Wilderness therapy is an intensive, out-of-the-box treatment modality. One of the elements that makes it so effective – multiple staff who devote focused, substantial time to clients, both individually and in group settings — drives up the price tag.

“[Wilderness therapy] is an investment, and I explain it to families as such, including the time and effort they put into it,” says Sabrina Marie Hadeed, a licensed professional counselor at Second Nature Cascades, a wilderness therapy program in Oregon.

Although models vary from program to program, wilderness therapy involves taking groups of clients WildernessHike— most commonly youth or young adults — out into the wilderness for an extended period of time. Participants, including some program staff, typically sleep outdoors, pitch tents, hike and cook food over an open fire.

Field guides are with clients around the clock; clients also see a staff therapist regularly and interact with a support crew – everyone from a wellness coordinator or other medical professional to administrators who plan and drop off water, food and supplies to groups.

“The ratio of staff and employees to clients is very large [in wilderness therapy], which means the cost per day – most of which goes to paying salaries and wages – is significant for many families,” says Gil Hallows, chair of the Outdoor Behavioral Healthcare Council.

The expense, compounded by the fact that it’s not often covered by insurance, makes wilderness therapy cost-prohibitive for some families, admits Hallows.

However, many in the field are working to change this fact.

The Outdoor Behavioral Healthcare Council, an organization formed to advocate, research and identify best practices in wilderness therapy, is spearheading a campaign to improve insurance coverage.

(Many in the field prefer the term “outdoor behavioral healthcare” to “wilderness therapy.” The former refers to a regulated industry, while wilderness therapy can be a more nebulous term.)

Historically, insurance companies have been reluctant to reimburse clients for costs incurred for participation in outdoor behavioral healthcare, says Hallows, the executive director of Legacy Outdoor Adventures, an OBH program in Utah.

The OBH Council is reaching out to insurance companies and providing data on wilderness therapy’s effectiveness in hopes of changing that scenario. The group also provides resources to help guide clients’ families through the appeal of insurance claim denials, Hallows says.

“Part of this campaign is to make outdoor behavioral health care more available to average families,” he says.

At the same time, Hallows asserts that the OBH model is cost-effective, especially when compared with nonwilderness programs with similar staffing levels.

“A brick-and-mortar type of residential program, in order for them to be priced lower than a wilderness therapy program, they have to lower the staff-to-participant ratio,” he says.




See the January issue of Counseling Today for an in-depth feature article on wilderness therapy, to which Hallows and Hadeed contributed.






Bethany Bray is a staff writer for Counseling Today. Contact her at bbray@counseling.org


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