Wilderness therapy

"Our Mothers" explores the Mother Archetypes that have shaped our life, employing a unique blend of Psycho-analytical and Theopoetic methodologies. Through an intricate weaving of psychological insights and spiritual reflections, this book seeks to unravel the complexities of the Mother symbol, Femininity, Maternal Influences and their lasting impact on personal & spiritual development. Using the lens of Jungian analysis, we aim to investigate the multifaceted roles played by various individuals in assuming the archetype of a Mother symbol throughout my meta-Spiritual Journey and human development. Theopoetic methods are used to bring a Spiritual dimension to the analysis, intertwining the Sacred and the psychological in a quest to illuminate the transformative power of the Mother archetype. A central theme in this book revolves around the Shadows cast by these Mother symbols – the deeply ingrained traumas and challenges that have left indescribable imprints on our psyche. Despite the Shadows, the book emphasizes the paradoxical and Theopoetic beauty in the transformative journey, acknowledging how these experiences have contributed to our evolution in the process of Becoming. The exploration transcends personal narrative to touch upon universal themes of growth, resilience, and the intricate relationship between light and darkness in the Inward Journey towards Self. "Our Mothers" is an emotional exploration of the interplay between maternal influences, psychological Shadows, and Spiritual growth, offering a compelling narrative that invites readers to reflect on their own Journeys of Becoming in the light of those who have mothered them.

This paper examines the opening chapters of Devarim (Deuteronomy 1-3) through a contemporary lens, exploring themes of exile, spiritual leadership, and monotheistic fidelity. Drawing from the Parashah reading for Shabbat (August 1, 2025), this analysis considers how ancient narratives of displacement, identity, and divine relationship illuminate modern experiences of migration, belonging, and spiritual attachment. The research particularly focuses on Moses as a flawed leader navigating complex ethnic and religious identities, offering parallels to contemporary discussions of displacement and belonging.

To my family and friends, your love and support through this long endeavor has been a source of strength. Thanks to my friends and colleagues for your support, and assistance with data collection. I want to thank Edmon Artinyan, for your assistance with edits, and for providing laughter when the process got stressful. And finally, I would like to thank God for providing me the undeserved opportunity to study His creation and marvel in its complexity. v CONTENT Approval Page .

To my family and friends, your love and support through this long endeavor has been a source of strength. Thanks to my friends and colleagues for your support, and assistance with data collection. I want to thank Edmon Artinyan, for your assistance with edits, and for providing laughter when the process got stressful. And finally, I would like to thank God for providing me the undeserved opportunity to study His creation and marvel in its complexity. v CONTENT Approval Page .

Wilderness therapy is a specialized approach to adolescent substance use and mental health treatment. While empirical evidence of positive outcomes grows to support this approach, qualitative understandings are lacking in the literature, thereby limiting theoretical explanations. Additionally, the voice of adolescent clients is hardly present, and was therefore the focus for this research. A sample of 148 adolescent wilderness therapy clients at one Canadian residential treatment program for addictive behaviour and mental health issues participated in the study. A realist approach utilizing thematic analysis of written open-ended responses produced six major themes; three depicting participant experiences (social dynamics, wilderness, catalyst for change) and three for perceived outcomes (skill development, self-concept, health). These findings are discussed in relationship to the development of a clinical model of wilderness therapy and the potential of wilderness interventions in adolescent residential treatment. Recommendations for practice and future research are discussed. Variations of group and residential care models are often categorized together in reviews of practice, research and reporting which may "blur and confuse key distinctions" (Whittaker et al., 2016, p. 95). Describing group homes, residential treatment centers (RTC),

Dignity is a universal principle that requires us to treat every person as having worth beyond who a particular person is or what they do. Dignity is a complex and sometimes contested idea, that at times can be compromised in health care and allegedly also within the practice of outdoor therapy. Outdoor therapies comprise a range of therapeutic approaches including nature-based therapy, adventure therapy, animal-assisted therapy, forest therapy, wilderness therapy, surf therapy, and more. Within the literature of outdoor therapies there has been limited research on ethics related to common understandings of care concepts such as relational dignity and human rights. The aim of this paper is therefore to unravel briefly whether dignity in general, and relational qualities of dignified care more particularly, might be a useful concept to apply in order to support an ethical practice in outdoor therapies.

Background and purpose: Participant state anxiety in outdoor therapeutic practices continues to raise many questions. To help inform this important topic we present and discuss the results of an exploratory pilot study on participant day-to-day state anxiety throughout a Norwegian wilderness therapy intervention. Materials and methods: Thirty-three adolescents from six groups completed a total of 251 state sections of the State-Trait Anxiety Inventory. Results: On average, there was a slight decrease in state anxiety as the program progressed and a significant reduction in anxiety between the first and final days. The between-subject range was large, and boys reported significantly lower anxiety than did girls. In light of the results, we discuss general understandings of day-to-day state anxiety, gender differences, group differences, the perception of risk, and the relationship between perceived autonomy and state anxiety. The paper concludes with implications for the outdoor therapy field at large.

