Wilderness Therapy: Ethical Considerations for Mental Health Professionals

Abstract

Wilderness therapy is a growing treatment modality for adolescents presenting with a variety of clinical concerns, and wilderness therapy clinicians and referring mental health professionals must carefully consider the ethical issues that are unique to this modality. Following an overview of wilderness therapy as a mental health treatment, relevant ethical issues for mental health professionals are described and discussed, including the distinction between therapy and therapeutic experiences, the use of efficacious treatment, consent and confidentiality, therapeutic boundaries, a continuum of care and family involvement, and aftercare. A thorough reflection of the unique ethical issues faced by wilderness therapists is not only necessary, but will also assist in moving the field of wilderness therapy and outdoor behavioral healthcare forward in its establishment as both a recognizable and ethical treatment option.Keywords Wilderness therapy Á Outdoor behavioral healthcare (OBH) Á Ethics Á Adolescents Melanie, 15-years-old, opens up the pasta and takes the lid off the pot of boiling water. She leans over, puts her brown hair behind the ears, and tosses the noodles into the bubbles. She then picks up the long-handled spoon and begins to stir. Over the next 10 minutes, Melanie continues preparing the dinner with Katie and Megan. As the sun begins to set behind the trees, the discussion moves away from casual conversation with increasing intimacy. Megan, a licensed therapist, prompts a discussion that continues a conversation that began the day before. Melanie, staring into the churning water, begins to describe the way she felt the first time she made herself throw up after a school picnic 3 years ago. Although she has not purged in over 4 months, each meal confronts Melanie with renewed confusion, fear, and, at times, disgust. Megan offers comfort and support, as Katie reaches over and rubs Melanie's back. After several more minutes, the meal is ready and the others are called

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

“…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.…”

“…The field of 'wilderness therapy' has, for example, undergone significant scrutiny for questionable care practices and unethical treatment of young people (Becker, 2010). While described by Becker as an 'industry' , many wilderness therapy programs are run in an ethical and professional manner.…”

Continuing the Discussion: A Commentary on “Wilderness Therapy: Ethical Considerations for Mental Health Professionals”

“…One goal was to continue the much needed discussion concerning wilderness therapy programs. We do commend Becker (2010) for his work and hope that this commentary added to the discussion and expanded on some of the issues touched on in his article. We also acknowledge that there are many licensed/accredited wilderness therapy programs that have well-trained staff and provide quality services.…”

“…Becker (2010) mentions the establishment of the Outdoor Behavioral Healthcare Industry Council (OBHIC 2009) as an organization that is conducting most of the wilderness therapy program research and promotes best standards in outdoor behavioral healthcare. At the time of press, OBHIC only has 15 member programs.…”

“…There is support for Becker's (2010) suggestion that parents and clients be provided with as much information about specific programs as possible before making any decision. The concern is that many times, the only information available for parents is the promotional material (print and internet) provided by the wilderness program (Behar et al 2007).…”