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Therapeutic Recreation and Adventure Therapy

Michael Burkhart and Luke Sober





Table of Contents
Pg. 2 Introduction
Pg.2-3 Community
Pg. 3-7 Agencys purpose
Pg. 4 Goals
Pg. 4 History
Pg. 5 Existing programs
Pg. 5 Attitude (of McLarens Services)
Pg. 5-6 Membership/Accreditation
Pg. 6 TR agency organization
Pg. 7 Relevant Legislation
Pg. 8-9 Clients
Pg.8 Specific Clients for Adventure Therapy
Pg. 9-11 TR Department



Pg. 10 Leisure Ability Model
Pg. 12 TR Profession
Pg. 13 TR Certification
Pg. 14 TR Philosophy
Pg. 15 Licensing
Pg. 16 Wilderness Therapy Certification
Pg. 17 Organizations
Pg. 19-20 Journals
Pg. 20 Wilderness therapy statement of
purpose
Pg. 20-21 Goals
Pg. 21 Adventure Program titles
Pg. 21-22 program descriptions
Pg.22-23 Investigation of expected outcomes
Pg. 24-25 works cited







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Therapeutic Recreation, also known as Recreational Therapy, is a key part to any hospital
environment or rehabilitation facility. With a variety of benefits aligning with varying programs,
Recreational Therapy can be the difference between adequate care and excellent care. Of the
many programs falling under this specific department of health care, wilderness/adventure
therapy is a little known program, but a program with a multitude of benefits. Using the
environment and landscape in the area of the facility, wilderness therapy allows for leisure
education, social learning, as well as new skills for leisure purposes. Some specific agencies that
could use a wilderness therapy program very efficiently are UCLA Medical Center, located in
Los Angeles, California, University of Colorado Hospital, located in Aurora, Colorado, or even
the Greenville Memorial Hospital, located in Greenville, South Carolina. Specifically, all of
these agencies provide a community located near natural resources, whether that be oceans,
lakes, forests, state parks, or mountains. Wilderness/Adventure Therapy is extremely effective in
such environments. Specific to this paper, McLaren Health Care facilities would greatly benefit
from not only from a wilderness/adventure therapy program, but also from the installation of a
recreational therapy program.
Mclaren Northern Michigan Health Care:
Mclaren Health Care makes the statement that healthcare does not begin with the onset of
illness or disability, and the problem is not finished when the patient returns home. McLaren
states that their purpose is to provide total wellness through services that continue to exist after
the patient has left the health care center. In this way, patients are able to live a lifestyle that
promotes healing and wellness.
Community
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A majority of the McLaren Health Care facilities are located right on the shore line of
Little Traverse Bay. There are also a number of state parks within driving distance of all the
facilities. Gaylord State park and Clear Lake State Park are both relatively close to a few of the
facilities, as well as Leelanau state Park located on an island a ways off Grand Traverse Bay.
McLaren uses multiple locations depending on the type of therapy, rehab, or care being
provided. Boulder Park Terrace, located in Charlevoix, Michigan, is specific to the center in its
community care and sub-acute rehabilitation center. The small town allows for quality medical
and pharmaceutical treatment, as well as an appropriate degree of independence for the patients.
Facilities such as the Outpatient Therapies and Rehabilitation at John and Marnie Demmer
Wellness Pavilion and Dialysis Center, use their own state-of-the-art facility, as well as the
community around the center, such as a wide variety of Physical and Occupational Therapists.
These types of therapy wellness programs also use daily life and activities that would be used in
the surrounding community to help the patients in their rehabilitation.
While the Mclaren Health Care Facilities make good use of their own buildings and
facilities, they appear to be located in prime areas to use their surrounding communities to a
greater extent. The location areas also allow for a prime opportunity to for involvement of
patients in town activities or leisure use of outdoors, with large State Parks, as well as perfect
location next to the bay and Lake Michigan.
Agency:
McLaren Health Care Mission: through [McLaren Healths] subsidiaries, [Mclaren
Health Care] will be the best value in health care as defined by quality outcomes and cost. In
summation, the mission of McLaren Health Care is to provide the best and most efficient service
to its patients, defined by the lasting outcomes that result for the individual patient, alongside the
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best value or cost for the care. McLarens vision is similar in the desire for McLaren to be
recognized as a leading care and health provider, preferred by the communities that it serves.
