The Role of Transport Use in Adolescent Wilderness Treatment: Its Relationship to Readiness to Change and Outcomes

Background Considering the sensitive ethical issues related to involuntary treatment of adolescents, research investigating youth transport practices and treatment outcomes is clearly needed. Youth transport is common practice in many private pay programs, including wilderness therapy programs. Objective This study of 350 adolescents in wilderness therapy sought to answer the following questions: (1) did youth who were transported to wilderness therapy present differently at intake than youth not transported in terms of both readiness to change and functioning? (2) Were there different outcomes for participants who were transported to the program compared to those who were not? (3) Were transport use and readiness to change predictors of overall improvement in the program? Methods In this exploratory non-equivalent groups quasi-experimental study, youth self-report pre- and post- mean scores of the YOQ and URICA, as well as parent YOQ reports, were compared between transported and non-transported groups. Regression analyses were performed to see if transport use was predictive of overall improvement. Findings Results suggested that youth improved significantly regardless of transport use; however, transported youth were more likely to have larger decreases in mental health symptomatology than non-transported youth, suggesting that being transported did not have a negative impact on treatment outcomes. Discussion While these are encouraging findings, the results represent the evaluation of a single wilderness therapy program and are limited by the research design; hence, future research is needed to increase confidence that transport does not negatively affect treatment effectiveness.