Wilderness therapy in the United States

Wilderness therapy in the United States is a form of outdoor behavioral healthcare in which adolescents and young adults participate in structured therapeutic programs conducted in remote natural settings. These programs typically combine elements of psychotherapy, group therapy, and experiential education with outdoor activities such as backpacking, camping, and survival skills training, with the aim of addressing behavioral, emotional, and substance use issues.

The approach developed in the United States during the mid-20th century, influenced by outdoor education movements and later expanding into a network of private programs, particularly in the western United States. By the late 20th and early 21st centuries, wilderness therapy had become a significant component of the broader “troubled teen” industry, with many programs operating as short-term interventions or as part of longer residential treatment pathways.

Wilderness therapy programs in the United States vary widely in structure, duration, and clinical overview. While some providers incorporate licensed mental health professionals and evidence-based practices, others have been criticized for limited regulation and inconsistent standards. The industry has been the subject of ongoing debate regarding its effectiveness, safety, and ethical practices.

Reports of abuse, neglect, and deaths at some programs, along with concerns about involuntary participation and the use of transport services, have led to increased scrutiny from journalists, researchers, and government agencies. At the same time, research on outcomes has produced mixed findings, with some studies suggesting improvements in behavior and self-esteem, and others highlighting methodological limitations and a lack of conclusive evidence.

History

Many programs in the western United States started operating in the 1960s and 1970s. Some were started by former students of Brigham Young University such as the Aspen Achievement Academy,[1] and the School for Urban and Wilderness Survival, which is located in the state of Idaho.[2] In the 1960s, school officials at Brigham Young University developed a course called "Youth Leadership 480." This course, which was taught by an undergraduate, Larry Dean Olsen, aimed to help failing, "troubled" students rehabilitate and gain "readmission" through the camp.[3] Through this camp, the "troubled youth" would learn outdoor survival skills on month-long backpacking trips in the Utah desert. This program caught the attention of Utah County officials, who then adopted the program's model to try to help juvenile delinquents. Seeing the potential of these programs to generate lucrative profit, some of Olsen's former peers decided to start their own private wilderness therapy camps. Over time, these wilderness camps targeting the troubled-teen sector have grown into a largely unregulated, multi-billion-dollar industry.[4] Over the years, Utah's scenic environment and relaxed oversight have made it a central location for wilderness therapy programs and facilities aimed at "troubled teens". These types of camps are also common in other parts of the U.S., especially throughout the West and Southwest.[3] Another wilderness program in the Western United States is blueFire[5] Wilderness, which primarily works with New Jersey teens. These programs aim to improve the mental health of their participants.

Pratices

Natalie Beck and Jennifer Wong, in their 2020 paper "A Meta-Analysis of the Effects of Wilderness Therapy on Delinquent Behaviors Among Youth", offer three models of wilderness therapy: an expedition model, generally lasting for less than 8 weeks; a base camp model, where clients stay at a central location but engage in "short wilderness excursions"; and a long-term model, where clients engage in wilderness excursions but otherwise remain in a residential program.[6] In the expedition model, clients undergo an extended hiking trip, setting up camps in various locations as they are taught survival skills.[6] With the base camp approach the clients stay at a central facility, but undertake wilderness excursions from that location which can last for multiple days.[6] Finally, when using the long-term model, clients stay at a "rural camp" for an extended period – potentially up to 2 years – and "a wilderness component is introduced in daily activities or in the facility setting."[6]

In the US a large number of these programs are located in the state of Utah.[7] Incidents of alleged and confirmed abuse and deaths of youths have been widely reported across many of these programs.[8]

Regulation and oversight

Aiming to combat widespread negative opinions about wilderness therapy and form an industry oversight body,[9] five wilderness therapy programs banded together to create the Outdoor Behavioral Health Council in 1996.[10] The OBH Council's main objective was to bring more recognition to wilderness therapy programs and their correlation to post-positive behavioral health in adolescents.[10] The council was also interested in exploring and investigating the best forms of practice and treatment plans to integrate into their programs.[10] They merged with the National Association of Therapeutic Schools and Programs in December 2024.[11]

In October 2007 and April 2008, the United States Government Accountability Office convened hearings to address reports of widespread and systemic abuse in adolescent treatment facilities. In connection to the hearing, they issued a report about the wilderness therapy industry, in which thousands of allegations of abuse were examined.[12][13] The Federal Trade Commission has published a list of questions for parents to ask when considering a wilderness program.[14]