McLaren Health also provides a Guiding Principle as a sub-category to its vision, with the goal
of providing healthcare as one would expect for their own family. (15)
One of the goals that Mclaren strives for is to provide an environment, for both the family
and the patient, which provides an atmosphere and environment for healing. They define this
environment as involving optimal health to the individuals physical, emotional, cultural and
spiritual aspects.
The history of McLaren Health Care dates back 1914 in a 10-bed hospital setting in Flint,
Michigan. Originally formed to be a private hospital, it became open to the community as a non-
profit hospital in 1919 as the hospital transformed into a Womens Hospital Association. The
hospital began to make significant headway with the start of World War II, bringing a fund
raising campaign of one million dollars towards building a new facility. The construction of the
facility wasnt completed until October of 1951, as the process was delayed because of a lack of
material (due to shortages from the war.) The addition increased the hospitals bed capacity to a
total of 436. In 1989, the hospital began to expand into multiple facilities with an MRI
Diagnostic Center. A number of other branches were added onto the hospital and care facilities,
including family care centers in West Branch, Houghton Lake, Fairview, Rose City, and Rifle
River. In October of 1996, the McLaren Medical Group (MMG) was established as a
management facility for McLaren Facilities in order to organize a large number of facilities
under the McLaren Services Corporation. This added a great number of new wings, such as
urgent care, practice management, managed care, and occupational/physical therapy, to name a
few. With a few modifications and additions to these existing wings, the Mclaren North
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Michigan Health Care facilities are up to a current and vast range of care units through north-
west Michigan. (14)
The McLaren Health agency provides a great number of existing programs. Of these
programs are include Cancer services, diabetes services, Hospice, orthopedics, pain
management, nutritional counseling, trauma care, and wound care, among many others. Also
included are physical rehab programs that apply to a wide variety of patients, as well as
occupational therapies, used in the process of allowing patients to resume a healthy and normal
day-to-day living style.
The attitude of McLaren Health is one of servant leadership. The vision, goals, and
mission of the agency is one of compassion and efficiency. The hospital and services aim to
provide the best care for the best price, and desire to be widely known through the areas they are
located in Michigan. A key point to the style of care and attitude is found in their mission vision,
stating that the desire is to provide all patients with a service that the staff would expect of a
hospital or service for their own family.
Mclaren Health uses a combination of membership agencies in order to provide patients
with quality services. Such agencies include The Joint Commission: Accreditation, Health Care,
and Certification, Centers for Disease Control (CDC), and the Food and Drug Administration
(FDA). (16) Such programs as these are accompanied by McLaren Health Care staff evaluations
in order to control and promote adherence to applicable laws and regulations. (pg. 11)
Specifically, to follow this commitment to ongoing evaluation, McLaren has set up a controlling
assessment plan via an audit and review program. By having policies that pertain to monitoring
employees and services in this unbiased manner, Mclaren Organizations are efficient in their
evaluation process.
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Of the current programs associated with McLaren Health Care, Therapeutic Recreation is
not included in the patient rehabilitation process. The closest programs to the skill types of
Recreational Therapy are found in the Physical Therapy, Fitness Centers, Home Care Center, and
Occupational Therapy programs. It is surprising that McLaren Health has not yet added a
recreational therapy program to its roster, as a recreational therapy program fits perfectly into the
realm defined by the McLaren Health vision, goals, and purpose. With the programs present in
McLarens services, the patients are able to receive excellent service by the staff, and are able to
be rehabilitated from disease, injury, or impairment, but little is offered in the range of helping
the patients to live a lifestyle of wellness, in mental, social, and physical health.
