I realize this is an older thread, but it's been really helpful for a list of places to research for my 16 yr old DD, who is now inpatient again for suicidal ideation after a hospitalization a year ago and a 6-month PHP/IOP. Needless to say we are so stressed at being back on the rollercoaster.

Does anyone have any recommendations for or against consultants to help find the right program?

And for those upthread who did have success at wilderness therapy programs, can you please name names if you ever come back?

There are several reasons why wilderness programs are considered a more extreme path versus trying residential programs covered by insurance or PHO/IOP first:

1) wilderness programs are extremely expensive and are almost never covered by insurance. So making that choice often means eating up the child’s college funds or retirement funds. We’re talking $40-50k+ for weeks of treatment.

2) residential programs covered by insurance, such as Rogers in Wisconsin, have just as much of a chance of being effective and cost substantially less. They also have more trained therapists and psychiatrists on hand versus many wilderness programs. So they are typically tried first.

3) if your child is severe enough to need residential treatment or a wilderness program, odds are they are not going to be fully well after one treatment program...it’s a longer haul over months or years, not weeks. Treatment for a child can send the family into bankruptcy if all the available funds are used on just one treatment stint that has almost no insurance coverage.

4) because of the financial reasons above, many of the children in wilderness programs are there because of more extreme issues...strong oppositional behavior, violence, addiction, major trauma. Oppositional behavior and violence in particular will keep these kids out of residential programs like Rogers, so the wilderness programs are some of the only choices their families have. Thus, choosing the wilderness route means being prepared for your child to potentially be exposed to more egregious stuff from other attendees.

5) while there are some strong wilderness programs, there are just as many that are thrown together as a money-making opportunity in the troubled teen industry. Their staff is not as trained or experienced and abusive treatment happens. You REALLY have to do your research and work with an educational consultant to make sure you’re not being snowed by “reviews”.

Anonymous wrote:I think Mountain Valley is absurdly expensive and doesn't take insurance.

Rogers in Wisconsin has good care for teens with mental health problems and they take insurance.

It is expensive. I wish we could find something closer, more effective, etc....that took insurance but we couldn't. MVTC was amazing. Full of caring individuals.

Rogers takes insurance but your child will be booted from there before they are ready....insurance is brutal

All of the wilderness naysayers need to understand a few things (1) yes, there are some bad programs, but there are some incredible life-changing programs that have helps thousands of people (2) using an educational consultant is expensive, but helps weed out the bad programs and helps find the right fit for your child and (3) every child is different - meds dont help every child. Not every child can stay home and be helped.

The Center for Anxiety and Behavioral Change in Rockville (also McLean) is a good place to start locally, but many kids will refuse therapy like they are refusing school. I have been there. And unless you have been there and know what it is like just stop commenting right now.

OP - do what is right for your family and your child. I am in your shoes.....I get you,

Anonymous wrote:lots of reasons

the most simple ones include:

$costs $50K+, and extremely rare to obtain reimbursement

almost everyone sends kid to a step down program afterwards for a year - so kid is away for 15 months+ (and cost of step down can be $150K for 12 months, if not paid for - some are more likely to be paid for than others - after fighting school district, fighting insurance company etc.). a lot of folks i know have spent $200K

depends on the dx.s/causes but wilderness is not appropriate for all kids, some can be traumatized

There are hybrid programs that combine the outdoor experience and the therapeutic environment. It’s a bit easier to get insurance coverage but still parents are saddled with a lot of bills. With these sorts of programs, you don’t need a step down- they are designed for a home discharge maybe with an IOP, which is typically covered by insurance. But even these are extreme options, not something most kids need.

Getting payment for mental health services, no matter what they are, is really tough.

Anonymous wrote:What is a wilderness program and why does everyone think it's more extreme? I would think it would be something to try before hospitalization. Why is it only tried after?

Google troubled teen industry. It is a lucrative and scary industry that often operates without much regulation. There are a bunch in Utah for a variety of cultural and legal reasons.

Can't speak to the ones on the east coast but I would be exceptionally cautious of any business operating in the troubled teen space.

lots of reasons

the most simple ones include:

$costs $50K+, and extremely rare to obtain reimbursement

almost everyone sends kid to a step down program afterwards for a year - so kid is away for 15 months+ (and cost of step down can be $150K for 12 months, if not paid for - some are more likely to be paid for than others - after fighting school district, fighting insurance company etc.). a lot of folks i know have spent $200K

depends on the dx.s/causes but wilderness is not appropriate for all kids, some can be traumatized

What is a wilderness program and why does everyone think it's more extreme? I would think it would be something to try before hospitalization. Why is it only tried after?

Anonymous wrote:I took my depressed ,anxious 14 year old, 8th grader out of school and took him for 2 weeks to a surf camp in Costa Rica. Cheaper than wilderness therapy. It reset him and helped him get out of a dark place.

This. A child may just need a change of scenery. I think it's also possible that a child may benefit from being away from the family, either because of dysfunction or just ineffective coping patterns. But you can accomplish that without completely giving up on evidence-based therapies or family support. Going to stay with a beloved aunt or grandparent for a while is also an option that may help.

I took my depressed ,anxious 14 year old, 8th grader out of school and took him for 2 weeks to a surf camp in Costa Rica. Cheaper than wilderness therapy. It reset him and helped him get out of a dark place.

Anonymous wrote:I am overwhelmed by all your responses. Thank you again.

Thank you for the Facebook group name. We will look into that. We have scoured the internet for candid insights and reviews on True North with some success. Most of what we found was positive.