Wilderness therapy is a specialized approach to adolescent substance use and mental health treatment. While empirical evidence of positive outcomes grows to support this approach, qualitative understandings are lacking in the literature, thereby limiting theoretical explanations. Additionally, the voice of adolescent clients is hardly present, and was therefore the focus for this research. A sample of 148 adolescent wilderness therapy clients at one Canadian residential treatment program for addictive behaviour and mental health issues participated in the study. A realist approach utilizing thematic analysis of written open-ended responses produced six major themes; three depicting participant experiences (social dynamics, wilderness, catalyst for change) and three for perceived outcomes (skill development, self-concept, health). These findings are discussed in relationship to the development of a clinical model of wilderness therapy and the potential of wilderness interventions in adolescent residential treatment. Recommendations for practice and future research are discussed. Variations of group and residential care models are often categorized together in reviews of practice, research and reporting which may "blur and confuse key distinctions" (Whittaker et al., 2016, p. 95). Describing group homes, residential treatment centers (RTC),

This paper discusses how the increased urbanization and technification trends of our time may partly explain the considerable rise in adolescent maladjustment, typically expressed through symptoms of depression and anxiety. The authors argue that if living life increasingly disconnected from the natural world is part of the cause, then reversing, or at least moderating these trends and resultant pathology, must be part of the solution. Evidencebased wilderness therapy approaches have a long history of enabling optimal growth and personal development with adolescents. This article proposes how specific core elements of these often-complex therapeutic outdoor programs can be put to use on a broad scale throughout our communities. We provide examples supporting a three-stage approach to address the deleterious effects of urbanization and technification in adolescents; (1) changing beliefs, (2) education, and (3) planning. Finally we present some practical examples of possible antidote measures. An extensive study of almost 200,000 Norwegian adolescents showed that the majority are well-adjusted, active, and enjoy good relations with their friends and parents (Norwegian Social Research, 2015) although approximately one in three agreed to the statement: 'I do not like the way in which I live my life' . This general lack of contentment among a third of the adolescent population is occurring in the country that currently ranks number one in global happiness . Barnes and colleagues (2016) raise their concerns in Canada, the 7th happiest nation in the world, following their national study of physical activity among children and youth when they concluded that despite a 'perplexingly favorable physical activity landscape … and good availability of facilities, policies and programs' the average level of physical activity is worryingly low (p. 115). The links between physical activity, well-being and most aspects of health are of course well established. As authors from Norway and Canada, respectively, it seemed natural to provide the above examples from our own neighborhoods. More important still is to stress that even in countries that empirically do well on a range of desired health and well-being indicators, there remains major, and increasingly ARTICLE HISTORY

Background: Adventure therapy (AT) is a term that includes therapies such as wilderness therapy and adventure-based counseling. With growing empirical support for AT, the diversity of studies make it difficult to attribute outcomes to specific treatment factors. Objectives: Researchers explored whether AT, often perceived as an alternative therapy, works because of AT's unique components, or whether factors shared by all therapies were responsible. Methods: A scoping review was undertaken utilizing a search of major databases, unpublished dissertations, and a hand search for direct comparison trials matching AT with another therapeutic intervention. Results: 881 publications were identified. 105 quantitative studies were included following a title and abstract review. Only 13 met the full inclusion criteria. Little to no differences were found to isolate specific therapeutic factors. Conclusions: We discuss the implications of these results considering the movement toward evidencebased practice and recommend future research to eclipse our current understanding of AT.

Outdoor behavioral healthcare is a specific model and industry utilizing wilderness therapy (WT), a residential treatment approach comprised of outdoor travel and living for youth experiencing mental health, substance use, and behavioral concerns. We present data from 6417 participants about reasons for referral, admission, and discharge scores from the Youth-Outcome Questionnaire (Y-OQ), youth interest and commitment to treatment, reliable change scores, and the relationship between these variables. One-third of youth entered WT with sub-clinical scores, varying levels of client motivation and voluntariness in relation to clinical outcomes, a diverse range of presenting problems without clear indication of specialized treatment planning, and differing responses to treatment by referral reason. Identifying those not responding to WT and those at risk of deterioration from the time of admission requires further investigation to improve client outcomes for this treatment modality. Recommendations include placing increased importance on accurate and thorough screening and assessment, utilizing baseline and routine outcome monitoring, reducing coercion, and considering specialized intervention.

The role of those who work in child protective services (CPS) is to ensure children's safety and well-being. This study explored eight CPS professionals’ perceptions of risk assessment in child protection cases and their ideas of barriers and facilitators they encountered in their decision-making in the field. Through a force field analysis, using Lewin's change theory, content analysis of narrative data collected using open ended surveys revealed child welfare professionals’ experiences with the driving and restraining
forces in child risk assessment. Findings highlighted continuing needs in the areas of training, cultural contexts, and ways for better collaboration and information to manage the pressures of the broader system in which they operate. The findings from the analysis further illuminated the challenges professionals undertake, constantly weighing protective factors against potential threats. This study may contribute to positive social change and further the social determinants of health by providing evidence-based insights to inform policy and practice improvements within CPS and by identifying common elements that influence risk assessment decisions. The findings may aid in the development of targeted training programs that enhance the ability of CPS professionals to detect and respond to risks effectively. This could lead to more precise interventions that protect children and promote their welfare. Further, understanding the systemic pressures and cultural contexts that impact decision-making can lead to organizational
changes that better support professionals in their critical roles.

