Episode 115: A History of Controversies- Part 1
Join me around this campfire so I can share with you this is a story of stories filled with controversies related to the field of wilderness therapy. This is part 1 of a 2 part story.
I am doing these episodes as I am asked by people in the field as well as journalist, students, parents over the years about the controversies so I might as well make it into a couple of episodes and point people to the episodes to get the information instead of repeating myself. I will also talk about controversies that are more known inside the field versus outside of the field.
I feel it is important to share my biases and lenses as I and you have many of them. So here are some of mine- I am a white male who grew up in an intact household which was financially stable. I am privileged in so many ways and the older I get the more I see it.
I am biased in that I have been educated in public and private schools (in the 60, 70’s) in the United States which has its education system that impacted my view of the world. My career path since the early 1980’s has been in service and that service has been specifically behavioral healthcare. I have worked in the wilderness therapy field (or, if you prefer, outdoor behavioral healthcare) for the last 30 years.
I have been a behavioral healthcare practitioner, teaching professional, researcher and small business owner and so many other things including being father of two boys (now young men) and now I am 60 year old (now),
I also biased as I come from a family with numerous mental health challenges-
There have been suicides, alcoholism and other drug addiction, one of my grandfather had electro shock therapy in the 1940’s and 1950’s to deal with his depression and it was horrible in the way it was implemented by mental health professional. IT happened many years ago but the scars on my family are still there.
I took the career path of working in this behavioral healthcare field and probably some of these family stories drew me to it. I am actually the only one in my extended family who took this path. The rest all went into business or education to make their livings.
I am also biased by being a consumer of mental health service for many times in my own life due to trauma, bouts of depression and other challenges. Without help I don’t know where I would have ended up. I
I am biased and, I think, most of us are in some ways or another.
One thing I think is that we are all traumatized in life and the last year the majority of us have been re-traumatized by the pandemic as well as so many other challenges. If you don’t think so do some reading and research trauma and you will find more about it. Perhaps this is why Bessel van der Kolk M.D.’s book The Body Keep Score, which came out in 2014, has been on the New York Times bestseller list for over 18 weeks!
So this is a history of controversies in wilderness therapy that comes from a historian, practitioner and believer in the field.
That said I don’t think I am a good predictor of the future (the last five years of my life I have been more wrong than right on any of my predictions) nor am I am that good at writing history. I am a hack but I do put in the time.
The only thing I would give myself a pass on is I am ok at connecting threads of a story and weaving them together (at least I think I am) you be the judge of that.
I also believe that wilderness therapy and the outdoors to help create change helped save my life.
If you don’t like to talk about controversies or think I am talking too much about controversies in this episode then turn it off or stop reading now.
So here is the outline of this episode.
First-Preface, Intro than first five controversies
Part 2 will be four more controversies with a bonus of a follow up with my interview with Kenneth Rosen who wrote “Troubled”
In each segment I will include citations where you can read more about the controversies because some of you are going to want to go down this rabbit hole of controversies and for those I am handing you a map.
In the map is filled with books and in-depth articles that I encourage you to read and come to your own conclusions.
You can find links to the citations and a full transcript of this episode on Stories from the field .com. I want to thank our sponsor White Mountain Adventure Institute for providing the funds to transcribe this episode. Check them out at wmai.org
Preface.
We are all living in a time of trauma due to COVID 19 and the critical
New traumas bring up traumas from the past.
Here is a story about trauma.
I am a licensed mental health practitioner (graduated with Masters in Social Work (MSW) Clinical Concentration) in 1987 who has seen so many changes in the field in my many years in the field. I will share a couple of stories from the early years of being a mental health provider.
Before going to graduate school and after getting my BS in Psychology from the University of Colorado, Boulder I worked at the Halcyon School from 1983-1985 and its group home in Boulder Colorado, at the time is was only for high school age students and it was run by Boulder Valley and Boulder Mental Health. I was a residential counselor who worked at the school and the associated group home.
In those years the students were given points for good behavior and deducted points for bad behavior. At the end of the week they could use the points to purchase things from the “Points Closet”. Do you know what was in the Points Closet for 13-17 year old teenagers to buy with their good behavior? Cigarettes and Candy. Yes this is true and in a progressive city of Boulder. It was run by PhD from University of Colorado and their treatment model was behaviorism. Let me tell you that more young people left that program addicted to cigarettes and seeing them as valuable because of the model.
