THE ROLE OF THE WILDERNESS i THE ROLE OF THE WILDERNESS THERAPY PROCESS : AN INTERPRETATIVE PHENOMENOLOGICAL ANALYSIS by VIRGINIA SANFORD B.A., University of Colorado Boulder, 2004 A thesis submitted to the Faculty of the Graduate School of the University of Colorado Denver in partial fulfillment of the requirements for the degree of Master of Arts Counseling Program 2018
THE ROLE OF THE WILDERNESS ii This thesis for the Master of Arts degree by Virginia Sanford has been approved for the Counseling Program by Scott Schaefle, Chair Troyann Gentile Robert Allan Date: May 12, 2018
THE ROLE OF THE WILDERNESS iii Sanford, Virginia (MA, Counseling Program) The role of the wilderness in the wilderness therapy process: An interpretative phenomenological analysis. Thesis directed by Associate Professor Scott Schaefle ABSTRACT The role of the wilderness in the wilderness therapy process was studied by examining the experiences of adolescent and young adult participants in a wilderness therapy program. Wilderness therapy is a type of counseling that utilizes the wilderness environment to deliver traditional therapeutic techniques such as group and experiential therapy to adolescent and young adults. A qualitative study of eight semi-structured interviews with adolescents and young adults in a wilderness therapy program in the summer of 2016 utilized an Interpretative Phenomenological A nalysis approach. Four themes emerged as being central to the participants' experience of the wilderness during their time in the wilderness therapy program. Implications and suggestions for future research are discussed. Keywords: wilderness therapy, wilderness setting, interpretative phenomenological, analysis, adolescents, young adults The form and content of this abstract are approved. I recommend its publication. Approved: Scott Schaefle
THE ROLE OF THE WILDERNESS iv ACKNOWLEDGEMENTS The completion of a Master's level thesis requires the support of many people to facilitate and help with the process. I would like to acknowledge and thank some of them here. I would like to start with thanking the participants who agreed to interviews with me in the summer of 2016. The insight into the participants' experience with wilderness therapy was invaluable to my own experience of my process with the research. My defense committee members have proven to be crucial supports throughout the process of completing my master's thesis. I would like to acknowledge and express deep gratitude for the tireless support, feedback, and guidance provided by my advisor, Dr. Scott Schaefle. The meetings, emails, and phone conversation over the past two years have pushed me to be a better and more concise writer, and have helped me maintain the motivation and enthusiasm to continue a project that has come to define much of my experience in the counseling M.A. program. Dr. Robert Allan has been so helpful in sharing with me his passion for and deep understanding of phenomenology and the world of research. I want to express my thanks for his commitment to reviewing my transcripts, my identification of themes and data analysis, and his thorough review of my written work. I would also like to thank Dr. Troyann Gentile for her commitment to supporting me through the research process. Her review of my written work, and the moral support that she has provided, particularly in the final stages of the project have been immensely helpful as I have worked to balance the demands of the counseling M.A. program with the demands of the research. Finally, I would like to thank the wilderness therapy program who graciously agreed to allow me to conduct interviews with their clients. The support of this program and their interest in helping future counselors pursue research is deeply appreciated and allowed this project to come to fruition.
THE ROLE OF THE WILDERNESS v This study involved human subjects and thus required approval from the Colorado Multiple Institutional Review Board (COMIRB). The COMIRB protocol number for this study is 15-0763.
THE ROLE OF THE WILDERNESS vi TABLE OF CONTENTS CHAPTER I. INTRODUCTION. 1 The Role of the Researcher .. 1 The Role of the Wilderness in the Wilderness Therapy Process: An Interpretative Phenomenological Analysis .. 2 Background and Significance. 4 Preliminary Studies 7 II. METHODOLOGY 9 Research Questions 10 Interpretative Phenomenological Analysis: The Framework for this Study 12 Phenomenology 12 Hermeneutics 16 Idiography 18 Method .. 19 Participants 20 Recruitment 22 Participant Screening Procedures .. 23 Data Collection .. 24 Wilderness Interviews 24 Data Analysis .. 27 III. RESULTS .. 32
THE ROLE OF THE WILDERNESS vii Different Setting 32 Safe and Non-Judgmental Setting 39 Metaphorical Power of the Wilderness 43 Immersion in Natural Environment 52 IV. DISCUSSION 56 Limitations 62 Recommendations for Future Research 63 REFERENCES .. 64 APPENDIX A. Interview Guide 68 B. Consent Form 69 C. Assent Form .. 74 D. Research Recruitment Letter 76 E. Table of Research Participants .. 77 F. Sample Data Analysis 78 G. Select Examples from Master Table of Themes 79 H. Saliency of Themes Across Cases 81
THE ROLE OF THE WILDERNESS viii LIST OF TABLES TABLE 1. Table of research participants 20 2. Sample data analysis 30 3. Select examples from master table of theme 30 4. Saliency of themes across participants 33
THE ROLE OF THE WILDERNESS ix LIST OF ABBREVIATIONS USED EEG Electroencephalograph IPA Interpretative Phenomenological Analysis IWOK Indigenous Ways of Knowing WT Wilderness Therapy
THE ROLE OF THE WILDERNESS 1 CHAPTER I INTRODUCTION The Researcher's Location Smith, Flowers and Larkin (2009) encourage the interpretative phenomenological researcher to select a topic that is not only personally interesting, but also allows the researcher to imagine what an "insider" status to a given phenomenon might entail, and how to negotiate access to insider accounts through appropriate participants. you will not have to remain without a solution if you will cling to Nature, to the simple in Nature, to the little things that hardly anyone sees, and that can so unexpectedly become big and beyond measuring; if you have this love of inconsiderable things and seek quite simplythen everything will become easier, more coherent and somehow more conciliatory for you, not in your intellect, perhaps, which lags marveling behind, but in your inmost consciousness, waking, and cognizance. (Rilke, 1934, p. 34.) The wilderness was imbued into my life at a young age. As an infant I was carried into the eastern woods on my father's back. Once I could walk, we spent every possible weekend hiking. Our major summer trips were often spent camping in the mountains of the East Coast. As a teenager, I followed the time worn path of my adolescent predecessors and rebelled against my parents' foundations, including the wilderness. It was not until I moved west as an undergraduate student that I reconnected with the natural world. Through hiking, rock climbing and camping, I began to explore for myself the transformation that is possible through the challenges faced in the wilderness. I began working with children and adolescents in a variety of wilderness adventure settings, facilitating the transformation for others that I had personally experienced. I
THE ROLE OF THE WILDERNESS 2 have spent ten years working with children, adolescents and adults to integrate the changes into their lives that can be afforded through experiences in the wilderness. I have been motivated by a committed belief in the transformative healing powers of the wilderness, though I did not integrate therapy into my outdoor work until I discovered the world of wilderness therapy. Through my work as a wilderness therapy guide, my belief in the inherent therapeutic value of nature was further cemented and inspired my pursuit of a master's degree in counseling. I was inspired to pursue this current study as a former wilderness therapy guide and as a current graduate student in counseling. While there appears to be a general consensus in the field of outdoor work that the wilderness is beneficial to participants' physical and mental health, there is little focus on why or how the wilderness is helpful. As an outdoor educator and wilderness therapy guide, I worked outside, but rarely talked about the impact the wilderness setting had on the transformations experienced. The wilderness appeared to be an essential element of the transformative adventure experience, though was not discussed as such. As a future therapist, interested in the therapeutic value of the wilderness, this study offers an opportunity to explore the role played by the wilderness in a therapeutic setting. The Role of the Wilderness in the Wilderness Therapy Process: An Interpretative Phenomenological Analysis Wilderness Therapy (WT) is a therapeutic modality that combines traditional therapy techniques, such as group and experiential therapy, with the use of the wilderness environment (Powch, 1994; Roberts, Stroud, Hoag, & Massey, 2017; Russell, 2003). While the prescriptive use of the wilderness for therapeutic purposes has been employed since the early 1950s (Casson & Gillis, 1994; Williams, 2000), research done on WT is limited. Much of the existing research
THE ROLE OF THE WILDERNESS 3 has focused on studying outcomes (Russell, 2003). Recent quantitative studies have demonstrated positive outcomes and the maintenance of in-treatment gains (Bettman, Gillis, Speelman, Parry & Case, 2016; Roberts et al., 2017). In addition to studies demonstrating positive and lasting outcomes with WT participants, there is a growing body of research exploring the impacts of the natural environment on the human brain, and physical and mental well-being. David Strayer, a cognitive psychologist at the University of Utah, is studying the restorative effects on the prefrontal cortex using electroencephalograph (EEG) machines (Atchley, Strayer & Atchley, 2012; Williams, 2016). Preliminary results indicate that spending time in nature has positive impacts on the functioning of the prefrontal cortex (Atchley, Strayer & Atchley, 2012; Williams, 2016). Given the technology saturated world that we now live in, and the general disconnect from the natural world, studies examining the impact of wilderness environments on mental and physical health are particularly salient. This study focuses on the role of the wilderness in the WT process in an effort to address a gap in the current literature regarding WT. As mentioned, the majority of the studies examining WT have focused on outcomes. Russell has paved the way for qualitative studies exploring the WT process and how it is linked to outcomes (2012; 2003; 2000; Russell & Farnum, 2004; Russell & Phillips-Miller, 2002). While the theme of the wilderness setting is touched upon, it is often referenced as a secondary factor to other processes (Russell, 2003). As WT becomes more widely accepted as an effective therapeutic modality, there is room to explore how specific processes link to positive outcomes, in particular whether the wilderness setting is an integral and necessary contributor to successful outcomes.
THE ROLE OF THE WILDERNESS 4 An Interpretative Phenomenological Analytic (IPA) approach was selected for the current study, given the researcher's interest in understanding the lived experience of participants in a particular phenomenon, i.e. a wilderness therapy program. Smith et al. (2009) describe IPA as a qualitative approach to research that is committed to examining how individuals make sense of major life experiences. The researcher chose to apply an IPA approach to the current study given the interest in understanding the personal experiences of participants in a WT program. Utilizing an IPA approach, the researcher examined the role of the wilderness in the experience of participants in a WT program to better understand the impact of the natural environment on the WT process. Background and Significance While WT is a relatively new field, it stems from a long tradition of using the wilderness to relieve physical, psychological and/or emotional pain (Grayshield, 2010). Using the wilderness as relief from pain is rooted in Indigenous Ways of Knowing (IWOK), which Grayshield (2010) defines as an epistemology that recognizes the interconnectedness of all things. Viewing the wilderness as a place for connection where one could "purge and cleanse the soul" has ties to Christianity (Stankey, 1989, p.12). T hough Stankey (1989) asserts that the Christian vision of wilderness is a place of refuge and contemplation rather than interconnectedness as viewed by IWOK. The tradition of the natural world being utilized therapeutically in the United States dates back to the use of tent therapy in the early 1900s. Two separate incidents forced asylums for psychiatric patients in New York and San Francisco to temporarily house patients outdoors in tents (Williams, 2000). In both instances, patients showed marked improvement in mental,
THE ROLE OF THE WILDERNESS 5 physical, and behavioral health (Caplan, 1974; Williams, 2000). The emergence of adventure therapy in the 1950s and 1960s was a result of the success of tent therapy in the early 1900s. Hospitals and detention centers began using adventure therapy during the mid-twentieth century in the treatment of a range of psychiatric and offender populations (Casson & Gillis, 1994; Williams, 2000). During the 1960s and 1970s Outward Bound was used as an alternative form of incarceration or treatment for troubled adolescents (Russell, 2001). The legacy of adventure therapy being used as an alternative treatment directed towards troubled adolescents carries forth into today's use of WT with primarily adolescent and young adult populations. The term "wilderness therapy" has been used synonymously with adventure therapy, outdoor behavioral health, wilderness experience programs and therapeutic adventure (Mitten & Itin, 2009; Russell, 2001; Roberts et al., 2017). The lack of consistency in defining WT is an indication of the paucity of formal consensus about what comprises WT. Russell (2003) synthesizes several descriptions of WT to create a multi-faceted definition. WT uses traditional therapy techniques, especially group therapy and experiential therapy, in a wilderness setting, where the wilderness is approached with a therapeutic intent (Powch, 1994; Roberts et al., 2017). Participants must be chosen based upon a clinical assessment and each client will have an individualized treatment plan (Davis-Berman & Berman, 1994). As mentioned, WT participants tend to be adolescents and young adults with "severe behavioral problems" (Russell, 2000, p. 71), and WT is frequently used as an alternative to inpatient services or rehabilitations services (Davis-Berman & Berman, 1989; Russell, 2000). The use of outdoor adventure and activities such as primitive skills, backpacking and reflection, facilitate personal and interpersonal growth (Kimball & Bacon, 1993). Miles and Priest (1999) propose that WT relies on unfamiliar
THE ROLE OF THE WILDERNESS 6 environments, physical remoteness, and natural consequences of the environment as catalysts for change. A natural consequence in WT might be failure to properly construct a personal shelter, which could result in getting wet and cold while sleeping. WT also focuses on ecological elements such as living in the natural world, or living in balance and connection to the ecology of a place (Beringer, 1999; Beringer & Martin, 2003; Mitten, 2004). As the literature has sought a clear definition of WT, there have also been efforts to study the effectiveness of WT programs. Russell has identified common themes in his studies of the WT process as: the importance of alone time for reflection, the significance of a nonconfrontational and caring approach in establishing relationships with therapists and staff, the role of peer dynamics, physical challenge and the experience of being in the wilderness (Russell, 2003; Russell & Phillips-Miller, 2002). However, the literature exploring the role the wilderness plays in therapeutic outcomes is minimal and seems to be secondary to other processes (Russell, 2003). Indeed, the focus on the role of the wilderness as a therapeutic tool is lacking in most descriptions of WT. Instead, the wilderness setting functions primarily as a backdrop for the program (Beringer & Martin, 2003). Within the scope of examining the WT process, there exists an arena to further explore the role of the wilderness as it relates to outcomes. Beringer and Martin (2003) suggest that the natural world may be equally or more critical to change than the therapist, program design, or adventure experience. Examining the WT process, in particular, how the wilderness setting impacts the experience of participants in a WT program, will contribute to a growing body of research focused on understanding how this alternative treatment differs from other modalities serving similar populations. The study strives to understand the lived experience of participants in a WT