This study examines the ethical dilemmas that social workers confront when referring to privately owned therapeutic boarding schools, using Iowa's Midwest Academy as a case study. It critically examines the conflict between parental preferences for residential treatment and the growing body of evidence advocating for less restrictive, community-based interventions as more effective for adolescents. The research uncovers diverse parental motivations for choosing residential programs, from seeking a fresh start to implementing behavioral control strategies. These motivations are set against a backdrop of mental health and educational systems prioritizing evidence-based, regulated care approaches. Profound ethical concerns arise with placements in unregulated Troubled Teen Industry (TTI) facilities, which lack licensing, accreditation, and qualified mental health professionals, thereby posing grave risks to youth's welfare. The case of the Midwest Academy is utilized to illustrate the ethical breaches, including allegations of abuse, neglect, and substandard mental health care, highlighting the dangers of such placements. The discussion extends to the responsibilities of social workers in making ethical referrals, emphasizing adherence to national and international ethical codes. Advocating for a cautious, principle-driven referral process, the paper argues for prioritizing accredited, evidence-based services to protect young clients and uphold the integrity of the social work profession. It concludes with a call for a collaborative decision-making process in managing complex referral scenarios, contributing to the discourse on ethical practices in social work and emphasizing the need for continuous scrutiny of referral practices to privately owned therapeutic programs.

This paper reports on a study involving the development and initial validation of a scale designed to assess the concept of ecopsychological self. This concept can be defined as the extent to which individuals identify with nature. Using a sample of 150 university students, an 11 item instrument, comprised of two subscales (nature inclusive self-concept and nature stewardship) was constructed through both exploratory and confirmatory factor analytic techniques. The instrument was found to have adequate inter-item reliability and satisfactory convergent, discriminant, and criterion validity. Correlational and regression analyses found that the two subscales were significant predictors of mental and spiritual well-being. The study concludes with a discussion of the findings, limitations of the study, and directions for future research. For at least a century, concerns have been raised about the impact of civilization on the natural world (e.g.

Dignity is a universal principle that requires us to treat every person as having worth beyond who a particular person is or what they do. Dignity is a complex and sometimes contested idea, that at times can be compromised in health care and allegedly also within the practice of outdoor therapy. Outdoor therapies comprise a range of therapeutic approaches including nature-based therapy, adventure therapy, animalassisted therapy, forest therapy, wilderness therapy, surf therapy, and more. Within the literature of outdoor therapies there has been limited research on ethics related to common understandings of care concepts such as relational dignity and human rights. The aim of this paper is therefore to unravel briefly whether dignity in general, and relational qualities of dignified care more particularly, might be a useful concept to apply in order to support an ethical practice in outdoor therapies.

This paper is a direct response to a recent article in this journal by Gass et al. (JAMA 39: 291-302) in which the authors describe an "ethical" model for the involuntary transport of youth into Outdoor Behavioral Healthcare programs, often synonymously referred to as wilderness therapy in the literature. These authors suggest that international law supports involuntary transport and that their approach is research-based, trauma-informed, ethical, and does not interfere with client outcomes. We believe each of these claims to be in error: The international laws cited include strict rules about involuntary transport, professional codes of ethics forbid all but exceptional uses of force, and there is a large literature on the harms of involuntary transport and admission that appears to be ignored. We suggest that involuntary transport is almost always contraindicated for wilderness therapy and this practice is a symptom of what has been called the "troubled teen industry." Keywords Adolescent treatment • Involuntary treatment • Transport • Behavioral Healthcare • Ethics • Wilderness therapy Gass et al. (2021) claim to be describing an ethical framework for involuntary youth transport services (IYT) that is a Thank you to Ben Anderson-Nathe, Professor in Child, Youth, and Family Studies at Portland State University.

Nature-based adventure (NBA) interventions can be broadly understood as any intervention of adventure occurring in a natural setting not necessarily involving a licensed mental health professional. Evidence suggests that some NBA interventions improve people's health. Although encouraging, the strength of this evidence is often impaired by the non-random allocation of participants to groups and the lack of comparison groups. These design limitations need additional care during data analysis. Moreover, some studies of NBA interventions omit necessary information for the interpretation of their results, which may lead to inaccurate conclusions and hinder replicability. To exemplify these analytical and reporting issues, we evaluated all quantitative studies assessing the effect of an NBA intervention published in the Journal of Adventure Education and Outdoor Learning from 2019 to 2021. We provide suggestions to improve the analysis of studies of NBA interventions and discuss the need to report these necessary elements in future studies.

