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TOUGH TEEN THERAPY

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Come you mothers and fathers throughout the land . . . And don't criticize what you can't understand.

Your sons and your daughters are beyond your command . . .It's been more than 25 years since Bob Dylan penned those lyrics in "The Times They Are A Changin'."

One thing hasn't changed much: Youths today - perhaps more so than in the tumultuous 1960s - are often out of their parents' control.

Parents, sometimes out of desperation, are turning to a variety of programs for help when their children's problems get serious - everything from residential psychiatric hospitals to 12-step treatment programs.

Though wilderness therapy programs for troubled youths have been around for about 20 years, they have only recently gained notoriety.

Parents from around the country pay hefty fees - sometimes as much as $20,000 - to place troubled children in the care of wilderness programs that take them into the deserts, canyons or mountains to learn survival skills. Program operators say the experience will give them self-esteem and self-confidence to help them overcome their problems.

Doug Nelson, chairman of the Intermountain Wilderness Program Association and administrator for one of Utah's 10 licensed programs, thinks the programs fill a void in adolescent lives, helping them move from childhood to adulthood by accomplishing a difficult task in a very visible way.

"America has lost her rites of passage," he said. "Many cultures have rituals that say, `You have passed through the veil. You are now a woman. You are now a man.' "

So youths create their own painful rites into adulthood, he said. Because they don't have formalized ways to "prove" themselves, they challenge the rules and their parents. A troubled youth's passage may include drugs, sexual activity, running away or participating in gangs.

Jason's parents enrolled him in a wilderness therapy program in the hope it would help him take positive control of his life. Like many of the students in wilderness programs, the 16-year-old had a history of drug and alcohol abuse and belligerence.

He had to earn the right to carry a knife with him into the wilderness. First, he had to pass through a "helpless" stage and prove that he could handle responsibility. Then he received the right to work with tools.

The programs vary greatly, but common threads bind them. Initially, a youth is stripped of his independence. Gradually, the groups of youths disperse, giving each youth some solo time to internalize and learn what he can do.

"We start with the instructors controlling everything. We get to where students conduct it unless there's a life-threatening situation. It's a process to get out on your own," Larry Wells, program director of Wilderness Conquest, said.

The programs force a troubled youth to be accountable for his actions, he said.

"I think these programs are the most effective method for breaking denial. There's no way to manipulate the wilderness. You get down to the core. My philosophy is not punitive. It's about learning. That's the reason wilderness programs are so effective. Teens learn through experience. We take that very natural process and put them in an environment where they can learn."

"The real therapist is Mother Nature," Nelson said. "With proper supervision, youths are given challenges they have to overcome. They become confident and accomplished in what they are able to do. They think something is insurmountable and yet they do it."

But critics don't see it that way.

Since the recent deaths of two girls in different wilderness programs, the whole concept has come under close scrutiny. Even before an autopsy showed that Kristen Chase, 16, Ponte Vedra, Fla., died of heat stroke, state Human Services officials told the program directors to bring all of the youths back to base camps.

The state called program operators together to discuss what state-mandated standards should govern their programs. At that meeting, operators agreed to eliminate hikingprograms. Chase's mother, Sharon between 10 a.m. and 5 p.m. when temperatures reach 90 degrees or higher and to monitor water intake.

Even parents disagree about the Fuqua, said she believes the program would have helped her daughter. Chase's father, Dr. Ronald Chase, said his daughter didn't belong in the program and blames Challenger for her death.

State officials have not decided if wilderness therapy is effective, one reason the state does not refer youths to the programs, said Tim Holm, director of Youth Corrections.

Wayne Holland, who licenses some of the programs, questions whether the high cost combined with a "quick-fix approach" really works. The longest program is 63 days.

"Can a 63-day program without serious after-care change troubled lives in the long term?" he asked.

Some programs promise to take a youth who doesn't change back into the program for free.

Nelson agrees that there have been no empirical studies to measure effectiveness. "We have testimonials, but there's no real body of research."

Another criticism is the training levels of the program employees, many of them young, former participants. One investigator assigned to the Chase case said, "From what we could tell, these folks (Challenger employees) are not well trained. . . . They only have minimal training.

The investigator, who requested anonymity, said Challenger, for instance, "does some really disturbing things."

"It almost seems they are trying to get their counselors to do something that their conscience normally wouldn't allow. They use certain terminology to avoid negative words. I asked (an employee) what they would do if someone refused to hike. He said he would `help' them along."

That "help" can mean forcing the student along with a stick, he said.

Although state officials won't say yes or no when asked if the programs help, they acknowledge that hundreds of youths are in the programs. And as long as the programs operate, licensing officials want to be sure they meet tough standards. For the first time, Youth Corrections and Office of Licensing officials worked together to draft strict guidelines to comply with a new law that requires the state to regulate all wilderness therapy programs.

The programs gave input. And the results, according to Ken Stettler of the Office of Licensing, who with Holland licenses the programs, are "stringent but fair." The regulations may even "weed out programs that aren't as serious as others."

Nelson said he expects three or four of the programs will continue as before "with a solid foundation." Some of the others may fold, he said.

Licensing regulations include detailed instructions on what a physical examination must include, with emphasis on providing doctors with details about terrain, temperatures and what will be expected. The examination must be made no more than 30 days before enrolling.

Requirements for staff qualifications, communications and emergency equipment are included. So are minimum nutrition and water intake specifications. Basic gear, such as blankets, is regulated. The new regulations fill 10 pages.

Holland and Stettler said enforcing the regulations will be a problem. Programs are required to give licensing officials schedules and itineraries so they can do spot checks. But no one works full-time monitoring wilderness programs. And the number of programs and their out-of-the-way locations seem to guarantee that visits will be, at best, "periodic," Stettler said.