On August 22, 2024, news broke that Evoke Therapy Programs will be closing its doors this September. The closure of wilderness therapy programs has become increasingly common in the United States, raising questions about the future of our sector and the diverse world of outdoor therapies.
 
While the reasons for Evoke's closure remain unclear, I've been following their online presence for years and have some thoughts on what might have led to this outcome. Here are a few insights I'd like to share.

1. The Individual Pathology Perspective
One possible factor in Evoke's closure could be their beliefs about the sources of distress and the nature of healing. Their approach seems to view mental health issues through an individual pathology lens, which focuses on changing the individual. However, this perspective has been losing ground for over a decade. Parents may no longer want their children to be coercively or punitively forced into change.

2. Misjudging Negative Feedback as "Bad Press"
Evoke, like other organizations, has faced negative press about their practices—something they acknowledge in their webinars. However, labelling client experiences as merely "bad press" may have prevented a swift and systematic response to legitimate concerns. Many past participants, who refer to themselves as "Survivors," have described their experiences as abusive, citing coercion, human rights violations, and punitive practices. The lack of a demonstrable response to these claims may have made wilderness therapy less attractive or even irrelevant, leading to a decline in enrolments.
 
Earlier this year, Evoke rebranded itself from a "wilderness therapy" organization to an "outdoor therapy" one. This change, which I and others have observed elsewhere, is not a solution. Merely changing a name without addressing underlying issues dilutes the work the rest of us are doing. The Outdoor Behavioral Healthcare industry should focus on substantial changes to practice rather than superficial rebranding.
 
The Rising Tide of Litigation
There is also the possibility that legal challenges have contributed to Evoke's decision to close. Survivors are increasingly pursuing litigation against programs they claim were abusive. We know that another similarly accredited wilderness therapy organisation caused the death of a 12-year-old participant as result of their standard practices, which included improvised restraints. These kinds of coercive practices are unfortunately not uncommon in some wilderness therapy programs.
 
Concerns about such practices were first raised within our field at the 4th International Adventure Therapy Conference in 2006. For years, we had opportunities to listen to Survivors and act to eliminate the coercive practices that harmed them, and that now damages our collective reputation. The belief that coercion is necessary to "save lives" is just that—a belief. In reality, the World Health Organization promotes a human rights-based approach because coercive practices are harmful. The American Bar Association has even advised its members on identifying illegal coercive practices in wilderness therapy. It seems that U.S. lawyers and Survivors are determined to bring these issues to light in courtrooms.
 
What Does This Mean for Us?
 
We should take two critical steps:

1. Separate Ourselves from Harmful Practices: We must distance ourselves publicly and definitively from the negative reputation and harmful practices of coercive wilderness therapy. While we should disassociate from the term "wilderness therapy," particularly in the USA, where it carries different connotations, reclaiming the term there is the USA’s challenge. I, along with other Friends of the Outdoor Therapy Centre, am available to help if needed. Outside the USA, we don't practice coercive wilderness therapy at the systemic level of the troubled teen industry. If you rely on USA literature on wilderness therapy, you may want to look elsewhere for evidence of good practice. Much of that literature may not apply to your work unless you take involuntary clients into remote places for around 90 days and control their every movement and communication. More on these practices can be found here.

2. Embrace Human Rights-Based Practices: The Outdoor Therapy community should adopt a human rights-based approach that can be measured and puts safety constraints around our practice. This would help reassure the public and refine our methods. Seeking, listening to, and responding to feedback is crucial. This proactive approach might help us address issues early and prevent negative feedback from escalating into complaints or bad press. In my experience, when practitioners consistently respond to client feedback and tailor the outdoor therapy experience accordingly, both the relationship and the healing process are strengthened. Adapting the process to fit the individual is more effective and enjoyable than trying to force change upon them.
​
Twenty years ago, I believed that encouraging people to rappel/abseil from a height would help them prove to themselves they could function under stress. However, after reading the complex trauma literature, I realized that pushing someone into a scary situation is coercive. I experimented with this idea and stopped forcing people into perceived risks. Instead, I focused on their lived experiences of dignity, choice, and control. Reflecting on this change, I’ve noticed that just as many people choose to rappel/abseil now, but they seem more content and confident. I have not had to "rescue" a frozen participant over the cliff edge in over ten years. The key is letting them know it is okay to say, "Thank you, Graham, I'm not abseiling today," and respecting their choice.
 
