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Wilderness Therapy Programs

Wilderness therapy programs like the Mindfulness-Based Ecotherapy 12-week Program combine therapeutic elements with outdoor activities in a natural setting to help treat individuals with a range of needs including behavioral, emotional, psychological, and substance use issues.

In 2021, the Washington State Legislature directed The Washington State Institute for Public Policy (WSIPP) to conduct a research review of wilderness therapy programs related to behavioral health.

This report, the first in a two-part series, summarizes findings from their systematic literature review.

In the youth literature reviewed, wilderness therapy programs typically served adolescents aged 13 to 18 with behavioral, mental health, and/or substance use issues. Participants were usually enrolled in programs from one week to three months.

While enrolled, participants backpacked and organized camps, and learned outdoor skills like fire-making, meal prep, and navigation. Therapy sessions facilitated by mental health professionals or therapeutic elements like reflection and goal-setting were embedded into daily outdoor activities.

In the adult literature, wilderness therapy programs were typically provided to individuals ages 18 to 26 with behavioral, psychological, and/or substance use disorders. Adults tended to enroll in programs for shorter periods than adolescents (about 21 days on average). Adults participated in similar outdoor activities as youth.

The majority of studies examining wilderness therapy for youth and adult populations found that outcome measures improved post-treatment, compared to pretreatment. Typically, improvements were observed for outcomes like self-concept, behavior, and clinical measures of depression, anxiety, and PTSD. Other outcomes like resilience, substance use, and social development were also common in both bodies of literature.

https://www.wsipp.wa.gov/ReportFile/1748/Wsipp_Wilderness-Therapy-Programs-A-Systematic-Review-of-Research_Report.pdf

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Wise Mind

wise mind

One of the skills we develop in the practice of mindfulness is the skill of acceptance. Acceptance allows us to experience emotions without feeling obligated to react to them. This is done by noting the emotion, and then letting go of the negative thought processes that the emotion generates.

We can benefit from mindfulness by learning to accept the flood of emotions that blocks rational thought. The goal of acceptance isn’t to become a totally rational person, devoid of emotion. Instead, the goal is to practice Wise Mind.

Wise Mind is the balance of emotional mind and rational mind, in perfect harmony.

To illustrate this concept, let’s suppose that a destitute woman has been arrested for stealing a loaf of bread with which to feed her hungry children. If we approach this situation from Rational Mind, we are only using logic and reason. There is no emotional content to our approach to the situation in Rational Mind. In this situation, Rational Mind would say that she broke the law, and there are penalties for breaking the law, therefore she should be punished.

Wise Mind, on the other hand, would allow logic and reason to be tempered with emotion. In this case, Wise Mind would allow some sense of compassion for the mother and her plight. While the woman in this scenario may have broken the law, she did so because she had love for her children and did not wish to see them go hungry. Wise Mind would recognize this and allow for some leniency.

On the other hand, what does Emotional Mind look like?

I’m sure we all know of someone who is subject to wild mood swings. Such a person is ruled by emotions that often run out of control. Imagine that this person is cut off in traffic. They may become very angry and chase down the offender, horn blaring and lights flashing. Perhaps this person even tries to run the offender off of the road.

In such a case, this person is being ruled by Emotional Mind. If this person could learn to live in Wise Mind, then he would realize that while the person who had cut him off in traffic had done something dangerous, it may not have been intentional. It could be that this person was distracted. Even if the person had done it intentionally, there is no need to increase the danger to himself by provoking further confrontation in an episode of road rage.

In this case, Wise Mind would accept the fact that such events are inevitable on a busy highway. Emotional Mind would then be tempered with Rational Mind, achieving the balance that is the goal of Wise Mind.

According to Follette, et al (2006), “”Wise mind is understood as a balance (or dialectic) between emotion mind and reasonable mind, where both emotion and reason are considered before taking action in life.”
This concept is often illustrated as below, where Wise Mind is the overlapping area between Rational Mind and Emotional Mind:

Wise Mind is where Rational Mind and Emotional Mind meet

In the clinical practice of Mindfulness, clients are taught the concepts of Rational Mind, Emotional Mind, and Wise Mind, and how to differentiate among these states.

