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Article Proposal
I picked Wilderness Therapy because I wrote about this topic for my senior paper for Outdoor Education and I feel that I know quite a bit about this topic and this page needs a lot of help with content and re writing. This page relates to class because therapy for individuals who are at risk, individuals who have mental health problems, and those who suffer from drug and alcohol abuse is a global issue. United States is high in all of these fields and we do a lot to help them but we are not the only country. Some countries have established forms of therapy (traditional or not) and some offer no help. I will use this page to inform readers who are not aware of wilderness therapy and why this is more efffective for those with behaviorial issues, mental health problems, and drug/alcohol abuse.

Wilderness Therapy
Wilderness Therapy (WT) is designed to help individuals connect with the outdoors but mainly with themselves. Individuals who participate in these type of programs need guidance with problems that they are experiencing in their lives. These participants may struggle with mood problems, substance use, and disruptive behavior. Although, these programs do not only have to be for those who struggle with a disease, it can be for any one who needs some guidance in their lives.

Wilderness Therapy is defined by taking traditional therapy techniques and mixing it with group therapy out in the wilderness setting that is approached with therapeutic intent, Powch, 2004). Through this form of therapy, participants are encouraged to create reflections that make them in tune with themselves and nature. WT has been defined and characterized in many ways. Rehabilitative outdoor-based approaches such as "challenge courses", "adventure-based therapy", "or wilderness experience programs(WEPs)", are often used interchangeably to describe "Wilderness therapy (Russell 2001)." These programs typically consist of 8-12 members that run on a 7-8-week schedule where licensed mental health professionals take clients out into the wilderness. The wilderness provides a place that is free of distractions, stress, substances, and more obstacles that effect an individual's self-growth. WT, according to Russell 2003, is a program for individuals who have no had success in psychiatric hospitals, rehabilitation programs, and out-patient treatment.

In WT therapist use a varied amount of theoretical orientations. These orientations include mindfulness-based therapy and cognitive behavior therapy. These therapies often use the come common therapeutic intervention approach. These interventions are individual, group, or family therapy. Finally, the last type of therapy that therapist may use is the common approaches. The common approaches are individualized treatment plans, medication management, and milieu-based care.

In the wilderness there are different ways in which the therapy becomes therapeutic. To become therapeutic, the therapy needs to have intentional outdoor challenge activities, physical activity, teamwork, and self-reflection. In order for WT to succeed clients must be able to work together, solve problems together, and to support each other.

The price of a wilderness therapy program is expensive. This can average $325 dollars per day with 40 percent of clients receiving financial assistance from medical insurance. "As wilderness Therapy programs strive for recognition from insurance companies by receiving accreditation from national agencies such as the Council on Accreditation (COA), the trend towards co-pay assistance is likely to continue making wilderness therapy more accessible for families with limited incomes."

The CHANGES AND GRABBS model
Before entering the wilderness, therapist use assessments to understand each individuals needs and to figure out how to make WT beneficial to them. They also use these models to give a baseline to the therapist on if these programs are meeting the individual or group’s needs, goals, and self-efficacy. These models also give the therapist ideas on what activities to have the group complete to be able to build their teamwork, trust, communication, and more. The first model used by therapist is called the CHANGES model (Gass & Gillis, 1995), which leads to the experiential wave model of Alvarez and Schaeffer (2001). Then after these models comes the GRABBS model (Schoel, Prouty, and Radcliffe, 1988).

The CHANGES model
The CHANGES model is a "helpful way to organize interactive steps to acquire information and reflect upon it to enable the development of functional client change In this process there are seven steps which are: Context, Hypothesis, Action, Novelty, Generating, Evaluation, and Solution. In an adventure therapy assessment there are three elements which are Diagnosis, Design, and Delivery.

In the first step of the CHANGES model the therapist figures on the context by acquiring all of the background information of the client groups. They focus on figuring out the groups strength, goals, drug/alcohol history, what their experiences are, and how long they have been in the WT programs. This stage will be able to help therapist focus on meeting the groups needs and to figure out how to beneficially help the group.

