InkBlog

Programs purport to teach teenagers struggling with mental health problems to learn choice and accountability through powers of nature, with little oversight

Rowan Bissette was 16 when she was transported against her will from Florida to Utah by two men she did not know. This was her first time leaving her home state.

These men were hired by her parents to take her from the psychiatric hospital in Jacksonville, where she had been receiving treatment, to a residential facility for more “intensive care”. She was terrified.

She had already been going to therapy twice a week for the past five years, but she was still struggling. Her parents were optimistic that this time, she would get the right treatment for her self-harm behaviors and suicide attempts.

Sitting on a plane bracketed by those two strange men as escorts, Rowan was flown to Sunrise Residential Treatment Center in Hurricane, Utah. There, she became violent both to herself and others, and was often put in restraints. She knew that if she behaved violently enough, she would get kicked out – and so that’s exactly what she did.

She was sent to a hospital for three weeks, where she expected a return to Sunrise. But the night before she was supposed to be discharged, her parents told her they were sending her to a wilderness therapy program that promised to temper her suicidal and violent tendencies. The program took place in WinGate, Utah, a tiny desert town where temperatures rise above 100F (38C) throughout the summer, and drop below 40F (4C) at night. She had heard stories of participants being made to hike 10 miles, being starved, not showering for three months, getting infections. “I was not looking forward to that,” Rowan said.

Six years on, Rowan is still reckoning with PTSD symptoms triggered by the experience.

From the moment she was picked up by the transporters and driven to the grounds to meet the rest of her group, she knew something wasn’t right. The “staff” driving the van were just a few years older than she was and spent the bumpy ride making fun of her for vomiting the Wendy’s burger she had just eaten.

The first day, her group of 10 teenagers hiked while carrying a 40lb pack. Rowan was not used to the physical exertion; the conditions were immediately too much for her body.

She refused to hike and sat on the ground. “I said, ‘I’m just gonna sit here.’ And they were like, well, you can sit here all day long. We had somebody sit here for 27 days. And eventually they gave up. No one gets out.” So she got up.

For weeks, they hiked anywhere from a half a mile to 15 miles a day in the oppressive desert heat, depending on where they needed to set up camp. The backpack she carried dug into her shoulders and rubbed her back raw. She was given two packs of tuna per week for her protein allowance and often felt weak. Overexertion and overheating would make her feel sick; she says she would often pass out during hikes.

To keep Rowan from running away in the middle of the night, the staff covered her sleeping bag with a tarp after she tucked herself in. They placed five-gallon containers of water on both sides so that it would make noise if she moved. She couldn’t adjust her body to be comfortable and began to have panic attacks.

Soon, she was using old coping mechanisms, including self-harm. “I was scratching myself, trying to cut myself. And they responded with a very violent, physically painful restraint where they hold you and force your hands to go towards your wrists, which can also often result in spraining or breaking wrists.”

One day, a staff member held her in a restraint, and cried while she cried. He was one of the nice guys, and had chosen to do this work because he genuinely wanted to help others.

He apologized while holding her arms to her sides and kept repeating, “I’m so sorry. I don’t know how else to stop you from hurting yourself. This is what they taught us.”

The misuse of restraints is routine within the “troubled teen” industry, an umbrella term grouping together therapeutic boarding schools, residential treatment centers (RTCs), wilderness programs and rehabilitation centers.

It is not uncommon for teens to attend different programs back to back for their complex mental health and behavioral disorders; Rowan attended seven of them between the ages of 15 and 18. Yet, the majority of these programs lack scrutiny and oversight.

Between 120,000 and 200,000 children live in these facilities, which are regulated through complicated laws on a state-by-state basis. There is no national set training standards or background checks for employees in frontline positions. One organization’s hiring requirement might require a college degree and certifications for all staff, while another will simply require staffers to be over 18 years old.

Data gathered by the US Government Accountability Office recorded more than 1,500 staff being involved in litigations for abuse in 33 states in 2005, the last year data was made available. Most of these involved restraints gone too far or done incorrectly, causing broken bones, joint dislocations and sprains.

