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http://www.sltrib.com/News/ci_10438421Controversy spurs gentler approach in Utah wilderness-therapy camps
Multimedia: Take a trip with Aspiro; click on map for program profiles
By Lindsay Whitehurst and Brian Maffly
The Salt Lake Tribune
Article Last Updated: 09/12/2008 02:41:54 PM MDT
Jessica suddenly stopped hiking.
"I can't do it," the 17-year-old panted, her dark hair damp and curled with sweat. The July sun blazed over the redrock of Glen Canyon National Recreation Area, pounding the teenagers hiking down the sage-covered sweep of Coyote Gulch.
"I'm seeing double. I have to stop," she said, her voice raw.
Liz Stika, a guide with wilderness therapy camp Aspiro, helped Jessica out of her 50-pound backpack and handed her a water bottle. "You are so much bigger than this," she said soothingly.
Jessica is one of hundreds of teens who annually pass through Utah's wilderness therapy programs, which thrive on the state's breathtaking and secluded public lands. Charging up to $30,000 for a stay of six to eight weeks, the industry contends immersion in nature - with a focus on self-sufficiency - helps teens who are estranged from their parents, battling substance abuse or coping with moderate mental illness.
The camps face continual controversy: Five teens died in Utah wilderness programs between 1990 and 2002, and a Utah teenager died in a Colorado program in 2007. A federal report released in October 2007 highlighted deaths, abuse and misleading marketing in camps and other residential-treatment programs across the country.
But Utah's 10 current programs say they have abandoned "boot camp" regimens tied to the abuses for a gentler, more targeted approach. They no longer welcome kids with violent criminal histories or severe mental illness. And they face some of the nation's toughest state rules, which include targets for backpack weights, hiking temperatures and calorie counts in menus.
Nearly all of Utah's camps say they have therapists with graduate degrees, and engage parents as well as the teens. Most say they minimize coercion - such as making a teen get out of bed or to carry his pack - in favor of "inviting" students to make positive choices.
Campers are separated from wayward friends, drugs and alcohol, and get regular therapy, exercise and healthful food. Generally, such a setting would help troubled teens, said Paul Florsheim, a psychology professor at the University of Wisconsin.
But proof that the camps create lasting change, Florsheim and others note, remains sparse.
Back on the redrock, Jessica took a deep breath and agreed to go on. Within minutes, she was grasping a rope and picking her way down a 12-foot drop to a dry riverbed below.
After two months of therapy at camp, she had revealed to her parents that a sexual assault by an acquaintance was behind her withdrawal and her new friendship with a drug dealer at home in Virginia.
"Being at Aspiro definitely helped me ... not let it control my life anymore," she said. "None of this is really about the hiking. It's about what you need to work on." Learning in nature: Teens at Hanna-based Aspiro get "adventure therapy" - mountain biking, rafting and rock climbing in Utah's "coolest" spots. While still physically demanding, the program offers modern comforts, such as nylon frame backpacks and propane stoves.
Overcoming physical limitations helps kids push past problems said Dan Lemaire, its 25-year-old head of instruction. "I don't think there's a place for primitive skills only."
But the rest of Utah's camps pitch hiking and survival skills - making a fire using a bow and arrow, setting traps for game -- as the best way wilderness can break through a teen's problems. The element of risk in being isolated in the desert makes therapy effective, said Andrew Powell, a field director for Outback Therapeutic Expeditions.
At Lehi-based Outback, kids build backpacks from sticks and leather, carve their own spoons from juniper and are given talismans to mark accomplishments.
Most of the teens in Utah camps are from affluent white families from around the country. Jason, a 17-year-old sent to Outback from Arizona, said his grades plummeted after he started smoking pot and lying to his parents. He had been in Utah for about six weeks when they arrived for a July reunion.
He called to them with his "bullroarer," a piece of wood swung on a string to communicate across open distances.
"I'm keeping mine forever. It's the happiest thing to swing that and know they'll be there," said Jason, a thin teen with intense brown eyes. "They saw me as a different person."
On an August day, the eight boys in Jason's group were working on therapy assignments, bathing and restocking their food. Between chores, they hollowed gourds for carrying water with tiny abrasive pebbles found at anthills.