Each state has its own usefulness; for example, Rational Mind might be good for solving math problems like balancing a checkbook, while Emotional Mind might be good for a romantic interlude. But there are also situations, such as those outlined above in which one mode of mind might not be as productive as another. In those cases, Rational Mind can be tempered with compassion from Emotional Mind, or Emotional Mind can be balanced with reason.

When using Mindfulness in clinical practice, it is helpful to teach clients the concepts of Rational Mind, Emotional Mind, and Wise Mind, then have them list examples of each in order to gain practice in differentiating among these states.

Follette, Victoria & Palm Reed, Kathleen & Pearson, Adria. (2006). Mindfulness and Trauma: Implications for Treatment. Journal of Rational-Emotive and Cognitive-Behavior Therapy. 24. 45-61. 10.1007/s10942-006-0025-2.

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Automatic Thinking

Learning to drive an automobile can be an overwhelming task. You have to focus on keeping the vehicle between the lines on the highway while watching for other cars, traffic signals and road signs. In addition to all of this, you must constantly glance at the speedometer to make sure that you are driving at a safe speed. You cannot look at the speedometer for too long because you must also concentrate on what may be happening on the highway. When learning to drive, you probably recited the ‘rules of the road’ to yourself over and over while driving (“Hands at two and ten,” “Watch out for animals and children running into the road,” etc.).

But as you gained knowledge and experience of driving, it became more and more of an automatic process. It may have become so automatic that now from time to time you make a routine drive without remembering anything about it. If you have ever let your mind wander and have missed an exit or a turn, then you are fully familiar with the process of automatization.

The process of automatization occurs in many areas of our lives. Just as the process of driving eventually becomes automatic, and can occur without our conscious awareness, so can thought and feeling processes become automatized.

If you have ever had a strong emotional reaction to a situation without knowing why, it is possible that one of your automatized emotional processes was activated (Moulds & Bryant, 2004).

Mindfulness is just the opposite of this automatic pilot experience. It is a way of paying close attention to your immediate experiences without getting lost in thought or shifting into automatic patterns of thinking or behaving. It is a shift from Doing Mode into Being Mode.

Doing Mode

Think about your morning routine. When you were in the shower this morning, were you actually ‘in’ the shower, or was your mind racing down the highway to your day-to-day errands? When you were there in the shower, were you feeling the warmth of the water on your skin, smelling the fragrance of the soap, and hearing the sound of the water, or was your mind elsewhere?

When we are preoccupied with thoughts of the past or the future, or with thoughts of getting things done, we are in Doing Mode. Doing Mode can also be expressed as Thinking Mode, because to get things done, we generally have to think about those things first. We make ‘to do’ lists in our minds and then do them in Doing Mode.

Thinking Mode takes us away from experiencing the world directly with our senses. When we leave Thinking Mode, and focus our awareness directly on the information provided by our senses, we have entered Sensing Mode.

Mindful Awareness teaches us to focus on the world experienced directly by our senses: touch, taste, smell, hearing, and sight. Experiencing life in sensing mode introduces us to a richer world. It’s impossible to be bored or apathetic if you treat each experience as if it is happening to you for the first time. Approaching each new situation without any assumptions or expectations is referred to as Beginner’s Mind, or sometimes as Child’s Mind.

Being Mode

Williams (2008) presents research that indicates the benefits of mindful states of being. Mindfulness is associated with decreases in levels of rumination (a process of becoming ‘trapped’ in negative thought cycles), avoidance (refusing to accept the reality of a given situation), perfectionism (attempts to control a situation), and maladaptive self-guides (attempting solutions that maintain the problem). Taken together, this reduction in negative thought and behavior patterns form what is known as Being Mode.

By focusing on the present moment, we leave Thinking Mode and enter into Sensing Mode.

In Sensing Mode, we simply allow ourselves to become fully aware of what is going on around us and within us, without attempting to control or manipulate these events and sensations. Being Mode reduces ruminations by allowing us to become aware of our thoughts and feelings as internal processes that we can choose to participate in, or choose to simply observe. In Being Mode we learn that we are not our thoughts.