According to an investigation published last March by the Salt Lake Tribune, 13 people were either fired or resigned between 2018 and 2021 from youth treatment centers in Utah alone for allegations of inappropriate sexual behavior, sometimes amounting to sexual assault.

At Rowan’s camp in Utah, teen participants were divided between boys and girls. The girls camp were given one set of clothes per week – one shirt, one bra, one pair of pants and four pairs of underwear – in which they would hike miles in the summer sun.

Hygiene was deemed unimportant: there was no soap and no showers. They were given one roll of toilet paper and about 10 pads and 10 tampons at the start of the program. The rain often soaked the toilet paper and feminine hygiene products, leaving the girls with nothing more to use. When they requested fresh, dry supplies, they were refused them and left to bleed through their clothes.

As a safety measure, participants who were high risk for self-harm were watched when going to the bathroom. A female staff would follow Rowan in and watch her defecate. More compassionate overseers would stand to the side as she squatted, trying to secure her a sliver of privacy and a scrap of dignity.

One day, another male staffer in his early 20s chaperoned her bathroom activities. To this day, Rowan still shivers when she recalls what happened.

“He stared at me and then he molested me and threatened me,” she says. “He said he would kill me and no one would care about me. He said if he didn’t kill me, he could make sure I never went home again. It was a fairly common threat from staff – to say they could make sure I never went home again.”

Once they returned to the main camp, a female staff member took notice and pulled Rowan aside, telling her that the male staffer was not supposed to be going to the bathroom with her. “I was just really upset, so I think she kind of understood what had happened.”

Rowan was told by the staffer that she alerted the program directors about the inappropriate behavior but there were no real repercussions; her abuser eventually left the company and started work at another program.

In response to these allegations, Chris Tarver, LCSW, executive director at WinGate Wilderness Therapy, said, “WinGate has no record of ANY assault allegations in 2015. Nor do we have any record during these past seven years of inquiries made by authorities investigating ANY complaint about an alleged incident at WinGate in 2015. With nothing more to go on, we must conclude this matter has no merit.”

He goes on to explain: “Student safety is our priority and our responsibility. Any report made by a student is taken seriously and recorded. We investigate and, if findings deem it necessary, we work with authorities until there is closure to the case.”

Much of Rowan’s therapy while at camp centered on her sexual orientation. She knew she was gay from a young age and had already come out to her family, who did not have an issue with the news.

At WinGate, she was told her homosexuality was a sin, and that she needed to seek God. The camp was not religiously affiliated, but many of the staff were members of the Mormon church and even though WinGate claims to be a safe place for LGBTQ+ teens that does not tolerate microaggressions of any kind, some staff would project their beliefs on participants. Former participants explained that being assigned a therapist that was homophobic was simply a matter of random determination.

As part of her therapy, Rowan was made to write an “accountability letter” to her parents which included explicit sexual details.

Tarver, explained the purpose of these letters: “The written word is the safest form of communication, and it’s a vital step in the healing process for students and their families. An accountability letter is similar to what other recovery programs call an amends letter. These letters are written after individuals have settled in at the program and begun individual and group therapy sessions.

“Accountability letters are a safe way for parents and their teens to communicate with each other, remind each other of their true selves, and see each other humanely, through the eyes of love and compassion.”

Participants were asked to read these letters out loud to their entire group exposing private details of their own trauma. These letters were also published in a book at the end of the participant’s time at WinGate to be given to the participant and their family as a memento of the experience.

Worse things were still to come. Rowan detailed in her letter which was delivered to the Guardian that she would sometimes pretend to be a young child to deal with her trauma – a common coping mechanism called age regression that is in no way sexual. For that, she was told by her therapist that her behavior was that of a child molester.

“Being called a pedophile is something that really affected me,” she says. “I can never really get that out of my head that I was called that. I’ve never had those thoughts. And I, of course, never want to do anything like that. So it was very, very, very upsetting to be labeled as a monster. I think about it every day. I can’t escape it.”

