246: Overcoming Anxiety: Dr. Alison LaFollette on ERP and Outdoor Therapy Integration

In this episode Will reconnects with Mod Barefoot Maves, who last appeared on the podcast just before the pandemic in February 2020. Mod shares the remarkable evolution of the Vermont-based program formerly known as True North Wilderness, which recently changed its name to True North Evolution. She discusses the thoughtful, incremental shift away from a nomadic wilderness therapy to a fully residential model, as well as the decision to focus solely on serving young adults rather than adolescents. Mod explains how this evolution reflects the changing needs and preferences of their clients, who increasingly seek in-depth, community-oriented experiences and meaningful engagement with the world around them. Beyond adapting their program structure, True North Evolution has also embraced new modalities that balance outdoor engagement with dynamic residential offerings. Mod highlights the importance of authenticity, collaboration, and long-term relationships with clients, including the role of coaching and the integration of technology in carefully managed ways. Throughout the conversation, she underscores the importance of listening to feedback—both from young adults and the broader field—while maintaining a strong ethical foundation. This episode offers valuable insights into how a pioneering program is reimagining the future of outdoor behavioral healthcare.

In this episode Will reconnects with Andrew Taylor, founder of Pure Life Adventure in Costa Rica and the podcast's very first guest in 2018. Andrew shares the significant developments at Pure Life over the past six years, including how the COVID-19 pandemic forced a one-year suspension of operations due to Costa Rica closing its borders. This pause led to transformative changes such as enhanced pre-program communication with students, the introduction of academic credits, and the expansion to include adolescent groups. Andrew emphasizes the importance of informed consent and willingness among participants, noting that these shifts have strengthened the program's impact on young adults dealing with anxiety, depression, ADHD, and executive functioning challenges. Andrew also discusses the inception of Octagon Mentoring, a coaching and mentoring initiative he started during the pandemic to continue supporting young adults. Octagon Mentoring offers services ranging from life coaching to an independent living facility in Salt Lake City, Utah. The conversation delves into his new book, "Launch: A Guide to Getting Unstuck, Navigating Life, and Thriving," which encapsulates his curriculum designed to help individuals overcome mental blocks and shift their mindsets. Andrew reflects on the evolving landscape of wilderness and adventure therapy, addressing the industry's recent contractions and expressing optimism for its future. He highlights the enduring healing power of nature and the necessity of adapting to meet the changing needs of young people and their families.

In this episode Will engages in a profound conversation with Danny Frazer, co-founder of the former Open Sky Wilderness Therapy program and founder of Gain the Ridge Consulting. Danny shares his journey into the field of wilderness therapy, beginning as an intern at Galena Ridge and progressing to roles at Aspen Achievement Academy. He reflects on the audacious vision that led to the founding of Open Sky in 2006, highlighting how they integrated innovative practices like yoga, meditation, naturopathic medicine, and extensive family involvement—elements that were revolutionary at the time. Danny discusses his leadership roles, including serving as the chair of the Outdoor Behavioral Healthcare Council, where he emphasized collaboration and ethical practices to advance the field. The conversation delves into the challenging decision to close Open Sky in early 2024 after 18 years of operation. Danny candidly examines the multifaceted reasons behind the closure, including negative media portrayals of wilderness therapy, societal shifts in parenting styles, increased competition from insurance-covered programs, and the impacts of the COVID-19 pandemic. He shares his personal process of grief and reflection, which led to the creation of Gain the Ridge Consulting. Through his new venture, Danny aims to support leaders and organizations in behavioral healthcare by offering coaching and consulting services that focus on leadership development, risk management, and program evolution. He expresses optimism for the future of wilderness therapy, emphasizing the enduring power of nature in healing and personal growth. To listen an episode about the closure of Open Sky check out episode 221-The Closure of Open Sky: Is this the "Winter" of Wilderness Therapy?  

In this episode Will reconnects with Nichol Ernst, CEO of Summit Achievement, an adolsecent residential treatment program in Maine. Nichol shares his journey from starting as a field staff member 21 years ago to leading the organization today. They delve into how Summit Achievement has evolved since its founding in 1996, discussing the core principles that have remained steadfast—the transformative power of nature, evidence-based clinical work, a strong focus on academics, and the critical involvement of family in the therapeutic process. Nichol highlights how the program has adapted to meet the changing needs of adolescents and their families, integrating technological advancements for safety, becoming a fully accredited school capable of awarding academic credits, and addressing the increasing complexity of mental health issues among youth. The conversation also addresses the broader challenges and criticisms faced by the wilderness therapy field. Nichol discusses Summit Achievement's commitment to transparency, ethical practices, and continual improvement through state licensure, national accreditations, and the publication of outcome data demonstrating significant reductions in depression and anxiety among participants. As mental health needs continue to rise, Summit Achievement remains dedicated to providing effective, individualized treatment without compromising its foundational values. This insightful discussion offers listeners a deeper understanding of how one organization navigates the complexities of mental health care while harnessing the healing power of the outdoors.

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.