A Closer Look at Involuntary Treatment and the Use of Transport Service in Outdoor Behavioral Healthcare (Wilderness Therapy)

Harper, Nevin J.; Magnuson, Doug; Dobud, Will W.

doi:10.1080/0145935x.2021.1938526

Cited by 9 publications

(11 citation statements)

References 41 publications

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“…According to the authors, the mixed results shown in their study may be partly explained by involuntary treatment admission and feeling of parental rejection, where out of home placement may have negatively impacted attachment relationships. Results from another study, however, have indicated that the use of forcible transport did not affect program outcomes among youth participating in residential care programs [38], but the validity of these results has been questioned [39].…”

Section: Discussionmentioning

confidence: 99%

“…Voluntary participation is linked to increased intrinsic motivation to change, whereas involuntary treatment, use of coercion, and transport services specialized for "uncooperative youth" in outdoor behavioral healthcare (wilderness therapy) have raised ethical and empirical concerns [39]. Despite ethical concerns, adolescents are still largely admitted involuntary to outdoor behavioral healthcare in the United States [40].…”

Section: Ethical Concernsmentioning

confidence: 99%

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Mapping the Concept, Content, and Outcome of Family-Based Outdoor Therapy for Children and Adolescents with Mental Health Problems: A Scoping Review

Stea

Jong

Fegran

et al. 2022

IJERPH

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Outdoor therapy and family-based therapy are suggested to be promising interventions for the treatment of mental health problems. The aim of the present scoping review was to systematically map the concept, content, and outcome of combining family- and outdoor-based therapy for children and adolescents with mental health problems. The Joanna Briggs Institute methodology and PRISMA guidelines were applied. Eligible qualitative and quantitative studies were screened, included, and extracted for data. Seven studies were included. Findings from these studies indicated that family-based outdoor therapy programs have a positive impact on family- and peer relationships, adolescent behavior, mental health, self-perceptions (self-concept), school success, social engagement, and delinquency rates. However, participant characteristics, study design, and content and mode of delivery of the interventions varied substantially, hence preventing detailed comparison of outcomes across studies. In addition, most of the studies included few participants and lacked population diversity and comparable control groups. Although important ethical concerns were raised, such as non-voluntary participation in some of the programs, there was a lack of reporting on safety. This review indicates that a combination of family- and outdoor-based therapy may benefit mental health among children and adolescents, but due to the limited number of studies eligible for inclusion and high levels of heterogeneity, it was difficult to draw firm conclusions. Thus, future theory-based studies using robust designs are warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Ethical Concernsmentioning

confidence: 99%

Mapping the Concept, Content, and Outcome of Family-Based Outdoor Therapy for Children and Adolescents with Mental Health Problems: A Scoping Review

Stea

Jong

Fegran

et al. 2022

IJERPH

View full text Add to dashboard Cite

show abstract

“…The Outdoor Behavioral Healthcare Center (OBHC) has significant influence in the AT field although it mainly focuses its research on WT. However, WT has a history of involuntary admission and treatment (Tucker et al, 2015), which contrasts with other AT approaches (Dobud, 2021). Further, OBHC accredits programs that appear to routinely violate human rights (Mater, 2022;Moniuszko, 2022;Okoren, 2022;Sheets, 2022).…”

Section: Adventure Therapy (At) Fieldmentioning

confidence: 99%

A tale of two systems; How beliefs lead to harmful outdoor practice

Pringle

2024

Preprint

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The fields of adventure therapy (AT) and complex trauma (CT) share similar belief systems however, internal divisions in each field seem insurmountable. Through a critical realist analysis, I present the clash between Neo-Liberal and humanist approaches and how they lead to a misunderstanding of the harmful effects of coercive treatment. Exploring ecological dynamics, sense of self, and the fundamental attribution error I discuss these complexities. A historical perspective reveals that AT already possesses solutions to bridge the gap between coercive practices and humanist CT informed AT. These solutions are outlined and a call to action encourages the international AT community to take a leadership role in mental health globally.

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“…While cautioning the importance of utilizing a quality transport service, these findings suggest that IYT may support treatment, by providing youth an opportunity to experience similar positive outcomes to those who are not transported (Tucker et al, 2018). Harper et al (2021) used exploratory data from the NATSAP Research Database to suggest caution in generalizing the research findings in the studies examining the quantitative findings regarding IYT. Criticisms levied by these authors present the need for more definitive procedures to produce valid and generalizable outcomes on what is occurring in IYT experiences.…”

Section: Prior Researchmentioning

confidence: 99%

Involuntary Youth Transport (IYT) to Treatment Programs: Best Practices, Research, Ethics, and Future Directions

Gass

Hardy

Norton

et al. 2021

Child Adolesc Soc Work J

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Involuntary youth transport (IYT) is a controversial practice used to admit adolescents into residential care. Critics point out that IYT is in need of regulation and is best used as a last resort. This article examines the risks and benefits of IYT, especially the longterm effects on the client, in order to ensure that all facets of a client’s treatment are trauma-informed and guided by research-based practices and ethical principles. Practices that re-traumatize youth need to be replaced with informed practices that facilitate positive outcomes. This article utilizes an ethical decision-making framework developed for behavioral health professionals to assess and improve the ethical use of IYT. Based on this ethical framework, a more effective and collaborative model is presented that results in less restrictive approaches, greater levels of willingness by the adolescent to enter treatment, and trauma-informed management of difficult emotional or physical behaviors. This model also guides professionals and caregivers on how to proceed when IYT services are deemed necessary. The article presents past research and addresses ethical guidelines and best practices for IYT. Steps for practitioners and future directions are discussed.

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A Closer Look at Involuntary Treatment and the Use of Transport Service in Outdoor Behavioral Healthcare (Wilderness Therapy)

Cited by 9 publications

References 41 publications

Mapping the Concept, Content, and Outcome of Family-Based Outdoor Therapy for Children and Adolescents with Mental Health Problems: A Scoping Review

Mapping the Concept, Content, and Outcome of Family-Based Outdoor Therapy for Children and Adolescents with Mental Health Problems: A Scoping Review

A tale of two systems; How beliefs lead to harmful outdoor practice

Involuntary Youth Transport (IYT) to Treatment Programs: Best Practices, Research, Ethics, and Future Directions

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