. Recently, researchers have specifically identified the qualities needed of wilderness therapists. It is clear, upon the examination of research done so far, that the need for a program to train wilderness therapists is emerging. Currently, individuals working with youth-at-risk do not have the necessary qualifications to deal with them (Berman & Davis-Berman, 1994). More research is needed to confirm the competencies expected of wilderness therapists who work with these clients, so that specific certified programs can be developed. Standards of ethical practice are also needed, and so is the need for documentation within the field. Professionals need to assume responsibility for advancing the field by submitting research that will help focus on key issues. Wilderness therapy is still evolving, but the importance of this work to special populations, especially troubled youth, is finally established as a legitimate form of therapy.
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The author is a graduate student at Southern Illinois University at Carbondale, in the Health Education and Recreation Department, specializing in Outdoor Recreation. Special thanks to Dr. Smith and Dr. Glover; professors in the Recreation Department at Southern Illinois University, for their dedication in bringing this research update paper together. Research Update is edited by Dr. Irma O'Dell of Southern Illinois University at Carbondale and Kim L. Siegenthaler, Ph.D. of Appalachian State University. — Magdalena Rosol