I still run the same activities as before, but the difference is that we define success by the participant's sense of dignity, not by whether they complete the activity. As Mike Brown wrote in his paper, Comfort Zone: Model or Metaphor? (Australian Journal of Outdoor Education, 2009), "enormously high perceptions of risk" are not only unhelpful but potentially re-traumatising. He was referring to this advice to practitioners from the literature of the time.

Social Sciences Week 2024 is just about a month away. This is a grassroots movement for researchers and practitioners to share their work to the wider audience. We've put together a cool series of presentations. Please register for all/any that interest you as this will also help with sharing the recordings.

As with all resources developed by the Outdoor Therapy Centre, these recordings are free for all of those interested and can be shared widely. As always, share everything...

​Two weeks ago I flew to Queensland to meet Mark Cartner from Walkabout training. Mark had offered to host me as part of my social work placement with the Outdoor Therapy Centre - and I was in for a treat! 

Mark runs a fantastic program with young people in year 10 from Bundaberg North High School. Over the school year he works with the students, training them in the outdoor skills necessary to gain a certificate II in outdoor recreation. As part of their training, Mark takes the students on three journeys, one in Cooloola National Park, one to the Gold Coast, and this mid-winter trip to Cape York.

I’d like to welcome Josh Heins, a social work student from Charles Sturt University on his first social work placement/internship with the Outdoor Therapy Centre.
 
Recently, Josh has worked as a freelance outdoor educator in New South Wales, Victoria, and Northern Territory. He has worked for a year in China delivering outdoor education programs with international schools and worked as a divemaster in the Cook Islands. Josh served three years as program manager at The Crossing, a unique permaculture, environmental, and outdoor education camp in New South Wales while pursuing his social work degree and qualification.

Throughout the past few months, Josh, myself, and many of the Friends of the Outdoor Therapy Centre have collaborated to develop a protocol and framework for social work placements in line with the Australian Association of Social Workers’ (AASW) accreditation standards to help social work students in Australia experience a diverse range of learning experiences in outdoor therapy. 

Last month, Josh began his 500 hour internship with the Outdoor Therapy Centre. Together, we’ve worked closely with the workplace learning team and practitioners in Australia to develop a learning plan unique to his goals and experience and inline with the AASW standards. 

Next week, Josh will attend an expedition with Mark Cartner from Walkabout Training to take a group of young people to Cape York for an outdoor therapy experience. During the expedition, Josh will implement feedback-informed treatment, gathering outcome and alliance data relevant to his own effectiveness, which can be used for supervision and critical reflection with Friends of the Outdoor Therapy Centre. 

During the placement, Josh will critically reflect on his experience networking, observing, and researching with organisations and practitioners in the Australian and international outdoor therapy community. Josh is also assisting in a new study using data from the Adventure Therapy Outcome Monitoring research project relating to outcomes of paraprofessional adventure therapy providers in Australia. This data will be presented next week as well at a policy summit hosted by Youth Flourish Outdoors. 

Josh’s favourite outdoor activity is hiking, followed by canoeing. His personal favourite location is the snowy mountains, but he loves living on the NSW South Coast in a tiny house on a farm.
After Josh graduates, he hopes to work in outdoor therapy in some yet-to-be-determined capacity, He’s especially interested in what outdoor education programs can learn from outdoor therapy and vice-versa, particularly sharing knowledge about risk management that is so well established in outdoor education literature; how counselling skills are helpful in all outdoor education programs; and how to bring trauma-informed ideas of safety into outdoor education.

We’re very excited for this development, especially when Australia’s federal government begins to pay students for their workplace learning in the helping professions. This aligns with the centre’s mission to fight for those behind us and provide accessible learning opportunities for those interested in the diverse world of outdoor therapies. 

-Will

Together with my friend Graham Pringle, we started to categorise the specific interventions and practices used in wilderness therapy in the United States. We questioned where these ideas came from and why they persist despite no evidence to suggest they improved outcomes. Instead, the evidence suggested that some of these practices might be terribly harmful.

Graham jumped into this rabbit hole. He listened to hundreds of hours of wilderness therapy podcasts, read literature from the 90’s describing the theoretical foundations for wilderness therapy, and watched documentaries while taking careful timestamps of specific practices. He described these practices as coercive, and began to think of them as a dissociative mechanism of change. They were techniques used and delivered by wilderness therapy clinicians and staff to facilitate ‘therapeutic’ change. The trouble is, they seemed likely to cause  trauma responses.