Due to the trauma and alleged harm reported by former wilderness program residents who have been forcibly escorted into placement, psychologists have heavily criticized this approach as inappropriate, and grossly inconsistent with establishing the necessary trust required for building a therapeutic relationship between youth and providers.[15] Some former participants have testified that they have suffered lifelong trauma from their experiences at these programs.[16]

In 2021, the state of Oregon implemented regulations on transportation, banning the use of blindfolds, hoods, and handcuffs.[17] Other states have considered similar legislation, though implementation has varied widely. These states include Utah, California, Montana, and Missouri, which have all implemented laws and regulations.[18]

Industry and organizations

Costs for U.S. wilderness therapy programs can vary widely, with some programs charging upwards of $50,000 per stay.[19]In 2016, the American Hospital Association recognized wilderness therapy as a viable treatment model and established an insurance billing code.[20] This recognition, together with the growing use of national accreditation programs, has enabled some providers to work with insurance companies to increase coverage for their programs.[20] Organizations such as Blue Ridge Therapeutic Wilderness offer financial aid and accept certain insurance plans.[21] However, insurance claims are sometimes denied due to limited evidence supporting the effectiveness of the treatment or the necessity of its cost.[19]

Controversy

Allegations of abuse, deaths, and lawsuits

There are well-documented cases of death, abuse, and other potentially traumatic situations associated with or caused by wilderness programs, including the following cases:

  • February 1990 – Three teens drown at Convict Lake whilst enrolled at Camp O'Neal.[22] Camp director Bobbi Trott, who was in charge during the teenagers' death, would go on to found Crater Lake School[23] and be a founding member of NATSAP.[24]
  • May 9, 1990 – Michelle Lynn Sutton from California dies from dehydration whilst enrolled at the Summit Quest program.[25]
  • 1990 – Kristen Chase dies three days into the Challenger Wilderness Program.[26]
  • January 15, 1995 – Aaron Bacon dies from acute peritonitis whilst attending the North Star Wilderness Program.[27]
  • 2001: The New York Times reports that there have been 31 deaths at outdoor camps for troubled youths in 11 states since 1980.[28]
  • May 27, 2002 – Erica Harvey dies from heat stroke and dehydration.[29]
  • July 15, 2002 – Ian August dies during a hike whilst attending the Skyline Journey Wilderness Therapy Program [30]
  • August 2002 – 11 teens are found in distress at a wilderness therapy program camp and taken into protective custody by the Montana Department of Public Health and Human Services child and family services division.[31]
  • September 18, 2002 - William Edward Lee suffers damage to his vertebral artery after being restrained.[29]
  • October 14, 2003 - Charles "Chase" Moody asphyxiates and dies after staff improperly restrain him at the On Track wilderness program in Texas.[32]
  • March 23, 2003 – Cory Baines dies after a tree limb falls on his tent during the Catherine Freer Wilderness Therapy program.[29]
  • August 28, 2009 – Sergey Blashchishen dies from dehydration and hyperthermia whilst at Sagewalk Wilderness Therapy Program.[33]
  • November 23, 2014 – Alec Lansing dies from hypothermia and a broken femur whilst trying to run away from the Trails Carolina program.[34]
  • December 2015 – Six students are evacuated from Open Sky Wilderness Program and flown to Denver, Colorado with frostbite; Open Sky Wilderness Program is accredited by Outdoor Behavioral Healthcare Council, Association for Experiential Education, and the Department of Human Services for Colorado and Utah.[35]
  • February 2024– A 12-year-old boy is found dead at a camp located in Lake Toxaway, North Carolina. He had arrived at the camp less than 24 hours before he was found dead by camp staff.[36] Days later, a woman filed a lawsuit alleging she was sexually assaulted by a fellow camper at age 12 at the same camp.[37]

Maia Szalavitz, author of the 2006 book Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids, has concluded that many tactics employed by wilderness-therapy programs are no different than those used at Guantanamo Bay.[38] Szalavitz has documented cases of emotional and physical abuse, and the withholding of food, water, and sleep.[38]

Kayla Muzquiz, who spent much of her childhood in "troubled-teen" institutions, said of her experiences in the SUWS of the Carolinas, a wilderness therapy program in rural North Carolina, "We would wake up every day and hike 10 miles with almost a 60-pound pack on our backs. It was excruciating because I had an undiagnosed autoimmune disorder throughout my time in the troubled-teen industry. So while I was hiking, I was constantly in pain. And it wasn't just regular pain that ibuprofen or Tylenol could take care of; it was just my body attacking itself constantly. So, if you complained, you couldn't move up in levels or ranks in wilderness, so it was more like you just had to bite your tongue and kind of just roll with the punches."[39]