THE ROLE OF THE WILDERNESS 7 program to better understand the WT process. Studying the WT process comple ments the recent studies which are helping to garner support from insurance companies and help to increase access to populations in need of alternative treatments (Norton et al, 2014; Russell & Farnum, 2004; Rutko & Gillespie, 2013). Preliminary Studies Studies examining the outcomes of wilderness therapy have shown improvement in selfconcept, social skills, decreased psychiatric symptoms, decreased drug and alcohol use and lower rates of recidivism (Berman & Davis-Berman, 2009; Roberts et al., 2017; Russell, 2000; Russell, 2008; Wilson & Lipsey, 2000). A recent longitudinal study evaluating the psychological wellbeing and functioning of 186 young adults enrolled in a WT program showed statistically and clinically significant change, such as improved overall psychosocial functioning, relief of symptom distress, and decreased interpersonal difficulties during the WT process. The gains made during the WT process were maintained for up to 18 months following discharge from the WT program (Roberts et al., 2017). WT as an effective alternative treatment modality to inpatient services has been studied, and the research indicates positive results including improved psychosocial functioning, relief of symptom distress, and reduced interpersonal difficulties that were maintained following discharge (Norton et al, 2014; Roberts et al., 2017; Russell, 2000). There is now room to examine the processes that contribute to these positive outcomes. As mentioned, Russell initiated much of the research focused on the WT process (1999; 2000; 2003; 2004; Russell & Farnum, 2004; Russell & Phillips-Meyer, 2002). He has used qualitative interviews to search for themes related to the process, which have helped to facilitate successful therapeutic results for WT participants. His work has primarily examined adolescents
THE ROLE OF THE WILDERNESS 8 enrolled in programs in the Desert Southwest and the Pacific Northwest (1999; 2000; 2003; 2004; Russell & Farnum, 2004; Russell & Phillips-Meyer, 2002). Although the wilderness experience is a theme touched upon in his work, the references are subtle, mentioned in terms of the setting rather than examining the wilderness itself as a therapeutic tool (Russell, 2000). This raises the question of whether WT truly needs to take place in the wilderness to be effective, as Rutko and Gillespie (2013) point out. Although it is generally agreed that wilderness plays a role in the therapeutic process, there is little understanding of how or why it does so (Harper, 2009). Little consideration has been given to the significance of the wilderness setting when exploring positive therapeutic results linked to the WT process Beringer and Martin (2003) suggest "what may be equally critical, if not more so [than the therapist, program design, or adventure], in bringing about change for the better may be due to nature'-being in and interacting with the natural world" (p.33). The lack of focused research on the relevance of the wilderness setting invites a deeper exploration of the wilderness aspect of the therapeutic process. Russell (2004) has proposed a concurrent model, rather than a stage-based model of the WT process which identifies three factors that are inter-connected throughout the therapeutic process. The three factors are the a) wilderness, b) physical self, and c) social self. The role of the three factors contributes to the therapeutic process in varying degrees of significance throughout the WT experience. Russell proposes that the three factors are all present throughout the WT process, and are interconnected; these factors are believed to exist in different intensities throughout the process, though none are forgotten as others become more salient (Russell, 2004). A greater understanding of the therapeutic role of the wilderness experience can offer insight for future program development and contribute to the growing body of literature
THE ROLE OF THE WILDERNESS 9 exploring how the process is tied to outcomes. If the wilderness proves to be a salient factor in the process, as suggested by Russell's concurrent model (2004), this might inform the attention given to allowing students to reflect upon their connection to the natural world. Many clients leaving WT programs continue treatment in a variety of after-care options, such as therapeutic boarding schools or transitional living programs. Implementing newly learned coping skills in an environment outside of WT programs is a challenge for most students (Russell, 2000). Increased clarity about how the WT process is linked to outcomes might be integrated into after-care treatment, making for a smoother transition and continuity in the change process. In summary, the existing research examining WT has focused largely on therapeutic growth, which is shown to be positive (Berman & Davis-Berman, 2009; Roberts et al., 2017; Russell, 2000; Russell, 2008; Wilson & Lipsey, 2000). The few studies exploring the WT process have examined the various elements of WT from a program perspective, meaning the focus has been on WT as a whole (Russell, 1999; Russell, 2000; Russell, 2003; Russell, 2004; Russell & Farnum, 2004; Russell & Phillips-Meyer, 2002), rather than exploring specific elements of the WT process such as the wilderness setting. The current study aims to contribute to the limited studies examining the WT process with a particular focus on how the wilderness environment impacts the process. CHAPTER II METHODOLOGY This study used a phenomenological approach to explore the WT process, a phenomenon that is not widely understood. Phenomenological research seeks to gain a deeper understanding of an experience to offer an insightful description of the phenomenon (Morrisette, 1999). Great
THE ROLE OF THE WILDERNESS 10 attention has been given to studying the outcomes of WT programs, leaving a deficit in the understanding of how the process of WT, particularly the element of the wilderness itself, contributes to such outcomes. Focusing on the WT process, with particular attention given to the role of wilderness, adds to the research begun by Russell (2000; 2001; 2004; Russell & PhillipsMeyer, 2002). Russell identifies the need for further exploration of the intensity of the three factors (wilderness, physical self, and social self) identified in his concurrent model of the WT process (K. Russell, personal communication March 5, 2015). In keeping with the research methods employed by Russell (Russell & Phillips-Miller, 2002), qualitative interviews were used to allow participants in the current study to describe what they identified as integral parts of the therapeutic process by way of reflecting upon their experience. A deeper exploration of the role played by the wilderness setting attempted to gain a greater understanding of how the wilderness itself contributes to cognitive and behavioral change. Additionally, this study sought to include both young adult participants (ages 18 to 22) and adolescent participants (ages 14 to 17) in the interview pool. Focusing on the role of the wilderness and including young adult participants fill a gap in the existing literature related to WT programs, which have not explored in depth the wilderness setting, and have primarily studied the experience of adolescents in treatment. Research Questions 1. How does the wilderness environment impact participants' experience in a WT program? 2. How does the wilderness environment serve as a therapeutic tool in the WT process? Interpretative Phenomenological Analysis: The Framework for this Research This study employed an Interpretative Phenomenological Analysis (IPA) approach to examine the role of the wilderness in the experience of individuals' participation in WT. IPA
THE ROLE OF THE WILDERNESS 11 strives to capture the quality and the essence of an individual's experience (Smith et al., 2009; Willig, 2010). However, the experience of another is never directly available to the researcher, thus IPA is, at its core, interpretative (Willig, 2010). Generally, IPA researchers analyze an individual's experience in order to understand the experience (Smith et al., 2009; Willig, 2010) Gaining an understanding of the WT participants' experience with the wilderness is essential to examine the therapeutic role played by the wilderness setting. This researcher is interested in the personal experiences of the students who have participated in the WT. Rooted in phenomenological philosophy, IPA views humans as sense-making beings. When people engage with a major experience, they will reflect upon the experience in an effort to make sense of the significance of what is happening. IPA attempts to interpret the individual's account to understand the experience (Smith et al., 2009; Willig, 2010). When conducting IPA, the researcher is concerned with a detailed examination of the human lived experience. The examination of an individual's experience is interpretative because the examiner does not have direct access to another person's experience; therefore, making interpretation necessary (Willig, 2010). The process of the researcher attempting to make sense of what the participant is trying to make sense of is called the double hermeneutic (Smith et al., 2009). The aim of IPA is to capture the essence of a phenomenon as it is described by the participant (Smith et al., 2009; Willig, 2010). IPA is rooted in phenomenological philosophy, hermeneutics (the theory of interpretation), and idiography (a focus on the particular) (Smith et al, 2009; Willig, 2010). The following section will discuss the philosophical and theoretical underpinnings of IPA research. Phenomenology, as a philosophy, draws from the works of German philosophers Edmund Husserl and Martin Heidegger, and French philosophers Maurice Merleau-Ponty and
THE ROLE OF THE WILDERNESS 12 Jean-Paul Sartre. IPA also draws from the theories of hermeneutics and ideography, which will be discussed in greater detail below. An understanding of the underpinnings of IPA guides the framework and design of this research. Phenomenology. Phenomenology is the study of the world as it is experienced by humans within particular contexts and at particular times (Willig, 2010). The focus of phenomenology is on the phenomena (or experiences) that appear in the human consciousness through engagement with the world in which we live (Willig, 2010). Phenomenological research draws from phenomenological philosophy. IPA, a subset of phenomenological research, is rooted in the work of Husserl, Heidegger, Mearleau-Ponty, and Sartre (Smith et al, 2009; Willig, 2010). Husserl. Universally considered the founder of phenomenology (Moran, 2000), Husserl believed the experience should be examined in the way it occurs, and on its own terms. He extolled the need to "go back to the things themselves," (Husserl, 1901, p. 7) with the things themselves being the lived human experience (Smith et al, 2009). By going back to the "things themselves," the individual is able to examine the essence of the meaning in his or her lived experience. In the context of this study, the "things themselves" are the participants' experiences with the wilderness itself and the meaning each participant derived from the WT experience. Husserl was interested in the lived experience, free from external influences, be they social, cultural or intellectual. He wanted to explore experience in a pure manner that was untainted by assumption (Moran, 2000). The phenomenological researcher strives to gain insight of the perception of objects or experiences. There is a need for the researcher to disengage from the object and attend to the "taken-for-granted" experience of it (Smith et al, 2009). Disengaging from the object is also referred to as bracketing, which involves setting aside the "taken-for-
THE ROLE OF THE WILDERNESS 13 granted" experience in order to focus on our perception of that experience (Smith et al., 2009). The researcher helps the participant reflect upon the thoughts, memories, images or feelings that are natural responses to experiencing a phenomenon (Smith et al, 2009). For example, the "taken-for-granted" experiences associated with an eagle flying overhead might include wondering where it came from, where it was going, wishing that it would fly by again. This study aims to understand in detail the "taken-for-granted" experiences participants had with the wilderness setting during the WT process. Heidegger. Originally a student of Husserl's, Heidegger diverged from his teacher, believing him to be too abstract and theoretical. Heidegger did not believe it was possible to disengage, or bracket, from the world (or the object) as our relationship to the world is an integral part of human existence (Smith et al, 2009). Rather, Heidegger was interested in the nature of human existence as it engages with the practical activities and relationships in which humans are caught up. Through connections to activities and relationships, the world appears to us and is made meaningful (Smith et al, 2009). Intersubjectivity refers to the shared, overlapped and relational nature of human engagement in the world (Smith et al., 2009). According to Heidegger, the person is always a "person-in-context", and "relatednesstothe-world" is a fundamental part of our constitution (Larkin, Watts, & Clifton, 2006). Intersubjectivity explains the relatedness between an individual's context and his or her relating to the world, and the human ability to communicate with and make sense of each other (Smith et al., 2009). Interaction with the objects and people that make up the world does not remain separate and distinct (Smith et al, 2009). Similar to the influence that culture has on the human experience, the way that people engage with one another and with the world around them is influenced by all the
THE ROLE OF THE WILDERNESS 14 previous and overlapping experiences leading up to that engagement. Heidegger believed that it was impossible to separate oneself from the world and preconceptions are therefore inevitable. However, when seeking to understand another's experience, priority ought to be given to the new object or experience being interpreted, not to the preconceptions (Smith et al, 2009). Interpretation is the essence of phenomenology for Heidegger. As the phenomenologist, this interpretation employs the concept of the double hermeneutic, i.e. the interpretation of the participants' interpretation (Smith et al., 2009). Merleau-Ponty. Influenced by the works of Husserl and Heidegger, Merleau-Ponty shifted the focus of phenomenology to the inseparable nature of the human experience to the world around us (Smith et al, 2009). Drawing from Merleau-Ponty, IPA attempts to understand how a person's relationship to the world is interpreted by analyzing individuals' attempts to make meaning out of his or her experiences in the world (Smith et al, 2009). The individual's interpretations are influenced by his or her subjective reality, which will be unique to each person. To capture the essence of an individual's experience with a phenomenon, the researcher must understand the individual's subjective reality. This study aims to explore the subjective reality of each participant's unique experience with the wilderness and the meaning he or she attaches to the time spent in the wilderness. In the Phenomenology of Perception (1945), Merleau-Ponty posits that a phenomenon, or human experience, is "a whole already pregnant with an irreducible meaning, which forms the basic layer' of all experience" (Langer, 1989, p. 8). It is the role of the researcher to extract this irreducible meaning, or to help facilitate an interpretation of the participant's experience. The "present and living reality" of perception forms the basis for human relationships to language,
THE ROLE OF THE WILDERNESS 15 culture and society (Langer, 1989). Perception creates our own reality. Thus, the way one person perceives an object or experience may be very different from the manner in which another perceives the same experience. The phenomenologist is concerned with making meaning out of each person's unique experience and explore what is common to multiple participants' experiences of the same phenomenon (Smith et al., 2009) A major contribution to phenomenology is Merleau-Ponty's concept of embodiment, which explains that our perceptions of other always stems from one's own embodied perspective. Therefore, it is never possible to fully share another's experience because it belongs to one's own embodied experience in the world (Smith et al., 2009). Merleau-Ponty suggests that the body shapes the fundamental character of our knowing about the world (Smith et al., 2009). The concept of embodiment prioritizes the physical and perceptual affordances of the body-in-theworld over the abstract or logical affordances (Anderson, 2003). The body-in-the-world does not exist as a discreet entity. In other words, there is an overlap between how we pass through the world, and how the world passes through us. Sarte. Sartre built upon the concepts of Heidegger and Merleau-Ponty, continuing to expand upon existential phenomenology (Smith et al., 2009). Similar to Heidegger, Sartre believed that individuals are caught up in their relatedness-to-the-world, or in "projects in the world" (Smith et al., 2009, p. 19). Like Heiddeger and Merleau-Ponty, Sartre believed it is impossible to separate ourselves from the context in which we live. Our projects in the world lead us to connecting with others, and our world is shaped by the presence of others and their projects (Smith et al., 2009).
