There are few high-quality studies using randomized controlled trials (RCTs) in the adventure and wilderness therapy literature. Thus, a unison call is heard for more such studies to be carried out. This article presents a Norwegian wilderness therapy research project that planned to incorporate this “gold standard” that is regarded as the most scientific and rigorous approach available. We did not succeed. Mounting challenges led us to discard the RCT altogether and select other methodologies. Here, we account for the ethical, health outcome, practical, and empirical obstacles that we encountered when attempting to randomize at-risk adolescents into experiment and control groups. Our conclusion is that although RCTs may be superior in some aspects, they hold the potential to become bad science when the interventions are as complex and multi-faceted as adventure and wilderness therapy programs.

Becker, S. P. (2010). Wilderness therapy: Ethical considerations for mental health professionals. Child & Youth Care Forum, 39, 47-61.
Google Scholar | Crossref | ISI
Berman, D., Davis-Berman, J. (2013). The role of therapeutic adventure in meeting the mental health needs of children and adolescents: Finding a niche in the health care systems of the United States and the United Kingdom. Journal of Experiential Education, 36, 51-64.
Google Scholar | SAGE Journals
Bowen, D. J., Neill, J. T. (2013). A meta-analysis of adventure therapy outcomes and moderators. The Open Psychology Journal, 6, 28-53.
Google Scholar | Crossref
Clark, J. P., Marmol, L. M., Cooley, R., Gathercoal, K. (2004). The effects of wilderness therapy on the clinical concerns (on Axes I, II, and IV) of troubled adolescents. Journal of Experiential Education, 27, 213-232.
Google Scholar | SAGE Journals
Fernee, C. R., Gabrielsen, L. E., Andersen, A. J. W., Mesel, T. (2015). Therapy in the open air. Introducing wilderness therapy to the adolescent mental health services in Scandinavia, 2, e14.
Google Scholar
Gass, M. A., Gillis, H. L., Russell, K. C. (2012). Adventure therapy: Theory, research, and practice. New York, NY: Routledge.
Google Scholar | Crossref
Gelman, A. (2006). Multilevel (hierarchical) modeling: What it can and cannot do. Technometrics, 48, 432-435.
Google Scholar | Crossref | ISI
Grossman, J., Mackenzie, F. K. (2005). The randomized controlled trial: Gold standard or merely standard? Perspectives in Biology and Medicine, 48, 516-534.
Google Scholar | Crossref | Medline | ISI
Hacking, I. (2000). The social construction of what? Cambridge, MA: Harvard University Press.
Google Scholar
Harper, N. J. (2010). Future paradigm or false idol: A cautionary tale of evidence-based practice for adventure education and therapy. Journal of Experiential Education, 33, 38-55.
Google Scholar | SAGE Journals
Henderson, B., Vikander, N. (2007). Nature first: Outdoor life the friluftsliv way. Toronto, Ontario, Canada: Natural Heritage Books.
Google Scholar
Neill, J. T. (2008). Enhancing personal effectiveness: Impacts of outdoor education programs (Unpublished doctoral dissertation). University of Western Sydney, NSW, Australia. Retrieved from http://wilderdom.com/wiki/Neill_2008_Enhancing_life_effectiveness:_The_impacts_of_outdoor_education_programs
Google Scholar
Norton, C. L., Tucker, A., Russell, K. C., Bettmann, J. E., Gass, M. A., Gillis, H. L., Behrens, E. (2014). Adventure therapy with youth. Journal of Experiential Education, 37, 46-59.
Google Scholar | SAGE Journals
Palinkas, L. A. (2014). Qualitative and mixed methods in mental health services and implementation research. Journal of Clinical Child & Adolescent Psychology, 43, 851-861.
Google Scholar | Crossref | Medline | ISI
Ridge, N. W., Warren, J. S., Burlingame, G. M., Wells, M. G., Tumblin, K. M. (2009). Reliability and validity of the Youth Outcome Questionnaire Self-Report. Journal of Clinical Psychology, 65, 1115-1126.
Google Scholar | Crossref | Medline | ISI
Shadish, W. R., Cook, T. D., Campbell, D. T. (2002). Experimental and quasi-experimental designs for generalized causal inference. Boston, MA: Houghton Mifflin.
Google Scholar
Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.
Google Scholar
Spirito, A., Stanton, C., Donaldson, D., Boergers, J. (2002). Treatment-as-usual for adolescent suicide attempters: Implications for the choice of comparison groups in psychotherapy research. Journal of Clinical Child & Adolescent Psychology, 31, 41-47.
Google Scholar | Crossref | Medline | ISI
Thistlethwaite, D. L., Campbell, D. T. (1960). Regression-discontinuity analysis: An alternative to the ex post facto experiment. The Journal of Educational Psychology, 51, 309-317.
Google Scholar | Crossref | ISI
Waddell, C., Godderis, R. (2005). Rethinking evidence-based practice for children’s mental health. Evidence-Based Mental Health, 8, 60-62.
Google Scholar | Crossref | Medline
Wilson, S. J., Lipsey, M. W. (2000). Wilderness challenge programs for delinquent youth: A meta-analysis of outcome evaluations. Evaluation and Program Planning, 23, 1-12.
Google Scholar | Crossref | ISI
Wolff, N. (2000). Using randomized controlled trials to evaluate socially complex services: Problems, challenges and recommendations. The Journal of Mental Health Policy and Economics, 3, 97-109.
Google Scholar | Crossref | Medline
View access options

My Account

Welcome
You do not have access to this content.



Chinese Institutions / 中国用户

Click the button below for the full-text content

请点击以下获取该全文

Institutional Access

does not have access to this content.

Purchase Content

24 hours online access to download content

Your Access Options


Purchase

JEE-article-ppv for $36.00