Abstract
Outdoor behavioral healthcare (OBH) is an emerging treatment that utilizes wilderness therapy to help adolescents struggling with behavioral and emotional problems. The approach involves immersion in wilderness or comparable lands, group living with wilderness leaders and peers, and individual and group therapy sessions facilitated by licensed therapists in the field. OBH also offers educational and psychoeducational curriculum all designed to reveal and address problem behaviors, foster personal and social responsibility, and enhance the emotional growth of clients. The extant studies on the effectiveness of OBH and wilderness therapy reveal consistent lack of theoretical basis, methodological shortcomings and results that are difficult to replicate. This publication reports the results of an outcome assessment for adolescent clients who received treatment in seven participating OBH programs that averaged 45 days in length from May 1, 2000 to December 1, 2000. Adolescent client well-being was evaluated utilizing the Youth Outcome Questionnaire (Y-OQ) and the Self Report-Youth Outcome Questionnaire (SR Y-OQ) (Burlingame, Wells, & Lambert, 1995). Complete data sets at admission and discharge were collected for 523 client self-report and 372 parent assessments. Results indicated that at admission clients exhibited presenting symptoms similar to inpatient samples, which were on average significantly reduced at discharge. Follow-up assessments using a random sample of clients found that on average, outcomes had been maintained at 12-months posttreatment.
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References
Achenbach, T. M. (1991). Manual for the child behavior checklist 14–18 and 1991 profile.Burlington, VT: University of Vermont, Department of Psychiatry.
American Psychological Association (1994). Diagnostic manual of mental disorders. (4th ed.). Washington, DC: Author.
Bandoroff, S., & Scherer, D. G. (1994). Wilderness family therapy: An innovative treatment approach for problem youth. Journal of Child and Family Studies, 3(2), 175–191.
Bandura, A. (1994). Encyclopedia of human behavior. In V. S. Ramachaudran (Ed.), Encyclopedia of mental health. San Diego, CA: Academic Press.
Bangert-Drowns, R. L. (1988). The effects of school-based substance abuse education: A meta-analysis. Journal of Drug Education, 18, 243–264.
Bennett, L., Cardone, S., & Jarczyk, K. (1998). Effects of a therapeutic camping program on addiction recovery: The Algonquin Haymarket relapse prevention program. Journal of Substance Abuse Treatment, 15(5), 469–474.
Brown, S. A., Stetson, B. A., & Beatty, P. A. (1989). Cognitive and behavioral features of adolescent coping in high risk drinking situations. Journal of Addictive Behaviors, 14, 43–52.
Burlingame, G. M., Wells, M. G., Hoag, M. J., Hope, C. A., Nebeker, R. S., Konkel, K., et al. (1996). Manual for youth outcome questionnaire (Y-OQ). Stevenson, MD: American Professional Credentialing Services.
Burlingame, G. M., Wells, M. G., & Lambert, M. J. (1995). The Youth Outcome Questionnaire. Stevenson, MD: American Professional Credentialing Services.
Burton, L. M. (1981). A critical analysis and review of the research on Outward Bound and related programs. Dissertation Abstracts International, 47/04B (University Microfilms No. AAC812247).
Cason, D. R., & Gillis, H. L. (1994). A meta analysis of adventure programming with adolescents. Journal of Experiential Education, 17, 40–47.
Castellano, T. C. & Soderstam, I.R. (1992). Therapeutic wilderness programs and juvenile recidivism:Aprogram evaluation. Journal of Offender Rehabilitation, 17(3/4), 19–46.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. (2nd ed.). Hillsdale, NJ: Erlbaum.
Crisp, S. (1998). International models of best practice in wilderness and adventure therapy: Implications for Australia. Paper presented at the Exploring the Boundaries of Adventure Therapy: International Perspectives. Proceedings of the International Adventure Therapy Conference, Perth, Australia, July 23–30, 1997.
Davis, J. S., & Berman, D. (1994). Wilderness Therapy: Foundations, theories and research. Dubuque, IA: Kendall/Hunt Publishing.
Davis-Berman, J., & Berman, D. S. (1994). Therapeutic wilderness programs: A national survey. Journal of Experiential Education, 17(2), 49–53.