In Western modes of thought, we are taught that our thoughts and feelings are our identities. Descartes said, “I think, therefore I am,” but does that mean that if you stop thinking, you cease to exist?

Being Mode allows us to detach from our cognitive and emotional processes and observe them, or stop them, if we so choose.

Being Mode reduces avoidance by allowing us to be in the present moment. If you are trying to avoid an unpleasant emotional state, you set up a cycle of denial. This denial creates anxiety and stress, which leads to more unpleasant emotional states to be avoided, which starts the avoidance cycle all over again. Being Mode allows us to participate in the unpleasant situation without internalizing it; i.e., without allowing the unpleasantness to become a part of our identity.

Perfectionism can be seen as a control mechanism. It is a displacement technique. If we feel out of control of certain areas of our lives, and we feel powerless to change those areas, we may displace our attention on the areas that we can control. By engaging in compulsive, perfectionist behaviors we assert our control over tangible areas as a substitute for areas over which we may feel we have no control. The idea of “perfection” becomes an obsessive means of anxiety management.

Being Mode allows us to realize that perfection is a subjective ideal. For example, if I asked you to describe your “perfect” day, you are likely to give me a totally different answer to that question than I would give if I were asked the same question.

Since our answers to the question, “What is your idea of the perfect day?” would not be identical, there is no objective definition to the word “perfect.” Being Mode helps one to realize that perfection is a self-defined concept.

In Being Mode we learn that every moment is perfect in and of itself, if we allow it to be.

Finally, Being Mode allows us to disengage from our own cognitive and emotional processes for a time. By doing so, we can become objective observers of our own inner states, without feeling that we must participate in them. Being Mode is a type of metacognition, or “thinking about thinking.” By observing the thoughts and feelings that have led to maladaptive consequences, we gain the ability to change those thought and feeling processes to lead to more productive conclusions.

Moulds, M. L. & Bryant, R. A. (2004). Automatic Versus Effortful Influences in the Processing of Traumatic Material in Acute Stress Disorder. Journal of Cognitive Therapy and Research, Vol. 28, No. 6, December 2004, pp. 805–817.

Williams, G. (2008). Mindfulness, Depression and Modes of Mind. Journal of Cognitive Therapy and Research, Vol. 32, No. 6, December, 2008. Pages 721-733.

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Mindful Moments – 7Cs of Family Resilience

All families encounter problems from time to time. When families go through a crisis, some fall apart, while others manage to “ride the storm out” and come through the other side relatively intact. Research has shown that families who manage to handle a crisis effectively all have certain characteristics in common. These characteristics are called resiliency factors. In this episode of Mindful Moments, we’ll discuss these resilience factors and the 7Cs of Family Resilience.

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Mindful Acceptance

One of the skills we develop in the practice of mindfulness is the skill of ‘acceptance.’ Acceptance allows us to experience emotions without feeling obligated to react to them. This is done by noting the emotion, and then letting go of the negative thought processes that the emotion generates.

We can benefit from Mindfulness by learning to accept the flood of emotions that blocks rational thought. The goal of acceptance isn’t to become a totally rational person, devoid of emotion. Instead, the goal is to practice ‘Wise Mind.’ Wise Mind is the balance of emotional mind and rational mind, in perfect harmony.
To illustrate this concept, let’s suppose that a woman has been arrested for stealing a loaf of bread with which to feed her children. If we approach this situation from Rational Mind, we are only using logic and reason. There is no emotional content to our approach to the situation in Rational Mind. In this situation, Rational Mind would say that she broke the law, and there are penalties for breaking the law, therefore she should be punished.

Wise Mind, on the other hand, would allow logic and reason to be tempered with emotion. In this case, Wise Mind would allow some sense of compassion for the mother and her plight. While the woman in this scenario may have broken the law, she did so because she had love for her children and did not wish to see them go hungry. Wise Mind would recognize this and allow for some leniency.