Youth (aged 12-30) are the most likely age group to experience problematic substance abuse, yet this population experiences relatively low rates of success in treatment and limited research and understanding exists regarding "client fit." This study explored how youth participation in one Canadian wilderness therapy program affects trait emotional intelligence (TEI) and readiness to change (RC) and how pretreatment client-level variables-presenting problems, sex, age, funding, digital interference in everyday life, or substance abuse severity-moderate these relationships. A case study design was engaged, and the intervention was found to produce statistically significant increases in RC but not in TEI. Relative to pretreatment client-level variables, participants who experienced interference in their everyday life due to video games or online activity before treatment had larger TEI change scores, while participants who experienced interference in their everyday life due to virtual relationships had larger changes in RC. No client-level pretreatment variables in this study significantly predicted increases in RC following wilderness therapy.

Outdoor behavioral healthcare is a specific model and industry utilizing wilderness therapy (WT), a residential treatment approach comprised of outdoor travel and living for youth experiencing mental health, substance use, and behavioral concerns. We present data from 6417 participants about reasons for referral, admission, and discharge scores from the Youth-Outcome Questionnaire (Y-OQ), youth interest and commitment to treatment, reliable change scores, and the relationship between these variables. One-third of youth entered WT with sub-clinical scores, varying levels of client motivation and voluntariness in relation to clinical outcomes, a diverse range of presenting problems without clear indication of specialized treatment planning, and differing responses to treatment by referral reason. Identifying those not responding to WT and those at risk of deterioration from the time of admission requires further investigation to improve client outcomes for this treatment modality. Recommendations include placing increased importance on accurate and thorough screening and assessment, utilizing baseline and routine outcome monitoring, reducing coercion, and considering specialized intervention.

The 9IATC saw an appetite amongst delegates for attention to be paid to social justice issues that exist in the International Adventure Therapy community. These include increasing diversity in the community and confronting practice-based issues that exist in some practice settings. One such issue was raised through social media, and the resultant 'heat' led the conference organizing committee to set up a facilitated session. An adapted Fishbowl facilitation approach was used to enable what was termed a 'courageous conversation' between key stakeholders, with delegates observing. Themes were identified that related to the topic under discussion (involuntary transportation of clients) and the method it was raised (social media). This facilitated session was one of a few planned responses to community-based issues that emerged at the conference, and illustrates a growing preparedness of the International Adventure Therapy community to address issues within the community and to promote ethical and just practices internationally. This paper does not intend to cover the full content of the Fishbowl, rather provide an overview to discuss the usefulness and practicality of the methods used and share resultant recommendations to the International Adventure Therapy Committee.

The training and development of international adventure therapy practitioners has had somewhat limited critical examination from cross cultural perspectives. While individuals and organizations have collaborated internationally for decades, to the authors’ knowledge, there has not yet been a concerted effort to examine core training for wide international scope, nor co-develop core cross-cultural training parameters. Given this backdrop and gap, directly before the 8IATC in Sydney (Australia) in 2018, a group of 24 AT practitioners from 11 nations gathered for three days in a ‘Cave’ to explore international perspectives on the necessary ingredients of training and development of adventure therapy practitioners. This paper explores the overarching
outcomes of this ‘Cave Think Tank’, along with feedback from participants of a workshop at the 9IATC in Kristiansand, Norway in 2022 and reflections afterwards,
to consider the question in the title of this paper. The five key themes arising in the ‘Cave Think Tank’ and explored in the workshop include: 1) Values (shared and held by adventure therapy practitioners), 2) Ways of being (as an adventure therapy practitioner), 3) Foundational knowledges (theories and bodies of knowledge that inform adventure therapy practice), 4) Skills (required for safe ‘good enough’ adventure
therapy practice), and 5) Interventions (commonly used strategies or micro-interventions that are appropriate in adventure therapy practice). These core ingredients, which were agreed as important across diverse cultural contexts, demonstrates the value and benefits of cross-cultural collaboration, and will no doubt continue to be enhanced by dialogue and collaboration.

Away from loneliness is being alone with one's thoughts and emotions. Solitude can also represent a positive condition where one discovers freedom, peace and serenity, contrasting with loneliness, characterized by a yearning for companionship and a feeling of seclusion. Many philosophical and spiritual doctrines view solitude as a pathway to deeper insight and growth. They assert that being alone is a fundamental aspect of human existence. Instead of seeking fulfilment externally, genuine wisdom and satisfaction arise from within. For some, solitude offers an opportunity for meditation and introspection. It permits individuals to detach from the external world

analyst "We discover, indeed that we do not know our part, we look for a mirror, we want to rub off the make-up and remove the counterfeit and be real. But somewhere a bit of mummery still sticks to us that we forget..." [ Rilke, Notebooks of Malte Lauride Briggs, p. 212] A parallax is the apparent displacement, or difference of position, of an object, as seen from two different stations, or points of view. I am putting forth an image, a parallax or view of daughters and a bit about fathers to show the dynamics arising from their distant, difficult or absent relationships. We explore this with the hope both can move out of old

The study consists of a pilot study aimed to the evaluation of a sailing therapy program with drug users and multi-diagnosed patients. A need that practitioners working in nature-based programs in Italy are identifying as urgent is the difficulty in finding effective evaluation methods and tools. Although some validated tools specific for outdoor programs do exist, context specific tools are needed. The wider participatory research, of which this study is part and that is still in progress, has the aim to collect and/or create a wide range of possible evaluation tools and methods to be used by nature-based practitioners or to serve as an inspiration for them to create their own. In this study, a self-assessment questionnaire for adult patients, living in a drug rehabilitation center and experiencing a sailing therapy week, was created starting from three preexisting tools, which were adapted to this specific context: the first results are encouraging.