THE ROLE OF THE WILDERNESS 16 Sartre emphasized the idea of "existence before essence" (1948, p. 26), which highlights the concept that we are not pre-existing entities, but are constantly becoming ourselves (Smith et al., 2009). Sartre is concerned with who we are becoming rather than who we are, and who we are becoming is shaped by both what is present, and by what is absent (Smith et al., 2009). Sartre refers to the things or people that are absent as nothingness which help to shape who we will be, and how we see the world as much as the things or people that are present (Smith et al., 2009). Thus, in order to understand another's experience we must attend to both the presence and the nothingness within a phenomenon that contributes to who the individual is becoming and how the individual sees the world. Hermeneutics. Hermeneutics, the theory of interpretation, is a major theoretical underpinning of IPA that parallels the philosophy of phenomenology (Smith et al, 2009). Phenomenology as a philosophy attempts to understand, or interpret, an individual's unique experience with a phenomenon (Smith et al., 2009). The theory of hermeneutics states that all description constitutes a form of interpretation, which makes hermeneutics an integral part of phenomenology (Willig, 2010). The phenomenological researcher interprets the participant's description of an experience in an effort to capture the essence of the phenomenon being studied. IPA draws upon the philosophical underpinning of hermeneutics and uses three specific hermeneutic concepts: the hermeneutic circle, the hermeneutic of suspicion, and the hermeneutic of empathy (Smith et al., 2009; Willig 2010). As mentioned, hermeneutics is also rooted in phenomenological philosophy. Heidegger is often credited with shifting phenomenology from the transcendental approach of Husserl towards a hermeneutic and existential focus (Smith et al, 2009). According to Heidegger, a phenomenon
THE ROLE OF THE WILDERNESS 17 appears and the phenomenologist has the role of assisting the participant in making sense of what is appearing to the participant (Smith et al, 2009). Thus, the researcher attempts to engage participants in reflecting upon and interpreting the essence of an experience through the interview process (Smith et al, 2009). Heidegger and German philosopher, Gadamer, were interested in the relationship between fore-understanding (pre-conceived notions, prior experiences, assumptions) and the new phenomenon being attended to (Smith et al, 2009). While it may not be possible for the researcher to fully separate him or herself from fore-understanding, it is essential for the phenomenological researcher to first attend to interpreting the new experience without the influence of preconceived notions (Smith et al., 2009). The hermeneutic circle is a useful framework for considering the method of IPA for the researcher. The hermeneutic circle describes the concept that the parts of the whole can only be understood through an understanding of the whole (Smith et al, 2009). Conversely, the whole can only be understood through an understanding of the parts (Smith et al, 2009; Willig, 2010). The researcher applies the hermeneutic circle by analyzing an individual's experience, or the parts, in an effort to understand the collective experiences of a particular phenomenon, or the whole. The hermeneutic circle will be explored in more detail in the discussion of idiography below, as it is central to the focus on detail in IPA research. Additionally, the focus on understanding the detailed parts in order to understand the whole experience is essential in capturing the essence of a phenomenon. However, the researcher never has direct access to the experience being described; therefore, he or she is engaged in double hermeneutics. The meaning-making of the participant is considered first-order meaning, and that of the researcher is considered secondorder meaning (Smith et al, 2009).
THE ROLE OF THE WILDERNESS 18 IPA draws from two traditions of hermeneutics: the hermeneutic of suspicion and the hermeneutic of empathy (Smith et al., 2009) The hermeneutic of suspicion uses outside perspectives such as theory or other research, to shed light on a phenomenon. Alternatively, the hermeneutic of empathy attempts to reconstruct the original experience in its own terms, or understand the unique experience of the individual (Smith et al, 2009). IPA combines the hermeneutics of suspicion and of empathy, though prioritizes an empathic interpretation (Smith et al., 2009). The researcher attempts to adopt an insider's perspective and at the same time, the researcher is also attempting to look at the participant from a different angle, asking questions and analyzing the participant's interpretations (Larkin, Watts & Clifton, 2006; Smith, 2004; Smith et al, 2009). Idiography. As mentioned, idiography is concerned with the particular. IPA is committed to the particular in terms of the detail of an individual's description of an experience and the subsequent analysis. IPA is also concerned with the particular in terms of understanding how an individual relates to his or her experience with a phenomenon (Smith et al, 2009). Idiography is a pillar of phenomenological philosophy and research. The phenomenological researcher is committed to understanding, in detail, the participant's experience, and how he or she makes sense of the experience. The researcher's understanding comes from both an attention to detail in engaging with the participants, and in the depth of the subsequent analysis (Smith et al, 2009). Any insight gained stems from an intensive and detailed engagement with the individual cases of each participant. However, any specific insight is only integrated into broader generalizations in the later stages of the research (Willig, 2010). Researchers can use the hermeneutic circle to alternate between an understanding of the
THE ROLE OF THE WILDERNESS 19 whole of an experience, and understanding specific elements of it, the particular, as emphasized by an idiographic approach (Smith et al., 2009). The researcher strives to examine and understand the parts of each participant's experience in order to capture the essence of said experience. Additionally, the researcher attempts to understand each participant's experience in order to understand the core of the collective phenomenon being studied. The focus on the particular, or on idiography, is integral to gaining an understanding of the whole. In an effort to understand the whole, idiography may focus on an examination of a single case, or it may look for what is common across cases (Smith et al., 2009). In this study, this researcher is interested in examining commonalities across cases. IPA focuses on personal meaning and sense-making of a particular phenomenon, for individuals who have shared a common experience, such as the WT experience (Smith et al, 2009). The focus on personal meaning involves attention to the particulars, or the details, of that sense-making and of the individual's experience. In this study, the common experience is the wilderness therapy process. This researcher is interested in exploring and understanding the personal meaning and sense-making that students in WT have made of their wilderness experience. The concepts of phenomenology, hermeneutics and idiography guided interviews with WT students and the analysis of the interviews, in an effort to capture the essence of their experience. Employing the aforementioned concepts involved a focus on the unique experience of each participant with the wilderness during the WT process, by interpreting participants' accounts of the WT phenomenon. Interviews were shaped by an attempt to understand the details and personal connections individuals made with the wilderness while in the WT program. Method
THE ROLE OF THE WILDERNESS 20 The following section will detail the method applied to the current IPA study. This will include a description of participants, the recruitment process, and screening procedures. Additionally, the following section will describe the process of data collection, which consisted of wilderness interviews, and data analysis. Participants. Participants for this study were students enrolled in the same WT program in the northeastern United States during the summer of 2016. The study strove for a sample of students representing the population of the program, meaning individuals identifying as male and female ranging from fourteen to twenty-two years old. Eight students were interviewed in August 2016, as they were in the final stage of the program, preparing for graduation. All participants had been enrolled in the WT program for a minimum of six weeks at the time of the interviews. The sample was comprised of seven males and one female, due to lower female enrollment. The adolescent group consisted of four males and one female, ranging in age from 14-16 years. The young adult participants consisted of three males ranging in age from 18 to 20 years. Table 1 describes the research participants. Table 1: Description of research participants Interview Pseudonym Gender Age 1 Jim Male 14 2 Darth Male 15 3 Paul Male 19 4 Bill Male 16 5 Cass Female 14 6 Rob Male 14 7 Henry Male 20
THE ROLE OF THE WILDERNESS 21 The average duration of stay at the program studied is eight to ten weeks, based upon the therapeutic needs and progress of each client. Some students require more time to meet their therapeutic goals, which are facilitated by the intensive wilderness experience, the group living dynamic, and individual work with a licensed therapist. Throughout the WT experience, students live in the wilderness, sleeping under open-air tarps (May-October), or in wood-fired cabins or canvas tents (November-April). During this time, the students progress through four stages related to their therapeutic progress. Students entering the program begin in stage one, which is characterized by acquiring basic wilderness living skills such as setting up a tarp for shelter, gathering materials for fire building, cooking meals over an open fire and learning how to build a fire using a flint and steel technique. Wilderness living skills are linked to establishing self-sufficiency through exhausting problematic patterns and behaviors, and building a foundation for growth throughout the program. In the second stage of the program students further develop the wilderness living skills of proficiency with fire building and learning how to build animal traps, both of which students have to master in order to move on to the next stage. The skills developed in stage two focus on the continued exhaustion of problematic patterns, and development of methods for group engagement with the intention of relating their work to family systems. Students create a goal with their therapist in this stage that will drive his or her forward movement. In the third stage, students develop proficiency with more advanced wilderness living skills, such as tree 8 Michael Male 18 Table 1: Description of research participants Interview Pseudonym Gender Age
THE ROLE OF THE WILDERNESS 22 identification and bow-drilling as a fire building technique. The aims of the third stage are to develop leadership, mastery and consistency within the group living dynamic, and with wilderness living skills. In the final stage students are working towards integrating the interpersonal and self-sufficiency skills developed throughout the program into a plan for life outside of the program with a focus on reflection and transition. Students work on developing a portfolio that represents what students found to be meaningful about their time in WT. Students are asked to reflect on the emotional, behavioral, and wilderness skills developed. As students move forward in the program they increase their proficiency with goal-setting, primitive skills and cognitive and behavioral awareness. IPA research dictates that samples are selected purposively to offer insight into a particular experience (Smith et al., 2009), i.e. the WT experience. Participants were selected based on their representation of a experience rather than a population. Generally, IPA researchers try to select a homogenous sample for whom the research questions will be meaningful (Smith et al., 2009). Recruitment. Participants were recruited from the pool of all students coming into the program in the late spring and early summer of 2016. This time frame reflects the enrollment period for summer students, who tend to struggle with less acute problematic behaviors than the winter students. The summer population is generally comprised of students who have struggled during the school year, whereas the winter population is comprised of students who have failed to complete the school year due to problematic behaviors All incoming students and parents received a research consent form and a description of the study in June of 2016. Signed consent forms were handed directly to the researcher.
THE ROLE OF THE WILDERNESS 23 Participants were selected from the overall student population who submitted a signed research consent form, and were expected to graduate in August 2016. Purposive sampling was used in order to achieve a research sample that was representative of the WT experience. Ideally, this would have included males and females ranging in age from 14-22. However, the focus was on achieving a sample that offered access to the perspective of the WT experience (Smith et al., 2009). As mentioned, female enrollment was low during the summer of 2016, thus the sample reflects the gender discrepancy within the program. Participant Screening Procedures. IPA is concerned with understanding particular phenomena in particular contexts; therefore, the IPA researcher selects small sample sizes that grant access to a particular perspective (Smith et al, 2009). To be included in this study, students must have been enrolled in the WT program. Participants were selected in an effort to achieve maximum variation based on age, gender and ethnicity. However, the sample was also homogenous based on the population enrolled, which is comprised of adolescents and young adults in need of therapeutic intervention for behavioral and relational problems. Participants were excluded from this study if they were not enrolled in the program at the time of interviews, or they did not sign a consent form. Research consent forms contain confidential information about both students and parents or guardians. In order to protect the identities of all parties identified by the consent forms, the researcher is the only person with access to these forms once the forms left the program site. As the selection criteria are partially based on demographic information such as age and gender, this information was included in these forms. The forms were stored in a locked box from the moment they enter into the researcher's possession. Once participants for the study were selected,
THE ROLE OF THE WILDERNESS 24 a code sheet was created that assigned pseudonym research names to each participant. All names listed in the study utilize the assigned pseudonyms. The code sheet links the participants to their demographic information, to which only the researcher has access. The code sheet has been stored separately from the consent forms to further protect the identity of participants. All subsequent transcriptions of interviews were done electronically, using their coded research names. Data Collection. IPA is best suited to a data collection method that allows for a rich, detailed, first-person account of a participant's experience (Smith et al., 2009). Therefore, indepth interviews were used in this study as a way to enter the participant's world (Smith et al., 2009). Data collection consisted of semi-structured interviews conducted with participants about their experience with the wilderness as they were preparing to graduate from the WT program after spending a minimum of six weeks in the program. Wilderness Interviews. In-person interviews with students were conducted during the summer season and during the final weeks of the participants' stay. The in-person interviews lasted between 45-60 minutes. Interviews were guided by the interview outline provided in Appendix A. Sample questions include, (1) What did you think about the wilderness when you arrived at [the program]? What do you think about it now? Why do you think that changed (if it did)?, and (2) What do you think were some of the most important parts of your experience at [the program]? How important do you think the wilderness was? Why? Prior to conducting the interviews, it was important for the researcher to explore her own experiences as a WT guide, and identify any biases or assumptions that she already held about the process. This researcher maintained a reflexive journal in order to identify preconceptions
THE ROLE OF THE WILDERNESS 25 throughout the research process (Ahern, 1999). Topics for exploration included the researcher's reason for exploring the research topic; assumptions regarding gender, sexual orientation, race/ ethnicity, socioeconomic status; the power differential between researcher and participant; the researcher's personal value system (Hanson, 1994); and potential role conflicts between research participants (Tufford & Newman, 2012). Identifying these prejudices, or the fore-understanding, and temporarily setting them aside allows for a more open exploration of the experience of participants (Smith et al., 2009). This is a process the phenomenological approach refers to as bracketing (Merriam, 2009). By paying close attention to the participant's words, the focus can remain on his or her experience rather than the researcher's experience or hypotheses. Heidegger emphasized the importance of attending to the participant's words in his belief that the phenomenologist must give priority to the new experiences being interpreted (Smith et al, 2009). During the interview, the participant's words are of the utmost importance and all followup questions should be generated from what he or she has to say (Smith et al, 2009). However, the researcher's fore-understanding will inevitably influence the research question and the interview questions asked, as the hermeneutic of suspicion, which uses outside perspectives such as theory or other research, to shed light on a phenomenon, not only shapes the research, but also encourages participants to consider questions they may not have asked themselves (Smith et al., 2009) Recognizing the presence of the hermeneutic of suspicion in the research and interview process, it is the role of the researcher to prioritize the participant's experience with a phenomenon, allowing for the hermeneutic of empathy (attempt to understand the unique experience of the individual) to drive the interviews (Smith et al., 2009; Willig, 2010).
