242: Transforming Wilderness Therapy: Insights from Dr. Denise Mitten on Emotional Safety and Ethics of Care

In the milestone 250th episode, Will reconnects with Matt Nannis, founder of PIVOTPoint, an experiential adventure program based in Western North Carolina. Since their last conversation in 2022, PIVOTPoint has evolved significantly, shifting its focus from working primarily with individuals in recovery to providing preventive and therapeutic services for youth within the local community. Matt discusses how the organization has integrated its programs into schools, offering after-school initiatives for high school and middle school students that emphasize self-awareness, self-regulation, and pro-social behaviors through outdoor activities like hiking, paddleboarding, and rock climbing. The episode takes a profound turn as Matt shares PIVOTPoint’s essential role in the aftermath of Hurricane Helene, which devastated parts of Western North Carolina. Faced with widespread destruction, loss of utilities, and a community in crisis, Pivot Point adapted swiftly to provide immediate mental health support and relief services. Matt delves into the challenges of mobilizing resources, coordinating with other organizations, and addressing his own emotional journey during this demanding time. Despite the overwhelming circumstances, PIVOTPoint’s commitment to serving the community highlighted the importance of adaptability, resilience, and the therapeutic power of connection during times of crisis. To donate to PIVOTpoint check out their website at https://pivotpointwnc.org/.

In this episode Will reconnects with Bill Brown, co-founder of Confluence Behavioral Health in Vermont. Since their last conversation in 2019, Confluence has evolved significantly to meet the changing needs of young adults. Bill discusses how today's youth are internalizing their struggles more than ever, shifting from outward expressions of distress to feelings of self-hatred and isolation. Recognizing this change, Confluence adapted its wilderness therapy model by integrating nightly returns to their residential property, increasing accessibility through insurance coverage, and expanding services with Arete Transitions and a new Intensive Outpatient Program (IOP) in Burlington. Bill emphasizes the importance of evolving treatment approaches to address the current mental health crisis among young adults. He notes that while the need for mental health services has risen, options have narrowed due to societal shifts and decreased parental willingness to engage in more challenging therapeutic interventions. Through innovative programs and a focus on integrating adventure therapy with clinical practices, Confluence aims to provide effective support tailored to the unique challenges faced by today's youth.

In this episode Will reconnects with Derek Daley, co-founder of Legacy Outdoor Adventures and a seasoned professional with over 25 years in wilderness therapy. Derek shares how Legacy has evolved since its inception in 2012, focusing on adults aged 18 to 35. He discusses their unique approach of combining epic adventure therapy—such as canyoneering, rock climbing, and skiing in southern Utah—with strong clinical practices to create meaningful and effective treatment experiences and a hybrid model of residential treatment and outdoor adventures. Derek highlights the importance of engaging clients who choose to participate willingly, which enhances the therapeutic process and outcomes. The conversation delves into the broader changes and challenges within the wilderness therapy field, including increased scrutiny, the impact of technology and screen time on young adults, and the closure of several programs. Derek addresses criticisms of wilderness therapy by advocating for greater transparency, accountability, and the need to demonstrate measurable outcomes. He emphasizes that despite challenges, wilderness therapy remains one of the most compassionate and effective forms of treatment. Derek also shares his passion for engaging the next generation of mental health professionals through initiatives like the upcoming 2025 HIP (Healing in Progress) Tour to college campuses.

In the opening episode of Season 21, host Will White delves into the significant transformations occurring within the wilderness therapy field for adolescents and young adults, paralleling them with the impacts of climate change on our environment. He reflects on the "Great Collapse" between 2007 and 2010, when the number of wilderness therapy programs dramatically decreased due to economic pressures from the Great Recession. Drawing striking parallels to recent events, Will discusses how the closure of seven wilderness therapy programs in the last two years mirrors that earlier contraction, signaling a new period of challenge and change in the field. He also explores how these challenges echo those faced by longstanding outdoor organizations like the Boy Scouts of America, NOLS, and Outward Bound, highlighting how declining enrollments, controversies and technology have impacted the broader outdoor experiential field. Despite challenges like increased operational risks, changing market demands, and heightened public scrutiny, some programs have demonstrated remarkable resilience and continue to adapt to the evolving landscape. Will announces that this season will feature interviews with leaders from enduring programs to explore how they've navigated these challenges and what they envision for the future of outdoor behavioral healthcare. Emphasizing the importance of stepping away from screens and engaging with the real world, he encourages listeners to embrace the outdoors as a powerful platform for mental health treatment. The episode sets the stage for a season focused on adaptation, resilience, and the ongoing impact of wilderness therapy on young lives.

In this episode Will sits down with Dr. Alison LaFollette, the Clinical Director of Mountain Valley Treatment Center. Alison shares her journey from conducting neuropsychological evaluations in several of Utah's wilderness therapy programs to leading the clinical team at Mountain Valley. She discusses the integration of Exposure and Response Prevention (ERP) therapy with outdoor experiential activities at Mountain Valley, highlighting how natural settings like the Zen Garden, farm, outdoor climbing wall and hiking trails enhance therapeutic outcomes for adolescents and young adults struggling with anxiety and OCD. The conversation delves into the rising levels of social anxiety among young people, the impact of the pandemic on mental health, and the importance of family involvement in treatment. Alison also explores the similarities between ERP and adventure therapy, emphasizing the value of taking committed action in accordance with one's values. She reflects on the challenges facing behavioral healthcare organizations, including staff burnout and program sustainability, offering insights into how Mountain Valley addresses these issues. The episode concludes with Alison sharing how she utilizes the outdoors for her own mental well-being and her excitement about future innovations at Mountain Valley, such as expanding experiential components and fostering team synergy.

