Descending from the Summit: Aftercare Planning for Adolescents in Wilderness Therapy

Despite substantial gains adolescents and families can make in the intensely therapeutic and structured environment of wilderness therapy, regression is still a significant risk at the time of discharge. Accordingly, intentional and comprehensive aftercare planning is crucial to support adolescents and families internalize the changes begun in wilderness therapy. Wilderness therapy is a powerful and focused intervention, but it is not the solution. This article describes why most adolescents leaving wilderness therapy programs transition to longer-term, residential therapeutic schools and programs upon discharge. Although intentional separation of parents and children might appear counterintuitive, these settings often provide the least-restrictive environment. Their therapeutic benefit is explained using Bowen theory and the trans-theoretical model of change. Considerations for a successful aftercare plan are identified, including the importance of the family therapeutic process in supporting adolescent clinical growth, and when going home upon discharge is recommended. Lastly, suggestions are offered for treatment providers to support families making difficult aftercare decisions.