Unpacking the Black Box of Wilderness Therapy

Abstract

Despite considerable progress within wilderness and adventure therapy research over the last decade, researchers are still unable to precisely answer why, how, and for whom this treatment modality works. There is also a need for more knowledge regarding the circumstances under which the treatment does not appear to be effective. In this realist synthesis, we attempt to unpack this "black box" of wilderness therapy more specifically, defined as a specialized approach to mental health treatment for adolescents. Through a focused review of the primary qualitative wilderness therapy studies, empirical findings are used to test and refine a key program theory. The synthesis results in a proposed wilderness therapy clinical model and offers informed implications for future theory development, research, and practice.

The role of wilderness therapy for adolescents in the face of global trends of urbanization and technification

“…First, an expression of common wilderness therapy practices delineating the wilderness approach from conventional office-based talk therapies (Gass, Gillis, & Russell, 2012;Harper, Peeters, & Carpenter, 2015) are described briefly in Table 1. Three core elements of clinical wilderness therapy are then described in more detail to theoretically support how therapy undertaken in wilderness, and to a lesser degree in nearby-nature, can be 'antidote' to the above-mentioned malaise (Fernee, Gabrielsen, Andersen, & Mesel, 2017).…”

“…Theoretically, a wilderness therapy clinical model has been proposed based on three core elements (Fernee et al, 2017;Russell & Farnum, 2004): Wilderness, the physical self, and the psycho-social self. While practices vary across wilderness therapy programs internationally, these three elements are central features common to most.…”

“…Systematic reviews of physical activity programs on adolescent social and emotional well-being have consistently reported positive effects, yet strong bias remains present in the body of research leaving questions as to efficacy (Lubans, Plotnikoff, & Lubans, 2012). These finding rings true of much wilderness therapy research as well which report primarily on positive outcomes, yet coming from a small group of researchers (Becker, 2010;Fernee et al, 2017). It's easy to grasp however, that the adjustment to the routine of outdoor travel and living implicitly requires physical challenges to be undertaken.…”

“…Wilderness therapy for adolescents generally occurs in small intact groups that become interdependent and challenge individuals to be relational, and to work toward attachment with others outside of their families (Fernee et al, 2017). From assessment through treatment, to post-trip evaluation, therapists can work with clients individually and within the group context, thereby gaining access to a broad range of emotional and behavioural states and growth opportunities.…”

“…From assessment through treatment, to post-trip evaluation, therapists can work with clients individually and within the group context, thereby gaining access to a broad range of emotional and behavioural states and growth opportunities. The young person's psychological and social self are transparent in the wilderness therapy context, stigma is reduced related to mental health issues, adherence to treatment increases and there are ample opportunities to explore alternative ways of being (Fernee et al, 2017). Individual growth has been found to occur within the group context of outdoor adventure programs including mindfulness, self-efficacy, life satisfaction and happiness, reduced anti-social behaviour and increased accomplishment motivation (Mutz & Müller, 2016;Paquette & Vitaro, 2014).…”