THE ROLE OF THE WILDERNESS 26 The interviews took place in August 2016 as students were preparing to graduate from the program, after spending at least six to eight weeks participating in an intensive wildernessbased experience. Through a semi-structured process (Merriam, 2009), participants were asked to describe their experience with the wilderness therapy process, which involved living in the wilderness in small groups of peers, learning and utilizing primitive skills such as fire building, constructing animal traps, and participating in personal and group therapy. Participants were asked to explore the role of wilderness in the therapeutic process. Participants were asked to identify any change experienced while enrolled in the program. As goals are an integral part of the WT experience, participants were invited to share any goals they would like to apply to their life outside of WT. The semi-structured interviews allowed the process to follow the experience of the participant, who is the experiential expert on the topic (Smith et al, 2009). This allowed the participant to describe what was personally significant. The structure of the interview was guided by the researcher's interest in examining the therapeutic value of the wilderness. The interviews offered a personal account of the entire WT process. This study was interested in the participant's experience in an effort to understand his or her perceptions of the wilderness setting and how it relates to therapeutic outcome. Because many clients in WT entered into the program following some crisis, every effort was made to not cause any emotional harm by asking participants to relive experiences that they were not comfortable sharing. Any questions that participants did not want to answer could be skipped. If at any time a participant no longer wanted to participate in the study, he or she was under no obligation to continue with the interview. If the interview process was upsetting for any participants, he or she was able to talk to his or her therapist within the program while still
THE ROLE OF THE WILDERNESS 27 enrolled. If participants wanted someone to talk to after leaving the program, they were provided with contact information for one of the therapists at the WT program who agreed to serve in the role of a counselor contact, at the end of the interview. The focus on examining the role of the wilderness in any change experienced during the WT process with students was done with every effort to pose no additional risk to participants. Data Analysis. Analysis employed an interpretative phenomenological approach, focused on capturing the essence of the participants' WT experience (Merriam, 2009). The goal of IPA analysis is moving from the particular to the shared, and from the descriptive to the interpretative (Smith et al, 2009). Smith et al. (2009) outline a six-step process for IPA analysis which are described below. Step One. Step one involves the researcher reviewing the audio recorded transcripts of interviews, which consists of reading and re-reading the data (Smith et al, 2009). This step is focused on entering the participant's world, allowing the participant to become the focus of the analysis (Smith et al., 2009). Qualitative data analysis preferences dictate that analysis will happen simultaneously with data collection (Merriam, 2009). As interviews were completed, the researcher transcribed the audio recordings into a typed document. Morrisette (1999) argues that this allows for a greater understanding of initial themes that might have arisen through the transcription process and begins an initial coding process. Step Two. Reviewing the transcripts will often merge with step two of making initial notes of anything of interest in the transcript (Smith et al, 2009). The initial coding stage aims to produce a detailed set of notes and comments on the data. The researcher focuses on descriptive, linguistic, and conceptual analyses (Smith et al., 2009). Descriptive comments describe the
THE ROLE OF THE WILDERNESS 28 content of the participant's talk. Linguistic comments focus on the presentation of the content and meaning, such as pauses, laughter, or tone. Finally, conceptual comments focus on data analysis on a more interrogative and conceptual level (Smith et al., 2009). Step Three. Following the initial coding process, the researcher begins to develop emergent themes (Smith et al, 2009). At this stage, the analyst attempts to consolidate the initial notes into a concise statement of what was important across the comments made in stage two (Smith et al., 2009). Step Four. Step four involves looking for connections across the emergent themes outlined in the previous stage. The researcher is attempting to draw together the emergent themes to create a structure that identifies the most interesting and important aspects of the participant's experience (Smith et al., 2009). Drawing together the emergent themes helps the researcher to identify superordinate themes. Step Five. After completing the first four steps, the researcher then retraces these steps with the next case, or transcribed interview. At this point, it is important to address each subsequent case in its own terms, or making efforts to bracket emerging ideas from the previous cases while attending to the next cases (Smith et al., 2009). Step Six. The final step of analysis looks for patterns across the cases. This comes after steps one through four were completed for every case (Smith et al., 2009). The patterns across cases are consolidated into recurrent superordinate themes. Auditing. Transcriptions were reviewed by a team of one coder (the researcher) and two auditors (the thesis advisor and a defense committee member ), in an effort to ensure saturation of analysis. Auditing is a means of checking the plausibility and coherence of the interpretation. An
THE ROLE OF THE WILDERNESS 29 independent auditor, who was not involved with the research project, attempts to ensure that the account produced is credible by examining how systematically and transparently the research was conducted. The independent audit is a way to consider validity in qualitative research (Smith et al, 2009). None of the team members (aside from the researcher) had access to any identifying information about participants. The researcher discussed themes with the auditors to a point of consensus in order to identify patterns amongst the themes and across the individual cases. The role of the auditors is to look at the transcripts independently, checking for bias amongst the coder (Merriam, 2009; Smith et al, 2009). As suggested by Merriam, (2009) the researcher read the transcripts, highlighting segments that began the process of category construction. In accordance with the IPA process outlined by Smith et al., (2009) the researcher and auditors worked collaboratively to identify emergent themes, or an organization of the highlighted statements into a master list of themes. A sample of the master list of themes is included in Table 3 below. The emergent themes were then grouped into superordinate thematic clusters, further clarifying the essence of the WT experience as reflected in the emergent themes. Superordinate themes refer to the connections between the emergent themes. The process described above occurred for individual transcripts of all interviews. Superordinate themes were then compared between participants and a between participant analysis to identify recurrent themes as outlined by Smith et al. (2009). A sample transcript showing the data analysis is included in Table 2 below. Relevant sections of the original transcript were bolded. Exploratory and emergent comments were identified in line with the text from the original transcript. Each line of the original transcript was assigned a number as is reflected in the emergent comments, i.e. can't run
THE ROLE OF THE WILDERNESS 30 away from problems-need to face them (2b615-618) Superordinate themes are not included in the transcript because they were identified by printing a list of emergent themes, cutting up the list, and organizing the emergent themes on the floor to identify the superordinate themes. Table 2: Sample data analysis Interview #2 Exploratory Comments Emergent Themes D: I have changed a lot since I've been here. Um I've like, like I've said you can't run away from your problems so i've had to face them all. Um I've learned to like, I've changed because I don't know if it's like I mean I guess it's change, but. Like I've had to like sort of put them into a perspective and like realize that they're not, it's not that, although it's hard to express those kind of things, like how you're feeling and stuff, it'll make you feel so much, that much better and it's worth it so I've learned to like keep that in mind when I'm feeling pretty shitty, just to like tell people what's going on for me sort of, which helps a lot. And yea I think I'ver also like confronted my like shame in a way. My feeling of always negative self talk that kind of stuff. Because often when I would get like I would make a mistake or something like that I would tell myself like umm I like stuff like I'm not good enough, like I messed up real bad I'm an idiot. That kind of stuff. And like I've denitely worked on that, like trying to realize that some things are out of my control and like it happened so you can't change that so you can't harp on it really. Like you should just try to get over it. So I've learned how to do that. Um yea and I just think I've learned better strategies for like coping with emotions and how to express that to people and how to better like respect people. Especially like if they' re sort of the ones that decide that can effect how it plays out for you. Changed a lot No escape/avoidance-confronting problems hard to express emotions and feelings as they are happening, but makes "you feel so much better"-still sounds uncomfortable with idea of sharing-vague description of feelings and stuff-role of mental/emotional challenge? Being able to share with othersvulnerability confronting shame-negative self talk related to mistakes-recognition of things being out of your control=acceptance, what's done is done-I'm here so now what?-environment example of rain when already feeling down? coping with emotions and how to express them to people who and how to respect people-guides can determine outcomes so how to work with that-genuine respect or self-serving? manipulative or respect? can't run away from problems-need to face them (2b615-618) change experienced in ability to express emotions and confront problems (2b614-618; 626-630) hard to express emotions in the moment and it is worth it (2b626-635) being able to share with othersvulnerability (2b631-635) increased ability to confront shame and negative self-talk (2b636-640) acceptance of things being out of his control (2b648-655) "you should just try to get over it" (2b653-656) learned to better respect others (2b660-665)
THE ROLE OF THE WILDERNESS 31 Table 3: Selected examples from master table of themes Theme One: Different Setting Interview One: Because being closer to home like makes me think about home more. Instead of like what I'm doing. [Being further away and being outside helps] zone into it. 635-647 Interview Two: Um yea I guess, I guess being out here like is another challenge added onto everything else. Just like added onto being away from everyone you love and stuff. 431-436 Interview Four: it definitely helps though that I'm like away from a lot of distractions out here. its something that i definitely struggled with at home, like managing my time with like distractions and there aren't many distraction out here. 202-209 Interview Six: yea um so like in the different environment for me its almost like i feel less like nothing reminds me of my past i mean less to remind me of my past less to remind me of old habits. its more like I'm looking with my like more with like ill have more self-confidence 774-784 Interview Seven: it was an entirely different world and i was figuring out who i was in a different setting and i think at is base thats what wilderness therapy is. its figuring out who you are and becoming comfortable with yourself in a setting thats unfamiliar to you. 1309-1313 Theme Two: Safe and NonJudgmental Setting Interview Three : Um and i think like even when you're doing something thats enjoyable like that like you're still kind of comparing yourself to other people. and you don't get the perspective that you get when you just like sit with yourself in nature and just like think through your problems. 511-522 Interview Four : I think I'm definitely a lot more comfortable out here I guess in like the wilderness. I definitely yea this is like a comfort zone for me i guess. and um definitely I don't know i just feel pretty safe out here to like uh talk about how I'm feeling or something 433-444 Interview Five : just like theres no distractions and i guess like here we' re all the same. we all wear the same clothes and we all do the same things and thats also helpful cuz like oh they've been through this too. 235-243 Interview Six : its not like the birds are gonna judge you or something like that. so you' re focused on you. 334-338 Theme Three: Metaphorical Power of the Wilderness Interview One : just whatever I guess mother nature throws at us. We have to live through You can't go inside a building or a car and wait out the storm. 426-429; 433-436 Interview Two : Like if it was in a building you could just like hide away in your room, lock the doors, not talk to people. Like here you can like go to your tarp and stuff or you can like walk away form everything, but then you' d have to count. 515-523 Interview Three : it definitely goes back to that thing of living based off of your bodily functions and your bodily needs rather than living based off of like contrived needs or things that you think that you need but you really don' t. 626-634 Interview Five : i guess like when we hike and theres a hard path theres always another way to get to the same place. 218-222 Interview Six: when you're out here you're not even in a tent you' re under a tarp so you have to face like the weather and stuff like that and like that also that sort of like hardship not like well its not like it really just sucks or anything like that but its hardship i mean its not like smooth sailing its sort of rough 418-429 Table 3: Selected examples from master table of themes
THE ROLE OF THE WILDERNESS 32 CHAPTER III RESULTS Analysis of the eight interviews revealed four recurrent themes central to the participants' lived experience with wilderness therapy (WT). This study focused on the the therapeutic role of the wilderness. The researcher identified four recurrent superordinate themes related to the role of the wilderness and its impact on the participants' WT experience. The following section will examine the participant accounts of: (1) the different setting, (2) the safe and non-judgmental environment, (3) the metaphorical power of the wilderness, and (4) immersion in the natural Interview Eight : you have to set up your ground cloth you have to put up a bug net if theres gonna be bugs out that night um and just out here as well theres just like i wouldn't call them smaller mistake but the choices you make kind of weigh a lot heavier than they would in a city environment where stuff is really easily like accessible. 249-258 Theme Four: Immersion in the Natural Environment Interview Two : It's just cool to think like I'me experiencing something like this and I guess cool to sometimes look around and like look up at night and see the stars. That kind of stuff. Just like I guess that part of it soothes me sometimes because it's cool like the trees everything. Like it' s pretty beautiful. Um just like cool to look at sometimes 838-850 Interview Three : And I think it creates a sense of mindfulness. Like I think like when you're out in nature you can actually like step outside of yourself and recognize like the connection that you have in nature. The fact that you're part of a natural process. 577-586 Interview Four : Um i mean nothing like really stands out to me its just like i really like everything about it like hiking you know being out here. theres just something about it that just like clicks with me i guess and um yea I'm not really sure how to describe it 492-500 Interview Seven : like what the actual things are that are around me so its been really cool to like take note of that and to learn from it so i have a higher appreciation of like the world I'm living in. um and i have a higher appreciation of like a higher awareness i guess of how i interact with the world around me. 438-449 Interview Eight : um i like just being out here with um with just like the plants and the animals it kind of relaxes me. sometimes if i just want to go and like think or go and meditate sometimes i'll even come out right here where we're sitting right now and i can just kind of look around at the view like get to really appreciate whats around me. like maybe there will be a butterfly to add just an extra element of like relaxation to whats happening. and it kind of just puts your mind at ease into a place where you can really just focus on what you want to think abou t 489-503 Table 3: Selected examples from master table of themes Table 3: Selected examples from master table of themes
THE ROLE OF THE WILDERNESS 33 environment. The four themes emerged from all eight interviews as elements of the WT experience that were valuable and integral to the participants' experience, and ultimately their change process. The following sections examine the four superordinate themes and how the themes impacted the participants' experience. As mentioned, all of the participants' names have been changed and all of the names listed in the following sections are pseudonyms. The table below shows the saliency of the four themes for each participant. A score of (1) indicates somewhat salient. Scoring (2) indicates salient, and a score of (3) indicates very salient. The scores were based off of the frequency with which participants mentioned each theme, and the intensity with which they discussed each theme. Theme One: Different Setting All of the participants discussed the wilderness as a different setting that contrasted the familiar setting of their life at home. The contrasting setting of the wilderness impacted them throughout their time in WT. One way that participants described the theme of the wilderness being a different setting was in the initial shock that many reported. Arrival in the wilderness was often described as shocking and challenging. As Jim says, "just being so far away and outside Table 4: Saliency of Themes Across Cases Jim Darth Paul Bill Cass Rob Henry Michael Different Setting 2 2 1 1 3 3 3 2 Safe and NonJudgmental Setting 1 1 3 3 2 2 3 3 Metaphorical Power of the Wilderness 2 3 3 1 2 3 3 3 Immersion in Natural Environment 1 2 2 1 2 0 3 3
THE ROLE OF THE WILDERNESS 34 really threw me off." Participants mentioned leaving behind the world and a setting they knew, the people they knew, and a life in which they knew what to expect. Darth: [It] was very tough for me when I first arrived here. Sort of acclimating to [the program]-it was different from what I was used to. I wasn't used to this kind of stuff. Just a whole new environment. Like at home I could do pretty much whatever I wanted. I had a lot of freedom. Here it's much different. The excerpt above reflects the contrast that most participants described between their lives at home and their lives in WT. Many of the participants described the world they left behind as a life in which they had the freedom to do what they wanted-a life with few boundaries or expectations placed upon them. Henry and Paul describe the contrast between living in the wilderness and their home setting: Henry: [At home having] the ease of being able to look something up [with technology] or being able to use a bathroom or a shower, or have a dry bed every night is really cool. Whenever I'm complaining about something next year I'm sure I'll think back to my first week and a half where it rained every day. Paul : [At] home it [was] very easy to get stuck in [my] head and catastrophize the situationLike I know if I were to try something and fail, I would just kind of get stuck to my laptop and watch netflix for a bunch of time. Henry describes the comforts of a permanent shelter and the facility provided by technology that were present in his life at home, which contrasts his life in the wilderness. While both mention the influence of technology in their lives outside of the wilderness, Paul describes the negative impact technology had on his life at home
THE ROLE OF THE WILDERNESS 35 For most participants, it appeared that the initial shock was accompanied by not knowing what to expect, adjusting to a new and regimented schedule, and acclimating to living in the wilderness. Many participants described not knowing what to expect because they did not know in advance that they were coming to WT. They did not know what to expect from the program, they did not know what to expect from living in the wilderness, and they did not know what to expect from peers and staff members. As Darth describes in the previous excerpt, many of the participants were adjusting to a regimented schedule that contrasted the freedom and lack of a schedule they were accustomed to in their lives outside of WT. Additionally, participants described the initial shock of arriving in the wilderness in relation to the challenges of a new environment, but also the loss of their previous environment. Drawing from the concept of "nothingness" proposed by Sartre (Smith et al., 2009) participants described the initial shock of being in the wilderness by referencing what was lacking, i.e. a bed, technology. Most of the participants also reported the challenges of wilderness living as an element that contributed to the initial shock of being in WT. Henry: I came here thinking, oh I've been camping before, I can do all this. But I had never slept in a tarp, and for the first few nights I remember, it's so silly to think about now, but I remember waking up at the slightest soundand being like, what's out there. Rob says, "the only thing that really annoyed me about being in the wilderness [were] the animals at night, especially the jumping mice. [They] really scare a lot of people when they first get here." The challenges of living in the wilderness included sleeping underneath an open air tarp, sleeping outside, the fear of the noises in the night, the weather, and the bugs. Living for an
THE ROLE OF THE WILDERNESS 36 extended period of time with these challenges of wilderness living was new and different for all of the participants. The initial shock period seemed to last about a week for most participants. While most of the participants had previous experience with camping or hiking, none of them had spent time in the intensive wilderness experience of WT. Henry: I had been camping before so none of this was super new to me, but like a week into me being here it just sort of hit me, and I couldn't do anything. I just sort of sat and thought about the fact that I was here for the long haul. And it was tough to confront that, but once that happened it freed up time and space for me to express myself in the group and be able to get out of [the first phase of the program]. The process of realization described in the above excerpt was identified by many participants as being a pivotal moment in shifting towards acceptance, and the ability to begin working on oneself and working through the program. The acceptance described by many participants refers to acceptance of the WT setting, but also refers to acceptance of the wilderness setting itself. While acceptance helped facilitate change for most participants, it is worth noting that the initial shock also described by participants may be necessary for the change process to occur. As acceptance set in, the different setting of the wilderness began to shift from being overwhelming towards being helpful, and even necessary to the participants' ability to change. Cass describes this shift towards the wilderness environment becoming more beneficial: Cass: When I got here I was like, I'm not gonna like this no matter what. My first night was horrible; I didn't like it, but then as I stayed in the wilderness I liked it more. It's just a cool environment.