In October 2007 and April 2008, the United States Government Accountability Office convened hearings to address reports of widespread and systemic abuse in adolescent treatment facilities. In connection to the hearing, they issued a report about the wilderness therapy industry, in which thousands of allegations of abuse were examined.[40][41] The Federal Trade Commission has published a list of questions for parents to ask when considering a wilderness program.[42]

Due to the trauma and alleged harm reported by former wilderness program residents who have been forcibly escorted into placement, psychologists have heavily criticized this approach as inappropriate, and grossly inconsistent with establishing the necessary trust required for building a therapeutic relationship between youth and providers.[43] Some former participants have testified that they have suffered lifelong trauma from their experiences at these programs.[44]

Staff qualifications

In some programs, licensed mental health personnel are not employed to work directly with participants,⁣[45] with programs instead hiring licensed mental health personnel as consultants or in other roles.[45]

To be licensed in the counseling field, one must possess at least a master's degree in counseling, but much of the time these counselors are individuals without even a bachelor's degree. Some programs report having no licensed mental health professionals on staff.[46] Some have argued that it is unethical for programs serving "high-risk" youth to deliver therapeutic services using less than professionally trained and credentialed mental health staff.[45]

Some researchers have argued that national standards should be created with respect to the training, formal education, and licensure in therapeutic wilderness programs.[45] Wilderness programs are not required to employ licensed workers, and so the counselors may be unqualified to help adolescents in the programs to create therapeutic change.[45]

Outcomes and research

One study found that, among 17 surveyed "outdoor behavioral healthcare programs" in the US, about half of the therapy participants attended involuntarily and were transported by a teen escort company.[47] A "remarkably low" proportion of these participants return home after taking part in the programs, with most youths continuing in some form of therapeutic program after the outdoor behavioral healthcare program is complete.[47] The study also found that participants are less likely to return home after treatment if they were involuntarily transported to the program than if they enrolled voluntarily.[47]

After a wilderness therapy program, clients may return home (although this is not typical[48]) or may be transferred to a therapeutic boarding school, young adult program, or intensive residential treatment center.

Critics say that the effectiveness of wilderness therapy is unclear, and that further scientific studies are needed.[49] Many of the studies that have been conducted have led to ambiguous conclusions. One meta-review of the outcomes of private pay clients over 36 different studies found that roughly half of the participants reported positive growth in qualities like self-esteem, locus of control, behavioral observations, personal effectiveness, clinical measures, and interpersonal measures, while the other half reported no change at all.[50]

One meta review concluded that wilderness therapy may reduce delinquent behaviors among young participants.[51] Another review has suggested that for childhood cancer survivors, wilderness therapy programs could increase social involvement, self-esteem, self-confidence, self-efficacy, social support, and physical activity, and may decrease their discomfort and psychological distress.[52] However, the majority of the articles included in the review did not assess possible safety issues for participants in wilderness programs, and the authors recommended that possible side effects be investigated further.[52]

Katharine Reynolds (2015) conducted a survey on 59 parents and 36 adolescents who had experience at the Anasazi Foundation's Wilderness Therapy Program with correlation to positive parent-adolescent relationships after completing the program.[53] She found that there is a positive correlation between positive parent-adolescent relationships and having completed treatment, in addition positive physical health, mental clarity, and continued association with the Anasazi Foundation after discharge from the program.[53]

While proponents claim involuntary transport to wilderness therapy programs is necessary to ensure "uncooperative" youth receive treatment, most participants do not return home after the programs are complete, instead remaining institutionalized in other treatment programs.[54][55]

After a wilderness therapy program, clients may return home (although this is not typical[56]) or may be transferred to a therapeutic boarding school, young adult program, or intensive residential treatment center.