I’m sure we all know of someone who is subject to wild mood swings. Such a person is ruled by emotions that often run out of control. Imagine that such a person is cut off in traffic. This person becomes very angry and chases down the offender, horn blaring and lights flashing. Perhaps this person even tries to run the offender off of the road. In such a case, this person is being ruled by Emotional Mind. If this person could learn to live in Wise Mind, then he would realize that while the person who had cut him off in traffic had done something dangerous, it may not have been intentional. It could be that this person was distracted. Even if the person had done it intentionally, there is no need to increase the danger to himself by provoking further confrontation in an episode of road rage. In this case, Wise Mind would accept the fact that such events are inevitable on a busy highway. Emotional Mind would then be tempered with Rational Mind, achieving the balance that is the goal of Wise Mind.

According to Follette, et al (2006), “Wise mind is understood as a balance (or dialectic) between emotion mind and reasonable mind, where both emotion and reason are considered before taking action in life.”
This concept is often illustrated as below, where Wise Mind is the overlapping area between Rational Mind and Emotional Mind:

Wise Mind is a balance between Emotional Mind and Rational Mind

In the clinical practice of Mindfulness, clients are taught the concepts of Rational Mind, Emotional Mind, and Wise Mind, and how to differentiate among these states. Each state has its own usefulness; for example, Rational Mind might be good for solving math problems like balancing a checkbook, while Emotional Mind might be good for a romantic interlude. But there are also situations, such as those outlined above in which one mode of mind might not be as productive as another. When using Mindfulness in clinical practice, it is helpful to teach clients the concepts of Rational Mind, Emotional Mind, and Wise Mind, then have them list examples of each in order to gain practice in differentiating among these states.

Follette, V., Palm, K. M. & Pearson, A. N. (2006). Mindfulness and Trauma: Implications for Treatment. Journal of Rational-Emotive & Cognitive-Behavior Therapy, Vol. 24, No. 1, Spring 2006.

Linehan, M.M. (1993). Cognitive Behavioral Treatment for Borderline Personality Disorder. New York : Guilford Press

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What is Mindfulness?

Mindfulness for Therapists


“Mindfulness is the energy of being aware and awake to the present moment. It is the continuous practice of touching life deeply in every moment of daily life. To be mindful is to be truly alive and present with those around you and with what you are doing. We bring our body and mind into harmony while we wash the dishes, drive the car or take our morning cup of tea.”

–Thich Nhat Hanh, Zen Buddhist Monk and Founder of the An Quang Buddhist Institute

Think about the things that have caused you anxiety, stress or depression in the past. Now ask yourself, “Was it the things themselves that caused the anxiety, stress and depression, or was it what I believed about those things?”

Can you think of anything that you’ve ever been worried about, that wasn’t a product of your thoughts and feelings? Isn’t it true, in fact, that the worries come from the thoughts and feelings themselves, and not from the situations in which you find yourself?

If it is true that anxiety and depression are rooted in our thoughts, then we should be able to change our thoughts and eliminate, or at least minimize, anxiety and depression. Mindfulness is a way to change our thoughts. If you can change your thoughts, you can change your world.

The last two decades have seen an explosion in interest in the utility of Mindfulness for treating mental disorders. Consequently, there has been an interest in devising a clinical definition for the term ‘Mindfulness.’
Kabat-Zinn (2003) refers to Mindfulness as “paying attention on purpose, in the present moment, and non-judgmentally to the unfolding of experience moment by moment.”

Segal et al., (2004) describe Mindfulness as a state of being “fully present and attentive to the content of moment-by-moment experience.”

According to Baer (2003), “In general, while the specific focus of mindfulness may vary, individuals are instructed to be aware of thoughts but to be removed from the content of these thoughts.”

In short, mindfulness is a state of awareness in which we can choose to participate in the thought stream, or to simply observe it.

When we are able to be fully in the present, without worries, stress, or anxiety about the past or the future, we are being mindful. This doesn’t mean that we ignore or deny our thoughts or feelings. Instead, it just means that for now, in the present moment, we are consciously choosing how to respond to those thoughts and feelings.

REFERENCES

Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125-143.

Davidson, R.J., Kabat-Zinn, J., Schmacher, J., Rosenkranz, M., Muller, D., Santorelli, S.F., Urbanowski, F., Harringtron, A., Bonus, K., Sheridan , J.F., Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65: 564-570, 2003.