THE ROLE OF THE WILDERNESS 37 As participants began talking about the process of acceptance, their perception of the wilderness environment as a different setting began to shift. They began to describe the wilderness as "a cool environment", providing distance from home, and previous patterns and behaviors. In the following excerpts Darth and Rob describe how the distance, coupled with the challenges of the wilderness environment, became beneficial: Darth: being out here is another challenge added onto everything else. Just like being away from everyone you love and stuffas opposed to, for example, a therapeutic boarding school[Living in the wilderness] just adds on the challenge of, well a few things. Like, just being out in the wilderness and not sleeping in a bed. That kind of thing. The environmental shift. [.] Like if it was in a building you could just hide away in your room, lock the doors, not talk to people. Rob describes the benefits of the environment, saying, "in the different environment for me it's almost like [there is] less to remind me of my past, less to remind me of my old habits. It's more like I'm looking [at myself] with more self-confidence." The above excerpts reflect the shifting mentality of most participants towards the wilderness being helpful. The wilderness is still being described as challenging, though in the above excerpt, Darth suggests that it is helpful to not have the option to hide away and shut a door. Rob entered WT from an out-patient treatment center, and describes the benefits of the unique and different wilderness setting as it compares to the outpatient setting. The lack of reminders and the difference of the wilderness environment for many participants, offered both a physical and mental contrast that helped facilitate change. As Henry says,
THE ROLE OF THE WILDERNESS 38 Henry: It was an entirely different world, and I was figuring out who I was in a different setting, and I think at its base that's what wilderness therapy is. It's figuring out who you are, and becoming comfortable with yourself in a setting that's unfamiliar to you. The unfamiliar and different setting often described not only the physical environment, but also what was missing from the participants' home environment. Many participants discussed the importance of having no longer having access to distractions such as technology and friends, again touching upon the concept of "nothingness" described by Sartre, who suggests that one's experience with a phenomenon is shaped by both what is present and by what is lacking (Smith et al., 2009). Henry explains how the freedom from distractions offered him the space to focus on himself: Henry: "I've become really comfortable out here. Before I got here I liked my air conditioning, I liked my tv, and I liked my phone and my car, but I don't know there' s a certain simplicity in just doing what needs to be donejust [being able to] provide for yourself out here is a really cool feeling." Many of the participants mentioned the lack of distractions in WT as being important in their ability to focus on the therapeutic work they had struggled to accomplish outside of WT. Bill describes the impact of distractions in his life outside of WT. "It's something that I definitely struggled with at home, like managing my time with distractions, and there aren't many distractions here." Henry: [T]here were a lot of distractions that were a big part of my lifeI just wasn't focusing on how to make myself better while using them, so wilderness has provided the simplicity and the bare bones aspect to therapy, and it's helped me.
THE ROLE OF THE WILDERNESS 39 For many, the wilderness provided a contrast to the distractions at home, and a distance from the modern construction of their world, i.e. technology, buildings. The excerpts in this section highlight the shifting role of the different setting of the wilderness environment to the participants' experience. Initially, the different setting was tough and challenging to accept. The lack of toilets, lack of a bed, sleeping outside, and hearing animals at night were all elements that were described as being initially scary or overwhelming. As participants began to adapt to the different and unfamiliar setting, they began to describe a physical and mental distance from their familiar world, which proved to be necessary to begin the change process. Theme Two: Safe and Non-Judgmental Setting As participants became more comfortable in the different setting of the wilderness, many described the wilderness setting as being safe and non-judgmental. Participants described the natural environment itself as being safe, calming, and soothing. Bill and Jim discuss the concept of the wilderness itself providing a sense of safety and comfort. Bill says, "I'm definitely a lot more comfortable out here in the wilderness. This is like a comfort zone for me, and I just feel pretty safe out here to talk about how I'm feeling." Jim also describes the safety of the wilderness environment. "It does seem like a really safe, calming, soothing environment outside." Many of the participants struggled to put into words what exactly makes the wilderness safe. Many participants discussed the lack of judgment from peers, but also the lack of judgement from the environment itself. Rob and Bill describe how the lack of judgement from the wilderness was significant:
THE ROLE OF THE WILDERNESS 40 Rob : I mean [the wilderness] has certainly been helpful, there's a lot less outside things just in general, going to school there's a whole bunch of people around. Here it's very peaceful. It's not like the birds are gonna judge you or something like that. So you're just focused on you. Bill states, "I mean, the trees won't judge me [for] how I'm feeling, or you know the birds or animals won't judge me. It's definitely helped; I definitely feel like I'm in a safe spot." The lack of judgement from the wilderness, or the world around the participants, contrasted the judgement they experienced outside of the wilderness that detracted from their ability to feel safe. It is worth noting that participants described judgement as a negative and critical experience connected to others. Their experience in the wilderness and the lack of "judgement" appears to be an experience of being judged positively, or accepted by the environment, rather than criticized or chastised. Paul mentions the increased ability to focus on himself in the wilderness: Paul: I think like even when you're doing something that's enjoyable, you're still kind of comparing yourself to other people, and you don't get the perspective that you get when you just sit with yourself in nature and think through your problems. The above excerpt touches upon the different perspective that can be gained through the wilderness, and also introduces the importance of the lack of comparison in the WT setting. The ability to compare oneself to others is removed from the WT setting at participants wear the same clothes, engage in the same activities, including developing the same wilderness living skills such as fire building, setting up tarps, and going to the bathroom in the woods.
THE ROLE OF THE WILDERNESS 41 Cass : The outdoors is [important], um I'm not sure. Just like there's no distractions and I guess like here we're all the same. We all wear the same clothes, and we all do the same things. That's also helpful [because it's] like, oh they've been through this too. In addition to the physical environment of the wilderness feeling safe, all of the participants mentioned the importance of connecting with others in a setting where comparison to others is removed from the equation, which also contributed to the safety of the WT setting. Connection with others contributed to the safety of the WT setting through the lack of comparison and judgement, but also through having someone to share the experience with, which diminished feelings of isolation. Cass describes what the connection to others looks like in reference to the shared experience: Cass: [It's nice to have someone to] do the same things with you. It's nice to sit down and be like, oh you have to do traps? I have to do traps. We can sit next to each other and work on traps.' The previous excerpt highlights the role of the shared experience when connecting to peers in the WT setting. As mentioned, participants are engaging with one another on a level playing field, i.e. wearing the same clothes, engaging in the same activities, living through the same wilderness hardships such as weather or developing wilderness living skills. For many participants, the connection to others contributed to a sense of emotional safety within the WT setting, which included being supported by others and wanting to support others. Paul: [W]hen I started with bow drilling, you fail a lot before you succeed, so it was really hard for me to handle that when I was going through it. And a lot of times I would just come out [to this meadow] and like meditate and center myself and then go back to it
THE ROLE OF THE WILDERNESS 42 [.] I think the fact that I had people who were supporting me and the fact that I could step away from it and just center myself. There are several important issues to note within the previous excerpt. Paul highlights the significance of feeling supported by others in his efforts to overcome the challenges of developing the wilderness living skill of bow drilling, a challenging skill that his peers also have to work to accomplish. He also mentions the role that the wilderness setting plays in this process. Being able to "step away and center" and confront the deeper fear of failure was facilitated by the wilderness setting. The above excerpt highlights how the wilderness environment and how connecting to others in the wilderness setting was helpful when confronting distressing patterns, such as a fear of failure. The following excerpt examines how connecting with others in the WT setting forced participants to build group cohesion and peer support through the shared experience of working through the challenges posed by the wilderness environment: Michael : A few weeks ago there was this hike we had to do and it took us a total of nine hours. We got back at like 11:00 at night and we still had to make dinner and all that, and it was pouring rain and so we really had to just be focusing on that [.] it really got us to come together as a group. We were like, ok we need to get this group tarp up right now so that we can start this fire with the wet sticks that we have. We need to work together as a group to do that or it's not gonna work so that we can have dinner and get to bed at a reasonable time. The excerpt above reiterates the importance of connecting with and working with others to ensure the physical safety and well-being of the group. Participants do not have the option to
THE ROLE OF THE WILDERNESS 43 escape the rain by seeking cover in a car, or in a building. Group members rely upon one another to stay dry and fed regardless of the weather or environmental conditions, effectively removing the option to not participate. Michael describes how working together and relying upon group members was necessary to provide for both individual and group basic needs such as shelter, warmth, and food. The theme of safety was referenced by all of the participants, whether it be safety of the wilderness environment, or safety of the WT setting. Both were significant for the majority of the participants. The safety of the environment was enhanced by the calming and soothing nature of the wilderness, and the lack of critical judgement from the environment itself. The safety of the WT setting was facilitated through connection to others without comparison or negative judgement, the shared experience of confronting challenges of wilderness living, and being supported both emotionally and physically. The concept of feeling safe within the wilderness environment and the WT setting was integral in helping participants' change process and therapeutic growth. Theme Three: Metaphorical Power of the Wilderness All participants mentioned the metaphorical power of the wilderness when they reflected on the role the wilderness environment played in their change process. Participants discussed the metaphorical power of the wilderness in their descriptions of living outdoors and developing the necessary skills for living and functioning in the wilderness (referred to as "hard skills" by participants) such as fire building or setting up a shelter. Proficiency in wilderness skills has a direct and immediate impact on one's experience in the wilderness, and the degree of individual and group success. Additionally, participants reported that overcoming the challenges of living in
THE ROLE OF THE WILDERNESS 44 the wilderness and developing proficiency with wilderness skills translated into lessons that were generalizable to other arenas of life. Henry describes the relevance of the wilderness environment itself: Henry: we're just entirely dependent on how the world works, you know. How when the sun's gonna rise is when we're probably gonna get up, and shortly after it sets we'll go to bed. So there's a huge simplicity to it and there's a huge dependence on the wilderness operating the way it should. You know, like my house is supported by trees out here, and the fire we cook dinner on is from the ground, and I don't know, it's just so integral to how we function out here. The above excerpt describes the dependence on the wilderness environment and the importance of being connected to the wilderness environment in order to support basic needs. It is crucial that participants learn how to use the trees to set up their tarps in order to have shelter to sleep beneath, and stay dry. It is necessary that participants learn not only how to build fires for warmth and for food, but how to identify the best materials for building fires under a variety of conditions. Many participants mentioned the significance of developing wilderness living skills in the immediate feedback setting of the wilderness. For instance, failure to set up a bug net at night might result in being covered with bug bites in the morning. Many participants also mentioned the importance of the metaphors behind these skills that tie into the lives of participants outside of the WT setting. Cass and Michael describe the lessons learned through facing the challenges of developing wilderness living skills:
THE ROLE OF THE WILDERNESS 45 Cass: Like making the traps [was] easy, it's just setting them up. That's where [counselors] want to see what's challenging for me and how I handle it. And I didn't give up, and they stayed up overnight. That's when I [was] like, ok if I actually put my mind to this, I can get things accomplished. Michael: In a way [the natural consequences] kind of prepares you for having to deal with just more naturally occurring stressors that occur back home, whether they're less rational than the ones out here, it definitely helps with knowing what to do in stressful situations, and how learning about your own patterns, and how you can use that knowledge to help you prepare yourself or work through stressful situations back out of here. Michael highlights how managing the stress of living in the wilderness better prepared him to handle stressors in life outside of the WT setting. The experience of confronting stressors that are rational due to the immediate feedback provided by the environment may set a new neural pathway, allowing participants to more readily confront stressors in other areas of life. Additionally, it may allow for greater evaluation of what is a rational stressor both in the wilderness and in life outside of the wilderness. Participants reported the stresses of living in the wilderness being weather, bugs, hiking, and developing wilderness living skills. In the following excerpt, Rob explains some differences between WT and outpatient treatment: Rob: It's not like you're in outpatient where sometimes you can get frustrated and feel like you're not making any progress. Here it's like you've done a lot of things you can look back on. Like you've moved through hard skills, you've done hikes, and you've done challenging things, and in that way you have progress to be proud of.