This paper highlights the role of the family in the treatment of youth who attend Outdoor Behavioral Healthcare (OBH) programs. It discusses the history of OBH, provides a critical overview of the research on the impact of OBH programs on family functioning, and discusses the importance of increased intentional integration of family therapy into OBH settings. To show this integration, this study presents a case study that highlights the role of the family, as well as the home family therapist throughout the phase of OBH treatment. Areas for future esearch are provided as well as suggestions for the increased utilization of adventure activities with families.

The Depth of Loneliness and Hatred We all need emotional health to be happy. Loneliness is a symptom of unhappiness. I was first reminded of that one day when listening to the American evangelist Billy Graham. He insisted that North Americans were feeling lonelier than ever, despite being surrounded by wealth, commodities, and the freedom of religion. That observation has kept me thinking for a couple of decades. Graham's observation, however, emerged from his evangelistic passion and sympathy toward his general audience.

Anaphylaxis is a challenging condition for any austere environment. It is unpredictable, has sudden onset and a high fatality rate, and is responsive only to epinephrine, a prescription medication. The Wilderness Medical Society has formally recommended that non-medical providers working in austere environments be trained to administer epinephrine. Medical providers frequently prescribe autoinjectors for this purpose due to their ease of use by nonmedical providers. However, auto-injectors have limitations in the wilderness environment, particularly due to their single-dose (or at most 2-dose) design. This paper describes an austere environment technique for obtaining multiple additional doses of epinephrine from auto-injectors that have already been used as designed.

This article presents an organizational development processa therapeutic residential care model known as "Armchair"that is based on qualitative experiences gained by the author in 10 years of practice, and that draws upon theories from child and youth care (CYC) and organizational psychology. The ideas described here have been implemented in several children's homes in Hungary. Based on the premise that CYC is an autonomous applied science, the paper describes briefly the theoretical principles created from everyday practice in Hungary. It examines similarities between this model and the Cornell CARE model from the United States in relation to such aspects as the basic needs of children in residential care and the long-term orientation to building practice methods within agencies. A practical approach with a system-oriented perspective developed in Hungary for implementing the principles is presented. This includes a Plan-Do-Check-Act cycle model-quality assurance system designed to meet the needs of children, and furnishes an example of how information technology software can support the daily job of employees in terms of administrative and supportive activities. The article discusses weaknesses, threats, or challenges that can occur during implementation and threaten the program's aims of helping both children and staff. This analysis uncovers the underlying role and importance of positive identity and self-esteem among staff, with a strong focus on personal and professional integrity. In conclusion, findings are presented that indicate some possible solutions for the problems discussed, comparing these qualitative results to previous quantitative evidence found in research studies measuring the effectiveness of the CARE model, and drawing some commonalities from the two approaches.

The concern of this thesis is with the history of ideas; specifically, the history of recent theological ideas. This thesis is not a work of systematic theology but rather situates discourse about a theological problem within the matrix of some relevant contemporary thought. Its category then is the history of the development of ideas. In the late twentieth century many academic theologians found the intelligibility of the traditional language used about the Christian Trinitarian God to be problematic. This is the thesis’ research problem. The research hypothesis is that these recent academic theologians sought to make trinitarian language used about the Christian Trinitarian God intelligible by replacing static definitions of ‘person’ with a dynamic relational model. The methodology of this thesis is essentially historical and hermeneutical. It draws on the hermeneutical philosophy of language of Paul Ricoeur as it developed around two key notions, his notion of text and his attention to the metaphorical process. Data is drawn from representative recent trinitarian works of a significant and scholarly nature written in and for the western arena at the end of the twentieth century. These sources are evaluated according to their ability, in Ricoeur’s language, to redescribe the reality of the trinitarian symbol and refigure the world of contemporary Christian consciousness. The thesis presents an investigation of western academic trinitarian theology in terms of a structure of analysis and synthesis. Via an exploration of a series of responses made by these recent trinitarian theologians to categories of thought pertaining to the concept of person and their consequent theological appropriations, this thesis demonstrates the research hypothesis. It demonstrates that in recent trinitarian thought
postmodern ideas on person as relational fuse with supportive biblical and derived patristic thought as theologians seek to make intelligible language used about the Christian Trinitarian God. In particular, the ancient concept of perichoresis is found by theologians to provide the necessary point of intersection. With a redefinition of person relationally, and in particular perichoretically, the Christian God is understood in communal terms.

The report provides an evaluation of the Prevention, Assessment, Support and Treatment (PAST) Program addressing children’s and young people’s problematic or harmful sexual behaviours (HSB). The Program is operated by Sexual Assault Support Service (SASS), and was initially funded by Children, Youth and Families (CYF), of the Department of Communities Tasmania (DCT).