Deschenes, E. P., & Greenwood, P. (1998). Alternative placements for juvenile offenders: Results from the evaluation of the Nokimus Challenge Program. Journal of Research in Crime and Delinquency, 35(3), 267–294.
Easley, A. T., Passineau, J. T., & Driver, B. L. (1990). The use of wilderness for personal growth, therapy, and education. (No. General Technical Report RM-193). Fort Collins, CO: Rocky Mountain Forest and Range Experiment Station.
Eggleston, E. J. (1998). Reflections on wilderness therapy. Paper presented at the Exploring the Boundaries of Adventure Therapy: International Perspectives. Proceedings of the International Adventure Therapy Conference., Perth Australia, July 23–30, 1997.
Erikson, E. H. (1963). Childhood and society. New York: Norton.
Ewert, A. (1983). Outdoor adventure and self concept: A research analysis. Eugene, OR: University of Oregon: Center for Leisure Studies.
Ewert, A. (1987). Research in experiential education: An overview. Journal of Experiential Education, 10(2), 4–7.
Friese, G. T., Pittman, J. T., & Hendee, J. C. (1995). Studies of the use of wilderness for personal growth, therapy, education, and leadership development: An annotation and evaluation. Moscow, ID: Wilderness Research Center.
Gass, M. (1993). Adventure Therapy: Therapeutic applications of adventure programming. Dubuque, IA: Kendall/Hunt Publishing.
Gibson, P. M. (1979). Therapeutic aspects of wilderness programs: A comprehensive literature review. Therapeutic Recreation Journal, 13(2), 21–33.
Gillis, H. L. (1992). Therapeutic uses of adventure-challenge-outdoor-wilderness: Theory and research. Paper presented at the Coalition for Education in the Outdoors, State University of New York, October 9—11.
Gillis, H. L., & Thomsen, D. (1996, 1997). Research update of adventure therapy (1992—1995): Challenge activities and ropes courses, wilderness expeditions, and residential camping programs. Paper presented at the Coalition for Education in the Outdoors, Martinsville, IN, October 12—14.
Giranda, M. (2000). A validity study of the youth-outcome questionnaire and the Ohio scales. Unpublished Dissertation, Department of Psychology, Pace University, New York.
Graziano, A., & Raulin, M. (1997). Research methods: A process of inquiry. (3rd ed.). New York, NY: Addison Wesley Longman.
Greenway, R. (1990). An eighteen year investigation of wilderness therapy. (Technical Report No. RM-193): USDA Forest Service.
Hans, T. A. (2000). A meta-analysis of the effects of adventure programming on locus of control. Journal of Contemporary Psychotherapy, 30(1), 33–60.
Hattie, J., Marsh, H. W., Neill, J. T., & Richards, G. E. (1997). Adventure education and Outward Bound: Out-of-class experiences that make a lasting difference. Review of Educational Research, 67(1), 43–87.
Hendee, J. C. (1999). New outdoor behavioral healthcare research cooperative founded at the University of Idaho. International Journal of Wilderness, 6(3), 39.
Jacobsen, N. S., & Truax, P. (1991). Clinical significance: A statistics approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 132–151.
Jenkins, M. (2000). The hard way. Outside, March, 45–52.
Kelly, F., & Baer, D. (1968). Outward Bound: an alternative to institutionalization for adolescent delinquent boys. Boston, MA: Fandel Press.
Kelly, F., & Baer, D. (1969). Jesness inventory and self concept measures for delinquents before and after participation in Outward Bound. Psychological Reports, 25, 719–724.
Krakauer, J. (1995). Loving them to death. Outside, October, 1–15.
Lambert, M., & Cattani-Thompson, K. (1996). Current findings the effectiveness of counseling: Implications for practice. Journal of Counseling and Development, 74(July/ August), 601–607.
Lambert, M., Ogles, B., & Masters, K. (1992). Choosing assessment devices: An organizational and conceptual scheme. Journal of Counseling and Development, 70(March/ April), 527–532.
Lambert, M. J., Huefner, J. C., & Reisenger, C. W. (1996). Quality improvement: Current research in outcome management. In W. T. Stricker & S. Sheuman (Eds.), Handbook of quality management in behavioral health. Plenum.
Levitt, L. (1982). How effective is wilderness therapy: A critical review. Paper presented at the Third Annual Conference for the Wilderness Psychology Group, Morgantown, WV, July 8–9.