In placing a Recreational Therapy program into this agency, the program could fit very
nicely underneath/alongside
such programs as physical and
occupational therapy. With
combined use of leisure
activities and rehabilitation
programs, patients would be
given access to a larger range of health, helping to develop motor skills, leisure education in
accordance with their rehabilitation, and an ability to continue this leisure lifestyle outside of the
program. While a recreational therapy program easily falls under these types of programs, there
is also the option of expanding McLaren Health by adding a recreational therapy program with a
specific focus on restoring mental and physical health, unassociated with other programs. One
specific way in which this could take place is in Wilderness and Adventure therapy. Using the
community surroundings, such as the lake and the state parks on the east and west sides of the
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McLaren facilities, programs could be developed to better McLaren Health in reaching a larger
community. Again, this type of program greatly appeals to the vision and purpose of McLaren
health, in attempting to provide the best service possible as would be expected for ones family
member.
McLarens Health Care facilities also carefully follow legislative demands. The owners
and operators of the facilities are aware of the necessity for the buildings to be accessible and
usable by all people. This means that all the facilities are wheelchair accessible, complete with
ramps, elevators, and the like, as well as all the buildings being designed with the purpose of
easy maneuverability of patients (such as incase of weather threats, or other occurrences that
may threaten the normal functioning of the facilities). Such legislation as the ADA (Americans
with Disabilities Act) give regulations as to how the facilities must be run. By following this
legislation, as well as similar legislations on hospital and facility functions, McLaren is able to
provide patients with proper, as well as efficient and safe, care.
Clients:
The range of clients that come to McLaren Health is of a vast variety. From ages, gender
and race, to economic status, education levels, and religious backgrounds, McLaren Health
seems bent on trying to reach as many people as possible in Northern Michigan. This range of
clients is drawn through the multiple facility locations, totaling out currently at 11 hospitals,
alongside a large variability of programs.
As for the age of clients, the focus is primarily on adult life, mainly because of the
specialties found in McLarens hospital and program structures. With such programs dominating
as Home Care, Diabetes, Cancer, Occupational therapy, Physical therapy, and diagnostic
services, a large majority of the clients will tend to fall in the older age range. However, there are
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still services for a broad range of clients, from child life and Family BirthPlace to Hospice
care.
Because of the multiple locations, there is also a wide variety of numbers able to attend
the hospitals and programs, as well as a wide variety of socio-economic statuses. The
predominant ethnicity would contain Dutch and Eurocentric cultures, primarily based on
location. Education levels are also varied, but all fall in a high rating, whether public school or
private. Religious background of the area is less varied as it still falls in the Christian Dutch
Reformed bubble of Western Michigan. Primarily, the hospitals are located in urban
environments, but because of their multiple locations, they are accessible by rural community as
well. The emergency care units specifically allow for rural and urban use of facilities.
As far as the history of leisure education and programs go, McLaren Health Care has yet
to focus a program primarily on this need. The programs found at McLaren facilities are focused
on providing excellent services in all aspects of the patients care, but have to this point lacked a
leisure education and therapy program.
Clients specifically focused into the typical adventure/wilderness therapy usually do so
because of a number of differing ailments and disorders. Some of the most common areas of
therapy for clients are founded in Adjustment Anxiety Disorder, Bi-polar disorder, Depression
disorder, Eating disorders, Obsessive-compulsive disorders, issues with suicidal thought, and
Alcohol Abuse/Dependence. An adventure program works on building relationships with these
clients to help them overcome their disorder and replace habits with leisure activity that
promotes a health well-being.
Adventure/wilderness therapy is an inpatient program, taking place over a few week to a
few months. This allows for time to build skills in a variety of programs, whether it be a pack-
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packing expedition, a rock climbing program, or a camping program. All programs take an
extend amount of time to complete. Because of the large quantity of time required for the
program to work, adventure/wilderness therapy is likely a voluntary program for most adults.
The program is less likely to be voluntary for those under the age of 18, as these programs are
used often to help a student change unhealthy behaviors as seen by an authority figure, such as a
school policy, work policy, or parental guardian.
TR Department
The purpose of a Recreational Therapy program is numerous. Therapeutic Recreation is
run by those who have passed the NCTRC (National Council for Therapeutic Recreation
Certification) certification exam after receiving their Bachelor degree in Recreational Therapy.
There are checks and balances that help Recreational Therapy programs to function and flourish.