Commonwealth and Covenant sets out to develop a "theology of relationality" as an organizing principle for contemporary society. Marcia Pally walks a tightrope between two opposing sanctities of American thought-liberty and community-and picks a careful path through the recent history of ideas to articulate a fundamental crisis in our current political thinking. For Pally, reading Charles Taylor and Alasdair MacIntyre, the problem is this: Through an excess of freedom, we are losing our rootedness in the cultures and capabilities that make such freedom and self-identity possible. Pally argues that we need a fundamental revision in the way that we understand our own being and its relationship to others. She would like to see a new ontology based on a notion of shared covenant and underwritten by a theological understanding of how we come to be as persons. Pally sets out from the claim that the West has had too much of a good thing, which she calls separability, but that we might equally call individualism or disembeddedness. Separability contrasts with situatedness: one's embeddedness in place, community, family, or social context. Pally is right to point out that too much situatedness is also a bad thing, leading to totalitarian state-over-individual government or the suffocating and exclusionary conservatism of the premodern village. Thus, separability offers a counter to situatedness and vice versa. The first part of the book focuses on situatedness-amongseparability in the social sciences (in the most part), seeking to elaborate the construct against a backdrop of structure-agency skirmishes. One has to admire the chutzpah of CHRISTIAN SOCIAL THOUGHT

Involuntary youth transport (IYT) is a controversial practice used to admit adolescents into residential care. Critics point out that IYT is in need of regulation and is best used as a last resort. This article examines the risks and benefits of IYT, especially the longterm effects on the client, in order to ensure that all facets of a client’s treatment are trauma-informed and guided by research-based practices and ethical principles. Practices that re-traumatize youth need to be replaced with informed practices that facilitate positive outcomes. This article utilizes an ethical decision-making framework developed for behavioral health professionals to assess and improve the ethical use of IYT. Based on this ethical framework, a more effective and collaborative model is presented that results in less restrictive approaches, greater levels of willingness by the adolescent to enter treatment, and trauma-informed management of difficult emotional or physical behaviors. This model also...

Background and purpose: Participant state anxiety in outdoor therapeutic practices continues to raise many questions. To help inform this important topic we present and discuss the results of an exploratory pilot study on participant day-today state anxiety throughout a Norwegian wilderness therapy intervention. Materials and methods: Thirty-three adolescents from six groups completed a total of 251 state sections of the State-Trait Anxiety Inventory. Results: On average, there was a slight decrease in state anxiety as the program progressed and a significant reduction in anxiety between the first and final days. The between-subject range was large, and boys reported significantly lower anxiety than did girls. Conclusion: In light of the results, we discuss general understandings of day-today state anxiety, gender differences, group differences, the perception of risk, and the relationship between perceived autonomy and state anxiety. The paper concludes with implications for the outdoor therapy field at large.

Youth (aged 12-30) are the most likely age group to experience problematic substance abuse, yet this population experiences relatively low rates of success in treatment and limited research and understanding exists regarding "client fit." This study explored how youth participation in one Canadian wilderness therapy program affects trait emotional intelligence (TEI) and readiness to change (RC) and how pretreatment client-level variables-presenting problems, sex, age, funding, digital interference in everyday life, or substance abuse severity-moderate these relationships. A case study design was engaged, and the intervention was found to produce statistically significant increases in RC but not in TEI. Relative to pretreatment client-level variables, participants who experienced interference in their everyday life due to video games or online activity before treatment had larger TEI change scores, while participants who experienced interference in their everyday life due to virtual relationships had larger changes in RC. No client-level pretreatment variables in this study significantly predicted increases in RC following wilderness therapy.

This paper discusses how the increased urbanization and technification trends of our time may partly explain the considerable rise in adolescent maladjustment, typically expressed through symptoms of depression and anxiety. The authors argue that if living life increasingly disconnected from the natural world is part of the cause, then reversing, or at least moderating these trends and resultant pathology, must be part of the solution. Evidencebased wilderness therapy approaches have a long history of enabling optimal growth and personal development with adolescents. This article proposes how specific core elements of these often-complex therapeutic outdoor programs can be put to use on a broad scale throughout our communities. We provide examples supporting a three-stage approach to address the deleterious effects of urbanization and technification in adolescents; (1) changing beliefs, (2) education, and (3) planning. Finally we present some practical examples of possible antidote measures.

This paper is a direct response to a recent article in this journal by Gass et al. (JAMA 39: 291-302) in which the authors describe an "ethical" model for the involuntary transport of youth into Outdoor Behavioral Healthcare programs, often synonymously referred to as wilderness therapy in the literature. These authors suggest that international law supports involuntary transport and that their approach is research-based, trauma-informed, ethical, and does not interfere with client outcomes. We believe each of these claims to be in error: The international laws cited include strict rules about involuntary transport, professional codes of ethics forbid all but exceptional uses of force, and there is a large literature on the harms of involuntary transport and admission that appears to be ignored. We suggest that involuntary transport is almost always contraindicated for wilderness therapy and this practice is a symptom of what has been called the "troubled teen industry." Keywords Adolescent treatment • Involuntary treatment • Transport • Behavioral Healthcare • Ethics • Wilderness therapy Gass et al. (2021) claim to be describing an ethical framework for involuntary youth transport services (IYT) that is a Thank you to Ben Anderson-Nathe, Professor in Child, Youth, and Family Studies at Portland State University.

