Family Therapy in Outdoor Behavioral Healthcare: Current Practices and Future Possibilities

Contemporary Family TherapyPublished in the Journal of Contemporary Family Therapy, an article about the role of family therapy in wilderness therapy.  Troy really enjoyed writing with Dr. Widmer on this project.  It shows the forward thinking and role that Legacy shows in helping shape the conversation about treatment in experiential treatment settings.


This paper highlights the role of the family in the treatment of youth who attend Outdoor Behavioral Healthcare (OBH) programs. It discusses the history of OBH, provides a critical overview of the research on the impact of OBH programs on family functioning, and discusses the importance of increased intentional integration of family therapy into OBH settings. To show this integration, this study presents a case study that highlights the role of the family, as well as the home family therapist throughout the phase of OBH treatment. Areas for future research are provided as well as suggestions for the increased utilization of adventure activities with families.


Outdoor behavioral healthcare Wilderness therapy Adventure therapy Family therapy

Research on Outdoor Behavioral Healthcare (OBH)

Outdoor Behavioral Healthcare Council

Over the last 20 years, research in wilderness therapy (often referred to as Outdoor Behavioral Healthcare, or OBH) has grown considerably in numbers and professionalism. While a number of programs and institutions have contributed to this promising research base, the Outdoor Behavioral Healthcare Council (OBHC), formed in 1997, has been a driving force for research and evaluation. PROGRAM joined the OBH Council in YEAR.

The OBH Council works with Outdoor Behavioral Healthcare Research Cooperative (OBHRC), whose purpose is to carry out comprehensive independent research and provide credible, objective information to the field. OBHRC has grown to include 12 full and affiliate research scientists with over 200 studies conducted in the field about the behavioral healthcare. Below is a summary of a few of OBHRC’s specific research areas. Follow the links to learn more about the research and work of the OBHC and the OBHRC.

The actual safety of participants in OBH Programs

Public perception of outdoor behavioral healthcare programs often misconstrues “wilderness therapy” as potentially dangerous and unsafe. This perception can often be linked to a lack of knowledge regarding this innovative method of treatment, unfamiliarity with the extensive risk management techniques used in such programs, the inappropriate practices of less developed yet seemingly similar programs, and the vulnerable and problematic states of many clients.

While no treatment can guarantee the total safety of any child, adolescents participating in OBHC programs are actually at less risk than adolescents not participating in these programs. In 2012, the average American adolescent was two times more likely to visit an emergency room than their counterparts in OBH programs.

Continue reading at: OBH is Safer than Being at Home for the Average Teen or OBHRC Risk Management

Effectiveness of OBH

Recent research produced by the Outdoor Behavioral Healthcare Research Cooperative (OBHRC) supports that OBH is effective at improving overall functioning of youth, reducing the use of abusive substances, and engaging resistant clients. A few outcomes with demonstrated statistical, clinical, and practical significance in the research are highlighted below.

  • Clients enter OBH programs with high clinical dysfunction.
  • Clients make dramatic improvements in emotional and behavioral functioning while in OBH treatment.
  • Clients maintain improvements up to six and 12 months post-OBH treatment.

Ongoing research of OBH’s impact on youth well-being affirms these findings and is discovering more about how and why OBH works. For more information, read more on the OBHC research page here, or on the OBHRC page here.


In partnership with the Association of Experiential Education (AEE), OBH Council is engaged in the most stringent accreditation process in the field. This accreditation program helps to identify programs of high quality. AEE has 25 years of experience in adventure-program accreditation and has invested over $1 million in refining the process. Programs holding OBH Accreditation have been rigorously evaluated by an independent review body and have successfully demonstrated that they maintain the industry’s highest standards of quality, safety and effectiveness. More information can be found here in the coming months.