Segal, Z. V., Teasdale, J. D., & Williams, J. M. G. (2004). Mindfulness-based cognitive therapy: Theoretical rationale and empirical status. In S. G. Hayes, V. Follette, & M. Linehan (Eds.), Expanding the cognitive behavioral tradition. New York: Guilford Press.

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Book a Training Seminar with Dr. Hall

client portal for teletherapy with Charlton Hall, PhD, LMFT

Charlton Hall, PhD is available for training and instruction at your organization. This could be an in-person training, a webinar training, or a hybrid of both. Seminars are available in half-day, all-day, or multiple day formats for any of the topics in our Courses section of the website.

The complete Mindfulness-Based Ecotherapy Certified Facilitator Program is also available as a live or web-based seminar. This fifty-hour seminar is only available live in a two-week format, in two 5-day weeks of five hours each, either online or live at your organization. Volume discounts on the Mindfulness-Based Ecotherapy Workbook are available for these seminars for your employees or members.

Any of our other courses are also available for your organization. Please view our Courses section if interested.

Dr. Hall is also available for public speaking opportunities on the following topics:

  • Clinical Supervision Best Practices
  • Ecotherapy
  • Marriage and Family Therapy
  • Mindful Suicide Prevention
  • Mindful Treatment of Addiction
  • Mindful Treatment of Anxiety
  • Mindful Treatment of Trauma
  • Mindfulness
  • Mindfulness-Based Ecotherapy
  • Play Therapy
  • Suicide Prevention
  • Trauma

Rates for public speaking and seminars are $500 per day per half-day or $1000 per day for full day, plus travel expenses, meals, and accommodations.

Charlton Hall, PhD is available for training and instruction at your organization. This could be an in-person training, a webinar training, or a hybrid of both. Seminars are available in half-day, all-day, or multiple day formats for any of the topics in our Courses section of the website.

The complete Mindfulness-Based Ecotherapy Certified Facilitator Program is also available as a live or web-based seminar. This fifty-hour seminar is only available live in a two-week format, in two 5-day weeks of five hours each, either online or live at your organization. Volume discounts on the Mindfulness-Based Ecotherapy Workbook are available for these seminars for your employees or members.

Any of our other courses are also available for your organization. Please view our Courses section if interested.

Dr. Hall is also available for public speaking opportunities on the following topics:

  • Clinical Supervision Best Practices
  • Ecotherapy
  • Marriage and Family Therapy
  • Mindful Suicide Prevention
  • Mindful Treatment of Addiction
  • Mindful Treatment of Anxiety
  • Mindful Treatment of Trauma
  • Mindfulness
  • Mindfulness-Based Ecotherapy
  • Play Therapy
  • Suicide Prevention
  • Trauma

Rates for public speaking and seminars are $500 per day per half-day or $1000 per day for full day, plus travel expenses, meals, and accommodations.

If you are interested in booking a training or a public speaking engagement with Dr. Hall, please complete the contact form below.

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December is National
Stress-Free Family Holidays Month

It’s been said that the holidays are the one time of year we get together with family to remember why we only see them one time a year.

We live in stressful times. The holidays can be particularly challenging when it comes to family dynamics. Here are some tips to help you have a calmer and stress-free holiday season.

Ten Ways to have a Stress-Free Holiday Season


1. Plan ahead
It can be tempting to attend multiple events in multiple locations during the holidays; however, if you give in to the temptation you may find yourself running around all over the place trying to visit everyone. Plan ahead by limiting your appearances to one or two special occasions. It may help to alternate locations in even and odd years.  For example, if you’re a married couple you may choose to spend the holidays with your parents in even-numbered years and then with your spouse’s parents in odd-numbered years. Look for compromises whenever possible to have a stress-free season.

2. Say no
It’s okay to say “no!” If you find yourself feeling overwhelmed, just set limits. For example, if you’ve been invited to too many holiday events this year, just say “no” and thank them for the offer, then consider attending next year. The ones who matter won’t mind you saying “no,” and the ones who mind you saying “no” don’t matter.