Many would act out when they did not get their points and we would have to put them in time out rooms. Looking back I think to myself we helped them become addicted to nicotine and then we controlled the nicotine. This was all in an effort to control teen behaviors. Looking back I see a great deal of trauma perpetuated in the name of mental health.
Intro:
A little known writer has burst onto the scene with a well written account of abuse of teenagers in wilderness therapy programs. His account talks in depth of lack of research, questionable practices, and hones in on transporting youth against their will from their homes to wilderness therapy programs across the country. This piece is really shaking up the industry in so many ways. But the change it is not moving fast enough.
This practice of transporting teens is legal but there are some really questionable outcomes about this practice and the problem is the field has been doing this a very long time because this little known writer that I am talking about is now a famous writer named, Jon Krakauer, who wrote Into the Wild, Into Thin Area, Under the Banner of Heaven and many other great books. One of Jon’s first published pieces was in a November 1995 Outside Magazine article titled Loving them to Death. It is a well written expose about wilderness therapy. It is over 26 years old.
Some things have changed and some things have not. Ken Rosen is this generation’s Jon Krakauer and mark my words I believe Ken will write as many powerful books as Jon Krakauer has.
Kenneth Rosen’s book Troubled: The Failed Promise of Behavioral Treatment Programs and the podcast episode were we talked had me question my assumption’s and my bias and listen more before defending the wilderness therapy field.
So after the interview and reading his book I went back and read Jon Kraukaer’s article which came out in 1995, Mai Szalavits’s book, Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids written in 2006. I actually reread my own book Stories From the Field: A History of Wilderness Therapy to remind myself what I wrote about the controversies in the field.
While I was reading these books I grouped controversies into 9 segments and I have to say that things have changed in some ways and other ways controversial issues have not been resolved. So listen or read these 9 controversies and if you want more about each segment I will point you in the direction to get more information to decide for yourself.
Some topics I will go on about and others I will just point you in the direction.
Part 1
1. Outdoors
2. Bootcamps
3. Research
4. Transportation.
5. Licenses and Accreditation
Part 2- to be released next week
6. Staff Training and Pay From Educators to Clinicians
7. Cost and Privilege
8. Safety
9. Parent Involvement
1. The outdoors-
The use of the outdoors is a common criticism about the field and it has been since the beginnings of the field. The first person to start an independent summer camp in the United States was a man named Ernest Balch and he founded it in 1881. The was an earlier one in 1861 at The Gunnery School it was a summer program that was outside for its students. The first independent camp was called Camp Chocorua on Squam Lake in New Hampshire. Balch was criticized by educators at the time as the camp was on an island where they had to cook their own food. The Private School educators were against that he would have a rough outdoor program for the youth at the time.
Now it is common for young people to go take an Outward Bound (OB) (originally founded in 1941 in the UK) or National Outdoor Leadership School (Nols) (founded in 1965). If you have listened some of the over 110 episodes of this podcast you will hear that many of the people who work in this field have taken a course from OB or NOLS and/or been an instructor there.
Over the years when telling people about the field I work in I used to have to explain how it works and why it works. In the last five years I don’t think I have had to explain it once as most people accept it that being in nature is good for us and helps our mental health. There are research articles that come out almost every week about it. Richard Louves book, Last Child in the Woods: Saving our Children from Nature Deficit Disorder became a bestseller in 2005 because it so resonantes with us.
I rarely find anyone who doesn’t believe that time in nature-whether in a park in a city or in the mountains or lakes- is good for you.
There is an interesting audible release called The 3-Day Effect by Florence Williams which talks about the research behind the therapeutic benefits about being outdoors in wild places for three days has a profound impact on mental health.
So the evidence is clear that spending time outodoors is good for mental health. Or is it?
The controversies in the field of wilderness therapy seems to be related to how students have been treated in wilderness therapy programs in which they are living out doors for up to 60 days or longer. Some in very primitive conditions depending the model of wilderness therapy which the program follows. Some utilize a very primitive model where young people do not eat warm food unless they are able to start a fire and cook. Many don’t use fancy backpacks or outdoor gear that you see at REI or other outdoor stores. They are primitive in many ways.
