1. By: Sarah Ake and Elizabeth Jubert

2. Utilizing outdoor challenges as a means for therapeutic change, often in group settings. Adolescents learn group dynamics, wilderness skills, and outdoor living. To build trust and self confidence in others and oneself using group outdoor activities. Includes group activities as well as solo self-reflective activities.

3. Catherine Freer Wilderness Therapy Program is designed to help “out- of control” adolescents enable positive change. They incorporate three models of wilderness therapy; a wilderness expedition, a school combining academics and wilderness therapy, and a transitional home. Catherine Freer Video There are multiple exercises that are utilized in wilderness therapy involving the establishment of trust and cooperation. Here is one example!

4. Eating Disorders Substance Abuse Drug Abuse Behavioral Disorders Juvenile Delinquency Sexual Behavior Problems

5. 1.Gives the child the opportunity to experience successful coping 2.Reduce the potential risk factors impacting the child 3.Promote self-esteem and self-efficacy 4.Introduces positive opportunities for change and growth in a child’s life 5.Encourage positive processing of negative life events. 6.Hopefulness replaces helplessness. 7.A feeling of safety and security

6. 1.Do not go into this work with Expectations of Successful Outcomes: It’s okay to make mistakes and experience failures 2.“Warm up” Exercises are designed to help build comfort in doing this work a. The Three T’s : Trust, Teamwork, Touch 3.Work in the Here-and-Now 4.The patient must have ultimate control; they can stop the exercise anytime 5.Don’t tell patients what to think, feel or do. Let them explore!

7. The Use of Touch by Clinicians: More Hands on Contact with the Client than Traditional Therapeutic Setting Confidentiality: Wilderness Programs must follow H.I.P.P.A which is difficult in group settings with multiple treatment plans. Liabilities: Death and Injuries are more likely to happen in wilderness therapy.

8. Insurance Companies do not cover the costs of Wilderness Therapy. It is estimated that a year in wilderness therapy can cost up to $100,000: Juvenile detention costs $48,000 in a year. Therefore, only those with higher SES can afford treatment. Outdoor Behavioral Healthcare Industry Council (OBHIC): a panel that searches for “best-practices” in wilderness therapy and meets required “ethical standards”.

9. Mentors and role models for guidance Community resources : proximity to safe environments Family involvement Religious & Spiritual supports Meaningful role in community Access to recreational activities Possible family therapy, psycho-educational groups, and parent sessions Access to a school or learning community

10. Scott, D., & Duerson, L. (2010). Continuing the discussion: A commentary on “wilderness therapy: Ethical considerations for mental health professionals.". Child & Youth Care Forum, 39(1), 63-68. doi:10.1007/s10566- 009-9090-x. Becker, S. (2010). Wilderness therapy: Ethical considerations for mental health professionals. Child & Youth Care Forum, 39(1), 47-61. doi:10.1007/s10566-009-9085-7. Ungar, M., Dumond, C., & McDonald, W. (2005). Risk, resilience and outdoor programmes for at-risk children. Journal of Social Work, 5(3), 319-338. doi:10.1177/1468017305058938. Longo, R. (2004). Using experiential exercises in treating adolescents with sexual behavior problems. Sexual Addiction & Compulsivity, 11(4), 249-263. doi:10.1080/10720160490900623.