Today, Rowan is 22 years old. She has a full life: many friends and a strong community on Twitch. She feels optimistic about the future, but her PTSD symptoms haven’t gone away. “I don’t know if I’ll ever be able to live a life where my trauma doesn’t completely dictate what I’m able to do. I’m not able to sleep on a regular schedule because of the terrible nightmares I get. I’m not able to take a full course load at university, and I’m not able to hold a job.”

After leaving the Utah wilderness camp, Rowan attended a New Haven, Utah, residential treatment center during which time Jason Calder, a therapist, groomed and sexually abused one of his patients. He has since been fired and sentenced to seven years to life in prison.

Wilderness therapy is supposed to be a vacuum for healing. The idea is to force a struggling teenager to leave their environment to learn consequences, choice and accountability through the powers of nature.

The first modern wilderness program was founded in 1941 by German educator Kurt Hahn, who partnered with Laurence Holt to train young sailors in the UK. Their program, Outward Bound, started with one school in Wales and now has 38 well-regarded schools in six different continents, and hundreds of copycats throughout the world.

In 1966, Brigham Young University, located in Provo, Utah, had resident professor Larry Olsen teach a course called “Youth Leadership Through Outdoor Survival” to students facing academic probation. The course inspired a series of similar initiatives throughout the Rocky mountains and Desert west.

Those grew in popularity throughout the 1980s and 90s, specifically in regions with rich national and state parks. Today, there are over 59 wilderness therapy programs in Utah alone.

Until 1995 there was very little public awareness of the industry. That year, Outside Magazine published an article by John Krakauer called Loving Them To Death, detailing the six preventable deaths of minors under the care of undertrained staff at multiple wilderness therapy programs throughout Utah.

The article was so shocking that the wilderness therapy industry leaders gathered together to find ways to prevent more deaths, which is how the Outdoor Behavioral Healthcare Research Center (OBHC), the third-party monitor specific to the wilderness therapy field, was created. It sets standards for accreditation, cost-benefit analysis, outcome-based research and risk management.

Parents don’t always know about the OBHC, and most don’t know that accredited programs have 424% better treatment outcomes than unaccredited ones. Without a national set of standards, parents rely on Google searches to divine their efficacy, rather than data-led knowledge about how the program performs.

Breaking Code Silence, a non-profit that promotes youth rights and evidence-based alternatives to the US troubled teen industry, counts over 5,000 current programs in the US. This number includes residential treatment centers, juvenile detention centers and wilderness therapy programs. Only 22 wilderness programs are currently accredited by OBHC, and WinGate Wilderness is not one of them.

Wilderness therapy can cost upwards of $50,000 per stay – and because there is not enough data to justify that the treatment is effective and that the cost is necessary for said treatment, insurance companies sometimes reject claims. Stories of parents refinancing, sometimes even selling their homes to cover treatment costs for their child, are not uncommon.

Steven Dunn, an attorney based in Dallas who specializes in mental health advocacy, worries that the industry is completely fractured. “For the most part, the industry is not regulated. After the Affordable Care Act became law, many private equity companies understood that millions of additional clients now had access to treatment. They could charge whatever they wanted for the services provided. And they knew how to get around the few regulations which did exist to prevent non-medical corporations from owning treatment centers … It became the perfect storm.”

One of the OBHC-accredited programs is the Anasazi Foundation in Arizona. Their program, developed by Larry Olsen, the same BYU professor who inspired the industry’s beginnings in the 1960s alongside his most promising student, Ezekiel Sanchez of the Totonac Nation in Mexico, is considered the industry’s gold standard.

Their curriculum is peppered with inclusive and motivating language, “making an ask” and “growing a seed of greatness”, using variations on local Indigenous belief systems to create a social system set apart from the suburban backgrounds the kids come from.

Brian and Liz Hawkins, of Utah, spent $30,000 to send their son to Anasazi as his drug usage and contentious attitude was not changing in the home. As part of the program, they also had to undergo therapy and learn how to better communicate with him.

“We chose Anasazi because they work with the parents,” Brian Hawkins said. “If we don’t change as much as our child changes, it’s probably not going to work. You can’t expect someone else to just fix my kid. It doesn’t work. You have to change the home.”