The American Therapeutic Recreation Association (ATRA) is the largest national membership
organization helping in evaluation and improved functions of programs. (5) The ATRA provides
such structure as a Code of Ethics with ten categories to help structured programming. This
includes laws and regulations, competency of staff personnel, beneficence, and fidelity. The
association also provides its members with opportunities to network, find marketing materials,
continue education in multiple formats, and find resources for students, staff, and professional
work.
With a built knowledge in
Recreational Therapy, as well as
having the resources and credentials,
those in the profession are able to
provide clients with a more full
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education, recover, or rehabilitation. Some ranges that Recreational Therapy touches on are
presented by the Leisure Ability Model. (Stumbo and Peterson, pg. 61) One area of work is
found in a therapeutic setting with a focus on improving function of the patient. In this segment,
the TR personnel works with the patient to build up motor skills and functions, as well as
developing knowledge of an activity or procedure that can help the patient. With a built capacity
of motor functioning, the therapist can be changed into a counselor setting, which allows the
patient more freedom than prior activities. In this range of work, the patient receives education,
knowledge, and a growing skill set in order for more independent capabilities. Lastly on the
model is the recreation participation segment. The TR staff becomes a resource for the patient,
and the patient has built up their skill and capabilities to a point where they have the freedom to
perform more health and complex leisure lifestyle activities.
A Recreational Therapy staff, as well as supporting hospital staff, is of great importance
to the success of the recreational therapy program. Depending on the number programs being
performed within the department, the staff will vary in size. For a program focusing on long term
care, child life, and rehabilitation of patients, it would be necessary to have anywhere from six to
twelve certified staff members. With specialization in Recreational Therapy programs, such as
adventure/wilderness therapy, staff with specific credentials are preferred in order to give proper
care. The addition of this program, or programs that are similar, require a larger staff, as well as a
larger payroll in order to accompany the staff. These factors are important in deciding proper
programs for patients that will provide efficiency and quality.
It is important for the Recreational Therapy department to also utilize other resources
provided by the hospital. This may include the Physical Therapy, Occupational Therapy, or
Speech Therapy departments in many hospital settings. The nursing staff and doctor staff help
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organize more efficiency and quality into the service provided to the patients. Budget for the use
of multiple programs is important. For example, when looking at the number of Recreational
Therapists, it is important to note that the average personnel in this department receives an
annual salary of approximately $45,000. With each program is a monetary cost for personnel and
equipment, so it is important to note the string of people involved in the process, and only
include programs that provide the best quality and efficiency.
Specific to adventure/wilderness therapy programs, it is necessary for staff to have both a
degree in recreational therapy, as well as possess knowledge of the activities they will be
leading. This includes having information on safety procedures, specifics to providing proper
teaching methods, and ability to form a quality experience for patients. It is also important to
have a support team to work through the multiple programs founded under wilderness therapy.
For one program, it would be most effective to have a minimum of two or three leaders in order
for optimal success and quality for the patients. It is important that programs of adventure and
wilderness therapy also use the resources of physical, occupational, and recreational therapies to
benefit the total quality of service.