3. Plan spending
Make a budget and stick with it. Remember that the purpose of the season is friends and family, not material goods. Don’t buy a lot of things that you’ll be paying off well into the next year. Consider making something hand-made instead if you have the time and talent, or just offer to help out. Your family will cherish and remember the hand-made things longer than something bought from a store. I know I still have many gifts that were made for my by my children that I cherish to this day.

4. Create a soothing environment
Turn on calming holiday music. Light scented candles. Dim the lights and create ambience. Research demonstrates that scents and music are especially useful in creating a stress-free environment.

5. Set boundaries
We all have at least one relative who triggers us at holiday get-togethers. Deal with difficult friends and relatives by setting appropriate boundaries. Remember that you can agree with another’s right to hold their viewpoint without agreeing with the viewpoint itself. If they still refuse to respect your boundaries, consider not inviting them next year. Being blood-related to someone doesn’t give them the right to be mentally or verbally abusive.

6. Respect differences
All families have different viewpoints, different interests, and different tastes. You can honor those varying opinions and interests without having to agree with them. It helps to focus on what you have in common instead of what you disagree on. This is difficult, but with practice you can respect differences, set appropriate boundaries, and have a calmer holiday season.

7. Be realistic
If you are one of those people who routinely takes on too much during the holiday season then winds up regretting it, learn to be realistic about budgeting your time and energy. Ask family members to help, or set aside some tasks for later and eliminate others altogether. Focus on the intention of the season, which is spending time with loved ones, and the rest will fall into place.

8. Take a break
Before beginning any holiday activity, first ask yourself, “What’s the smallest thing I can do today to make a difference?” then concentrate on doing that. Once that’s done, take a break. If you have any energy left after your break, then go on to the next thing. Repeat this process until you’re out of energy or you’ve finished everything.

9. Be flexible
The nature of plans is that they change…sometimes on the spur of the moment. It helps to realize that this will happen at least once and with all probability more than once this holiday season. When you plan ahead and expect the unexpected, you’re less likely to be stressed out when things go wrong. Flexibility goes a long way towards helping you de-stress your holidays.

10. Unplug
Finally, don’t forget to spend time outdoors! While the holidays tend to be less conducive to outdoor activities, depending on the weather where you live, you can still bundle up and enjoy a brisk walk around the block or in a park. Spending time outdoors naturally calms the nervous system and re-sets your body to help you calm down and be more present in the moment.

Always remember to focus on the intention of the holidays: Spending time with loved ones. Everything else is secondary to that goal. A year from now your family won’t remember the decorations, the party, or the meal, but they will remember the laughter, good times, and the love you shared together!

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Mindful Moments – The Emotional Aggression Cycle

We create our reality based on our assumptions and our perceptions about the world and our place in it. By making assumptions about the world, and using our perceptions, based on those  assumptions,  to  look  for  evidence  to  support  our  beliefs,  we  eventually  create  a  reality  that reflects those assumptions and perceptions.
In this episode of Mindful Moments will talk about how our assumptions and our perceptions influence our reality.

 

To be informed when new episodes of Mindful Moments are available, subscribe to the Mindful Ecotherapy Center’s Youtube channel. You may also subscribe to the newsletter. Future episodes will be announced in the newsletter as they become available.

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NEW COURSE COMING: STARTING A THERAPY BUSINESS

starting a therapy business

Dr. Charlton Hall started his Family Therapy business career in 2008 by creating and running the Family Therapy Teaching Clinic at the Upstate Family Resources Center in Spartanburg, South Carolina while still in graduate school. He served as the Clinical Services Director, then went on to start several successful Family Therapy private practices. His last job before becoming the Director of the Mindful Ecotherapy Center was Chair of Behavioral Health for a major medical clinic in South Carolina.

Starting a Therapy Business Course Content

In this course due to be released in January of 2023 Dr. Hall shares his expertise and experience in starting a private practice therapy business. In this course we will cover:
• Is private practice right for you?
• Types of business entity
• Taxes and licenses needed for each type of business entity
• Learn the basics of getting on insurance panels and the process of billing
• How to get on EAPs and HMOs
• Professional Organizations: Should you join them?
• Advertising and Branding
• Marketing your therapy business
This course will be announced in the newsletter when available!