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.

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Disrupted systems of meaning are a core domain in which adults with a complex trauma history are impacted, often leading to adversely affected belief systems. For adult survivors of childhood trauma, experiences related to shame, betrayal, meaning-making, and mourning often complicate their spiritual and/or religious beliefs. This article uses a clinical case example to introduce and illustrate the relevance of a particular complex trauma intervention framework in the context of spiritually-informed treatment with adult Christian clients. Component-Based Psychotherapy (CBP; Hopper, Grossman, Spinazzola, & Zucker, in press) consists of four principal components: (a) relationship, (b) regulation, (c) parts work, and (d) narrative, and is predicated upon the importance of clienttherapist parallel process to therapeutic movement and client change. Each treatment component is summarized and practically applied to case material, with particular focus on the ways in which client's faith beliefs and practices can serve as a potential resource and/or barrier in treatment. Particular integrative focus is given to the final treatment component (narrative), where issues of a client's lament, spiritual meaning making, and the therapist's potential vulnerabilities in working with this population are addressed. There is a growing body of literature that addresses trauma, spirituality, religious coping, and posttraumatic growth, with helpful delineation between adaptive and maladaptive religious coping practices (

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The spiritual disciplines of silence and solitude have long been practiced within the contemplative Christian tradition as a means of character transformation and experiencing God. Do these disciplines affect the use of silence in psychotherapy for Christian clinicians in a graduate training program? Nineteen graduate students in clinical psychology were assigned to a wait-list control condition or a training program involving the disciplines of solitude and silence, and the groups were reversed after the first cohort completed the spiritual disciplines training. One group, which was coincidentally comprised of more introverted individuals, demonstrated a striking increase in the number of silent periods and total duration of silence during simulated psychotherapy sessions during the period of training. The other group, more extraverted in nature, did not show significant changes in therapeutic silence during the training. These results cause us to pose research questions regarding the interaction of personality characteristics and spiritual disciplines in training Christian psychotherapists.