And you want to know something interesting. Every generation of practitioner seems to think that current practices are too easy. Some believe and practice wilderness therapy where long long hikes and struggles and coming right to the edge. Others consider modern day practices as way too soft. You will often hear “Oh wilderness is so much easier than it was back in the day.”
This goes back generations. It kind of like that saying “Kids don’t know how easy they have it. Back in the day…..” fill in the blank.
In my dissertation “Stories from the Elders: Chronicles and Narratives from the Early Years of Wilderness Therapy” published in 2011 there are oral histories of the 1960’s and 1970’s where wilderness programs had no backpacks, or sleeping bags just a blanket, plastic ground cloth that doubled as a poncho. A knife and a spoon and whatever you could find to eat out of. In the early 1970’s at Brigham Young Universities 380 and 480 course the instructors used to have a saying “If they weren’t puking green bile, we weren’t doing our job.” (p.158). That same person, a leader in the field, said, that all started to change in 1978. I asked the early leaders in the field of how do they think the future of the field is and all three said in one way or another that the field started as a reaction against talk therapy for teens and that the woods and now it is talk therapy in the woods.
So is the outdoor experiences in wilderness therapy programs over the top. I would say “sometimes” as it really depends who the person is. I have an old friend I camped with as a teenager in the 1970’s. I was having dinner with him and his partner and reminiscing about backpacking and climbing together in the White Mountains of New Hampshire. His wife laughed out loud and said, “ John’s idea of camping now a days is a four star hotel. He likes comfort and complains bitterly if he doesn’t have it.”
Every expedition and outdoor experience is different and much of the differences is based on how familiar you are about the outdoors. If you listen to some of the episodes on the podcast you will hear how some people felt completely transformed by their wilderness expeditions. Others not so much.
Bootcamps
Many people in the field cringe when journalists or otheres compare wilderness therapy programs to boot camps. They are different in their approach as Boot Camps seem to become directly from a model of military approach or back to the intro- Behaviorism. If someone steps out of line you respond with a negative reinforce like “drop and give me twenty” There is a in-depth research article by Dr. Keith Russell published in 2006 titled, Brat Camp, Boot Camp, or… Exploring Wilderness Therapy, is actually an article that goes into the differences.
I feel compelled to share that I experienced a boot camp style wilderness program when I was a teen in the early 1970’s which my parents forced me attend. In the beginning I did not like at all as it was tough as it was founded by a military person who was all about hierarchy and following the leaders even if the leaders where putting us in perceived and sometimes real jeopardy. It had a level system and you had to complete tasks in order to move up the ranks. Some kids that I was in the program with were abused by the leaders. Others say it was the best thing that ever happened. Sometimes I look back on that time fondly and at other times I look back and shake my head about all the messed up things that happened. There have been lawsuits related to the program.
I am not talking about a Wilderness Therapy Program but a wilderness program that unintentionally was very therapeutic for many including myself. That said it is probably one of the most influential programs (along with Outward Bound)- in which the OB founder Kurt Hanh said he was influenced by this boot camp style wilderness program.
The program that I went to and helped me believe in myself and many others and helped the field of wilderness therapy evolve and which many people who worked in the field were part of when they were teens is called Boy Scouts of America. It cause a great deal of good and many cases of harm which are well documented. Some troops in Boy Scouting were good while others not so much. Scouting is evolving but it may have been to slowly to stay in operations. It is now open to all genders and referred to as Scouting USA there are plenty of books about its evolution and it is still changing.
Wilderness therapy programs are not operating in a boot camp model as Russell points out but it did spring forth from a boot camp and military approach. The majority of early leaders in the field of wilderness therapy were Boy Scouts. All the subjects in my dissertation where. Some said the really learned from scouting while other said it was horrible.
So is wilderness therapy really a boot camp? I would say “No” with the caveat that it evolved in many ways from the military.
I have a friend that I went to college with in the early 80’s who is a retired Navy Seal. I talked to him last year and he said, “You know the cadets now a days could never deal with the training camps we went through. Every generation tends to say it went through tough things.
