Preteens Sometimes Better Candidates For Therapeutic Interventions Than Teens

The experiential therapeutic model is proven more effective than talk therapy for children under 14 years of age. SUWS Seasons is one of the few wilderness programs specializing in this age group.

This summer more child psychologists will recommend that their preteen clients try “adventure therapy” instead of traditional talk therapy. There is an increasing amount of evidence indicating that preteens are not developmentally ready to sit and analyze their problems in one-hour weekly sessions at a therapist’s office.

A study by Yale University professor Alan Kazdin found that 40% to 60% of young people drop out of psychotherapy after a few sessions. Psychiatrists at the Nagoya City Graduate School of Medical Studies in Japan found that “talk therapy” was helpful in the short-term but produced “no significantly favorable” results in follow-up studies six months later. German professors at Aachen University found that only 31% of children undergoing twenty-five sessions of psychotherapy improved, compared to the 8% in the control group who improved without any therapy whatsoever.

Wright State University professors Dene Berman and Jennifer Davis-Berman, writing in a journal article entitled “Adventure vs. Psychotherapy,” said that traditional therapy “is not an effective way of reaching all types of people, especially those who are, by nature, rather nonverbal.” For example, they believe that adolescents with problems like Attention Deficit Disorder may not be good candidates.

“Some clients simply cannot discuss their issues within a time schedule,” said Dr. Berman, who is Clinical Professor of Psychology at Wright State University in Dayton, Ohio.

Since approximately 2% to 5% of preteens suffer from mental problems like depression and anxiety, psychologists are increasingly recommending “adventure therapy.”

Adventure therapy involves going into a wilderness setting for several weeks with trained therapists who interact with the preteens on a twenty-four basis. A study by the University of Idaho’s Wilderness Research Center showed that most of those who participated in such programs continued to improve one year after treatment. Dr. Berman and others believe that “the 24-hour-a-day, small group experience sets the stage for intense psychotherapy.”

“We can turn around the negativity,” said therapists at Seasons, a therapeutic wilderness program for ages 10 to 13 years. “This is the best time to do it – before they hit high school. Before they learn to drive. Before the pressures of getting into college come into play.”

Seasons is one of only a few wilderness programs for preteens: the vast majority are set up for ages 14 and up. Seasons enrolls preteens only after a careful screening process that insures each candidate is right for the program. Many have only mild to moderate behavioral or social problems. Some have problems with aggression, depression, and anxiety. Some are caught in the middle of severe custody and divorce battles. In such situations, time spent at Seasons gives parents breathing room to manage their problems privately, while their children freely work out their concerns with therapists.

Many of the children who enroll in the Seasons camp program have been through a year or two of the traditional weekly hour of “talk therapy.”

“Preteens are not developmentally ready for psychotherapy,” a Seasons counselor said. “These kids think in concrete terms and learn by tangible experience. They think in terms of what’s in front of them, what’s happening now. They are not ready to sit and analyze their behaviors. It’s better to ‘show them, not tell them.”

Campers typically stay four to nine weeks at Seasons, which is an auxiliary of the SUWS wilderness program for older teens in Old Fort, North Carolina. During that time, preteens hike and camp in small groups of seven or fewer campers. They live with counselors who work with them on a twenty-four hour basis to help them change their negative behaviors and attitudes into positive ones. The emphasis is on building self-care, confidence, trust, empathy, and an appreciation of the natural world in all its wonder.

“Kids this age are more malleable, more open to change than older teens,” said a therapist. “They know they’re miserable and they want to change, but sometimes they have fallen into negative patterns. When they get out in the wilderness, their old patterns of behaviors don’t work anymore. They can’t slam doors. Other people ignore them when they pout and sulk. They have to come back to the group and work it out in a healthy way.”

Another advantage of working with the preteen group is that their parents are often more open to change than parents of teenagers. For one thing, they have been through fewer years of disruption and bad behaviors. They are more willing to change their parenting styles, if necessary, and to learn new ways of coping with the problems of older children. They are ready to do whatever is necessary to change the negative patterns in their family.

Talk therapists often never see their young clients tantrum and sulk, because most of these young people can control themselves during a weekly office hour. Meltdowns do occur during a wilderness program when little daily frustrations like being caught in rain or having a blister mount up.

“Suddenly we understand what their parents were talking about,” a Seasons therapist said. “This mellow little kid really does have anger issues after all.”

In the wilderness, preteens have to learn to talk through problems, communicate frustrations, and cope in healthy ways. They learn the give and take of healthy relationships as they bond to their little group of adventurers. They begin to understand that their behavior affects themselves and the other members of their group. If you don’t dry out your socks, you’ll develop blisters the next day. If you are angry and sulk, you take away from the fun of a campfire.

“It is therapy in the here and now,” the counselor explained. “If you do this, you have this impact. If you are kind to others, things get better. It’s all about natural consequences and learning by concrete experience. They become aware of the effect of their behaviors as they happen. We help them understand and process their feelings. What they learn here carries over into their family and school life when they return back home.”

One particularly effective tool Seasons uses is “Paws With a Purpose”. The administrators at Seasons teamed up with a non-profit agency to provide children with gentle animals. Often a child who closes up in relationships will show affection and caring to a friendly dog. In the North Carolina program, for example, a Labrador named Zeb seems to know just the right thing to do. If a camper is upset, he licks her face. If she is lonely, he brings a stick to throw and retrieve.

“It’s only a summer, but we can change lives,” one Seasons therapist said. “When a family reunites for their final campfire and truth circle, and their child demonstrates all the survival skills she’s learned for her parents, it’s a happy time for everyone. The family heals. Things are better. Everyone can go home.”

References

1. Clinical Child Psychology and Psychiatry, Vol. 1, No. 1, 133-156 (1996)
DOI: 10.1177/1359104596011012
© 1996 SAGE Publications
Dropping Out of Child Psychotherapy: Issues for Research and Implications for Practice
Alan E. Kazdin at Yale University

2. Prax Kinderpsychol Kinderpsychiatr. 2005 Sep;54(7):598-614. Related Articles, Links. [Efficacy of psychodynamic short-term psychotherapy for children and adolescents with behavioral disorders]

[Article in German]
Winkelmann K, Stefini A, Hartmann M, Geiser-Elze A, Kronmüller A, Schenkenbach C, Hildegard H, Kronmüller KT.

3. http://www.lin.ca/resource/html/Vol22/v22n2a4.htm
Adventure As Psychotherapy: A Mental Health Perspective
Dene S. Berman and Jennifer Davis-Berman *

4. Psychotherapy for depression among children and adolescents: a systematic review
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan and 2Section of Evidence-Based Mental Health, Health Service and Population Research Department, Institute of Psychiatry, London, UK

Norio Watanabe, Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku Nagoya 467-8601, Japan.
E-mail: noriow@med.nagoya-cu.ac.jp
Watanabe N, Hunot V, Omori IM, Churchill R, Furukawa TA. Psychotherapy for depression among children and adolescents: a systematic review.