See also

References

  1. ^ "Behind Wilderness Therapy". Los Angeles Times. January 15, 1995. Retrieved December 27, 2022.
  2. ^ Maffy, Brain (September 12, 2008). "BYU alumnus sparks off lucrative, controversial wilderness-therapy industry". The Salt Lake Tribune. Retrieved December 12, 2022. After Olsen left BYU, he and other established the first wilderness therapy programs, such as Idaho's School for Urban and Wilderness Survival.
  3. ^ a b Myers, Sam (2023-08-07). "Survivors of wilderness therapy camps describe trauma, efforts to end abuses". Arkansas Advocate. Retrieved 2025-05-14.
  4. ^ "Five Facts About the Troubled Teen Industry". www.americanbar.org. Retrieved 2025-05-14.
  5. ^ "Wilderness Therapy New Jersey". bluefire. Retrieved 2025-04-20.
  6. ^ a b c d Beck, Natalie; Wong, Jennifer S. (May 2022). "A Meta-Analysis of the Effects of Wilderness Therapy on Delinquent Behaviors Among Youth". Criminal Justice and Behavior. 49 (5): 700–729. doi:10.1177/00938548221078002. ISSN 0093-8548.
  7. ^ Miller, Jessica (April 5, 2022). "How Utah became the leading place to send the nation's troubled teens". The Salt Lake Tribune. Salt Lake City, Utah. ISSN 0746-3502. OCLC 8086936. Retrieved December 27, 2022.
  8. ^ Smith, Christopher (June 10, 1998). "The rise and fall of Steve Cartisano". High Country News. Retrieved April 12, 2009.
  9. ^ Blankenship, C. A. (2019). "Wilderness and Adventure Immersion Therapy". Eco-Informed Practice: Family Therapy in an Age of Ecological Peril. AFTA SpringerBriefs in Family Therapy (1 ed.). Cham, Switzerland: American Family Therapy Academy (Springer Cham). p. 83. doi:10.1007/978-3-030-14954-3_7. eISSN 2196-5536. ISBN 978-3-030-14953-6. ISSN 2196-5528. S2CID 156045157. ISBN 978-3-030-14954-3.
  10. ^ a b c Tucker, Anita R.; DeMille, Steven; Newman, Tarkington J.; Polachi Atanasova, Christina; Bryan, Philip; Keefe, Mackenzie; Smitherman, Lee (2023). "How adolescents view the role of the wilderness in wilderness therapy: "I am in the middle of nowhere and that is okay"". Children and Youth Services Review. 153 107045. doi:10.1016/j.childyouth.2023.107045.
  11. ^ "PRESS RELEASE: NATSAP Welcomes Outdoor Behavioral Health Council (OBHC) into Its Network". GZ Module Pages. Retrieved 2024-12-22.
  12. ^ GAO (2007). "Residential Treatment Programs - Concerns Regarding Abuse and Death in Certain Programs for Troubled Youth, Statement of Gregory D. Kutz, Managing Director Forensic Audits and Special Investigations and Andy O'Connell, Assistant Director Forensic Audits and Specials Investigations, October 10" (PDF).
  13. ^ "Congressional Hearings on Child Abuse and Deceptive Marketing by Residential Programs for Teens". Committee on Education and Labor, House of Representatives. 2008. Retrieved August 15, 2013.
  14. ^ FTC (2009). "Residential Treatment Programs for Teens". Archived from the original on March 3, 2020. Retrieved August 15, 2013.
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  16. ^ Bastian, Jonathan (July 30, 2021). "'Almost everyone is left with trauma': The impact of American's unregulated wilderness teen therapy industry". KCRW. Retrieved July 31, 2021.
  17. ^ Salter, Jim (September 27, 2022). "Rules sought for 'gooning,' taking troubled kids to care". AP News. Retrieved December 30, 2022. They might be restrained with handcuffs or zip ties. They could be blindfolded or hooded.
  18. ^ Evans, Cameron (2022-01-21). "State Laws Aim to Regulate 'Troubled Teen Industry,' but Loopholes Remain". KFF Health News. Retrieved 2025-04-21.
  19. ^ a b Okoren, Nicolle (November 14, 2022). "The wilderness 'therapy' that teens say feels like abuse: 'You are on guard at all times'". The Guardian. Retrieved December 29, 2022.
  20. ^ a b Tucker, Anita R.; Norton, Christine Lynn; DeMille, Steven; Talbot, Brett; Keefe, Mackenzie (2022). Leffler, Jarrod M.; Frazier, Elisabeth A. (eds.). Handbook of Evidence-Based Day Treatment Programs for Children and Adolescents. Cham: Springer International Publishing. pp. 375–393. doi:10.1007/978-3-031-14567-4_21. ISBN 978-3-031-14566-7.