The Hawkinses were recommended to Anasazi by a friend who transports children to and from treatment facilities. The Hawkinses now feel optimistic for the first time in a long time, and their son feels like he is on a good path, having detoxed from drugs and stepping away from negative influences. He feels that he now has a real relationship with his parents.

“I like the wilderness program because he has ADHD, so having him stuck in a dorm-type situation at a residential facility wouldn’t have worked for him,” Liz Hawkins said. “You have to do your homework. We asked our friend who had all this experience because you could do a lot of damage if you pick the wrong one.”

Liz Johnson sent her son to wilderness therapy, and although the program did not ultimately save his life, she believes wilderness therapy gave him a second chance at a full and productive life before his passing.

Johnson’s son lost his battle with depression and chronic traumatic encephalopathy (CTE) – a progressive brain condition associated with players of contact sports caused by repeated concussions and blows to the head – eight years ago.

It was his wish that his family help others find good and safe programs for their children, which is why Johnson created the Parker Bounds Johnson Foundation in his honor. After Parker’s death, Johnson found herself able to count less than a dozen out of hundreds of programs that would be mentally and physically safe enough to send a child for help.

Recently, while attending a motorcycling class, she learned her instructor ran a wilderness program in Oregon. She asked about his philosophy and immediately recoiled at his response. He described a bootcamp military model that would “scare the teen straight”.

“When your child is so fragile and crying out for help, your child doesn’t have the tools [to heal]. They are grasping at whatever they have, like a cat in a corner. They are trying to figure out how to feel better, whether it be alcohol or drugs. It’s all bad, but that ‘scared straight’ model doesn’t give them better tools to cope.”

In fact, research shows the “scared straight” model actually did nothing to decrease offenses by delinquents. This model actually increases offenses by delinquents from 1% to 28%.

Johnson also raises money for families hoping to make treatment more financially accessible. The cost for six weeks of treatment at vetted, research-based facilities can be anywhere between $10,000 to $100,000.

David Peterson, 37, a rapper and musician from Utah, also went to Anasazi when he was 20 years old and also had a successful outcome, feels more resilient, accountable and able to make positive choices – but the financial sacrifice of over $20,000 his parents made still lingers in the corners of his relationship with them.

He took the program seriously and learned that he could do hard things.

“Everything from a really challenging hike to being able to make fire out of sticks taught me that I could survive. There’s something in your soul that needs to know that you could make it rather than just feeling like a toothless 20-year-old baby.”

Initially, he didn’t feel like the program affected him in any major way. It wasn’t until a year later that he noticed himself doing things differently. Events that would have beset him, like a hard class or a girl not liking him, weren’t keeping him in bed any more. He now had a visceral knowledge that he could endure hard things and rise to the occasion.

“People have asked me if I would recommend Anasazi to people, and I do in certain situations. I never recommend it for anyone that is not willing to go. If you’re tricking someone or snatching them in the middle of the night, I couldn’t imagine how that is gonna get a good outcome. The other thing that I would say to parents is they should have no specific outcome in mind. This is about that person learning something about themselves.”

David is right – it is often how a child arrives at wilderness therapy that will determine their outcome. Some described being “gooned” in the middle of the night by strongmen hired by their family to forcibly transport them to camp. For others, direct betrayal was at the heart of it.

Nathan Mosher was sent to Anasazi when he was 17, but the way he was sent there severed further ties with his family.

Nathan’s father had died of cancer three years prior, and his processing of the death was more aggressive and solitary than the rest of his family’s. He was riding his motorcycles at all hours, arguing over petty miscommunications with his siblings and getting into fights at school. His mom tried to get him to therapy but after bad experiences with therapists as a child, he was vehemently against it.

She was running out of options, and finally told him he was going to go dirt biking with his uncle in Arizona.

When he got on the plane with his mom, he realized something was off – it just didn’t make sense to have her fly down to Arizona from Colorado with him.

