2012 Study Suggests An Adolescent’s Readiness to Change When Entering Wilderness Treatment May Not Impact Long-term Outcomes

In their 2012 publication, Bettmann, Russell, & Parry discussed that adolescent treatment coercion can sometimes involve an adolescent literally being escorted by a third-party service (e.g., youth transport service) into treatment via physical force or implied intimidation.  In reasoning that entering treatment unwillingly or coercively (perhaps third-party escort/transport) might impact an adolescent’s readiness (motivation) to change, Bettmann and colleagues suggested that their findings–adolescent readiness to change when entering wilderness treatment did not relate to post-treatment outcomes at 6 months and 12 months–may be applicable to coerced adolescents as well.  More explicitly, Bettmann and colleagues’ central finding was that an adolescent’s (initial) readiness to change was not related to the post treatment outcomes of the adolescents in their study.  From this, they surmised that parents admitting their adolescent teens into wilderness treatment coercively (i.e., against adolescent’s own volition) might not impair post treatment outcomes.  Thus, coercing an adolescent into wilderness treatment (e.g., via a third-part youth escort/transport service) may not obstruct the therapeutic process.  Rather they may stand to benefit from wilderness treatment as much as those entering non-coercively or with greater treatment motivation.

Notwithstanding this suggestion—especially considering coercive admission practices for adolescents—this study was limited in scope and more robust data is essential before drawing any absolute conclusions.  Specifically, the population of investigation was limited to one wilderness program of privately placed (middleclass) adolescents.  Also the first author of this article (although highly reputable) is directly affiliated (with ownership) in this particular wilderness program, indicating a potential bias in both the design and data interpretation.  Importantly, wilderness treatment is distinct from traditional residential treatments (e.g., therapeutic board schools, residential treatment centers):  Wilderness programs are relatively shorter in their duration and treatment occurs in an open outdoor setting, which may lessen an adolescent’s perception of coercive pressures during treatment per se.  Therefore, these findings should not be extended to traditional residential treatment contexts until supporting data is collected.

Despite the mentioned (and likely other) limitations, Bettmann and colleague’s (2012) study has offered sound evidence that more research is essential to understanding the practices of private wilderness programs and their long-term implications (e.g., post-treatment outcomes) for adolescent participants in particular.  Furthermore, there is a pronounced need to better understand the perceptions and responses of adolescents to treatment contexts that enroll adolescents unwillingly (or coercively).  Although this discussion is far from conclusive, at this point (according to this publication) it seems plausible that some adolescents can experience positive results from participating in wilderness treatment, even if they are not ready (or perhaps willing) to change at the onset of (wilderness) treatment.

I look forward to future research contributing to these issues.  The reference of this article is enclosed below.

Bettmann, J. E., Russell, K. C., & Parry, K. J. (2012). How substance abuse recovery skills, readiness to change and symptom reduction impact change in wilderness therapy participants. Journal of Child Family Studies. doi: 10.1007/s10826-012-9665-2


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