Early wilderness therapy research described the importance of impelling cognitive dissonance in programs for youth. Cognitive dissonance occurs when people are faced with situations that do not confirm their expectations about who they are and how they see the world. In the right circumstances, this change in thinking can lead to positive behaviour change, such as exercising more, reducing alcohol or tobacco consumption, or prioritising a good night’s sleep. However, when outdoor therapy forces cognitive dissonance onto involuntary clients, specifically youth who are in their formative years of identity development, outcomes can be dreadful. 

We found that many wilderness therapy providers working with involuntary youth were appearing to superficially achieve good therapeutic outcomes; youth typically became compliant and participated in tasks associated with the wilderness therapy program. However, compliance does not equate to increased therapeutic engagement. Afterall, successful completion of the program, which averages 90 days in length, is the only way 94% of youth can actually leave the wilderness! 

Focusing on compliance, program completion, and “successful” treatment actually manifested like a natural trauma response that occurs when a person cannot escape a harmful experience. 

Along with scholars from the International Society for the Study of Trauma and Dissociation, and two young adults harmed as youth by America’s troubled teen industry, we drafted a paper detailing our research methodology that justifies our claim that wilderness therapy programs can deliver a potentially dissociative mechanism of change, often mistaken for an (intended) therapeutic cognitive dissonance. You can find that study here which is available to read in full in its pre-print format. 

The “Evidence”: One owner of multiple wilderness therapy and Outdoor Behavioral Healthcare programs described on a podcast placing young people in “threatening environments” which were “disorienting” and “part of the magic” of wilderness therapy. In the literature, we found proponents arguing that adventure therapy was effective at disrupting the equilibrium of a young person's life and that “change is rarely voluntary.” We watched videos of young people being blindfolded “to prevent runaways” while being involuntarily driven to the woods. When youth asked to call their parents or complained of blisters and a sore back, staff said it was “excellent acting.” 

These quotes are taken from publicly sourced material and are referenced in the article. It seemed clear that what was written in research papers was not a transparent depiction of the practices and theoretical backing informing this work. 

So back to mechanisms of change. We asked how practices with little to no research evidence supporting their positive impact on treatment outcomes continue despite the obvious contribution to dissociation, trauma responses, and harm. Are they designed to be therapeutic? If so, we have yet to hear the rationale for it. 

We invite you to join the discussion. Read the paper. Share fiercely if you’d like. Ask questions. 

Call To Action: In February 2024, a 12-year-old boy died within his first 24 hours at an accredited wilderness therapy program using practices similar to what we described in our recent study. Together with members of a community of tens of thousands of survivors from these and similar programs, we penned an open letter to the international adventure therapy community to publicly decry these practices and the associations and professionals enabling the systematic harm of youth - in the name of outdoor therapy - to continue. We hope you will sign this letter and continue advocating for safe and effective outdoor therapy. 

Above all else, we invite you to ask what specific practices in your work lead to outcomes. Have you tested them? What if a client doesn’t want to journal or meditate or walk in the woods? Who are the practices for? Author Kenneth Rosen and survivor of multiple wilderness therapy programs said during a podcast interview that adventure therapy providers are just pushing their hobbies onto their clients. An interesting, and probably mostly accurate take, so what do we do about it? 

Practitioners make evidenced, clinical judgments every day, from one experience to the next. That’s the adventure. We navigate outdoor environments and juggle our clients’ experiences in the rain, sunshine, sleet, and snow. That’s the work. 

Until next time,

​Will

The traditional long-form of academic discourse, that can be dominated by an insular group, is undergoing a significant transformation. One capable of improving transparency and community engagement and bridging the division of research and practice in outdoor therapies.

Blind peer-review in which two researchers knowledgable on a certain topic volunteer to review and analyse submitted research papers in good faith without knowing authors was  once a cornerstone. This is challenging in the field of outdoor therapies.

If someone submitted a research paper about the Adventure Therapy Outcome Monitoring study, we can make an educated guess on who wrote it. If I'm writing about dissociation or complex trauma and adventure therapy, many in the community will know they are most likely reviewing my work. We're a small and engaged community so the notion of a 'blinded' peer-review becomes increasingly challenging.

To preserve this process, we require discipline to politely decline reviewing papers when you know you cannot provide an objective review. 

Today, this process is faltering, signalling the need for a shift towards a more inclusive and democratic approach to ongoing research.

Dr. Scott D. Miller, the co-founder of the International Center for Clinical Excellence and previous consultant and trainer for the Adventure Therapy Outcome Monitoring study, described three types of reviewer; those who enrich the discourse with fresh insights, those who seek to align narratives with their own, and those who dilute original perspectives by including tangential information.

