Does Wilderness Therapy Work?
One of the most frequently asked questions about wilderness therapy is; “Does it work?” How effective is this kind of treatment or intervention with teenagers or young adults? Students spending their time in the wide open spaces, hiking and camping, instinctively seems like it would help. Time away from technology with the ability to refocus, master their lives at a simpler level and gain emotional insight appears to be healthy option. But, does it actually work? Is there real physical and emotional improvement that takes place? If so, how is that improvement measured? The following information will help you understand the success of RedCliff Ascent and how that success is measured.
A History of Wilderness Therapy Research
The wilderness has been used for personal development for decades. Those who have walked along the beach, climbed to the summit of a mountain, drifted through whitewater rapids or simply sat on a park bench recognize the value of outdoor activity. The last 50 years have seen various research efforts all with the purpose to demonstrate the efficacy of using the wilderness environment as a therapeutic intervention. Anecdotally, parents, schools and allied health professionals have found wilderness treks as a powerful way to build character in teenagers and young adults.
Early research identified four benefits of a wilderness therapeutic intervention. Treatment that takes place in a wilderness environment:
- Promotes personal growth/maturity.
- Develops resilience.
- Develops an internal locus of control.
- Builds self-esteem.
A review of early research found that students who were enrolled in programs that include a therapeutic approach actually internalize their insight and emotional resilience at a more rapid rate and for a longer-term than those enrolled in programs that are more recreationally focused.
Although early research was important in the development of wilderness therapy, the question of therapeutic efficacy still remained.
The First Outcome Study on Wilderness Therapy
RedCliff was the first to actively pursue a research effort that included a validated and standardized research instrument. This first study was conducted by Doctor Steve Aldana, a researcher from Brigham Young University (BYU). RedCliff wanted to see how participants did on a longitudinal basis. The students progress was rated while in the program and also three months and six months after they returned home. The instrument used was the Youth Outcome Questionnaire (Y-OQ) to assess teenager functioning. Even today, this is the standard instrument used for monitoring clinical improvement and program effectiveness. In this first study, Doctor Aldana found:
- Participants improved from intake to six months after completing treatment.
- For the participants in this evaluation, 91.4% experienced clinically significant improvement.
Patented Teen Assessment (Y-OQ)
It is important for parents and allied health professionals to realize that the Youth-Outcome Questionnaire (Y-OQ) is used to measure and assess an adolescent's psychological and emotional functioning and progress.
The Y-OQ provides a research system that includes cut-off scores with the ability to track progress using a reliable change index. Higher scores on the Y-OQ indicate higher levels of dysfunction. The score for a teenager that is admitted to a psychiatric hospital usually runs in the 100’s. It is important to realize the average score for teenagers in outpatient treatment is about 78. The normative score for the general population is less than 47.
One of the hallmarks of good research is the ability for there to be a replication of the study and results attained from different researchers. 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. 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 the student self-report.
Of the original wilderness therapy programs that participated in Dr. Russell's research, only two remain in operation today and RedCliff is one of them.
Research Results Continue to Validate Improvement
In 2005, Doctor Russell published a two year follow-up study to his original article published in 2003. Dr. Russell contacted another sample of the wilderness therapy 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.
Our Commitment to Quality
In addition to our individual research efforts, RedCliff Ascent provides leadership by example and 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. As a result, NATSAP recently reported:
“RedCliff Ascent has substantially increased contributions of YOQ [Parent Report and Self Report] assessments at intake, discharge, and post-discharge. 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.”
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.