Monthly Archives: August 2017

The difference a year makes…going back to college

 

As Onward Transitions looks to the fall and the beginning of the school year, one current member stands out as an individual working his way back into a more traditional academic routine. In addition to the rigors of living independently, holding down jobs and or volunteer roles in the community, maintaining a consistent fitness regimens, practicing budgeting, designing and maintaining a schedule to keep appointments and commitments, learning more about reciprocity in peer relationships, and managing his own transportation to and from commitments, this member has an eye on being a full time student in the very near future.

Member Profile

  • Male, early twenties
  • Highly intelligent, anxiety and depression due in part to a chronic health issue
  • Came to us from home after a brief hospitalization and struggling in the first semester of his small college
  • Embraced in vivo exposure therapy with an academic slant with us
  • Started with adult community/continuing education classes in his desired field of study
  • Next took two community college classes in his first semester and was successful
  • Next tried to take four community college classes and despite illness was able to complete two successfully
  • Serving as a tutor for both his college and a community adult education program
  • Registering again for four classes this fall
  • Contrast:
    • one year ago – living at home, participating in individual therapy, engaged in self-study in his chosen major, medication and health care managed by family members, being driven by family members to his appointments, etc.
    • today – living on his own, engaged in individual, group and family therapy, engaged in life coaching, registered for his third college semester, tutoring for two different institutions, managing his apartment, managing his own medication and health care, training in the performing arts, exercising daily, involved in a long-term relationship, navigating public transportation on his own

Success after wilderness

Transitioning Backcountry Durability to the Front Country

Many practitioners take part in the opportunity to explore best and future practices at the each year at the Wilderness Therapy Symposium in Park City, Utah. One interesting area for continued growth was highlighted in a journal article co-authored by a group of notable past and present wilderness therapists in the Journal of Counseling and Development. As part of their longitudinal assessment of young adults having participated in wilderness therapy (Roberts, et. al., 2017), the study confirmed previous Outdoor Behavioral Healthcare Council findings about the efficacy of wilderness programs in areas like psychosocial functioning, symptom reduction, etc. Researching-practitioners like these professionals truly lend credence and credibility to the field and deserve our collective thanks.

Their research also highlights previous suggestions that some of the success in maintaining gains made in wilderness treatment may be due to the focus on relapse prevention and transition planning towards the end of participation. The authors at the same time acknowledge that there has been historical criticism about client gains being lost post-treatment in residential settings. However, the study gave encouraging results that even 18 months post-treatment, study participants were maintaining their successful gains. 

Where wilderness “graduates” go after program completion can and does make a difference. The authors recommend further study for future assessment. Onward Transitions’ Clinical Director Darrell Fraize offers that in his anecdotal experience, wilderness therapy participants tend to identify their own strengths and capabilities that were either hidden or forgotten. “Clients tend to become more durable as they overcome pre-conceived limitations, and eventually some actual, historical limitations related to their mental health. They cope with stressors they cannot negotiate with like the weather, distance or elevation gain and loss. They build tolerance in delaying gratification, sustaining focus and simply following-through. They learn empathy and to put others’ needs ahead of their own, but doing this after exiting the wilderness can really be difficult to implement,” he adds.

Many programs teach and reinforce the Leave No Trace ethic, and yet post-treatment, many young adults struggle with the process of keeping their living spaces clean. They can recite the benefits, tell you why they have been able to do it in the past, but figuring out how to consistently do it on their own is a significant hurdle.  Onward Transitions relies on its clinical team of Fraize, Austin Melhorn and Andy Derstine to utilize their wilderness backgrounds to help program members transition this and other backcountry skills into the front country.

With more than half of Onward Transitions’ current and past populations having wilderness therapy experience it makes sense to provide specific focus on this aspect of transition.  “When in the backcountry, therapists have experience with both back and front country challenges. It makes sense to us that our therapists here in the front country have experience with both too,” adds Fraize. “We often find ourselves in sessions relating something that is happening now in the front country with an experience that the member had in the wilderness. A therapist having years of wilderness experience in the back pocket can really help in relating to the members’ struggle, and in identifying potential solutions.”

“Being able to sit with our members and help them recall that they have faced these types of challenges before and found solutions, often leads them to a greater sense of personal power and initiative.” Where wilderness therapy graduates transition to after program completion is determined by a multitude of factors (financial resources, clinical complexity, etc.) However, one factor that might benefit from future study is the efficacy of working with a former wilderness therapist, post-treatment. “As one member said to me after coming to Portland, ‘there’s getting it, and then there’s GETTING it’” Fraize recalled. “We have actually walked a mile in their shoes, or boots if you will.”

Roberts, S., et. al.  (2017, January). Outdoor Behavioral Health Care: A Longitudinal Assessment of Young Adult Outcomes. Journal of Counseling & Development, 45-55.