The students were proud of simple things - their handmade Aboriginal didgeridoos; their ability to "bust a coal" - or start a fire with a drill-and-bow set, twirling a wooden peg into a board.
"It's a tenet of any ancient culture, whether it's a walkabout or vision quest. You send the adolescent out and they would learn from the trees, rocks and skies. It's enough for them to turn the corner of their past," Outback founder Rick Meeves said.
"This gets them away from all their distractions, the video games and from their failing environments, where there's nothing for them to listen to but the sound of their own voice," he said.
Do camps work? Research on long-term results for all types of residential treatment for youth is surprisingly scant, experts say.
Most research into wilderness therapy focuses on whether it improves the parent-child relationship, seen as a key factor in a teen's mental health.
Joanna Bettman, a University of Utah professor of social work, has tracked students at Aspen Achievement Academy, a Loa-based program where she first worked as a field counselor in 1994.
For kids without antisocial disorders or severe mental illness, studies indicate wilderness therapy does help that relationship, said Bettman, also clinical director at the Open Sky program in Durango, Colo.
Still, the results of her interviews with students - at admission and seven weeks later at discharge - were mixed.
Teens "got less angry with their parents, but they also perceived them to be less available to their needs," Bettman said.
The most comprehensive studies are the work of Keith Russell, an associate professor of physical education, health and recreation at Western Washington University. Industry, through its Outdoor Behavior Healthcare Research Cooperative, funds his research. But he emphasizes that he controls his data and how his findings are released, and he ensures they undergo peer review before publication.
Russell uses a standard social work questionnaire to gauge student and parent perceptions of the child's problems, from admission to two years after discharge. "At admission, kids are resistant to the idea that they have issues they need to work on," he said. "Parents ... tend to exaggerate issues."
But after treatment and as time passes, their perceptions begin to align, which suggests they are understanding one another better, he said.
Russell's research has shown teens who had been using drugs or alcohol are generally still using the substances one year after camp, although less frequently. That finding has spurred the industry to better focus its substance abuse treatment, he said.
About two-thirds of the teens in Utah programs have substance abuse issues, camp directors and researchers said. Most kids go on to some kind of aftercare, typically a therapeutic boarding school, a cycle that concerns critics.
Debating diagnosed teens: Although Bettman and Russell caution that wilderness therapy isn't helpful for all troubled teens, Utah camps claim to help children diagnosed with depression, bipolar disorder, eating disorders and other illnesses.
Michael Merchant, president of Monticello-based Wilderness Quest, believes wilderness therapy can help campers with mild to moderate mental illness deal with side issues, such as substance abuse or ruined relationships.
He also asserts its outdoor lifestyle can help tame behavior caused by chemical imbalances in a child's brain. "The right diet, exercise, getting up with the sun, will certainly help you chemically," he said.
At 15-year-old Red Cliff, based in Enterprise, clinical director Daniel Sanderson believes kids sometimes use a diagnosis as a crutch. He describes such a teen's mind-set:
"As soon as I encounter a situation that expects something beyond my abilities, all I have to [do is bring up] the abandonment issues or abuse issues and that will bring forth an cadre of individuals who will remove it," he said. "In spite of a diagnosis, the real problem is the difficulties they have experienced have allowed them to take a 'developmental vacation.' "
At camp, teens learn no one is going to carry their pack just because they are bipolar, Sanderson summarized.
But Florsheim, formerly at the University of Utah, said there is no reliable research on whether camps help children cope with mental illness, and questions the programs' long-term impact.
"Are you giving them the skills they can take with them when they go home? I'm skeptical of that," said Florsheim, who worked in a Florida camp as a young counselor 26 years ago.
Before arriving at Aspiro, 14-year-old Kayla was diagnosed with depression and attachment disorder. The redhead with a soft Southern-accented voice spent her early childhood in foster homes. She was adopted at age 8, but withdrew from her family and began cutting herself.
In camp, she found solace in the outdoors and her therapy sessions. She was "really excited" about an upcoming visit from her parents.
"But I'm kind of scared, too," she said, a feather tucked in her hair. "It'll be the first time my parents know I'm being genuine. ... I want to look them in the eyes and say, 'I love you' and for them to know I'm not faking it."