The proceedings from the 9th International Adventure Therapy conference were un-blinded and collaborative. Many of us volunteered in support for the project. We helped each other more as supervisors and colleagues than as judge and jury. Talking with colleagues, I found we all experience helpful, collaborative, and supportive reviews, ultimately leading to better outputs for our field.

Where reviewer power was lost, author capability was increased.

Now something else is here that signifies a departure from blind review and the suppression of diverse viewpoints by entrenched groups. My guess is pre-print servers (such as https://socopen.org/) will become the new normal for academic discourse.

Before undergoing formal peer-review in an academic journal, articles can be uploaded to pre-print servers, swiftly verified for authenticity, and made accessible to the public. The authors are identified and the pre-print is known to be a draft. Both large academic publishers Springer and Taylor & Francis endorse this process.

After uploading to the pre-print server, articles are moderated to eliminate AI generated and incomplete articles and allocated a DOI in 1-3 days. A DOI is a Digital Object Identifier, a set of numbers or symbols used to identify an article or document. This will also provide a URL to help with locating specific articles.

This newfound accessibility empowers the professional community to engage in robust discussions, offer feedback, and iterate on ideas, while ensuring proper attribution to the original authors.

As manuscripts undergo successive revisions, discourse evolves dynamically, akin to the iterative nature of conference proceedings.

The distribution of the original, and developing perspective is controlled by the public and not by the delaying reviewers of type 2 and 3 described by Scott.

Journals must adapt their processes to accommodate this shift, recognising that past methods of quality control have often stifled dissent and innovation. The precise trajectory of academia's evolution remains uncertain.

I think the new professional and academic discourse will be fast and fascinating and will be less stressful as we find ways to respond in ways helpful to the public. We must rapidly adapt to the new discourse.
​

This blog was provided by Graham Pringle

For more about Graham visit:
The Emu Files
Youth Flourish Outdoors

Last week I facilitated an intensive school for first year social work students focused on developing foundational interviewing skills. Comprised of roughly 230 graduate and undergraduate students, these five-day intensives are exhaustive, yet super fun. And we're doing it all again this week focusing on experiential group work.

I personally love the balance between engaging with those who bring extensive human services experience, and those wide-eyed and new to the helping professions. After all, it is the "beginner's mindset," that leads us to new opportunities. 

Along with my dearest colleague, Friend of the Centre, and former PhD supervisor, John Paul Healy, I read loads of Jane Addams, John Dewey, Virginia Satire, William James, and Myles Horton over the last year. We considered how we could best bring in more of the foundational experiential and pragmatist philosophies to our teaching during the social work theory and practice subjects.

During this one, I was reminded of an awesome idea I didn't know would translate so well to students from a range of backgrounds. 
 
On Tuesday afternoon, we worked in breakout groups with a 1:16 ratio to practice how social workers can deliver their role induction. Whether one works indoors or out, adventure-based or via talking methods, the role induction is an initial phase to prepare participants for what is next to come. 

Depending on one's cultural context, this may involve discussing confidentiality, mandatory reporting, and what we do as practitioners if our work becomes ineffective. Omitted quite often from discussions of role inductions is how the practitioner elicits a participant's sense of hope by describing their work. The role induction is a therapeutic tool, as well as an important task for consent.

As I did my best to model the purpose of "practicing" the role induction, one student asked, "How should we talk about safety? My safety? The participant's safety?"

I, for one, don't love shoulding on people but I was missing an important point. What a brilliant question!

I was reminded of Gippsland Adventure Therapy's 'role induction.' When a new participant engages, they are shown a Venn diagram (below) saying their collaborative work together should be Fun, Safe, and Useful. They also show each participant their rights during their adventures.

​I'm not sure if Doug Moczynski will agree, disagree, or correct whether or not I get this right, but I pulled up Gippsland Adventure Therapy's website and discussed it with the students. 

That afternoon, I observed students creatively tailoring the Fun, Safe, Useful idea to their own work. After practicing how we can describe the responsibility of preserving one's self-determination, human rights, confidentiality, autonomy, and safety, one student said during a simulation:

"At the end of the day, I just hope our work feels engaging, safe, and effective for you. This can be accomplished in many different ways. I hope we can use these ideas as guardrails as we keep reflecting on our experiences together. What do you think?" 

How we talk about outdoor therapy with new participants is much more important than an administrative task. It's a moment to elicit hope and expectancy. I'm curious to know how others describe their work to prospective service users. ​

Excited to test this further in the future. So simple and concise, but could be a useful tool moving forward. Be sure to let us know how you begin first meetings with those you work with in the outdoors. 

Until next time,
​
​Will