Background: Routine outcome monitoring (ROM) was popularized in the mid-1990s to improve client outcomes in psychotherapy, though implementation in clinical practice has been slow. Although increased outcome research in adventure therapy (AT) in the last decade has demonstrated AT as a viable treatment option, recent reviews have found worrying trends regarding research methodology and poorly substantiated claims of superiority. Purpose: The purpose of this article is to explore the potential for ROM in AT. Methodology/Approach: We conducted a brief review of the literature on ROM and offered a discussion that positions principles of ROM with the nascent knowledge base of AT. Findings/Conclusions: We propose ROM is a viable next step in AT research and practice. ROM can explore when change is likely to occur during an AT program and provide a platform for improving client engagement and outcomes. Implications: We recommend implementation of ROM in AT and that future AT research explore therapist effects and important therapeutic factors, such as the therapeutic alliance and deterioration.

Dignity is a universal principle that requires us to treat every person as having worth beyond who a particular person is or what they do. Dignity is a complex and sometimes contested idea, that at times can be compromised in health care and allegedly also within the practice of outdoor therapy. Outdoor therapies comprise a range of therapeutic approaches including nature-based therapy, adventure therapy, animalassisted therapy, forest therapy, wilderness therapy, surf therapy, and more. Within the literature of outdoor therapies there has been limited research on ethics related to common understandings of care concepts such as relational dignity and human rights. The aim of this paper is therefore to unravel briefly whether dignity in general, and relational qualities of dignified care more particularly, might be a useful concept to apply in order to support an ethical practice in outdoor therapies.

Background: Adventure therapy (AT) is a term that includes therapies such as wilderness therapy and adventure-based counseling. With growing empirical support for AT, the diversity of studies make it difficult to attribute outcomes to specific treatment factors. Objectives: Researchers explored whether AT, often perceived as an alternative therapy, works because of AT's unique components, or whether factors shared by all therapies were responsible. Methods: A scoping review was undertaken utilizing a search of major databases, unpublished dissertations, and a hand search for direct comparison trials matching AT with another therapeutic intervention. Results: 881 publications were identified. 105 quantitative studies were included following a title and abstract review. Only 13 met the full inclusion criteria. Little to no differences were found to isolate specific therapeutic factors. Conclusions: We discuss the implications of these results considering the movement toward evidencebased practice and recommend future research to eclipse our current understanding of AT.

Wilderness therapy is a specialized approach to adolescent substance use and mental health treatment. While empirical evidence of positive outcomes grows to support this approach, qualitative understandings are lacking in the literature, thereby limiting theoretical explanations. Additionally, the voice of adolescent clients is hardly present, and was therefore the focus for this research. A sample of 148 adolescent wilderness therapy clients at one Canadian residential treatment program for addictive behaviour and mental health issues participated in the study. A realist approach utilizing thematic analysis of written open-ended responses produced six major themes; three depicting participant experiences (social dynamics, wilderness, catalyst for change) and three for perceived outcomes (skill development, self-concept, health). These findings are discussed in relationship to the development of a clinical model of wilderness therapy and the potential of wilderness interventions in adolescent residential treatment. Recommendations for practice and future research are discussed.

Outdoor behavioral healthcare (OBH or wilderness therapy) is
an out-of-home adolescent treatment option serving tens of
thousands of youths annually for behavioral, substance, and
mental health issues in the United States. About half of OBH
participants attend involuntarily and are transported by services
specialized for “uncooperative” youth. Transportation has
been argued by some researchers to have little impact on
youth in treatment, and Tucker and colleagues found little difference
in outcomes between not transported and transported
youth. Ethical and empirical concerns arise from these findings,
and we apply a critical perspective to address these concerns.
Specifically, we examined the claim in OBH research
that being transported has no significant bearing on client
treatment outcomes. We propose that the findings of no difference
were random, rather than systematic, because they
were constructed on a post hoc measure of perceived voluntariness.
To demonstrate, we used data from OBH to construct
five different measures of voluntary/involuntary, also fabricated
post hoc. All five operationalizations resulted in statistically
significant differences across a variety of social and
psychological outcomes, demonstrating inconsistencies across
the findings. Further independent and rigorous research is
called for in OBH to understand the use and ethics of forced
transportation, coercion, and involuntary treatment.

This chapter explores wilderness therapy practice through the lens of
complex trauma in an attempt to map the application of theory to practice.
We explore the question, if adverse experiences can shape the way a
child’s brain develops, can therapeutic experiences, in this case physically
active experiences in natural environments, lead to changes that orient
a person toward healing and recovery? For Perry (2009) and others, the
short and long answers are ‘yes’ (Cozolino, 2002; Doidge, 2007; Kezelman
& Stavropoulos, 2012; van der Kolk, 2000). Informed by practice and treatment
guidelines (see Kezelman & Stavropoulos, 2012; 2019a; 2019b), a
phased model is presented as to how wilderness therapy practitioners can
implement trauma-informed practice to ensure physical and emotional
safety, trustworthiness, collaboration, choice, and empowerment (Fallot
& Harris, 2009). This, we offer, is the next frontier in the pursuit of safe,
effective, and relational wilderness therapy practice.