Therapeutic Recreation Profession:
Recreational therapy, also referred to as therapeutic recreation, is defined by the United
States Department of Labor as a profession of specialists who utilize activities as a form
of treatment for persons who are physically, mentally or emotionally disabled (Paraphrased,
Occupational Outlook Handbook, U.S. Department of Labor, Bureau of Labor Statistics, April
1991). Differing from divisional or recreation services, recreational therapy utilizes various
activities as a form of active treatment to promote the independent physical, cognitive, emotional
and social functioning of persons disabled as a result of trauma or disease, by enhancing current
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skills and facilitating the establishment of new skills for daily living and community
functioning.(5)
Recreational therapy services are delivered by qualified professionals with training and
education in therapeutic recreation/recreational therapy service delivery and professionally
certified by the National Council for Therapeutic Recreation Certification (NCTRC). The
professional certification designation is Certified Therapeutic Recreation Specialist (CTRS). The
credential requires a bachelor's degree or higher from an accredited institution of higher
education in the area of therapeutic recreation (recreational therapy), an approved internship
under the supervision of a professionally credentialed CTRS, and the passing of a national
certification examination administered for the NCTRC by the Educational Testing Service
(ETS).(5)

Philosophy of Therapeutic Recreation:
Recreational therapy embraces a definition of "health" which includes not only the
absence of "illness", but extends to enhancement of physical, cognitive, emotional, social and
leisure development so individuals may participate fully and independently in chosen life
pursuits. The unique feature of recreational therapy that makes it different from other therapies is
the use of recreational modalities in the designed intervention strategies. Recreational therapy is
extremely individualized to each person by his or her past, present and future interests and
lifestyle. The recreational therapist has a unique perspective regarding the social, cognitive,
physical, and leisure needs of the patient. Incorporating client's interests, and the client's family
and/or community makes the therapy process meaningful and relevant. Recreational therapists
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weave the concept of healthy living into treatment to ensure not only improved functioning, but
also to enhance independence and successful involvement in all aspects of life.(5)
Wilderness/Adventure Therapy Profession:
Wilderness and Adventure experiences take students out of their comfort zone and
familiar environments by immersing them in unfamiliar settings and situations. Through a series
of activities or tasks that are demanding physically, mentally and emotionally, students quickly
learn that old ways of coping are ineffective when pitted against the challenges and
consequences of nature and adventure activities. Behavior patterns are revealed and interrupted,
presenting students with an opportunity to utilize their strengths for group problem solving.
These efforts help students learn leadership, determination and perseverance, teamwork and
cooperation. Through personal and group achievement, self-esteem and confidence are
increased, belief in ones own abilities is enhanced, and interpersonal skills strengthened.
Expeditions and adventure activities are not survival ordeals. Research shows that
students who are cold, hungry, and miserable will not be able to process or benefit from the
experience. Students are given the best clothing, gear and equipment available in order to make
the experience as comfortable as possible, while retaining a reasonable level of challenge. The
food, which is top notch for backcountry cooking, is nutritious and filling.(3)
People often confuse wilderness therapy with juvenile boot camps. Boot camps have their
origin in the juvenile justice system and utilize military style approaches to discipline to change
the student. The idea of wilderness/adventure therapy is one in which the staff develop
relationships based on compassion and respect and utilize nature and adventure as a teacher.
Boot camp programs utilize physical and psychological aggression toward students while
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wilderness/adventure therapy programs create therapeutic opportunities as students face the
unpredictable circumstances that can emerge in nature and adventure activities. Boot camps use
coercion and obtain control through the use of intimidation and manipulation and take advantage
of a persons fears. Wilderness/adventure therapy and boot camps are completely different forms
of working with youth and are based on entirely opposing philosophical approaches. Wilderness
therapy is based on compassion and the honorable journey of self-discovery.(2)
Wilderness/Adventure Therapy Philosophy:
Through the shared experiences on expedition, students build relationships with staff and
fellow students. Working together to overcome obstacles builds trust and provides the emotional
safety needed for students to feel comfortable sharing their story and their feelings. This
emotional safety also creates an environment in which students are more open to hearing
criticism and feedback about their behavior, choices or treatment of others.(3)
Wilderness/Adventure Therapy Status:
This new brand of outdoor treatment began as a reaction to some wilderness therapy
programs created in the 1970s. Those programs, however; lacked good oversight and were run
by a mish-mash of providers, many of them unqualified and unlicensed. At the time, many such
programs were state-funded, and some took the form of "boot camps" designed to create
challenging and even punishing experiences for young clients, many of whom came from the
juvenile justice system. This type of treatment reached a nadir in 1994, when 16-year-old Aaron
Bacon died from a treatable ulcer on a trip to southern Utah. When he complained of abdominal
pain, his counselors called him a "faker," then deprived him of his sleeping bag for 14 nights and
food for 11 nights.(6)
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That's when the program directors and founders of five wilderness therapy programs
came together for a meeting in Salt Lake City, put their differences aside, and recognized that
discussing best practices and agreeing on common principles would be best for the industry. To
those ends, they created the Outdoor Behavioral Healthcare Research Cooperative to make sure
these programs were properly studied and evaluated. The cooperative's members have conducted
some 200 studies, currently under the direction of Michael A. Gass, PhD, of the University of
New Hampshire.(6)
Currently insurance agencies will pay for only the discrete therapy sessions throughout
wilderness/adventure therapy programs. As such wilderness/adventure therapy programs are
expensive and tend to only be available to wealthier clients. With that, research is starting to
show that some of these programs are effective. A 2010 Journal of Therapeutic Schools and
Programs article by Ellen Behrens, PhD, and colleagues, for instance, examined several large-
scale, multi-center longitudinal studies and found that youth in these programs improved
significantly in mood and behavior during treatment, and that those improvements continued
when they returned home. Meanwhile, in six years of tracking participants and parents over a
number of programs, Second Nature, a leading wilderness therapy agency, researchers found
significant improvements in the clients overall motivation, life skills, interpersonal
relationships, hope, self-confidence and emotional control both at graduation and at six-month
follow-ups. Importantly, parents perceived those differences, too.(6)
Wilderness/Adventure Therapy Therapist Certifications:
The following is a list of certifications and their requirements both mandatory and
preferred of a Wilderness/Adventure Therapist. Some of these certifications have prerequisites
that must be met before application is considered, others do not.