THE ROLE OF THE WILDERNESS 46 The above excerpt highlights the sense of pride and accomplishment that many participants discussed in connection to the development of wilderness living skills. Rob describes how the sense of pride and accomplishment experienced in WT translated into competence and confidence that could generalize to other areas of his life, which contrasts his time spent in outpatient treatment. The development of new skills provides tangible progress, but also an increased sense of accomplishment and self-worth. Henry describes the sense of self-worth attached to developing news skills, there's something about hard skills that can be really satisfying. Like it took me two weeks to make my figure four [trap], and when it stayed up overnight I was literally jumping for joy." Cass discusses how the new skills developed translated into a sense of accomplishment through perseverance and creative problem-solving, "there's always another way and if I'm struggling there's always another way to find out [....] like when we hike and there's a hard path, there's always another way to get to the same place." The sense of accomplishment and pride linked to overcoming the challenges associated with developing wilderness living skills was important for many participants, and helped prepare them for situations they would face back home. For instance, several participants mentioned the metaphor of finding balance within the family system, which is highlighted while learning how to build deadfall traps. Many participants also described the patience and humility they gleaned through the process of learning how to build fires using the bow drilling technique. For many, the relevance of the hard skills was tied into their usefulness in the wilderness environment, and to their translation into life outside of the WT setting. Most of the participants also described how the challenges of living in the wilderness setting offered insight into internal resources, such as perseverance and the ability to overcome
THE ROLE OF THE WILDERNESS 47 hardship, which could be generalized to all areas of life. Living outside for two to three months came with a number of challenges from which there was no escape, such as bugs or inclement weather. Michael explains how specific challenges of the wilderness setting contributed to learning that choices have consequences, which also helped him understand the consequences of his choices at home: Michael: I personally think wilderness therapy works so well because of the wilderness aspect [.] just like working really hard. Like you need to work to set up a shelter so you don't get rained on when you're sleeping, and it's not particularly difficult but it's definitely still work. You don't just need to go to your room and lock the door. You have to set up your ground cloth and you have to put up a bug net if there's gonna be bugs out that night. Just out here...the choices you make weigh a lot heavier than they would in a city environment where stuff is really easily accessible. The above excerpt emphasizes the value of the wilderness environment, and the metaphorical power of the wilderness, i.e. the connection between choice and consequences. Michael describes how the decisions he makes in the wilderness will have immediate consequences, which highlights the necessity of personal responsibility. The connection between choice, consequence, and personal responsibility is more apparent in the wilderness setting, though has the ability to translate to life outside of WT. Many of the participants talked about the importance of not being able to escape from problems, and instead learning how to confront fears, challenges, and problems. Rob describes this inability to escape from the challenges inherent in wilderness living:
THE ROLE OF THE WILDERNESS 48 Rob: [W]hen you're out here, you're not even in a tent, you're under a tarp. So you have to face the weather and stuff like thatand that's sort of a hardshipit's not like smooth sailing, it's sort of rough. Like in a building you don't really have to face what's outside, but like when you're out here, there's no escape. Everything happens and you're in the middle of itit sort of builds a life goes on attitude in a way. You're gonna have to face it, so you just spring up to face challenges more. Many of the participants talked about the impact of living in the wilderness with the bugs, the weather, the nighttime noises, and being forced to confront these challenges or fears. In the excerpt above, Rob discusses how working through the challenges of the wilderness setting provided concrete lessons about accomplishment and the ability to overcome, which ultimately could be generalized to other areas of his life. Rob's experience of learning how to confront fears, challenges, and problems translated into the realization that he is capable of overcoming hardship in the wilderness, and perhaps he is capable of overcoming hardship in other places as well. Several participants mentioned the inability to escape from the challenges of the environment in the context of not being able to close a door on the natural elements. As Jim says, "[W]hatever mother nature throws at us, we have to live throughyou can't go inside a building or a car and wait out the storm." The need to work through the challenges of the wilderness setting was emphasized by most participants in contrast to working through challenges in an urban setting, or in a building. The wilderness setting was valuable due to the inability to escape. There is neither a physical, nor metaphorical door to close on challenges. For many, working through the environmental
THE ROLE OF THE WILDERNESS 49 challenges translated into the necessity to confront and move forward with challenges to therapeutic change and personal growth. Darth describes how this applies to a range of problems, including personal, interpersonal, environmental, and programmatic problems: Darth: [Y]ou won't be able to escape things. You have to face your problems head on. Like that's pretty much always going to be there. Every problem you face here, you're going to have to face it at one point. You can't just avoid it. Like there's no way that would work. The above excerpt reflects the wilderness serving as a metaphor for the inability to escape or hide from problems in the wilderness setting, and how wilderness living translates to the ability to confront other challenges in life as well. Darth's account of having to confront problems was also mentioned in terms of acceptance. Many of the participants discussed the challenges of living in the wilderness in the context of being pushed to accept that which they cannot control, which was relevant for all of the participants as they transitioned from the initial shock of arriving in the WT setting towards acceptance of place. Adaptation was also an important step for many participants, which corresponded with a subsequent move towards personal accountability. Paul describes how adapting to the wilderness environment ultimately led to a sense of having more control over his life and the realization that he was capable of taking action: Paul : I don't know how to phrase it, like you don't feel like you're being pushed around by your daily situation  you need to do all these different things and you don't have any control. Like you're stuck in your situation. Whereas when you're out in the wilderness you feel like you have control on your situation. You have the tools given to
THE ROLE OF THE WILDERNESS 50 you to know what to do, like [putting] up a shelter wherever you are, to be able to make a fire based off of the materials around you. Just being able to fend for yourself. Like you feel like you have that control and you don't really have anything else pushing you around. The above excerpt speaks to Paul's ability to adapt to an undesirable situation, which was facilitated by the wilderness setting in a unique way. The ability to fend for himself through the development of wilderness living skills provided a sense of control that was otherwise lacking in his life. The increased sense of control shifted his perspective from being pushed around by life circumstances towards being able to take action over his own life, and a greater assumption of personal responsibility. Many participants also mentioned having to adapt to the initial shock of being in the wilderness as a segue into being able to accept other things over which they have no control. Several participants attributed this acceptance to the wilderness environment itself. Paul and Rob describe the role played by the wilderness. Paul says, "I think being out in nature for this long I've definitely learned to accept a lot of situations that I'm in." Henry: [Change] will come regardless of whether you want it toit's about being able to be adaptable, [when] it rains when you're not expecting it toit's about being able to say, what's the best move for me here because life is changing around me and I need to figure out how to deal with it. The above excerpts reflect the role of the wilderness on the shift towards acceptance and personal responsibility. Paul and Henry highlight the adaptability and acceptance that they experienced in response to the challenges of living in the wilderness. Henry also discusses how
THE ROLE OF THE WILDERNESS 51 this adaptability translated into taking action and assuming responsibility for his own life in spite of the hardships he might encounter, both in the wilderness and in other areas of his life. Acceptance and the shift towards personal responsibility provided many participants the space to start working through the program, and to start working on themselves. As participants experienced increased acceptance and personal responsibility, they also described an increased ability to establish and work towards therapeutic goals for change. Henry talks about the process of change facilitated by WT and by the wilderness itself: Henry: People don't change this much [outside of WT] I think because they are distracted and so obsessed with what's going on in their world. I think that coming out here and being in the wilderness and being not like alone, but alone with yourself sort of inspires that change and it creates an environment where you can look at yourself and figure out what you need to work on, and work on it. Most participants highlighted ways in which the lessons learned in the wilderness setting served as metaphors for new skills that could translate into other areas of their lives. Living in the wilderness environment demands a proficiency with wilderness living skills, and an ability to respond to the immediate feedback of the wilderness setting. Developing proficiency with wilderness living skills, and responding to the challenges and natural consequences inherent in wilderness living translated into a sense of pride and accomplishment that could be applied to other areas of participants' lives. The wilderness setting was also mentioned as important due to the participants' inability to escape from the weather, the situation, and from problems, and how this translated into an increased ability to confront challenges. Participants also described a degree of adaptability and acceptance that was facilitated through overcoming the challenges of
THE ROLE OF THE WILDERNESS 52 wilderness living, which led to increased personal responsibility in the WT setting that could also be applied to life outside of the WT setting. Theme Four: Immersion in Natural Environment Many participants spoke of the impact the wilderness had on their experience. This section will examine the impact of being immersed in the natural environment, which is part of the wilderness; participants described things such as spending time looking at the trees and the plants, seeing the stars at night, and encounters with wild animals. For most of the participants, the immersion in the natural environment was discussed with a sense of awe and wonder for a foreign and beautiful world. The wilderness was also described as being intrinsically calming and possessing a therapeutic quality in its ability to sooth participants and facilitate relaxation and introspection. Bill describes his experience of wilderness living, saying, "I really like everything about [the natural environment ], like hiking, being out here. There's just something about it that just clicks with me. I'm not really sure how to describe it." Darth: It's just cool to think that I'm experiencing something like this, and cool to look around and look up at night and see the stars. I guess that part of it soothes me sometimes because it's cool-like the trees and everything. It's pretty beautiful. The above excerpts highlight the impact of the natural environment on the participants' experience. Bill and Darth both describe a connection to the wilderness. Darth is able to articulate the soothing aspect of being surrounded by trees, seeing the stars at night, and the beauty of the setting. Bill recognizes that something feels inherently good about being immersed in the natural environment though does not have the words to describe why or how.
THE ROLE OF THE WILDERNESS 53 For most of the participants, immersion in the natural environment was a stark contrast to their lives at home. Most of the participants were coming to the WT setting from an urban setting. Jim talks about the difference of the wilderness setting as a unique experience: Jim: [When I leave] I don't know how I'm going to think about the woods in general, like all the wildlife and the different trees and plants. Like the cool things that are out in the wilderness that I just hadn't really experienced before. Encounters with wildlife were another aspect of the natural environment that many participants discussed, in a similar way to describing being surrounded by trees, plants, and the wilderness. For many, encounters with wildlife were mentioned as poignant experiences that stood out when reflecting on their time living in the wilderness. Henry: I saw [the bear] moving relatively slowly and breathing really heavily and breaking a bunch of sticks. Once it realized I was there it turned a little but and started walking away from me, but it was an awesome moment. Yea it was totally awesome. In retrospect I probably shouldn't have gotten out of my tarp, but I was way too curious. Michael: [The other morning we went] over to [a] tree and there's just this big porcupine sitting on this little branch, just so out of place, but it's so cool, it's just so interesting to see what life is like naturally with no, when the boundaries are really on us rather than on the stuff we think we're in control of. In the above excerpt, Henry and Michael describe their wildlife encounters with a sense of curiosity, awe and respect for the natural order of the natural environment. Most of the participants had stories of specific encounters, or interactions with wildlife, which were described as meaningful aspects of their wilderness living experience. Seeing wild animals in
THE ROLE OF THE WILDERNESS 54 their natural environment inspired a sense of curiosity of the wilderness setting for many participants. The sense of curiosity that many participants experienced with wildlife encounters, also extended to a greater curiosity of the natural environment for many participants. Curiosity about the wilderness translated into a desire to know more about the environment, such as tree and plant identification, knowledge about weather patterns, and how to harvest materials for wilderness living skills. Henry: We were walking along a path the other day and we were just stopping and looking at [trees] like, that tree looks really cool, what is it, and then we'd be like it's an American Beech or a White Pine. It was really cool to have some knowledge of where I was and what I was interacting with because before I came here I would have been like, it's a tree [....] it's cool to be more interested in it and have a higher appreciation of what's around me. The higher appreciation of the world around him that Henry describes in the above excerpt was mentioned by several participants as a positive result of being immersed in the wilderness. Participants talked about a greater sense of connection to the wilderness facilitating a greater awareness of how they engage with the world around them. Michael describes how becoming more self aware during his time in WT and how his increased self-awareness had led him to accept responsibility for his mistakes rather than looking for someone or something to blame. Interviewer : What do you think about your experience in the wilderness contributed to that greater self-awareness?
THE ROLE OF THE WILDERNESS 55 Michael: ...just being aware of what our impact is on the areas we camp in [.] we don't want them to look like an area where people camp. I guess just that level of awareness, just making sure that we're really on top of preserving where we're staying kind of contributes to an overall awareness and definitely helps me focus on stuff that could normally slip my mind. Knowledge of the plants and trees, wildlife encounters, and weather patterns were all mentioned as elements that also contributed to an increased awareness of the environment and world around participants. Michael explains how his appreciation of the natural environment also translated into a respect for the setting, which translated into a desire to take care of the wilderness. The greater awareness of the natural environment also fostered a sense of connection to the wilderness that was beneficial to most participants. Paul and Michael describe the benefits of the wilderness: Paul: I think [the wilderness environment] creates a sense of mindfulness. I think when you're out in nature you can actually step outside of yourself and recognize the connection that you have in nature. The fact that you're part of the natural process Michael: Being out here with the plants and the animals, it kind of relaxes me. Sometimes if I just want to go and think, or go and meditate, I'll even come out [to this meadow] where we're sitting right now and I can just look around at the view and really appreciate what's around me. Maybe there will be a butterfly to add an extra element of relaxation to what's happening, and it just puts your mind at ease into a place where you can really just focus on what you want to think about.
