Counselors and therapists as well as medical and mental health professionals are not necessarily more qualified to evaluate and deal with a risk of suicide than a reasonable person.

Physicians are trained to diagnose and treat medical conditions, medicate if necessary, and admit patients to holding or psychiatric facilities. Evaluation, intervention and treatment of a suicide risk are specialized skills that require training and supervised experience.

Program personnel should consider themselves responsible for the outcome, when that program and their staff assume the authority to intervene or dismiss the risk of suicide.

The evaluation of a suicide risk is in fact an intervention and that intervention should not end once the child’s risk is no longer considered immediate. Consultation with parents and obtaining second opinions from qualified professionals are reasonable standards of practice.

A minimally qualified professional to deal with a suicide risk would have:

~  a masters degree in a mental health field,
~  licensure in a mental health field,
~ 16 hours of continuing education training in crisis intervention (with emphasis on suicide and violence risk), and
~ 6 months of supervised experience and training working with suicidal adults and children on regular basis.

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Failure to recognize Borderline Personality Traits (BPT) in a wilderness program can lead to chronic problems and can have a destructive impact on a child’s life. Many  students with the initial behavioral symptoms of this disorder will go undetected primarily because they hide these behaviors from parents and family members.

They are generally not evident until the child is under stress and they are observed continuously in a structured setting such as a therapeutic boarding school, psychiatric hospital, residential treatment or wilderness program.

In a wilderness program, a student may not demonstrate all of their symptoms until the third or fourth week. In severe cases they will be uncompensated within a week.

Behaviors That Will Be Encountered In The Field:

~ Intense emotional pain (shame, guilt, fear, loneliness, emptiness, longing)

~ Rapid mood swings (anger, sad, fearful to happy).

~ Failure by others to meet their needs are interpreted and reported to others as personal, intentional, neglectful or abusive.
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A wilderness program is more likely to detect bulimia than a therapeutic boarding school, psychiatric hospital, residential treatment or wilderness program. In a wilderness program, a student may not demonstrate all of their symptoms until the third or fourth week.

Students with Bulimia and Anorexia have four primary problem areas. These include:

~ Control
~ Argument and Debate
~ Secretive Behaviors
~ Guilt and Shame
~ Obsession over weight

Behavior That Will Be Encountered In The Field:

>> Hiding food.

>> Arguing over certain foods they can or cannot eat.

>> Comments that they are fat, unattractive and need to loose weight despite evidence to the contrary.

>> A pattern of drifting to the perimeter of the group or asking to leave the group to void their bladder soon after eating an adequate or large meal and then purging their meal without staff awareness.

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Boarding schools and wilderness therapy programs offer services to parents for adolescents and teenagers who are “at risk” and those who may also have “special needs”.

Unfortunately, the terms “special needs” and “youth at risk” are unclear and potentially misleading. These terms are commonly used in wilderness programs and therapeutic boarding schools. They generally refer to children and teenagers who have problem behaviors, difficulty in school, may be using drugs, or are involved with kids who are in trouble and have conflicted relationships with their parents.

While these terms are vague, they have are not without redeeming qualities. For one thing, they side-step the use of equally misleading and potentially harmful terms such as mental illness, mild mental retardation, antisocial personality or a  psychiatric disorder.

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MRI (Mentor Research Institute)
OBHIC (Outdoor Behavioral Health Industry Council)
OBHRC (Outdoor Behavioral Health Research Council)
NATWC (National Association Of Therapeutic Wilderness Camps)
NATSAP (National Association Of Therapeutic Schools and Programs)
WRC (Wilderness Research Center, University of Idaho)
AEE (Association For Experiential Education)
OEREC (Outdoor Education: Research & Evaluation Center)
WEA (Wilderness Education Association)
OPISU (Outdoor Program. Idaho State University)
Experientia
Naropa

In most cases it takes time for a crisis to become critical, life threatening or intolerable. A pattern of crises have usually taken place before yet another crisis  quickly becomes dangerous.

At some point, one can trace the cause to one or more factors. Identifying these factors can help characterize the evolution of the crisis, the appropriate response and the duration of intervention that may be necessary.

> Drugs
> Alcohol
> Peer and social pressure
> Traumatic experience
> “Brittle” or fragile emotional temperament
> Parental divorce or separation
> Untreated parental alcoholism, drug abuse or mental disorder
> Failure to provide rules, discipline and a bonded relationship with a child
> Family conflict and discord

To read the full resource article, please click here.
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The early signs of a crisis can be subtle. In order to intervene parents and family members must recognize there may be a problem and they must know how to communicate this not only among themselves, but with others who can or should help. The following is a list of signs that are ranked approximately in terms of warning signs and critical signs.

Warning Signs

> Change in routine and healthy sleep habits.
> Joining new group of friends who are unacceptable to parents.
> Recent and dramatic drop in school work, attendance or grades.
> Abrupt failure or refusal to contribute to the family in terms of work.
> Deception, lying and keeping their activities a secrete.

Critical Signs

> Dramatic disregard for self-care and hygiene.
> Drugs or drug paraphernalia
> Abrupt change in personality, attitude and emotional stability
> Possession of weapons
> Reckless, destructive and threatening behavior
> Violent, self-harming or suicidal statements or behavior.

To read the full resource article, please click here.
Cartoon credits.

If you are searching for a suitable wilderness program for your kid, then you should arm yourself with interview questions for possible programs you have stumbled upon your research. Surely, they will help you decide which is the best therapy for your troubled teen. Read on and be informed.

1. What is the name and position of the person you are talking with? Where are they physically located? Are they located at the program?

2. Is the person you are talking with a licensed counselor, medical or mental health professional?

3. How long has this person worked in this program? What jobs have they had in the program? Have they ever worked as an instructor, guide or therapist?

4. How long has the program existed?

5. Has there ever been an injury or death of student that resulted in a criminal or civil action against the program. If Yes, ask for the name of the newspaper that covered the story. (This is not confidential information because it should be a matter of public record.)

6. Has the program undergone a change in ownership in the past 2 years? Who owns the program? Ask for information necessary to contact the owners.

7. Who is the program director? How long have they been there? What is their experience? Are they licensed?

8. Is the program licensed or accredited and with what organization or agency? What is the contact information for that organization or agency?

9. Is there a licensed professional in your program who will be directly responsible for your child’s safety and well-being? Who is specifically and ultimately responsible for your child?

10. Is the program co-ed? How are boys and girls supervised?

To read the rest of the checking questions in finding a suitable wilderness program, please click here.

Psychological trauma, physical injuries or death of children in programs are invariably the result of trauma, abuse, negligence and/or accidents. The following is a checklist of factors that are necessary to insure that a wilderness program is safe.

The risk decreases as more of the following that are present.

~ The program is licensed or regulated by a state agency that is empowered to monitor, inspect and investigate complaints.

~ Staff who are responsible for the health and well-being of children are screened, trained or certified as competent to provide services within the standards of practice of related intervention programs.

~ The program’s therapeutic activities were developed by or approved by a licensed psychologist who is qualified in behavioral health and safety.

~ The safety and well-being of your child is the direct responsibility of a qualified and licensed medical or mental health professional.

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