They landed and walked to the passenger pickup. He looked for his uncle’s truck with the dirtbikes in the back but instead saw him pull up in a compact car. They all got in the car, and his mom told him that instead of dirt biking, he was going to go camping for a few weeks.

It started to dawn on Nathan that this was an intervention, and he frantically tried to memorize street names so he could run.

They stopped at a worn-down building in Mesa, Arizona, less than 15 miles outside Phoenix, a building Nathan would come to understand as the Anasazi Foundation. His uncle and mom stepped out of the car and walked towards the building, locking him in the car.

“They planned this out very thoroughly, because they knew that I would escape,” Nathan said. “I was thinking about kicking the door. But I have respect for my uncle. I didn’t want to break the window. I was like, the second they open this door, I’ll bolt.”

Once the staff came out of the building to retrieve him, Nathan realized he had no chance against the handcuffs. So he refused to get out of the car.

He sat as the temperatures rose above 90 degrees, with the windows rolled up. Realizing that the heat was going to beat him quicker than expected, he knew he had to get out and run. He also knew the desert did not care about his persistence, direction skills, desperation or willingness to panhandle.

The safest and only option would be to submit to the program and get out as soon as he could.

Nathan was sent on a week-long safety course called the Rabbit Course. It was just him and a “trailwalker”, a frontline staff member trained to guide the boys along a route and ensure their safety while also accommodating their healing. He learned how to pack his bag, hunt and start a fire with primitive resources.

He then spent weeks hiking between six and 10 miles a day under the baking sun. He caught most of his own food and created his own shelter with seven other boys.

The group would take breaks every week, and the therapists would come by and meet with each boy and report on their progress. They would also deliver letters from home. Participants were cut off from technology and completely removed from the outside world, so this chance to get word from families was precious and also highly regulated by the therapist.

Some boys in the group were detoxing from heroin addiction, and not afraid of using their knife as a weapon. In order to survive this group, Nathan felt he had to posture as the leader of the pack. At 17, he stood at 6ft 3in and was wiry but strong. In a fight, he could hold his own and was willing to take all the punches. He also knew that the trail walker was not going to be able to protect him.

“You start getting this gang mentality,” he recalls. “Then you’re realizing, I’m becoming manipulative to the other kids and the trail walkers. I’m learning how to use people and use their emotions and use their trauma instead. I feel like that in itself is pretty evil, but you gotta do what you got to do. And you have kids who are trying to stab you in your sleep, or kids that try and kill the trail walker. You are on guard at all times and you have to sort of eat or be eaten.”

Leavitt Wells, marketing director for Anasazi Foundation, explained that staff are trained to be proactive and initiate knife restrictions in the band if knives are being used as weapons or violence is being threatened. If a physically violent situation happens, staff are directed to use a therapeutic hold.

Wells said, “The truth is we don’t like to use them, but just like other safety measures, it’s there if needed and warranted. All of our staff are trained in therapeutic holds through an advisory company called Positive Control Systems.”

Once a hold is used, a series of follow-up documentation, discussions and trainings is initiated.

“In short, we are constantly learning, evolving and making changes to best suit our clients’ needs and keeping everyone as safe as possible in a wilderness setting,” she said.

The days melted together in the desert heat; Nathan still doesn’t know how long he spent there. But 13 years on, Nathan is still learning to trust his family. He spent the past five years bouncing between Arizona and Colorado, and feels the desert is one of the only places he feels equipped to survive in.

“I thought about going back and being a positive force in one of these places but at the same time, I don’t want to be a part of it because I don’t want to perpetuate pulling kids away from their families where the actual issue is.

“With Anasazi, I lucked out because they weren’t abusive,” Nathan said. “I don’t know if Anasazi would have made a difference or not but I do feel like I learned that I am one hell of a manipulator if I wanted to be. And if I wanted to run a gang, I probably could. That’s when I learned. And that’s scary to me. I’m not meant to have that kind of power.”

This article was amended on 16 November 2022 to remove a reference to Larry Dean’s “Youth Leadership Through Outdoor Survival” course being part of the Outward Bound program.

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