This article presents a review of the extant literature concerning Abraham Maslow's hierarchy of needs theory of motivation as the key component of Maslow's broader view of motivation. It also includes a synopsis of prior criticisms of the theory. Further, this manuscript presents a Christian critique of Maslow's motivation theory (specifically his methodology, view of human nature, and hierarchy of needs) so that the reader will gain new insights about motivation from a Christian worldview in contrast to Maslow's secular model. After analyzing Maslow's concepts, including self-actualization, peak experience, and the hierarchy of needs using a biblical perspective, we find that Maslow's theory of human motivation is not supported by Scripture and Maslow is attempting to create a new worldview designed to supplant the traditional Christian worldview.

Adolescent depression is a serious mental health crisis, often occurring in the context of negative psychosocial development. This study explored the efficacy of a therapeutic wilderness experience on adolescent depression and psychosocial development by measuring pre-to-post changes on the Reynolds' Adolescent Depression Scale-2 (RADS-2) and the Measures of Psychosocial Development (MPD). Participants in this study were selected from the Intercept program at Outward Bound Wilderness, a therapeutic wilderness program for youth-at-risk. This mixed methods study found clinically and statistically significant pre-to-post decreases in levels and prevalence of adolescent depression and increases in psychosocial health after a therapeutic wilderness intervention. This study also showed qualitative indicators of change in these areas. This study further demonstrated a clinically and statistically significant relationship between adolescent depression and psychosocial development, and showed statistically significant improvements in the areas of school problems, substance abuse, and family conflict. In addition, this study analyzed what process variables were related to the adolescent depression and prosocial outcomes. These findings are highlighted in this article and are presented as key components of the therapeutic wilderness experience.

The editor of Spirituality in Clinical Practice, Lisa Miller, invited me to reflect on my career over the past 35 years focused on integrating spirituality into public mental health. Woven into this account is the story behind a recently developed spiritual assessment interview that I developed for use in many California county mental health agencies and have presented at American Psychological Association skills building sessions and workshops. This article traces the interplay of personal experience, clinical work, research, and public policy that illustrates core dynamic interactions of psychological science and praxis.

Wilderness Programs (WP) are specialized frameworks for group therapy in an unfamiliar environment. The participants progress through a series of increasingly difficult challenges which seem unsolvable, yet are structured in such a way that success is guaranteed. The present article will describe the principles of WP, followed by the findings of a field research which examined the effect of a WP on a group of dropout youth in Israel, comparing them to an alternative therapy program and a contrast group. The assumptions of the research were that self-esteem and locus of control in the Wilderness group would be improved in comparison to the alternative group and to the contrast group. The research findings partially supported these assumptions, pointing to a significant progress of both experimental groups compared to the contrast group. The WP group stood apart in its results, showing increased self-esteem in four out of six factors compared to the contrast group, but there was no significant change compared to the Alternative Program group. In both experimental groups a clear significant improvement was found in locus of control after the intervention, in contrast to a decrease in those who did not take part in the activities. The discussion will address the research findings and the possibilities and opportunities presented by WP.

Children and young people in residential care have often lived lives saturated with loss, neglect, rejection, and traumatic experiences. Children express the pain of trauma in various ways, namely pain-based behaviors manifesting in ways that often leave their care givers confused, frustrated, frightened, angry or exhausted. For residential caregivers to respond to children and young people in a consistent and therapeutic manner, residential environments must provide an ethos of respect, caring, and trust, creating a safe place for children and staff to live and learn together. This paper describes the Children and Residential Experiences (CARE) model, its implementation, and evidence for its effectiveness. CARE is a trauma-informed, principle-based, multi-component program designed to enhance the social dynamics in group care settings and help agencies create a living environment that provides developmentally enriching experiences for children in their care. By incorporating the CARE principles throughout all levels of the organization and into daily practice, the CARE program model has been shown to improve the capacity of staff to establish positive developmental relationships with the children in their care, offer developmentally enriching experiences and a "sense of normality", and create cohesion and congruence throughout the organization. Through consistent and predictable compassionate and responsive interactions with adults, as well as opportunities to overcome challenges and to experience successful learning opportunities, children can grow, develop and thrive.

In the field of adventure therapy the curative powers of natural environments are too often not recognised as therapeutic in itself. Compared with the ecological and experiential values of wilderness the symbolic values thereof have largely been overlooked. Through restoration, physical self, primitiveness, humility, timelessness, solitude, privacy, freedom of choice, personal self and spiritual upliftment, this study aims at determining whether wilderness can be experienced as symbolically unique and whether this natural world can be considered a necessity for achieving therapeutic outcomes. In doing so, this study compared a centre-based adventure programme with an expedition-based wilderness programme, using a crossover research design with a mixed-method approach. For a meaningful adventure experience, results showed that the experience of above-mentioned components made the most important contribution during the expedition-based wilderness programme and that this programme is most effective in creating this very aspect. However, it is possible to also experience the above components during a centre-based adventure programme, but to a lesser extent and with a different meaning.