McCord, D. M. (1995). Toward a typology of wilderness-based residential treatment program participants. Residential Treatment for Children and Youth, 12(4), 51–60.
McGrath, L. D. (2000). Youth Outcome Questionnaire: A multiwave instruments' susceptibility to retest artifacts. Dissertation Abstracts International: Section B: The Sciences & Engineering, 60(9-B), 4896.
Moore, T., & Russell, K. C. (2002). Studies of the use of wilderness for personal growth, therapy, education, and leadership development: An annotation and evaluation. (Technical Report Available at www.its.uidaho.edu/wrc/publications). Moscow, ID: University of Idaho-Wilderness Research Center.
Moote, G. T., & Wadarski, J. S. (1997). The acquisition of life skills through adventurebased activities and programs: A review of the literature. Adolescence, 32(125), 143–167.
Mosier, J. (1998). The predictive validity of the Youth Outcome Questionnaire: Prognostic Assessment. Unpublished dissertation, University of Utah, Salt Lake City.
Mosier, J., Burlingame, G., Wells, G., Ferre, R., Latkowski, M., Johansen, J., et al. (2001). In-home, family centered psychiatric treatment for high-risk children and youth. Children's Services: Social Policy, Research, and Practice, 4(2), 51–68.
Prochaska, J. O., & DiClemente, C. C. (1992). Stages of change in the modification of problem behaviors. In M. Hersen, R. M. Eisler & P. M. Miller (Eds.), Progress in behavior modification. (pp. 184–214). Sycamore, IL: Sycamore Press.
Robinson, K. (2000). Outcomes of a partial-day treatment program for referred children. Child and Youth Care Forum, 29(2), 127–137.
Rogers, C. R. (1961). On becoming a person. Boston, MA: Houghton Mifflin Company.
Russell, K. C. (1999). Theoretical basis, process, and reported outcomes of wilderness therapy as an intervention and treatment for problem behavior in adolescents. Unpublished doctoral dissertation, University of Idaho, Moscow, ID.
Russell, K. C. (2000). Exploring how the wilderness therapy process relates to outcomes. Journal of Experiential Education, 23(3), 170–176.
Russell, K. C. (2001). What is wilderness therapy? Journal of Experiential Education, 24(2), 70–79.
Russell, K. C. (2003). A nation-wide survey of outdoor behavioral healthcare programs for adolescents with problem behaviors. Journal of Experiential Education, 25(3), 322–331.
Russell, K. C., & Phillips-Miller, D. (2002). Perspectives on the wilderness therapy process and its relation to outcome. Child and Youth Care Forum, 31(6), 415–437.
Stinchfield, R., Niforopulos, L., & Feder, S. (1994). Follow-up contact bias in adolescent substance abuse treatment outcome research. Journal of Studies on Alcohol, 55, 285–289.
Vermillion, J., & Pfeiffer, S. (1993). Treatment outcomes and continuous quality improvement: Two aspects of program evaluation. Psychiatric Hospital, 24, 9–14.
Wells, M., Burlingame, G., Lambert, M., Hoag, M., & Hope, C. (1996). Conceptualization and measurement of patient change during psychotherapy: Development of the outcome questionnaire and the youth outcome questionnaire. Psychotherapy, 33(2), 275–283.
Wells, S. E. (1990). At-risk youth: Identification, programs, and recommendations. Engelwood, CO: Teacher Ideas Press.
Winterdyk, J., & Griffiths, C. (1984). Wilderness experience programs: reforming delinquents or beating around the bush? Juvenile and Family Court Journal, Fall, 35–44.
Winters, K. C. (1999). Treating adolescents with substance use disorders: An overview of practice issues and outcomes. Substance Abuse, 20(4), 203–225.
Winters, K. C., Latimer, W. W., & Stinchfield, R. (1997). Examining psychosocial correlates of drug involvement among clinic referred youth. Journal of Child and Adolescent Substance Abuse, 9(1), 1–17.
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Russell, K. An Assessment of Outcomes in Outdoor Behavioral Healthcare Treatment. Child & Youth Care Forum 32, 355–381 (2003). https://doi.org/10.1023/B:CCAR.0000004507.12946.7e
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DOI: https://doi.org/10.1023/B:CCAR.0000004507.12946.7e