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Not Optional - Certified Therapeutic Recreation Specialist (CTRS)
Applicants must meet specific academic requirements related to coursework and
internship in order to apply for certification. Upon approval of the application to National
Council for Therapeutic Recreation Certification (NCTRC), the student will receive an invitation
to sit for the national exam. This exam tests for knowledge about the important skills and
information necessary for minimum competency in therapeutic recreation practice. Upon
meeting the eligibility requirements and passing the exam, the individual will receive the CTRS
credential, which requires annual maintenance and renewal every five years.(8)
Preferred - Certified Park and Recreation Professional (CPRP)
Those with a major in recreation are eligible after a year of work in the field. The
professional organization will notify students applying for CPRP status of approval or
disapproval to sit for the exam. The exam assesses the core knowledge of job-related tasks
common to entry-level professionals. Approximately six weeks after completion of the CPRP
exam, applicants receive notification of their status. Professionals maintain certification by
earning approved Continuing Education Units or academic credit.(8)
Preferred - Emergency Medical Technician Basic (EMT-B)
No prerequisites are needed to enroll into a course, can be earned within three months
alongside a completion of 48 clinical hours.
Preferred - Cardiopulmonary Resuscitation (CPR)
No prerequisites are needed to enroll into a course, can be earned in one day.
Preferred - Crisis Prevention Intervention (CPI)
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No prerequisites are needed to enroll into a course, can be earned in one day.
Preferred - Wilderness First Aid (WFA)
No prerequisites are needed to enroll into a course, can be earned in two days.
Preferred - Swiftwater Rescue Technician (SRT)
No prerequisites are needed to enroll into a course, can be earned in three days.
Wilderness/Adventure Therapy Professional Organizations:
The following are a list of professional organizations that represent the Therapeutic
Recreation field and its branches such as Wilderness/Adventure Therapy.
American Therapeutic Recreation Association (ATRA)
The mission of the American Therapeutic Recreation Association is to serve as a
member-driven association that collectively supports the recreational therapy profession.(5)
National Council for Therapeutic Recreation Certification (NCTRC)
NCTRC is the nationally recognized credentialing organization for the profession of
therapeutic recreation. Established in 1981, as an independent non-profit organization, NCTRC
represents over 12,000 Certified Therapeutic Recreation Specialists employed within a variety of
healthcare and human service settings.(8)
Michigan Therapeutic Recreation Association (MTRA)
The MTRA was established to further the objectives of the American Therapeutic
Recreation Association.(4)
Outdoor Behavioral Healthcare Industry Council (OBHIC)
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OBHIC is an organization of behavioral health providers who are committed to the
utilization of outdoor modalities to assist young people and their families to make positive
change.(1)
The National Association of Therapeutic Schools and Programs (NATSAP)
The National Association of Therapeutic Schools and Programs serves as an advocate
and resource for innovative organizations which devote themselves to society's need for the
effective care and education of struggling young people and their families.(10)
The Association for Experiential Education (AEE)
The Association for Experiential Education (AEE) is a nonprofit, professional
membership association dedicated to developing and promoting experiential education
worldwide.(11)
Therapeutic Adventure Professional Group (TAPG)
The Therapeutic Adventure Professional Group (TAPG) is committed to the development
and promotion of adventure-based programming and the principles of experiential education in
therapeutic settings.(11)
The National Association of Therapeutic Wilderness Camps (NATWC)
The National Association of Therapeutic Wilderness Camps (NATWC) supports the
establishment and continuation of therapeutic wilderness camping organizations and educates the
public about the existence of such organizations and their success in helping troubled young
people change their lives for the better.(1)

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Therapeutic Recreation Professional Journals/Publications
Refereed Publications
Tucker, Anita. "The Use of Adventure Therapy in Community-Based Mental Health: Decreases
in Problem Severity Among Youth Clients ." Outdoor Behavioral Healthcare Research
Cooperative. OBHIC, 19 Nov. 2012. Web. 26 Nov. 2013.