In this episode Will talks with Hayley Caddes, co-founder of Not Therapy Coaching, about her powerful personal journey through wilderness therapy and an all-girls therapeutic boarding school. Hayley shares how these experiences inspired her to help others who have gone through treatment, creating a unique coaching model that fills the gap between traditional therapy and the support needed to thrive in everyday life. She discusses how peer mentorship, structure, and community play pivotal roles in recovery and growth after treatment. Hayley also addresses the controversies surrounding wilderness therapy and the closures of the programs she attended, taking a business-minded approach to understanding the challenges faced by the industry. She reflects on how successful programs are, those that not only offer quality care but also adapt to the evolving mental health landscape. From selling her first startup, Chill Pill, to running Not Therapy Coaching, Hayley’s story is one of empowerment, recovery,  resilience, and entrepreneurial spirit. Tune in to learn how wilderness therapy shaped her path and how she is paying it forward to others on their mental health journeys.

In this powerful episode Will speaks with JD and his mother, Amber, as they recount their powerful journey through wilderness therapy. JD opens up about the struggles that led him down a dangerous path of substance abuse, starting as a teen during the COVID-19 pandemic. Amber shares the difficult decision to send JD to a wilderness therapy program in Utah, and how the experience not only saved his life but transformed their family. Together, they discuss the challenging process of recovery, manipulation, and ultimately the breakthrough that wilderness therapy provided. As September is National Recovery Month, this episode highlights the healing potential of wilderness therapy for addiction and mental health recovery. JD and Amber's story is a testament to the life-changing impact of being in nature, far from the destructive influences of modern life. Their conversation touches on the urgent need for support, as many wilderness therapy programs are closing despite their success in helping young people recover from addiction.  

In this deeply moving episode Will sits down with Melissa and Graham Squier, founders of the Harlan Serenity Foundation. This foundation, created in memory of their late son, Chris Squier, supports young people struggling with addiction by providing access to wilderness therapy programs. The interview takes a poignant turn when Will realizes he had interviewed Chris back in 2020, unaware that Chris would later lose his battle with addiction. This realization, combined with the ongoing closures of critical wilderness therapy programs, makes for an emotional conversation about the profound impact of wilderness therapy on those struggling with addiction. Melissa and Graham share Chris’s journey—from his initial struggles with addiction to finding sobriety through wilderness therapy, and later becoming a field guide to help others on the same path. They discuss the creation of the Harlan Serenity Foundation, its mission, and the importance of keeping wilderness therapy programs alive in a time when they are needed more than ever. This episode is a testament to the healing power of nature and the enduring legacy of those who have benefited from it. Link to the Harlan Serenity Foundation. Episode with Chris Squire which was released in September of 2020.

In this episode Will talks with Dr. Denise Mitten, a pioneering figure in outdoor education, adventure, and wilderness therapy. Denise shares her journey from her early days in the 1970s, overcoming gender barriers in a male-dominated field, to co-founding the influential Woodswomen organization, which focused on emotional safety and support in outdoor programs. Throughout the conversation, Denise discusses the evolution of outdoor therapy emphasizing the importance of creating safe, relational environments rather than relying on stress-based models. Her insights into the ethics of care, the role of women in the field, and the shift towards eco-psychology offer listeners a profound understanding of how wilderness experiences can foster deep personal growth and healing. Denise also reflects on the importance of relational connection in outdoor programs, critiquing the traditional "power over" models often seen in wilderness therapy. She advocates for a more deliberate and thoughtful approach to risk-taking, where the focus is on maintaining comfort and regulation rather than pushing participants beyond their limits. Her teachings challenge the field to embrace inclusivity, sustainability, and a deeper connection with nature, making this episode a must-listen for anyone interested in the future of outdoor therapy and education.

In this episode Will talks with Sheldon Nelson, founder of Crossroads Discovery and a veteran of the wilderness therapy field. Sheldon discusses the inspiration behind Crossroads Discovery, a program that bridges the gap between traditional wilderness therapy and ongoing support for adolescents and their families. He highlights the unique approach of offering short-term wilderness immersion experiences that emphasize not only survival skills but also personal growth and self-discovery. Sheldon shares how the program evolved to meet the needs of families seeking continued guidance after their children completed the wilderness programs, integrating in-home coaching and nature-based activities into their everyday lives. Sheldon also reflects on his extensive career, including his years at Anasazi Foundation, one of the oldest wilderness therapy programs for adolescents in the country. He emphasizes the importance of focusing on a change of heart over mere behavior modification and how this philosophy underpins the work at Crossroads Discovery. The episode offers a deep dive into the current state of wilderness therapy, its challenges, and its potential future, making it a must-listen for anyone interested in the field of adolescent mental health and outdoor experiential therapy.