  21. ^ "Insurance and Cost FAQ - Blue Ridge Therapeutic Wilderness". blueridgewilderness.com. Retrieved 2025-04-21.
  22. ^ Hurst, John (February 23, 1990). "Camp O'Neal Has History of Violating State Rules". Los Angeles Times. Retrieved August 11, 2023. Camp O'Neal, the youth facility in charge of three teen-agers who died in the Convict Lake tragedy, has been repeatedly cited over the last two years for violating state licensing standards--including improperly supervising and medicating residents, failing to train staff adequately and supplying inadequate clothing for youngsters.
  23. ^ "Crater Lake School to close for good". Longview Daily News. Associated Press. January 2, 2004. Retrieved August 11, 2023.
  24. ^ Santa, John L. (November 30, 2019). "A Brief History of the National Association of Therapeutic Schools and Programs, Reprinted and Updated". Journal of Therapeutic Schools and Programs. 11: 18–29. doi:10.19157/JTSP.issue.11.01.10 (inactive July 12, 2025). S2CID 203019189.{{cite journal}}: CS1 maint: DOI inactive as of July 2025 (link)
  25. ^ Archives, L. A. Times (May 13, 1990). "Teen-Ager's Death on Hike Investigated". Los Angeles Times. Los Angeles, California. ISSN 0458-3035. OCLC 3638237. Retrieved July 30, 2023.
  26. ^ Mcentee, Peg (May 28, 1992). "Founder of Wilderness Survival Program Cleared in Teen's Death". AP News. OCLC 50857345. Archived from the original on 16 March 2023. Retrieved December 29, 2022.
  27. ^ Morgenstern, Joe (January 15, 1995). "A Death in the Desert". Los Angeles Times. ISSN 0458-3035. OCLC 3638237. Retrieved December 29, 2022.
  28. ^ Janofsky, Michael (July 15, 2001). "States Pressed As 3 Boys Die At Boot Camps". The New York Times. ISSN 0362-4331. Retrieved August 10, 2023. At least 31 teenagers in 11 states have died at these camps since 1980, including 3 this year, in widely diverse circumstances.
  29. ^ a b c "Utah wilderness therapy deaths". The Salt Lake Tribune. October 11, 2007. Retrieved December 29, 2022.
  30. ^ "Teen Dies During Utah Wilderness Hike". AP News. July 15, 2002. Retrieved December 29, 2022.
  31. ^ "'Wilderness Therapy' Teens Found in Distress'". Los Angeles Times. August 10, 2002. Retrieved December 26, 2022. Eleven teens enrolled in a "wilderness therapy" program are in protective custody after social workers found them camping in cold, rainy weather with limited food and shelter, state officials said in Helena.
  32. ^ "Teen Died in Illegal Restraint Hold". The Edwardsville Intelligencer. 2002-10-23. Retrieved 2023-11-30.
  33. ^ Levine, Art (July 18, 2012). "Dark side of a Bain success". Salon. Retrieved December 29, 2022.
  34. ^ "Autopsy: Missing teen fell, broke hip, died of hypothermia". WYFF. November 26, 2014. Retrieved May 23, 2023.
  35. ^ "Open Sky chief says agency 'deeply concerned' about frostbite cases". November 8, 2020. Archived from the original on November 8, 2020. Retrieved December 25, 2022.
  36. ^ Mikkelsen, Emily (2024-02-16). "Campers removed from Trails Carolina amid investigation of 12-year-old's death, NCDHHS orders". FOX8 WGHP. Retrieved 2024-02-22.
  37. ^ Praats, Michael (2024-02-12). "Lawsuit says sexual assaults went unreported at NC wilderness camp where child died". WSOC TV. Retrieved 2024-02-22.
  38. ^ a b Silverman, Amy (November 5, 2009). "Losing Erica: Cynthia Clark Harvey Doesn't Want Anyone Else's Child to Die in a Wilderness-Therapy Program". Phoenix New Times. Retrieved July 31, 2021. After years of research, she's concluded that many of the tactics employed by wilderness-therapy programs are no different from those used at Guantanamo Bay.
  39. ^ Myers, Sam (2023-08-07). "Survivors of wilderness therapy camps describe trauma, efforts to end abuses". Arkansas Advocate. Retrieved 2025-05-14.
  40. ^ GAO (2007). "Residential Treatment Programs - Concerns Regarding Abuse and Death in Certain Programs for Troubled Youth, Statement of Gregory D. Kutz, Managing Director Forensic Audits and Special Investigations and Andy O'Connell, Assistant Director Forensic Audits and Specials Investigations, October 10" (PDF).
