Part 1 in a series. Click here to go back to the Research Overview page.
Turning Outcomes Research into Treatment Effectiveness
One of the most frequently asked questions about wilderness therapy is, “Does it work?” The following information will help you understand the outcomes of wilderness therapy.
A History of Wilderness Therapy Research
The wilderness has been used for personal development for decades. Hence, in the last 150 years parents and schools have found wilderness treks as a powerful way to build character in teenagers.
Early research identified four benefits of a wilderness trek. A wilderness trek:
- Includes personal growth/maturity.
- Develops resilience.
- Develops an internal locus of control.
- Builds self-esteem.
Right now, it is currently being combined with a therapeutic intervention to work with struggling adolescents. A review of early research found that programs with a greater therapeutic approach do better than programs which are more recreational focused. Although the early research was important in the development of wilderness therapy, but it couldn’t answer if it was effect.
The First Outcome Study on Wilderness Therapy
Almost fifteen years ago, and study was conducted by, Doctor Steve Aldana, a researcher from Brigham Young University (BYU). He wanted to see how participants did, not just in the program, but rather six months after they returned home from the program. Doctor Aldana developed the Youth Outcome Questionnaire (Y-OQ) to assess teenager functioning. In his study, Doctor Aldana found:
- Participants improved from intake to six months after completing treatment.
- For the participants in this evaluation, 91.4% experienced significant clinical improvement.
Click here for a link to the original study results.
Patented Teen Assessment (Y-OQ)
Important to realize the Youth-Outcome Questionnaire (Y-OQ) is used to measure an adolescents functioning. Doctor Aldana developed the Y-OQ in his studies.
The Y-OQ is used to assess an teenager’s functioning using cut-off scores and track progress using a reliable change index. Higher scores on the Y-OQ indicate higher levels of dysfunction. The average score for teenager in psychiatric hospitals is as much as 100. It is important to realize the average score for teenagers in outpatient treatment is about 78. The normal population score is less than 47.
Further Study into Treatment Outcomes
Another major study on the effectiveness of wilderness therapy was published in 2003 by Doctor Keith Russell from the University of Idaho.
In Doctor Russell’s study he looked at seven program outcomes at admission, discharge, and twelve months post discharge. Above all, Doctor Russell wanted to know if wilderness therapy worked and if the effects lasted a year after the teenager completed treatment.
This study has become the most commonly referenced outcome study on wilderness therapy, because of its strong treatment results. To sum up, Doctor Russell’s study found that:
- Participants experienced a significant improvement in functioning from admission to discharge on both the Y-OQ parent report and the student self report.
- Results continued one year after completing treatment.
- Of all the wilderness treatment models used in the study the ‘continuous flow’ model, used by RedCliff Ascent, produced the greatest improvement in student functioning on both the Y-OQ parent report and self report.
Click here for a link to the original article by Doctor Russell.
However, only two of the original programs studied by Doctor Russell remain in operation. RedCliff is one of only two remaining programs.
Two Years Later
Furthermore, in 2005 Doctor Russell published a two year follow-up study to his original article published in 2003. Russell contacted a sample of the participants two years after completing treatment and found:
- Over 80% of parents contacted perceived wilderness therapy as effective.
- 83% of adolescents were doing better.
- Of the 83%, 58% were doing well or very well.
- 17% were still “struggling.”
- Over 90% of adolescents contacted perceived wilderness therapy as effective.
- Participants were also doing well in school.
- 86% were in high school or college, or had graduated from high school and were working.
- 7% graduated from high school, yet were living at home and “doing nothing.”
- 6% had not graduated from high school, were living at home, and working or “doing nothing.”
- 1 participant was in prison.
- A majority reported that family communication had improved.
Living up to our Commitment of Quality Wilderness Therapy Treatment
In addition, RedCliff Ascent contributes to the National Association of Therapeutic Schools and Programs (NATSAP) research database. Each year NATSAP produces a report summarizing RedCliff’s research efforts for that year. In 2012, RedCliff continued to produce high quality research outcomes. As a result, the NATSAP reported:
“RedCliff substantially increased contributions of YOQ 2.0 [Parent Report and Self Report] assessments at intake, discharge, and post-discharge from 2012-2013. RedCliff has sufficiently matched youth report data from intake through post-discharge. This data states that, on average, RedCliff clients arrive at the program with clinically significant levels of behavioral and emotional dysfunction. However; they are within the healthy range of functioning upon completion of the program, and these gains are maintained at 6-12 months post discharge.”
Continue to Part 2 of the Research Series: Is Wilderness Therapy Safe?
Russell, K.C. (2003). Assessing treatment outcomes in outdoor behavioral healthcare using the Youth Outcome Questionnaire. Child and Youth Care Forum. 32, 6, 355-381.
Russell, K.C. (2005). Two years later: An applied test on youth-well-being and the role of aftercare in outdoor behavioral healthcare treatment. Child and Youth Care Forum, 34, 3, 209-239.