Bettmann, Joanna. "Reflecting team and other innovative family therapy techniques, adapted for
outdoor behavioral mental health settings ." Outdoor Behavioral Healthcare Research
Cooperative. OBHIC, 10 Feb. 2011. Web. 26 Nov. 2013.
White Papers
Behrens, Ellen. "The evidence base for private therapeutic schools, residential programs, and
wilderness therapy programs ." Outdoor Behavioral Healthcare Research Cooperative. OBHIC, 8
Jan. 2011. Web. 26 Nov. 2013.
Case Studies
Gass, Michael. "Adventure-based family therapy with youth ." Outdoor Behavioral Healthcare
Research Cooperative. OBHIC, 31 Aug. 2010. Web. 26 Nov. 2013.
Gass, Michael. "When I go back home." Outdoor Behavioral Healthcare Research Cooperative.
OBHIC, 31 Aug. 2010. Web. 26 Nov. 2013.
Conference Presentations
Behrens, Ellen. "Longitudinal Outcomes in Private, Regula." OBHIC. 8 Jan. 2011. Web. 26 Nov.
2013.
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Technical Reports
Gass, Michael. "Preliminary Data from the NATSAP Research and Evaluation Network: Client
Characteristics at Admission." Outdoor Behavioral Healthcare Research Cooperative. OBHIC,
31 Aug. 2010. Web. 26 Nov. 2013.
Wilderness/Adventure Therapy Statement of Purpose
To provide comprehensive therapeutic recreation programs and services that give clients the
opportunity to learn a sense of their own personal power while discovering true potential; that is,
establishing an awareness of self and leisure in respect to others, the ability to teach and learn
new leisure skills in a safe and effective manner, acquiring positive social skills, and acquiring
knowledge related to leisure resource utilization.
Wilderness/Adventure Therapy Goals
1. Provide opportunities that promote positive growth in character development
2. Provide opportunities that promote positive leadership skills
3. Provide opportunities that promote personal healing and self-reflection
4. Provide clients with exposure to new and captivating leisure skill areas
5. Provide opportunities that promote client resilience
6. Provide activities that increase clients comfort in social situations
7. Provide opportunities that promote positive teambuilding skills
8. Provide opportunities that promote positive family dynamics

Wilderness/Adventure Therapy Program Titles:
One-on-One Treks
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Offered year round: Ages, 13+
The One-on-One trek is an individualized and customized experience free from the distraction of
peers, and offers a unique window to reflect, assess, clarify, and plan for health, success, and
support needs. Clients will trek through Michigan Upper Peninsula backcountry, navigate
stretches of rivers on canoes/kayaks, and or experience snowshoe camping.
Associated Goals: 1, 3, 4, 5
Young Adult Backcountry Backpacking Trek
Offered spring and summer seasons: Ages, 18-25
The program provides a focused learning opportunity to support young people facing transitions
into college, community and adulthood with greater meaning and purpose. The trek will take
clients into Michigans Upper Peninsula backcountry for up to two months time.
Associated Goals: 1, 2, 3, 4, 5, 6, 7
Adolescent Backcountry Backpacking Trek
Offered summer and fall seasons: Ages, 13-18
The program provides a focused learning opportunity to support young people facing transitions
and the consequences that can come with certain decisions. The trek will take clients into
Michigans Upper Peninsula backcountry for up to two months time.
