Objective: Wilderness therapy (WT) is a complementary/integrative approach for treating struggling adolescents by using outdoor adventure activities to foster personal and interpersonal growth/well-being. Empirical support for the effectiveness of traditional WT is growing, but evidence supporting traumainformed WT (TIWT) is lacking. This pilot study addresses that gap. Method: Between 2009 and 2019, 816 adolescents (Ages 13-17, M age ϭ 15.36, SD ϭ 1.25; 41.1% female) completed the Youth-Outcome Questionnaire-SR 2.0 at intake and discharge (M ϭ 75.02 days, SD ϭ 28.77). Three-hundred seventyeight adolescents also completed the Family Assessment Device-General Functioning (FAD-GF), and 253 adolescents completed two, 2.5-min segments of heart-rate-variability biofeedback (one while resting and one while using a coping skill). One-hundred eighty-nine caregivers completed the Youth-Outcome Questionnaire 2.01, and 181 caregivers completed the FAD-GF. Between 25 and 99 adolescents and caregivers also completed psychological and family measures at 6 months and 1 year postdischarge. Results: Adolescents reported experiencing improvements in psychological and family functioning. They also exhibited improvement in psychophysiological functioning (heart-rhythm coherence). Caregivers reported improvements in family functioning and their child's psychological functioning. Caregivers observed more persisting benefits in their child's psychological functioning, whereas adolescents reported more persisting benefits in family functioning. Changes in psychological and family functioning were related. There were very few differential effects on the basis of demographic factors, trauma exposure, or past and current treatment factors. Conclusion: Results of this pilot study suggest TIWT is a promising complementary/integrative intervention for improving the psychological, family, and psychophysiological functioning of struggling adolescents. Clinical Impact StatementThis study indicates trauma-informed wilderness therapy can help improve how struggling adolescents feel, behave, cope, and relate with others. These preliminary findings suggest trauma-informed wilderness therapy is a complementary/integrative treatment that has potential benefit both for trauma-exposed and other vulnerable youth.

In this study, we explored how couples raising children with autism spectrum disorder negotiate intimacy, including what contextual and temporal factors influence these processes. We conducted conjoint interviews with 12 couples, employing grounded theory methodology to collect and analyze the data. Our results indicated that fostering intimacy in these couples' relationships involves partners working together to make key cognitive and relational shifts. Couples are aided or hindered in making these shifts by the degree to which they experience various contextual and environmental factors as resources or roadblocks. We also found that intimacy is not a fixed point at which couples one day arrive, but is an iterative process taking place over time and requiring work to develop and maintain.

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