The next stage in the model is the hypothesis and this is when the therapist makes plans based on what the expected behavior of the group might be. These are test through engagement in adventure experiences. "The Wampum experience was used to see if the group could maintain their Composure with an activity that involved hitting one another These experiences will be test out within the Residential Treatment center. Therapist ask many questions in this model which include; what kind of past experiences from the therapist do they bring to the group, and what questions do they want to test out.

The action stage is next in the CHANGES model. "Much of the material used for constructing change is obtained from the actions of the group members as they involve themselves in adventure experiences" The idea of a never-fail kind of materials is used in this stage so participants can show their strengths and weaknesses without feeling discouraged. Some activities that can be used during this stage is mood ball and group juggle. In this model therapist might be thinking "Are Clients' actions congruent or in congruent with your hypothesis? Does initial hypothesis confirm, adapt, revise, or reject your thoughts? Can you engage clients in their motivation areas, not your own? "

In the Novelty stage therapist try to find the true behavior of the participants by using spontaneity. By using spontaneity, therapists are able to identify the true issues of the group instead of the “Social Proper” ones. Therapist will also use projection with the client groups.

In the generating stage of the CHANGES model therapist observe many actions that the group present. They can identify functional and dysfunctional behaviors as well as concrete, abstract, distorted, or critical thinking patters. Also, therapist can determine the group’s appropriate or inappropriate affect. Many questions come into place in this stage like the groups beliefs, behavior patterns, how the behaviors make sense, and many more.

Next is the evaluation portion of this model. During this stage the hypothesis is brought back into play and is compared on how the group behaved overall. Also, during this stage feedback is given to the clients.

Finally, the last stage is the solutions. This is when the therapist evaluates the total group behavior and they are able to design solutions. They will find solutions that fit best to help the group’s needs, individual goals, and more.

To break this model down a little more, the context and hypothesis stage of the CHANGES model is when the therapist are diagnosing the problem/s. Then in the Actions, Novelty, and Generating stage the therapist is delivering this information. In the evaluating and solution stage, therapist is debriefing & departing.

The GRABBS model
The next model within the Wilderness Therapy program is the GRABBS model (Schoel, Prouty, & Radcliffe, 1998) which “was developed by project adventure as a scanning device for helping facilitators remember important domains when holistically assessing their groups in the moment (Gass, Gillis, Russell, 2012).” In 2002 the model was updated and an extra S, for setting, was added to be more effective in assessing the groups.

Goal setting in groups is highly critical because therapist needs to know individual goals, and creative goals that both the client and therapist agree too. An Acronym that is highly affect is called SMART. SMART breaks down into Specific, Measurable, Attainable, Realistic, and Trackable. Also, in creating goals therapist have to factor in the goals of whoever is paying the bill for the program. Readiness in GRABBS model is defined as what the group can do as of this moment that was impacted by their past experiences. The next stage of the GRABBS model is affect. This is used in finding out the behavior of the group. Is the group sad, happy, good mood, bad mood, etc.? Should therapist use energizing activities to bring up the groups spirit? Behaviors is the next step which is similar to the affect stage. This is when you determine how the group is treating each other and if there is any bullying going on. Then comes the Body Stage and this is when the therapist determines the physical state of the group. The therapist needs to figure out if clients can life one another and if the group can hike the route that is a part of this program. Stage is when the therapists figure out if the group is new to working with each other of if they have experiences together.

Programs in the United States
There are many programs across the United States that offer wilderness therapy. In this section, a few of them will be discussed. Each program will be analyzed in terms of: Their mission statements, treatment options, certifications, and cost of attendance.

