The impact of a wilderness therapy program on attachment, separation and mental health functioning in adults

Wilderness therapy (WT), also referred to as Outdoor Behavioral Healthcare (OBH), utilizes wilderness experiences provided by social workers and other licensed mental health clinicians to meet the therapeutic needs of clients. Although WT research supports its effectiveness with youth, there is little research on outomces with young adults. To address this, our study explored the impact of WT on functioning, attachment and independence from parents in young adults. Methods: The present study utilized a longitudinal one-group design to explore the outcomes of 117 adults participating in one wilderness therapy program. The mean age of study participants was 20.0 years (SD= 2.1), with more male (65.0%) than female participants (35.0%). The majority of participants were Caucasian (94.0%). The three most common Axis I diagnoses for clients, most of whom had co-morbid issues (96.7%) included Depression (68.8%), followed by Substance Dependence (52.7%) and Substance Use (47.7%). To measure outcomes pre and posttest the Adult Attachment Scale (AAS) and the Outcome Questionnaire 45 (OQ) were administered to young adults and the Psychological Separation Inventory (PSI) was completed by parents. Paired samples t-tests with Bonferroni corrections to minimize Type I error were conducted comparing means from clients at intake and discharge. Results: At discharge, all OQ scores were below the associated clinical cut off scores except Social Role. Improvements reported at discharge for all the OQ scores were large enough to be considered statistically significant (p\u3c .001), with large effect sizes of over .87. In terms of attachment mean levels of Dependency decreased significantly while mean levels of Closeness increased significantly. PSI levels of Separation from Mother increased significantly and both Independence from Mother and Independence from Father increased significantly. Diagnosis appeared to impact outcomes with depressed participants reporting mean improvements for the OQ Total Scores that were significantly larger than non depressed adults as well as larger improvements for their report of Symptom Distress. Scores on the PSI also revealed that depressed adults reported significantly lower levels of change in terms Independence from Mother as well as Independence from Father compared to non-depressed adults. Discussion: The present study found that wilderness therapy significantly improves mental health functioning of young adult clients and can move young adults toward healthy independence and separation from their parents. Changes of this nature are believed to be reflective of secure parental attachment and to be strongly related to various adaptive outcomes for young adults. Young adults with depressive symptoms were less likely to report healthy changes in their independence from parents; however showed greater improvements in mental health. In terms of attachment findings suggest that wilderness therapy significantly improved young adult clients’ feelings of closeness while decreasing their feelings of dependence in their relationships. Clearly, more research is needed, especially since this was the first study of its kind. Despite this, our study provides preliminary support for WT as a viable option for young adults who struggle both with mental health as well as independence from parents