THE ROLE OF THE WILDERNESS 56 The increased awareness and interest in the natural environment translated into a greater connection to place which was relaxing and meditative for several participants. Connection to the natural environment allowed for a mental break from other worries, that provided the space to reflect on other things aside from stressors. All of the young adult participants discussed the experience of heightened awareness in relation to being connected to a world with which they could live symbiotically. Henry: It's cool to know [what's around you] and to understand that while you're living here, it's not really your home. You're using the forest, and the forest is composed of a bunch of different living things. I think that's a cool thing to be aware of and be conscious of. The immersion in the natural environment contributed to a greater sense of calm and relaxation that many participants experienced. Many participants described the trees, the leaves, the mountains, and animals as elements that created a soothing and calming environment that facilitated greater self-reflection. The participants' experience of wilderness living also led to a higher level of awareness and consciousness that fostered greater self-awareness. For many, increased awareness of self and the environment was also connected to a greater sense of ease and relaxation with self and with the environment. The connection to the environment, and subsequent connection to self, helped many participants focus on themselves, and the therapeutic change they would like to enact. The calming and soothing nature of the wilderness environment allowed many of the participants the space to relax, reflect on themselves, and take steps towards creating change. CHAPTER 4
THE ROLE OF THE WILDERNESS 57 DISCUSSION The overall findings of this study suggest that the wilderness was an integral part of the participants' experience in a WT program, and helped facilitate greater perceived change amongst participants than participants had experienced in previous therapeutic mileus. All of the participants reported that the wilderness was helpful to fostering an experience of noticeable personal and therapeutic growth. As Rob says, "Living in the wilderness changed me a lot [.] it's made me a lot more self-confident and I feel like I have a lot more self-worth because of having to overcome challenges. You feel good when you have something to feel proud of." All participants expressed the belief that the therapeutic change experienced in the WT setting would not have been as noticeable, nor would the change have occurred as quickly in a nonwilderness setting. The aim of this study was to examine the role of the wilderness in the WT process, and to the lived experience of the participants in the WT program, in an effort to determine the impact of the setting. The following recurrent themes were identified as important elements of the wilderness that contributed to the participants' WT experience and the change process: (1) the different setting, (2) the safe and non-judgmental setting, (3) the metaphorical power of the wilderness, and (4) immersion in the natural environment. Analysis revealed that all participants in the study believed the wilderness to be a valuable component of their experience and their change process. Several themes that emerged were very similar to themes identified in previous studies examining the WT process (Kaplan, 1995; Russell, 2012; Russell & Farnum, 2004; Russell & Phillips-Miller, 2002). Kaplan (1995) emphasizes the role of "being away" in his study of the
THE ROLE OF THE WILDERNESS 58 restorative benefits of nature. The wilderness component of being away provides a psychological and physical distance from daily life that allows the psyche to recover (Kaplan, 1995). The different setting theme identified in the current study support the importance of the psychological and physical distance described by Kaplan (1995). Participants in the current study described the importance of being in a different and unfamiliar setting, that contrasted their setting at home, to their change process. The role of the different setting also supports what Russell and PhillipsMiller (2002) describe as "the challenge and structure of process", which states that individuals in WT experience greater change when they are uncomfortable, they experience adversity and challenge, such as hiking and primitive living in wilderness conditions, and they experience the shock of being placed in the wilderness. The challenge and structure of process construct identified by Russell and Phillip-Miller (2002) is supported by the accounts of participants in the current study regarding the reported initial shock of entering the wilderness and the challenges associated with wilderness living. Russell's concurrent model of the WT process identifies "the social group" as a key element in the WT process (2012; Russell and Farnum, 2004). Russell states that the social group focus in the WT setting promotes a breakdown of preconceived stereotypes and self-doubt through the unique and intense feeling of community and belongingness (2012; Russell and Farnum, 2004). The social group focuses on peer dynamics and relationships between staff and participants. The safe and non-judgmental setting theme identified in the current study highlights a similar experience of breaking down preconceived stereotypes and self-doubt as reported by participants. However, where the current study diverges from previous studies is how this study explores how participants experienced the phenomenon of higher self-worth and positive regard
THE ROLE OF THE WILDERNESS 59 through the wilderness. Participants discussed how the calming and non-judgmental qualities of the wilderness, and the shared experienced of confronting wilderness challenges with peers contributed to an overall sense of safety that facilitated personal growth. The theme of the metaphorical power of the wilderness in the current study supports one aspect of a key construct of the WT process that Russell identifies as "the active self" in his concurrent model of the WT process (2012; Russell & Farnum, 2004). The active self refers to therapeutic variables that arise through personal interaction with the natural environment. Russell and Farnum (2004) break the active self into (1) physical fitness and well-being, and (2) tasks associated with wilderness living. The findings of the current study support the value of the tasks associated with wilderness living, which promote self-concept through tasks inherent in wilderness living as shown in two previous studies examining the WT process (Russell, 2012; Russell and Farnum, 2004). Participants in the current study reported experiences of pride and accomplishment that accompanied the experience of overcoming the challenges of wilderness living such as hiking, or developing proficiency with wilderness living skills. Participants described the sense of pride and accomplishment as an experience that translated into a greater sense of worth and personal responsibility which could be generalized to other areas of their lives. Finally, the current study's theme of immersion in the natural environment supports what Kaplan (1995) termed "soft fascination." Soft fascination is described as being cognitively engaged by the visual and auditory beauty of the natural environment while having the ability to engage in reflective thought. Kaplan (1995) asserts that soft fascination does not require the full attention of the mind, which for both mental and physical relaxation, as well as the capacity to
THE ROLE OF THE WILDERNESS 60 think of other things, such as reflective thought. According to Kaplan (1995), the soft fascination provided by engagement with the wilderness environment offers a release from the stressors that cause mental fatigue, and is an important factor in the restorative benefits of the natural environment. Participants in the current study described a similar sense of mental and physical relaxation that was facilitated by observing and engaging with the natural world. The wilderness was described by many as soothing and calming, which allowed for greater self-reflection. The value of WT as an effective treatment modality is gaining recognition both in the field of counseling, and in the eyes of the general public. A recent article in Bloomberg BNA talks about the increased acceptance of WT as an effective treatment in the medical community and the subsequent impact on insurance companies. The coverage of mental health benefits under the Affordable Care Act has increased access to mental health treatment. Twenty lawsuits have been filed against insurance companies denying coverage for WT since the mental health parity regulations went into effect in 2014 (Wille, 2017). In spite of the growing evidence for WT as an effective treatment, insurance companies are slow to recognize the validity of the WT model. Findings from studies such as this study, and recent quantitative analyses of WT outcomes will be crucial in the push towards the recognition of WT as a valid and effective treatment option. Participant accounts in the current study suggest the wilderness contributed to greater perceived change as demonstrated in the impact of the different setting, the safe and nonjudgmental setting, the metaphorical power of the wilderness, and the immersion in the natural environment. In a recent meta-analysis of WT program outcomes, Bettman et al. (2016) found medium-sized effects for the six WT constructs measured, which were similar to overall effect sizes reported in previous meta-analyses on WT programs (Bedard et al., 2003; Bowen & Neill,
THE ROLE OF THE WILDERNESS 61 2013; Cason & Gillis, 1994; Hattie et al., 1997; Wilson & Lipsey, 2000), suggesting the consistent effectiveness of WT programs (2016). In fact, Roberts et al.'s (2017) longitudinal study of WT outcomes suggests that WT may facilitate higher rates of improvement for clients with greater rates of distress than clients enrolled in outpatient treatment facilities. It is interesting to note that this finding supports the personal account of one of the participants in the current study who entered the WT program following time spent in outpatient treatment. As mentioned, the current study included young adults in the interview sample in an effort to address a gap in much of the existing literature about WT. The researcher found that the young adult participants described greater perceived change and insight gained during the WT process. Additionally, the young adult participants were more likely to describe the environmental impact of the wilderness on their ability to relax, meditate, and experience therapeutic growth as a direct result of the environment as highlighted in the immersion in the natural environment theme. The relationship between age of participants and higher rates of positive outcomes is also shown in a number of studies examining WT outcomes. The research suggests that older adolescents are more likely to experience greater therapeutic gains when compared to younger adolescents in the same setting (Bettman et al., 2016; Bickman et al, 2004; Bowen & Neill, 2013). The researcher's experience of interviewing both young adults and adolescents match a number of recent studies suggestion that developmentally, WT may be a stronger treatment option for older adolescents and young adults due to higher cognitive functioning and the ability to process key metaphors to the WT process, and the ability to develop personal identity and meaningful relationships with others (Bettman et al., 2016; Gass et al., 2012; Roberts et al., 2017). The young adult participants in the current study were more
THE ROLE OF THE WILDERNESS 62 capable of expressing how they processed metaphors within the WT process and how they could be applied directly to all other areas of their lives. The results of this study suggest that the wilderness was a valuable and effective therapeutic tool for the participants' lived-experience in the WT program studied. The importance of the wilderness has implications for the mental health field and the future of mental health coverage provided by insurance companies. The current study suggests that the wilderness served as a therapeutic tool for the participants that amplified the other therapeutic tools utilized in the WT program, such as group dynamics and group therapy techniques and physical challenge. Given the suggested effectiveness of the wilderness as a therapeutic tool, consideration might be given to the incorporation of wilderness activities in more traditional therapeutic settings. Additionally, findings from the current study coupled with the results of recent quantitative reviews of WT outcomes suggest that the use of wilderness in treatment is a key therapeutic component (Bettman et al., 2016; Roberts et al., 2017). The implications of such findings might garner an increase in support for WT coverage from insurance companies. Limitations Several limitations exist within this study. First, the focus on the role of the wilderness was the dominant theme which influenced the questions asked of participants during the interview process. Participants were aware that the researcher was interested in studying the role of the wilderness, and questions asked were focused on the wilderness topic. It is possible that participants attached more importance to the role of the wilderness than they would naturally. Second, the researcher did not contact participants following the initial interview to confirm the validity of their responses and thoughts regarding the wilderness. The researcher transcribed the
THE ROLE OF THE WILDERNESS 63 interviews and utilized an adviser and auditor throughout the coding process in an effort to limit the impact of researcher bias and ensure validity. Third, the findings of the current study cannot be generalized to the overall WT experience due to the limitations of a qualitative study. The findings of the study reflect the experiences of eight participants in one WT program during the summer of 2016. Finally, the lack of follow-up interviews did not allow the researcher to explore the meaning attached to the wilderness once participants were no longer enrolled in the program. The role of the wilderness may have been amplified by the immediate relevance offered by the fact that participants were still living in the wilderness setting at the time of the interview. Recommendations for Future Research Further research examining the application of WT with young adult populations would be useful given the evidence indicating higher therapeutic gains amongst older adolescents and young adults. Additionally, further research exploring the wilderness setting as a distinct therapeutic tool is needed. Current research supports the physical and mental benefits of the wilderness. Future studies might examine specific wilderness factors that contribute to wellbeing with the intention of applying such factors to more traditional therapeutic modalities such as, outpatient treatment, residential treatment centers, and talk therapy.
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THE ROLE OF THE WILDERNESS 68 APPENDIX A Interview Questions 1. Tell me about your experience at True North (TN). What was it like at the beginning? What is it like now? What changed and why? 2. What did you think about the wilderness when you arrived at TN? What do you think about it now? Why do you think that changed (if it did)? 3. What do you think were some of the most important parts of your experience at TN? How important do you think the wilderness was? Why? 4. How did being in the wilderness affect what you got out of your experience at TN? 5. How do you think your experience would have been different if it had not taken place in the wilderness, i.e. in a city or a building? 6. Do you think you have changed while you have been at TN? If so, how have you changed/ what has changed? 7. What parts of your experience at TN helped contribute to this change? 8. What will help you maintain this change when you leave TN? What do you think will make it hard to maintain this change? 9. Do you think being in the wilderness was helpful, or was it a distraction or hindrance?
THE ROLE OF THE WILDERNESS 69 APPENDIX B Consent Form You and your child are being asked to participate in a research study. This form provides you with information about the study. A member of the research team will describe this study to you and answer all of your questions. Please read the information below and ask questions about anything you don't understand before deciding whether or not to take part. Why is this study being done? This study plans to learn more about the process of wilderness therapy and how it is related to outcomes. Studies have shown wilderness therapy to be an effective treatment process, but few studies have examined how different elements of the wilderness therapy process contribute to the successful outcomes. Increasing the research in this field will bring greater understanding of a treatment method that is shown to be effective with adolescent populations. This could lead wilderness therapy towards being a more accessible and evidence-based practice for future families in need of support. You are being asked to be in this research study because wilderness therapy has not been researched as much as more traditional treatments (such as inpatient hospitalization or outpatient talk therapy). By interviewing willing students as they leave the program, we hope to gain a greater understanding of what makes wilderness therapy effective. If aspects of the process appear to be highly effective, it is the hope that they can be integrated into follow-up care to ease the transition out of the wilderness experience. Up to twenty-four people will participate in the study. This includes up to eight student participants and eight to sixteen parent participants. What happens if I join this study? If you join the study, you will agree to allow your child to participate in a voluntary interview about his/her experience in the program both during his/her time at True North, and six months following graduation. You will also be asked to participate in an interview, separate from your child, six months following graduation to understand your perceptions of True North. Questions will explore any change facilitated during the program, along with what contributed to the change. They will also examine what aspects of the program were most helpful. Answers will be audio recorded for accuracy and transcribed following the interview. We would like permission to contact your child during his/her stay at True North to participate in an in-person interview. He/she will be asked to provide assent for participation in the study. We would also like permission to contact you and your child six months after
THE ROLE OF THE WILDERNESS 70 graduation from the program for a 5-10 minute interview to understand what your and your child's perceptions of the program are at that time. Are you interested in being eligible to participate in this follow-up interview? Yes No Not all individuals who volunteer to participate in this study will be selected. Participants will be selected based upon their representation of the True North population. This includes age, gender and ethnicity. This study aims to interview one student who represents the demographics of True North. For example, only one fourteen-fifteen year old male will be selected. This selection process will be determined by the order in which consent forms are received and representative demographics are filled. What are the possible discomforts or risks? Discomforts you/your child may experience while in this study include emotional distress over being asked to recall the wilderness experience. If you, or your child experience any psychological and/or emotional distress related to the questions examining the wilderness therapy experience you may contact Madhurii Barefoot at (802) 498-3211. What are the possible benefits of the study? This study is designed for the researchers to learn more about the wilderness therapy process and how it contributes to effective outcomes. With a greater understanding of what contributes to the effectiveness of wilderness therapy programs, it is the hope that this information can be applied to other treatment options working with families and adolescents. It is also hoped that this will increase awareness in the scientific literature related to therapy and this treatment modality, making it more accessible to families in need of support. Will I be paid for being in the study? Will I have to pay for anything? You will not be paid to be in the study. It will not cost you anything to be in the study. Is my participation voluntary? Taking part in this study is voluntary. You have the right to choose not to take part in this study. If you choose to take part, you have the right to stop at any time. If you refuse or decide to withdraw later, you will not lose any benefits or rights to which you are entitled.
