What is Wilderness Therapy?

2. What is Wilderness Therapy? Basic setup: • Groups of 4-10 single gender, young people • Live primarily outdoors for 6-10 weeks (adults can live in residence at times) • Based around remote hiking or other outdoor adventure activities with highly trained professional guides and field staff. • Intensive clinical work including weekly individual and group therapy by licensed therapists • Weekly parent calls with therapist • Care management from admission to extended care • Intensive to communication to loved ones through letter writing • Two wilderness models (base camp or nomad)

3. Wilderness Cornerstones • Primitive and healthy living • Nature! • Highly trained staff, minimum 1-3 ratio • Experiential and adventure activities • Positive peer milieu • Heavy use of primitive skill building and metaphors • Group work • Communication skills • Positive and constructive feedback • Unavoidable success/challenge! • Natural consequences • Accepts escorted/involuntary clients (11-17)

4. Background about our Wilderness Programs Rigid safety protocols and redundancies CARF Accredited Therapists are licensed and have years of field instructor experience Field Staff are outdoor enthusiasts with multiple certifications (NOLS graduates, first responder, first aid, EMT, lifeguard, universal precautions, etc.) Adventure beyond hiking (canoeing, mountain biking, cross country skiing, fly fishing, high element ropes) More than rice and beans Intensive family program with systems philosophy Supplemental psychiatric services both f2f and remote “Mentoring” experiences for wilderness alumni Ongoing alumni groups in local communities Optional credit capture program for credit recovery

5. Student Profile • Age range 11-13, 13-17, 18-28 • Broad range of clinical issues usually combined with complex social and/or familial struggles • Drug and alcohol abuse and/or dependence • History of treatment failures and may be unmotivated and resistant • History of trauma, domestic violence, abuse • School failure , anxiety and depression • 17-30% adoption and/or attachment issues • Some learning disorders, processing disorders, ADD combined types • 60-70% of adolescents come via escort • Specialty groups for Spectrum disorders and substance dependence • Do not usually treat insulin dependent kids, active eating disordered, psychotic and/or acutely suicidal

6. Typical Therapies and Activities • Individualized treatment planning • Individual and group therapy • AA/NA meetings • Art therapy • Martial arts • Life skills training • Psycho-educational skills training • Family therapy • Meditation • Cognitive Behavioral Therapy • Motivational interviewing • Experiential education (ROPES course) amd adventure programming (canoeing, skiing) • Motivational enhancement therapy • Career/vocational/psychological testing • Gender-specific treatment • Solution-focused therapy

7. Why does it work? Mother nature does not rescue or enable! Removal from environment (drugs, parents, school, computer, phone) Responsibility, accountability, integrity Immediate natural consequences Group living Primitive skills are hard! Therapy to process it all

8. Drawing from the works of Piaget and Yalom, the Adventure Therapy Process is explained:

9. Rites of Passage and Aftercare Planning • During treatment every student/client participates in a healing rite-of-passage ceremony. They are guided through ceremonies that include a “solo” outdoor experience, family work and graduation all geared toward preparing them to step out of the past and into the future • From the beginning of treatment therapists are working on a detailed and extensive aftercare plans. This can include relapse prevention, community reintegration, therapeutic boarding school, outpatient treatment and development of support systems that help sustain the progress they have made. • Lifelong alumni meetings and parent support

10. Practical Outcomes From 2007-2010, CRC’s Aspen Education Group treated over 12,000 adolescents with issues such as depression, anxiety, ADD/ADHD, trauma, and co-occurring substance abuse. Outcome Study (2010)Parent Questionnaire Before treatment After treatment I fear for my child’s safety: My child is tearing our family apart: I don’t trust my child: Percentages are averages for combined results of Aspen’s Therapeutic Boarding Schools, Residential Treatment Centers and Outdoor Programs. Questionnaires asked parents “Before and after treatment, how strongly did you agree or disagree with the following statement?” (1= strongly disagreed, 5 = strongly agreed). Those marking 4 or 5 are shown.

11. Y-OQ 2.01 – Outdoor Adolescents in Aspen Outdoor programs show clinically and statistically significant improvement in Y-OQ scores at discharge, at 180 days post discharge, and one year post discharge.

12. Aspen Outcomes Measurement System • The measures used include: • Youth Outcome Questionnaire (Y-OQ & Y-OQ SR), • The FAM-III Assessment of FamilyFunctioning • Satisfaction with Life Scale (SWLS- Child Version) • Measures are administered at admission, at 6 months during treatment, at discharge, at 180 days post discharge, and at 365 days post discharge.

13. Parent Testimonial For the first time in his life Mike is proud of himself for being able to complete something. My son looks great, has never felt better and has matured more in the last two months then he had in the last ten years. When Mike left for ALE he had given up on life and I had given up on him. When he came out, he had a glow in his eyes and a smile on his face that was worth every penny and tear I had shed over the last two months. You are a dedicated and professional team that works miracles. ALE, thank you for taking our broken child and making him whole again. Parent 2011