  41. ^ "Congressional Hearings on Child Abuse and Deceptive Marketing by Residential Programs for Teens". Committee on Education and Labor, House of Representatives. 2008. Retrieved August 15, 2013.
  42. ^ FTC (2009). "Residential Treatment Programs for Teens". Archived from the original on March 3, 2020. Retrieved August 15, 2013.
  43. ^ Pinto, Dr Alison (October 15, 2007). "Congressional Testimony: Hearings on Residential Treatment Programs: Concerns Regarding Abuse and Death in Certain Programs for Troubled Youth". Committee on Education and Labor, House of Representatives. Archived from the original on December 21, 2021. Retrieved August 15, 2013.
  44. ^ Bastian, Jonathan (July 30, 2021). "'Almost everyone is left with trauma': The impact of American's unregulated wilderness teen therapy industry". KCRW. Retrieved July 31, 2021.
  45. ^ a b c d e Davis-Berman, Jennifer; Berman, Dene S. (1993). "Therapeutic wilderness programs: Issues of professionalization in an emerging field". Journal of Contemporary Psychotherapy. 23 (2): 127–134. doi:10.1007/BF00952173. ISSN 0022-0116. S2CID 2015559.
  46. ^ Russell, Keith; Gillis, H. Lee; Lewis, T. Grant (August 2008). "A Five-Year Follow-Up of a Survey of North American Outdoor Behavioral Healthcare Programs". Journal of Experiential Education. 31 (1): 55–77. doi:10.1177/105382590803100106. ISSN 1053-8259. S2CID 144968814.
  47. ^ a b c Dobud, Will (June 14, 2021). "A Closer Look at Involuntary Treatment and the Use of Transport Service in Outdoor Behavioral Healthcare (Wilderness Therapy)". Child & Youth Services: 1–20. Retrieved July 27, 2021.
  48. ^ Dobud, Will (June 14, 2021). "A Closer Look at Involuntary Treatment and the Use of Transport Service in Outdoor Behavioral Healthcare (Wilderness Therapy)". Child & Youth Services: 1–20. Retrieved July 27, 2021.
  49. ^ Bauer, Ethan (July 12, 2021). "Can the $300 million 'troubled teen' therapy sector be reformed by legislation and public pressure?". Deseret News. Retrieved July 31, 2021.
  50. ^ Bettmann, Joanna E.; Gillis, H. L.; Speelman, Elizabeth A.; Parry, Kimber J.; Case, Jonathan M. (2016-09-01). "A Meta-analysis of Wilderness Therapy Outcomes for Private Pay Clients". Journal of Child and Family Studies. 25 (9): 2659–2673. doi:10.1007/s10826-016-0439-0. ISSN 1573-2843.
  51. ^ Beck, Natalie; Wong, Jennifer S. (May 2022). "A Meta-Analysis of the Effects of Wilderness Therapy on Delinquent Behaviors Among Youth". Criminal Justice and Behavior. 49 (5): 700–729. doi:10.1177/00938548221078002. ISSN 0093-8548.
  52. ^ a b Jong, Mats; Lown, E. Anne; Schats, Winnie; Mills, Michelle L.; Otto, Heather R.; Gabrielsen, Leiv E.; Jong, Miek C. (2021-01-06). Wieland, Lisa Susan (ed.). "A scoping review to map the concept, content, and outcome of wilderness programs for childhood cancer survivors". PLOS ONE. 16 (1) e0243908. Bibcode:2021PLoSO..1643908J. doi:10.1371/journal.pone.0243908. ISSN 1932-6203. PMC 7787391. PMID 33406103.
  53. ^ a b Reynolds, Katharine (2015-09-16). "The promise of the wild for families : factors of the Anasazi Foundation's wilderness therapy program associated with positive parent-adolescent relationships: a project based upon an investigation at The Anasazi Foundation, Mesa, Arizona". Theses, Dissertations, and Projects.
  54. ^ Dobud, Will (June 14, 2021). "A Closer Look at Involuntary Treatment and the Use of Transport Service in Outdoor Behavioral Healthcare (Wilderness Therapy)". Child & Youth Services: 1–20. Retrieved July 27, 2021.
  55. ^ "Troubled Teens Endure Wilderness Therapy". ABC News. August 15, 2002. Archived from the original on February 22, 2016. Retrieved May 24, 2023.
  56. ^ Dobud, Will (June 14, 2021). "A Closer Look at Involuntary Treatment and the Use of Transport Service in Outdoor Behavioral Healthcare (Wilderness Therapy)". Child & Youth Services: 1–20. Retrieved July 27, 2021.
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