Research-
Here is a caveat one of the reasons I went to social work school instead of psychology is I never felt very skilled with numbers or statistics. I am not a skilled researcher- my form of research is asking people to tell me about their experiences- and then sharing those stories. My dissertation was a qualitative study using narratives and a literature review. Qualitative studies are sometimes looked down upon by quantitative researchers because it is challenging to replicate and it cannot be broken down into numbers.
In all of the critiques about wilderness therapy I have read there is a recurring theme of lack of research on the model. The most recent article besides Kenneth’s book was titled “Does Science Support the Wilderness in Wilderness Therapy” by Adiel Kaplan which came out in Jan 2020. She does a good job in talking about the field as a whole and I am grateful that she talked with me about the history of the field when she was writing the article. There is a great deal about the research in the field and more specifically the research done at the University of New Hampshire’s Outdoor Behavioral Healthcare Research Center (OBH Center) which is co-directed by Dr. Mike Gass and Dr. Anita Tucker. I have interviewed on this podcast the Co-Directors of the Center Dr. Mike Gass and Dr. Anita Tucker and I believe them both to be skilled and ethical researchers who do all that they can to eliminate their biases (we all have biases) and use models to ensure that. With that said it is important to realize that the OBH Research Center is funded primarily (not totally) by the Outdoor Behavioral Healthcare Council (OBH Council) which is a trade group for the field. This is pointed out in the majority of critiques of the field. To be transparent all of the profits from my book, Stories from the Field: A History of Wilderness Therapy has gone to fund research in the field at the OBH Center.
There has been more research done under the purview of the OBH Center on the field of Wilderness Therapy in the last 10 years than in the previous 50 years. So the field has done more research than ever and yet it is often viewed as biased because the funding of the research was by a small but growing number of OBH Council programs.
I have been one to defend the research which I think is great but my life partner gave me a new perspective one night. We were talking about the research and how it is critiqued by others due to the funding. She looked at me and asked me this, “how did you feel about the funding of research by tobacco trade organizations or petroleum companies?” I finally got it as I don’t trust research funded by trade groups except when it comes to my trade. Ha!
No matter how we in the field view the research when you have been funding it there will be questioning of it.
The challenge I see is where does the money come from to fund research? Especially now with Universities cutting payrolls, research grants as higher education changes due to the pandemic and on-line education versus brick and mortar.
Should wilderness therapy researcher have a bake sale, set up a Gofundme page,? The more I learned about research is funded the more I understood that research is often funded trade groups in order to help the trade do better. I don’t have the answer but I will say that my next book will again direct all of the profits to research in the field.
The area that I see (as well as many others) the most lacking in the research is transporting young people against their will to wilderness therapy programs. There are plenty of stories about it but the research is lacking. There has been exactly two research studies on transports by the OBH Research Center and yet that is one of the most controversial parts of the field. My opinion is that there needs to be a whole lot more as from listening to stories on this podcast and reading accounts there is clearly people who have been traumatized by this practice.
I believe there will be more research done and it will take time. For now I am personally against the practice.
So onto the next segment.
Transports- In the early day of the field it was called “in home enrollment” and it started in 1981 in Idaho at a program called School of Urban and Wilderness Survival (SUWS). To put it simply it is the practice of waking a teenager up in the middle of the night or some other time and bringing them to a wilderness therapy program. This is with their parents consent and some times, the parents are there to witness it, while others are not.
The labelling of the practice switched as programs off loaded the practice and small companies started to do it. It has been called “escorting” (which clearly can be confusing) as well as “assisted enrollments”.
Others who have been the recipient call it “gooned” and others refer to it as “kidnapping.” I am not going to debate semantics and I will say words reflect experience.
I did a whole season of students stories and many of them where transported to programs. Some said it was the only way that they would have gotten the help they needed and that there parents did the right thing. Other episodes paint a different picture in which the young person feels that it was unnecessary and resents it many years later.
Some OBH Council member programs receive the majority of their students via transports while other receive none. That means that the field of wilderness therapy is not dependent on this practice to keep going in operations. In my interview with Kenneth Rosen I misspoke when I said that the progam I worked for did not enroll students via transport. I was wisely corrected that in its 25 year history we enrolled 10 different students (this was in the last 10 years) via transport who met a criteria of being home bound and their parents had to come to the campus behind them. After my talk with Kenneth we followed up with some of them and some said it helped change the course of their lives. Another who actually had a great growing experience and is doing quite well said he still feels the impact of being transporting against his will and that it colors the way he looks at the experience. So this is a data set of 10 students has led us to stop doing any “assisted enrollments” until more research is conducted as trauma is trauma.