Cost, as some of you have mentioned is a big consideration. Sadly, our insurance coverage is not very good for mental health (although that seems to be case across most insurers) and we are likely going to face a big bill with whatever direction we pursue. It is a sad and frustrating reality that mental health coverage is not nearly as robust as it needs to be, but as important as physical health. That said, my wife and i are weighing our options based on many criteria, including cost.

My son is in crisis mode and needs a dramatic change to hopefully alter his current path.

We will continue to research the many suggestions everyone has provided. Thank again for your input/feedback. This journey is overwhelming and can feel quite isolating, especially now.

Why would you send your very young child in crisis away to an unproven boarding school with no MDs on staff, that does not use evidence based therapies? Please get a new therapist here before you do that.

I am overwhelmed by all your responses. Thank you again.

Thank you for the Facebook group name. We will look into that. We have scoured the internet for candid insights and reviews on True North with some success. Most of what we found was positive.

Cost, as some of you have mentioned is a big consideration. Sadly, our insurance coverage is not very good for mental health (although that seems to be case across most insurers) and we are likely going to face a big bill with whatever direction we pursue. It is a sad and frustrating reality that mental health coverage is not nearly as robust as it needs to be, but as important as physical health. That said, my wife and i are weighing our options based on many criteria, including cost.

My son is in crisis mode and needs a dramatic change to hopefully alter his current path.

We will continue to research the many suggestions everyone has provided. Thank again for your input/feedback. This journey is overwhelming and can feel quite isolating, especially now.

I would not send my kid to wilderness school before exploring meds -- it can take time to work through different types -- anti-anxiety, anti-depressant or mood stabilizer. Are you working with a psychiatrist in addition to a therapist?

Re: school. School is not working in COVID for a lot of kids. If your kid is in middle school, I would not worry too much about grades right now, mental health is the priority. Has the child been assessed by a neuropsychologist? There may be underlying learning issues that are increasing anxiety, especially in the DL format.

Is the anxiety becoming a form of school refusal? I happened to notice this place when researching something else -- https://changeanxiety.com/services-specializations/anxiety-based-school-refusal/ It is in Rockville.

Do you have a 504 plan or IEP for your DC who is experiencing anxiety? A 504 plan could offer your DC extended opportunities to cut or make up work when missed due to anxiety or depression. Depending on how anxiety affects school, there may be other accommodations available.

I would hope that all of the above have been used before sending off to boarding school.

FWIW, my DC was extremely oppositional. I thought it was anxiety or LD frustration, but it was actually depression and medication made a tremendous difference.

I agree with other PPs that "wilderness schools" are to be looked at with extreme caution as many of them have been found to have abusive aspects or practices. Force is not the antidote to anxiety.

PP's experience squares with ours: my DD went to a wilderness program only after multiple hospitalizations and intense ongoing resistance to individual and group therapy--to the point where her therapist, like your DC's, recommended wilderness as a possibility. Given that DD's hospitalization experiences involved multiple instances of ward lock-downs and violent outbursts from other patients, the idea of ongoing therapy in the outdoors seemed like a positive thing at the time. Like PP, we chose a program with a lot of family support: workshops, weekly parent support calls, family therapy, and weekly calls from DD's individual therapist.

Because your DC is so young, my strong recommendation would be to look for a program that specifically works with younger teens. TRAILS is one, and there are a few others.

If you can hold on (but make the application now), there is a summer therapeutic program at Wediko in New Hampshire that was highly recommended by a trusted therapist when DD was your child's age. One of the big regrets I have is not making that early intervention.

To add a few things to what others have said about wilderness programs:

My child (12 or 13 yo at the time) did a wilderness program which now two years out was absolutely life-changing in a positive way. It wasn't just drop your kid off - there was a LOT of family involvement and family therapy components. That said, we'd exhausted all our options and had been through multiple hospitalizations, we considered a lot of options and ruled out hospital-based programs for a number of reasons specific to our child, and our child was the exact opposite of most of the kids in the wilderness program, who were in general much more defiant. We hired a consultant to help us find the program (who recommended a specific therapist and group of peers within the program for our child; e.g. our child was not placed with kids with drug and outward behavior problems) which I think really contributed to the success. Not all of these programs are bad, but I don't think it's a one-size fits all sort of thing and you need to really do your homework - this seems to work for some but certainly not all kids.

How would you get your child there? Our child knew they needed help badly and went willingly despite being terrified, but most kids aren't so willing, and at least from my exposure to other parents in our wilderness program most are encouraged to hire a couple of people to surprise and drag your child out of bed in the middle of the night and escort them to the wilderness program, e.g. being "gooned", which can be traumatic to some kids.

As others have said, insurance won't cover most of the costs which are incredibly high. Insurance will reimburse the therapy components, and our wilderness program broke down the bill into billable components we could submit to insurance. That said, what we didn't know is the frequency of therapy needed to be pre-authorized/approved by insurance, and we got no guidance from our program about this, so we got almost nothing back from insurance.

If you do go this route, go into it knowing the exorbitant costs won't necessarily stop with the wilderness program. Most programs will strongly recommend your child not go directly back home where they had problems originally; they almost universally recommend a therapeutic boarding school to follow up and transition your child back which supposedly facilitates better success. Obviously these are also insanely expensive.

Anonymous wrote:The Blue Ridge School in Virginia may be what you are looking for:

https://www.blueridgeschool.com/mid-year-enrollment/

the child needs therapy and family support - not sure why a boarding school would be the answer?