Program one: Confluence

Confluence is a wilderness therapy program that is based out of Thetford Center, Vermont. Their mission statement reads:

"Our mission is to unlock an individual's potential to heal, change and grow by providing effective, high quality mental health treatment and transformative experiences. Our goal is to offer the perfect balance of support and challenge in a safe and encouraging setting where participants can realize their fullest potential. Confluence uses outdoor and wilderness excursions as a means to develop accomplishment, build self-esteem and foster engagement. Outdoor experiences instill belonging and connection and help participants create patterns for healthy living"

Confluence offers: Cognitive Behavioral Therapy, Relational-Cultural Therapy, Family Systems Theory, Developmental Psychology, Positive Psychology, Positive Peer Culture, Trauma-Informed Care, MBSR - Mindfulness Based Stress Reduction, Adventure-Based Counseling, and more. Confluence is licensed by the Vermont Agency of Human Services, which is an executive agency that deals with the development and implication of human services for the state of Vermont. Confluences offers both residential treatment as well as day long excursions, stating that “Outdoor experiences instill belonging and connection and help participants create patterns for healthy living"  The cost of attending Confluence is around $500 per day with a onetime fee of $2,500 (for gear, equipment, clothing)  and that includes “clinical treatment, transitional support, family services, mentoring, coaching, room and board and all activity fees and program costs”.

Program 2: Trails Carolina

Trails Carolina is a Wilderness Therapy program that is based out of Toxaway, North Carolina. Their mission statement reads:

"Wilderness provides time for reflection and natural consequences that are the impetus for behavioral change. Our program is rooted in wilderness. We combine this therapeutic background with clinical theory and research-based practices to address the unique developmental and psychological needs of each student"

Trails Carolina is a family oriented, but youth focused, program in terms of using the participant’s family as resources and support while the treatment is in progress. They offer family therapy as well as weekend long family camps that focus on building connections between families. “Our family programming is designed to provide concrete skills and training for the entire family. Change doesn’t occur overnight and so family support provides an incredible opportunity to understand how to make change last and reconnect family members” Trails Carolina also offers individual specialized therapy and equine based therapy. While enrolled, children can also maintain their school work because “Trails Carolina is proudly accredited by AdvancEd (SACS) and employs a full time certified teacher working with every student”. Trails Carolina is accredited by the National Association of therapeutic Schools and Programs, Commission on Accreditation of Rehabilitation Facilities, and the Department of Health and Human Services. The cost of attending the Trails Carolina depends on the child's age, needs, and financial situation; therefore there is no sticker price of attendance.

Program 3: Second Nature

Second Nature is a wilderness therapy program that is based out of Duchesne, Utah. They work with adolescents ages 13-17 and their families. According to Second Nature:

Our model is highly effective with therapeutically resistant students. The 24/7 supervision, over-arching clinical support and therapeutic application of principles against the backdrop of a safe but challenging environment effects change in ways that can’t be duplicated in other therapeutic recreational program settings"

Second Nature is the most medically based wilderness therapy program that we have looked at so far. All of their applicants are run through a series of psychological tests as well as state and country background checks. Many of their applicants also attend group therapy sessions along with their private sessions. Second Nature treats adolescents with Depression, Anxiety, Bipolar Disorder, Substance Abuse/Dependence, Gaming Addictions, Academic Failure, Low Self-Esteem, Life Adjustment Problems, ADHD/Learning Difficulties, Identity Issues, Attachment and Adoption Issues, Social Problems, Family Conflict, Grief and Loss, Sexual Acting Out, and Victims of Abuse. As with the Trails Carolina School, Second Nature is also accredited by the National Association of Therapeutic Schools and Programs and supported by the Utah Department of Health and Human Services. Cost of attending the Second Nature wilderness therapy program is not available for viewing online to the general public.

Bibliography- ADD 8-12 SCHOLARLY ARTICLES
What is wilderness Therapy https://journals.sagepub.com/doi/pdf/10.1177/105382590102400203

Exploring how the wilderness therapy relates to outcomes https://journals.sagepub.com/doi/pdf/10.1177/105382590002300309

How Wilderness Therapy Works: An Examination of the Wilderness Therapy Process

to Treat Adolescents with Behavioral Problems and Addictions

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.475.8428&rep=rep1&type=pdf

5 https://files.eric.ed.gov/fulltext/ED424052.pdf

https://www.allkindsoftherapy.com/treatment/youngadults/wilderness-therapy

Gass, M. A., Gillis, H. L., & Russell, K. C. (2012). Adventure therapy: Theory, research, and practice. New York: Brunner-Routledge.

https://www.natsap.org/

https://www.outbacktreatment.com/wilderness-therapy-works/

http://www.second-nature.com/