Associated Goals: 1, 2, 3, 4, 5, 6, 7
Outpatient Adventure Activities
Offered winter and summer seasons: Ages, 13+
Clients will engage in leisure education learning a variety of adventure activities such as cross
country skiing, downhill skiing, luging, snowshoeing, mountain biking, kayaking, canoeing, etc.
All treks are a day length; number of sessions will vary depending on client.
Sober, Burkhart 22

Associated Goals: 3, 4, 5, 6
Family Adventure
Offered when available: Ages, We ask that children are at least 7 years of age.
Clients will engage in leisure education with all or select family members. Every family has a
unique dynamic so every program will be tailored appropriately. Programs take a variety of
forms, from multiple day length outpatient sessions to treks lasting up to two weeks.
Associated Goals: 1, 2, 4, 7, 8
Investigation of Expected Outcomes:
Each client seems to leave wilderness therapy with a different set of outcomes, yet there
exits similarities across these sets of expected outcomes.(12) Upon completing a
wilderness/adventure therapy program clients have a sense of accomplishment that is represented
by something concrete and real that can be used to draw strength from in the future. This sense
of accomplishment is combined with physical health and well-being, which may help clients feel
better about themselves, leading to increases in self-esteem which is in turn the first step of
personal growth. The process also teaches the clients how to access and express their emotions,
and understand why talking about their feelings is important. An enhanced self-concept
represents a sense of empowerment and resiliency. Clients will believe that if they could
complete something like wilderness/adventure therapy then they can also complete other
formidable life tasks. Clients will leave wilderness/adventure therapy knowing the journey to
personal growth has now begun and that they can rise to the occasion.(13)



Sober, Burkhart 23















Works Cited
1. Gass, Michael. Outdoor Behavioral Healthcare Research Cooperative. OBHIC, n.d. Web.
25 Nov. 2013. <http://www.obhrc.org>.
2. Open Sky Wilderness Therapy . Open Sky Wilderness Therapy , n.d. Web. 25 Nov. 2013.
<http://www.openskywilderness.com/>.
3. Summit Achievement . Summit Achievement , n.d. Web. 25 Nov. 2013.
<http://www.summitachievement.com/>.
4. Michigan Therapeutic Recreation Association . MTRA, n.d. Web. 25 Nov. 2013.
<http://www.michigantra.com/>.
Sober, Burkhart 24

5. American Therapeutic Recreation Association . ATRA, n.d. Web. 26 Nov. 2013.
<http://www.atra-online.com/>.
6. DeAngelis, Tori. "Therapy Gone Wild." American Psychological Association Sept. 2013.
Web. 26 Nov. 2013.
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<http://www.apa.org/>.
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College , n.d. Web. 26 Nov. 2013.
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2013. <http://www.nctrc.org/index.htm>.
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<http://www.aee.org/>.
12. Russell, K. C., Hendee, J. C., & Phillips-Miller, D. (2000). How wilderness therapy
works: The wilderness therapy process for adolescents with behavioral problems and
addictions. In D. N. Cole, & S. F. McCool (Eds.), Proceedings from Wilderness Science
in a Time of Change Conference. Fort Collins, CO: USDA, Forest Service, Rocky
Mountain Research Station. (Proc. RMRS-P-15-vol. 3).
13. Gass, Michael. "When I go back home." Outdoor Behavioral Healthcare Research
Cooperative. OBHIC, 31 Aug. 2010. Web. 26 Nov. 2013.
14. "History." McLaren Health Care. N.p., n.d. Web. 26 Nov. 2013.
Sober, Burkhart 25

15. "Mission, Vision and Guiding Principles." McLaren Health Care. N.p., n.d. Web. 26
Nov. 2013.
<http://www.mclaren.org/northernmichigan/MissionVisionandGuidingPrinciplesNM.asp
x>.
16. "Standards of Conduct." Home. N.p., n.d. Web. 26 Nov. 2013.
<http://www.mclaren.org/Main/AboutUs.aspx>.