Catherine Freer Wilderness Therapy Expeditions: An Exploratory Case Study of Adolescent Wilderness Therapy, Family Functioning, and the Maintenance of Change

Abstract

This exploratory longitudinal case study aimed to identify practical adolescent and family outcomes following participation in a 21-day wilderness therapy program for adolescents with emotional, behavioral, and substance use problems. Results showed gender differences in presenting issues pre-treatment, significant positive changes assessed two-months post-treatment in family functioning, and adolescent behavior and mental health issues. Twelve-month assessments showed maintenance of positive outcomes coupled with deterioration in some aspects of family functioning and drug and alcohol use. Implications and suggestions for future research are discussed.

Outdoor Behavioral Healthcare: Its Impact on Family Functioning

“…These findings are similar to other research which shows that changes and improvements in mental health functioning do not necessarily transfer to increases in family cohesion or functioning (Harper, Russell, Cooley & Cupples, 2007). It is unclear the nature of these discrepancies between youth and parents, especially fathers.…”

“…Family functioning could be seen radically different depending on if the child was at home or at another program not living with parents. Harper et al (2007) stress how transition planning and aftercare services are "critical" to retain the positive improvements of intermediate programs like OBH and OBH programs should "invest available resources to enhance the capacity of families to maintain emotional and behavioral change initiated during the intervention" (p. 126).…”

“…These differences would logically impact family functioning differently; hence future research is needed to look in more depth at how family is used and how different types of family engagement impact both family functioning as well as youth mental health improvements. In fact, strong working alliances between parents and clinicians may be key to long term maintenance of change for youth (Harper et al, 2007) and engaging the family while youth are in out of home care is significantly related to increased positive long term outcomes for youth (Nickerson, Brooks, Colby, Rickert, & Salamone, 2006). Hence, not only understanding OBH's engagement with family but finding ways to intentionally bolster this alliance and make the family a larger focus in OBH programs could be crucial for promoting lasting change in youth participants and their families (Tucker, Widmer, Faddis, Randolph, & Gass, in press).…”

Integrating Narrative Family Therapy in an Outdoor Behavioral Healthcare Program: A Case Study

“…In one study, Harper et al (2007) developed a questionnaire to measure adolescent and family outcomes in an OBH program. The 60-item questionnaire contained five subscales; (a) Family Functioning, (b) Adolescent Mental Health, (c) Adolescent Behavior, (d) School Success, and (e) Positive Social Relations.…”

“…As an emerging and contemporary approach, OBH is receiving attention in the professional literature and professional conferences (Outdoor Behavioral Healthcare Research Cooperative;OBHRC 2015), in professional magazines (Bray 2014;DeAngelis 2013) and in the popular media (Telep 2014). While most of the OBH research has focused on its general effectiveness for struggling adolescents, some research has been conducted to explore the integration of aspects of family therapy in OBH (DeMille and Burdict 2015; Faddis and Bettmann 2010) and to evaluate family change resulting from the OBH process (Harper and Russell 2008;Harper et al 2007). Although the ideal role and quantity of family involvement in OBH treatment is currently unclear in the literature (Becker 2010), family involvement will likely be identified as a predictor of post-treatment outcome, as seen in other studies of family involvement in adolescent treatment and residential care.…”