Some say it saved their lives, others say it damaged them. I believe them.
Can it be done in a way that does not damage people? I think so but I don’t know so
My hope is that research is done and that accreditation standards are put into place so people do not come out of it feeling harmed.
Accreditation and License
The field of wilderness therapy evolved out of experiential education field to help young people to grow through the use of the outdoors. The early pioneers, including Kurt Hanh, the founder of Outward Bound were for the most part “educators.” Just a side note about Kurt Hana during the pandemic my we have been watching series “The Crown” on Netflix which is about the Royal Family. It traces the life of Queen Elizabeth and the family. Check out Season 2, Episode 9 which is about the Prince Philip who went to the Gordonstoun School and him forcing Prince Charles there. That school was founded by Kurt Hanh and the school and Hanh are portrayed as very demanding and physically rigorous. Give it a watch and see that you think but you will see that it was highly influenced by a military model of toughing young people up.
OK, so most of the educators who helped the field evolve including Kurt Hanh had great disdain for psychiatrist and other mental health practitioners. You can read up on that in my book or dissertation.
In perhaps an overgeneralization but it wasn’t till the later 1980’s and 1990’s that mental health practitioners came into the wilderness therapy field. As you should know most masters level and above mental health practitioners are licensed by the State in which they practice. We have to do so many hours of practice (usually about two years) under the supervision of a licensed professional and then take a series of tests and pass them and then “boom “ you can independently practice mental health in a private practice. You also have to do so many hours each year of continuing education in things like ethics and other aspects of mental health. All depends on the state you are licensed in. There is not a federal license to practice mental health.
They are most likely also part of a national professional group that also is sort of a trade/ professional group. For example I am licensed Clinical Social Worker in Maine and New Hampshire and I am a member of the National Association of Social Workers that has a code of ethics I sign each year.
So in terms of Licenses of a program they are provided by the State in which a program operates in. Each state has different rules and regulations regarding how a program must operate to be licensed as wilderness therapy program. Some states do not have a license to operate a wilderness therapy program others like, Utah, Oregon and North Carolina do have wilderness therapy license.
State of Maine does not have such a Wilderness Therapy License. So the program that I am part of went for a license as Residential Treatment Program for adolescents as that is the closest we could come to it. Because of that we had to include building etc as the State of Maine mandated that if you are going to have program that is providing mental health and substance abuse treatment to young people you are going to have buildings to house the teens in. So that is part of the reason we Summit Achievement is a hybrid model wilderness therapy program. The State comes to the facility one to two times a year and often without notification to review records, check the facility, check employment files, ETC
Another reason is my business partners were not mental health professionals and I wanted to make sure that we were licensed as a facility to provide treatment. I am licensed so I only want to work at programs that are licensed as my career (as a clinical social worker) is more important to me than a job.
I believe that most states have websites to see if a mental health provider has been cited for misconduct and I believe you can find the same for any mental health treatment programs.
Any program that is not licensed to provide mental health services in the state they operate should be avoided.
Accreditation is a different thing as accreditation tends to be on a national level so it is not so much the state in which a program is operating as any program that goes for accreditation has to be licensed by the state in which they operated. Accrediting bodies for wilderness therapy include Joint Commission, Commission on Accreditation for Rehabilitation Services (Carf) and the Association for Experiential Education. Each one of these accrediting bodies have programs go through a vigorous process of review of policies and procedures and sending in that information to the bodies to see if they meet best practice standards. Each one of the accrediting bodies will send review teams out to the programs to meet with staff, students and look at the facilities to see if they meet the standards and if not they will be given so much time to meet the standards or they won’t be accredited.
Accreditation is not required to operate in a State and many wilderness therapy programs are not accredited by any of those but that is changing as more and more programs see the value of having outside reviewers help them by pointing out things that they may have not been aware of. I believe in the next five years or so that if a program is not accredited by one or both of the previously mentioned accredited bodies than they will be out of business.
Well that is the end of part 1. My hope is that you are taking care of yourself and getting outside.