Substance Abuse Wilderness Therapy

Substance Abuse Groups in the Wilderness

Amy Bailey, CADC, is a certified Therapist and Field Supervisor for SUWS Adolescent and Youth Programs in Idaho, who specializes in treating chemically dependent students. She has been working with substance-abuse groups for many years and is now developing new processes to help the students in these groups.

Like all SUWS programs, the substance-abuse groups are tightly structured within the wilderness setting, meeting together once a week in addition to each member’s weekly one-on-one with Amy. In order to provide consistent feedback, Amy also maintains radio contact with her groups.

In a recent interview, Amy said that her program is definitely growing.

“It is exciting to be working with adolescents with substance-abuse issues, as we hope the new approaches will really help these students,” she said. “There is a movement within our organization to become very savvy about chemical dependence at every level-helping to screen parents, identifying needs, and helping parents understand that their child being out of control may have something to do with substance abuse.”

Amy stresses the importance of parental involvement, from learning new techniques to parent teens with substance-abuse issues more effectively to doing the reading and getting their own therapy in order for each family to make the most of the program at SUWS.

Ideally, when a parent calls SUWS, staff would be able to identify if that student has chemical-dependency problems that have previously gone unidentified. A current goal at SUWS is to have all staff members fully educated about drug use and aware of chemical-dependency symptoms and issues.

From early identification, the program moves to placement and planning, finding the right road to recovery for each child. It is important, however, for families to realize that healing children who are chemically dependent is a long process. It is not simple or something that can be dealt with overnight. While wilderness programs are proving very successful, the success rate is tied to the length of time the child spends in the program-the longer the treatment, the better the success rate.

Because most of the students are dealing with other issues as well, including disruptive behavior, depression, and other core issues, there is a minimum stay of six weeks for teens with chemical dependence. “Parents commit to an appropriate length of treatment, but students know they are in control of their program length because this ultimately depends on their progress,” Amy said.

Once in the program, chemically dependent students work with Amy and the staff in a process similar to the 12-step program used in Alcoholics Anonymous. The unique character of the program at SUWS is not only the outdoor setting, but also the wilderness metaphor that infuses the entire approach.

Students learn that just as the wilderness demands a certain problem-solving approach and skill set if they are to survive, so their lives demand a positive problem-solving approach and a skill set that does not include drug use if they are to achieve their goals and resume a happier existence.

Learning wilderness skills such as building fires with a bowdrill and setting traps, requires patience, the mastery of a number of smaller steps, and confidence developed from experiencing success over a period of time. Managing their lives in the world of family and school requires the same patience, mastery of skills, and confidence. Once students see and use this metaphor in the application of the tools they use in the therapeutic setting, Amy is confident that they will be on the road to healing their lives in both the present and the future.

Many of the skills the students learn involve creating more appropriate routes to resolve emotional challenges in their lives, including family conflict or grief over various kinds of loss. Drugs or other substance abuse may have provided an easy way to feel better, leading to repeated use and physiological as well as psychological dependence.

Dealing with the increasingly central role that substances and their acquisition take in addicted teens’ lives often results in unhealthy coping mechanisms ranging from dishonesty to abusive behavior and thought distortions. Thought distortions involve false beliefs, feelings of entitlement, and feeling justified in using drugs and participating in other negative behaviors. “Unlearning” these pathways, reconnecting with original value systems, and developing healthy coping mechanisms for stress of all kinds begins with honest confrontation.

Amy uses cognitive restructuring, a technique that has been shown to work in conjunction with the direct confrontation about their behavior the students need to hear from their parents, peers, and staff.

Substance-abuse groups at SUWS operate as a place to work through the 12-step program intensively, with the support of staff members and peers of the same gender.

“Students complete a written assignment-a thorough substance-abuse inventory, a complete and in-depth inventory of what they have been doing and every substance they have been using. The idea is to develop a level of honesty that will help them throughout the program and afterward,” Amy said.

Intense emotions often develop in these groups, because the students can’t use other outlets in an addictive manner any more and reach for new ways to resolve their issues. The program covers all the major life areas, with an ultimate goal to help students recognize how their substance abuse is related to other problems in these areas. They are confronted again and again in the program. According to Amy, “They realize that drugs are leading them down a path that is totally contradictory to the person they wanted to be and the values they thought they held. They see how bad their lives have become and have to develop some kind of internal desire for change.”

The students share their stories with each other, telling of specific incidents when substance abuse affected their lives or their families. Amy illustrates what a successful change in thinking patterns means:

“A chemically-dependent student working through our program should eventually be able to think, ‘If I get mad at someone, screaming and yelling at them will feel good in the short run, but ultimately will get me kicked out of school or destroy relationships,’” she said.

Amy emphasizes the unique role the wilderness plays in helping students to heal and learn new pathways of behavior. “A lot of neat things happen in the wilderness. When students are away from drugs and other substances, they are away from the influence and out in the wilderness. Exercise and fresh air helps their minds to heal.”

When students are preparing for a return to family and school, the SUWS Program staff helps parents set up behavior contracts and educational plans. The program emphasizes skills the students will need to move through difficulties or stressful situations using acceptable behavior. Using the behavior contract, students are required to demonstrate their ability to exercise these skills without resorting to destructive behavior.

“Aftercare is essential,” said Amy. “Whether they are going home or back to a school, the students really need a therapeutic program after they return home. Otherwise, they will continue their substance abuse. Often education helps prevent such relapses, which can happen throughout their lives.”

After the students admit they have a problem, with the support of the program they can continue to take responsibility for it. “In the substance-abuse groups, we do a lot of future facing. We talk about the need to accept that this is a life-long issue,” she said. “The students will develop the exact same symptoms and problems if they go back to using substances.”

“The great thing about the wilderness setting,” Amy said with real enthusiasm, “is that it is a metaphor for the students’ lives. The group is like their family, and they have chores and work to do, just as they would in a family setting. In the wilderness setting, from the very beginning we establish the communication pattern that ‘I’m going to tell you when I see you doing negative behaviors.’ They get a direct approach on confronting these behaviors, and they also get positive feedback for positive behaviors.”

In the wilderness, the margin of error is slim. Survival means confronting reality and assessing one’s ability and skills to cope with it with complete honesty. For these teens, after chemical dependency, surviving in the real world demands the same rigorous honesty.

The supportive program at SUWS helps them to reach that milestone.