THE ROLE OF THE WILDERNESS 71 Who do I call if I have questions? The researcher carrying out this study is Virginia Sanford If you have questions, you may call Virginia Sanford at (303) 895-6491. You may have questions about your rights as someone in this study. You can call Virginia Sanford with questions. You can also call the University of Colorado Multiple Institutional Review Board (IRB). You can call them at (303) 724-1055. You can also call Dr. Scott Schaefle, Ph.D., LPC, LMFT, NCC, Assistant Professor at University of Colorado. You can reach him at (509) 607-1987. Who will see my research information? We will do everything in our power to keep your records a secret. Virginia Sanford, the Principle Investigator (PI) will be the only person with access to the consent forms. The consent forms will be the only document identifying your child's name. After the PI receives the consent forms, pseudonyms will be assigned to all consenting clients. Consent forms will be stored in a locked box, accessible only by the PI. There is a minute chance that something could happen to consent forms before they arrive in the PI's possession. Once the consent forms are in the PI's possession, every possible action, as described above, will be taken to keep the records a secret. Both the records that identify your child as a participant and the consent form signed by you may be looked at by others. Federal agencies that monitor human subject research Human Subject Research Committee The researchers doing the study Regulatory officials from the institution where the research is being conducted who want to make sure the research is safe The results from the research may be shared at a meeting. The results from the research may be in published articles. Your child's name will be kept private when information is presented. All confidential information, such as your child's name, will be stored in a locked box by the primary researcher, Virginia Sanford. A coded sheet linking this information to pseudonyms used in the research results will be held only by Virginia Sanford. Basic demographic information will be gathered, such as age, gender and ethnicity. Although information will be reported in aggregate, or as a compilation of all interviews, it is possible that some demographic information could be identifiable. To protect the identity of your child, any identifying information that is specific to a participant will not be reported.
THE ROLE OF THE WILDERNESS 72 Some things we cannot keep private. If you give us any information about child abuse or neglect we have to report that to your state Social Services or other agency. I f you or your child tell us you are going to physically hurt yourself or someone else, we have to report that to your state police or other agency. Also, if we get a court order to turn over your study records, we will have to do that. Any confidential information, including, but not limited to, name, address, phone number, demographics, will be recorded on paper, to be viewed only by Virginia Sanford. Your child's name will not appear in any transcripts and the initial interview will be identifiable only by Virginia Sanford. Any paper documents will be transported in a locked box and any electronic documents will be encrypted and coded to protect identity. No members of the research team, review board or council will have access to any identifying information. No names or identifiers will be mentioned in any audio recordings. Agreement to be in this study I have read this paper about the study or it was read to me. I understand the possible risks and benefits of this study. I know that being in this study is voluntary. I choose to be in this study: I will get a copy of this consent form. Print Name (Minor): Signature (Parent 1 or Legal Guardian 1): Date: Print Name (Parent 1 or Legal Guardian 1): Signature (Parent 2 or Legal Guardian 2): Date: Print Name (Parent 2 or Legal Guardian 2):
THE ROLE OF THE WILDERNESS 73 Signature (Investigator): Date: Print Name (Investigator): Consent form explained by (if applicable): _____________________ Date________ Print Name __________________________________ Please be sure to initial every page of the consent form in addition to signing pages 4-5. If you agree to participate in this study please answer the basic demographic information about your child attached to this consent form. Please return the consent form and demographic information to Virginia Sanford using the pre-stamped envelope included with this packet. Contact Virginia Sanford at (303) 895-6491 with any questions.
THE ROLE OF THE WILDERNESS 74 APPENDIX C Assent Form What is this study about? I am being asked if I want to be in this research study. The goal of this study is to explore the wilderness therapy process through the unique experience of wilderness therapy participants. This study will help explain how different elements of the wilderness therapy process are related to any changes in thoughts or behaviors. Why are you asking me? I am being asked to be in the study because I have participated in True North Wilderness Therapy Program. This study aims to understand what this experience was like. This study wants to understand how participants in wilderness therapy felt about their time spent in the program. What Do I Have to Do or What Will Happen to Me? If I am in the study, I will: agree to participate in an interview about my experience at True North. This interview will last between 30 and 45 minutes. agree to allow the interview to be recorded. We would like permission to contact you six months after graduation from True North for a 10 minute follow-up interview. Are you interested in being eligible for this follow-up interview? __ Yes __ No The interviewer, Virginia Sanford, is not connected to True North. All information gathered during the interview will be confidential. It will not affect your graduation from True North. Your name and all identifying information will be kept private. If I am in this study I will be asked questions. I will be asked about: my experience at True North how the wilderness setting affected my experience what I liked about True North what I did not like about True North how I think I have changed while at True North What are the possible discomforts or risks? It is possible that talking about the wilderness therapy experience at True North will cause some emotional distress or discomfort. If this happens, Madhurii Barefoot, or my course leader, is available to talk to while I am still at True North. If I want to talk to someone after I leave True North, I can call Madhurii Barefoot at (802) 498-3211 for a referral.
THE ROLE OF THE WILDERNESS 75 Can I ask Questions? I asked any questions I have now about the study. All my questions were answered. __ Yes __ No I know that if I have a question later, I can ask and get an answer. If I want to, I can call Virginia Sanford at (303)895-6491, or Scott Schaefle at 303-315-2172 Do I Have to Do This? I know that I do not have to be in this study. I will not be in trouble, or face any consequences if I say no. I want to be in the study at this time. yes no I will get a copy of this form to keep. Minor's Printed Name:____________________________________________ Minor's Signature:________________________________________________ Date:____________________________ I have explained the research at a level that is understandable by the minor and believe that the minor understands what is expected during this study. Signature of Person Obtaining Assent:______________________ Date:__________ Initials:________
THE ROLE OF THE WILDERNESS 76 APPENDIX D Recruitment Letter Dear Sir/Madame: I am a graduate student at the University of Colorado Denver. I am working towards a Master's in Counseling Psychology. As part of my program, I am conducting a research study to learn more about the wilderness therapy process. As a former guide with True North, I have focused this study on the student and parent population at True North Wilderness Program. Although True North is allowing me to interview consenting students for the purpose of my research, this study is being administered independently from the program. True North has granted permission to recruit participants, though they are not responsible for anything related to the study. Working as a guide with True North opened my eyes to the power of the wilderness therapy experience. As I have moved from being a part of the wilderness therapy experience to researching the experience, I have realized a need to understand more about how and why the wilderness therapy process works. Studies have indicated that wilderness therapy is an effective treatment process, but few studies have explored how the different element of this treatment process contribute to successful outcomes. This research study strives to examine this process, with a focus on the role of the wilderness. Participation in this study will provide permission for your child to be contacted for participation in an in-person interview during their stay at True North. The details of the study are described in the consent form, attached to this letter. Please do not hesitate to contact me with any questions or concerns at (303) 895-6491. I am happy to discuss this study at any point along the way. Sincerely, Virginia Sanford
THE ROLE OF THE WILDERNESS 77 APPENDIX E Table of Participants Interview Pseudonym Gender Age 1 Jim Male 14 2 Darth Male 15 3 Paul Male 19 4 Bill Male 16 5 Cass Female 14 6 Rob Male 14 7 Henry Male 20 8 Michael Male 18
THE ROLE OF THE WILDERNESS 78 APPENDIX F Sample Data Analysis Interview #2 Exploratory Comments Emergent Themes D: I have changed a lot since I've been here. Um I've like, like I've said you can't run away from your problems so i've had to face them all. Um I've learned to like, I've changed because I don't know if it's like I mean I guess it's change, but. Like I've had to like sort of put them into a perspective and like realize that they're not, it's not that, although it's hard to express those kind of things, like how you're feeling and stuff, it'll make you feel so much, that much better and it's worth it so I've learned to like keep that in mind when I'm feeling pretty shitty, just to like tell people what's going on for me sort of, which helps a lot. And yea I think I'ver also like confronted my like shame in a way. My feeling of always negative self talk that kind of stuff. Because often when I would get like I would make a mistake or something like that I would tell myself like umm I like stuff like I'm not good enough, like I messed up real bad I'm an idiot. That kind of stuff. And like I've denitely worked on that, like trying to realize that some things are out of my control and like it happened so you can't change that so you can't harp on it really. Like you should just try to get over it. So I've learned how to do that. Um yea and I just think I've learned better strategies for like coping with emotions and how to express that to people and how to better like respect people. Especially like if they' re sort of the ones that decide that can effect how it plays out for you. Changed a lot No escape/avoidance-confronting problems hard to express emotions and feelings as they are happening, but makes "you feel so much better"-still sounds uncomfortable with idea of sharing-vague description of feelings and stuff-role of mental/emotional challenge? Being able to share with othersvulnerability confronting shame-negative self talk related to mistakes-recognition of things being out of your control=acceptance, what's done is done-I'm here so now what?-environment example of rain when already feeling down? coping with emotions and how to express them to people who and how to respect people-guides can determine outcomes so how to work with that-genuine respect or self-serving/ manipulative respect? can't run away form problems-need to face them (2b615-618) change experienced in ability to express emotions and confront problems (2b614-618; 626-630) hard to express emotions in the moment and it is worth it (2b626-635) being able to share with othersvulnerability (2b631-635) increased ability to confront shame and negative self-talk (2b636-640) acceptance of things being out of his control (2b648-655) "you should just try to get over it" (2b653-656) learned to better respect others (2b660-665)
THE ROLE OF THE WILDERNESS 79 APPENDIX G Select Examples from Master Table of Themes Theme One: Different Setting Interview One: Because being closer to home like makes me think about home more. Instead of like what I'm doing. [Being further away and being outside helps] zone into it. 635-647 Interview Two: Um yea I guess, I guess being out here like is another challenge added onto everything else. Just like added onto being away from everyone you love and stuff. 431-436 Interview Four: it definitely helps though that I'm like away from a lot of distractions out here. its something that i definitely struggled with at home, like managing my time with like distractions and there aren't many distraction out here. 202-209 Interview Six: yea um so like in the different environment for me its almost like i feel less like nothing reminds me of my past i mean less to remind me of my past less to remind me of old habits. its more like I'm looking with my like more with like ill have more self-confidence 774-784 Interview Seven: it was an entirely different world and i was figuring out who i was in a different setting and i think at is base thats what wilderness therapy is. its figuring out who you are and becoming comfortable with yourself in a setting thats unfamiliar to you. 1309-1313 Theme Two: Safe and NonJudgmental Setting Interview Three : Um and i think like even when you're doing something thats enjoyable like that like you're still kind of comparing yourself to other people. and you don't get the perspective that you get when you just like sit with yourself in nature and just like think through your problems. 511-522 Interview Four : I think I'm definitely a lot more comfortable out here I guess in like the wilderness. I definitely yea this is like a comfort zone for me i guess. and um definitely I don't know i just feel pretty safe out here to like uh talk about how I'm feeling or something 433-444 Interview Five : just like theres no distractions and i guess like here we' re all the same. we all wear the same clothes and we all do the same things and thats also helpful cuz like oh they've been through this too. 235-243 Interview Six : its not like the birds are gonna judge you or something like that. so you' re focused on you. 334-338 Theme Three: Metaphorical Power of the Wilderness Interview One : just whatever I guess mother nature throws at us. We have to live through You can't go inside a building or a car and wait out the storm. 426-429; 433-436 Interview Two : Like if it was in a building you could just like hide away in your room, lock the doors, not talk to people. Like here you can like go to your tarp and stuff or you can like walk away form everything, but then you' d have to count. 515-523 Interview Three : it definitely goes back to that thing of living based off of your bodily functions and your bodily needs rather than living based off of like contrived needs or things that you think that you need but you really don' t. 626-634 Interview Five : i guess like when we hike and theres a hard path theres always another way to get to the same place. 218-222
THE ROLE OF THE WILDERNESS 80 Interview Six: when you're out here you're not even in a tent you' re under a tarp so you have to face like the weather and stuff like that and like that also that sort of like hardship not like well its not like it really just sucks or anything like that but its hardship i mean its not like smooth sailing its sort of rough 418-429 Interview Eight : you have to set up your ground cloth you have to put up a bug net if theres gonna be bugs out that night um and just out here as well theres just like i wouldn't call them smaller mistake but the choices you make kind of weigh a lot heavier than they would in a city environment where stuff is really easily like accessible. 249-258 Theme Four: Immersion in the Natural Environment Interview Two : It's just cool to think like I'me experiencing something like this and I guess cool to sometimes look around and like look up at night and see the stars. That kind of stuff. Just like I guess that part of it soothes me sometimes because it's cool like the trees everything. Like it' s pretty beautiful. Um just like cool to look at sometimes 838-850 Interview Three : And I think it creates a sense of mindfulness. Like I think like when you're out in nature you can actually like step outside of yourself and recognize like the connection that you have in nature. The fact that you're part of a natural process. 577-586 Interview Four : Um i mean nothing like really stands out to me its just like i really like everything about it like hiking you know being out here. theres just something about it that just like clicks with me i guess and um yea I'm not really sure how to describe it 492-500 Interview Seven : like what the actual things are that are around me so its been really cool to like take note of that and to learn from it so i have a higher appreciation of like the world I'm living in. um and i have a higher appreciation of like a higher awareness i guess of how i interact with the world around me. 438-449 Interview Eight : um i like just being out here with um with just like the plants and the animals it kind of relaxes me. sometimes if i just want to go and like think or go and meditate sometimes i'll even come out right here where we're sitting right now and i can just kind of look around at the view like get to really appreciate whats around me. like maybe there will be a butterfly to add just an extra element of like relaxation to whats happening. and it kind of just puts your mind at ease into a place where you can really just focus on what you want to think abou t 489-503
THE ROLE OF THE WILDERNESS 81 APPENDIX H Saliency of Themes Across Cases Jim Darth Paul Bill Cass Rob Henry Michael Different Setting 2 2 1 1 3 3 3 2 Safe and NonJudgmental Setting 1 1 3 3 2 2 3 3 Metaphorical Power of the Wilderness 2 3 3 1 2 3 3 3 Immersion in Natural Environment 1 2 2 1 2 0 3 3