Research-Proven Results

In 2012, Open Sky concluded our sixth year of data collection in the study of our outcomes and our empirical research shows that Open Sky is extremely effective at helping our adolescent and young adult students. In addition, we have found that our students maintain these gains for months after graduating.

Watch the webinar , "Does Open Sky Work? A Review of Research"


“Open Sky conducts research with each and every student and family. We believe that empirically evaluating our students’ outcomes, in addition to their satisfaction with treatment, is critical to conducting an effective and powerful program.”

Joanna Bettmann, PhD, LCSW, Former Open Sky Research Director
Assistant Professor, University of Utah School of Social Work


Learn more about the empirical research being conducted at Open Sky:
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Open Sky Research Question

Open Sky conducts evaluative research with every student and family. Our research seeks to answer the question: for which students and families is wilderness treatment most effective? We are currently conducting two studies, one with the adolescents in our program and one with the adult students.

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Empirical Research: Much More than Satisfaction Surveys

Most programs conduct satisfaction surveys at the conclusion of treatment with its students and families. Satisfaction is an important measure for customer service but not for determining if the program is effective. Open Sky employs empirically validated research instruments to measure the success of our program and the results prove that it works.

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Open Sky Research Outcomes

Mental Health Improvessmiling student writing home

Using the Youth Outcome Questionnaire (Y-OQ), an empirically-validated instrument designed to indicate change while in treatment, our adolescent students show statistically significant improvements from arrival to departure on every subscale of the instrument (Intrapersonal Distress, Interpersonal Relations, Behavioral Dysfunction, Somatic Symptoms, Critical Items, and Social Problems).

In 2009, after analyzing three years of our outcomes, we found that our adolescent students’ average score upon arrival is 92 and average graduation score is 31. On this instrument (where lower scores equal less mental health distress), a clinically significant drop is only 13 points: Open Sky students drop over 60 points during their stay!

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Within two months, our adolescent students will go from needing intensive inpatient treatment to returning to a normal community range. This research also shows that for more than a year after graduation from Open Sky, our students are able to maintain those gains made at Open Sky and stay within the normal community range.

Using the Outcome Questionnaire, an adult version of the Y-OQ, we measured statistically substantial gains among our adult students from arrival to graduation. These findings show a clinically significant improvement in mental health symptoms and show maintenance of this improvement for months after graduation.

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Substance Abuse and Addiction Issues Improve

Using the Adolescent Relapse Coping Questionnaire, our adolescent students reported significantly stronger skills to cope with substance abuse, relapse and addictive behaviors and reported stronger abstinence-focused coping skills by the end of treatment and maintained those gains for more than a year afterwards.

According to Myers and Brown (1996), abstinence-focused coping is the best predictor of concurrent and future substance use. Notably, higher abstinence-focused coping scores correlate with lower drug/alcohol use at 1-year post alcohol treatment (Myers & Brown, 1996). The higher abstinence-focused coping scores of our teen students one year after Open Sky indicates their greater resiliency to relapse. It also indicates Open Sky’s effectiveness at helping our students overcome their substance and addiction issues.

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Problem Behaviors Decrease

On the University of Rhode Island Change Assessment, our adolescent and adult students reported significant increases from arrival to graduation (average of 60 days stay at Open Sky) on their readiness to recognize and change their own problem behaviors. Further, our students reported continued growth in openness to change for more than a year following treatment. Open Sky is effective at helping students begin the process of change and accept responsibility for their problems.

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Open Sky Summary of Research Conclusionsgirls team!

Our research shows that our students are getting better across multiple dimensions and maintain these improvements well after departing Open Sky. Most of our adolescent and adult students make behavior, interpersonal, and mental health gains while overcoming substance abuse and addiction issues. These gains made while at Open Sky are maintained well beyond graduation. We will continue to research the effectiveness of Open Sky to measure the impact of what we do, so as to continue to refine our program in order to best serve our students and their families.

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Open Sky Research Rationale

Significant numbers of children spend their days and nights in residential and inpatient treatment, but estimates differ on the numbers. Smollar and Condelli (1990) found that, in the United States in 1986, over 100,000 children and adolescents between the ages of 10 and 19 were admitted to psychiatric hospitals, while thousands of others were placed in other out-of-home treatment centers. Goodrich (1994) asserts that “[t]he best estimates are that at least 50,000 adolescents are placed in residential treatment each year in the United States and perhaps a larger number in inpatient psychiatric hospital settings” (p. 277). Between 1969 and 1981, the number of children under 18 in out-of-home placements doubled (Wells, 1991). Even in an age of managed care (Foster, 2002), the data seem to indicate a trend towards ever-increasing numbers of out-of-home placements for adolescents.

Even while the numbers of students in this type of treatment have increased (Edwards, 1994), research and understanding regarding children and adolescents in residential treatment has lagged (Curry, 1991). Since 1994, there is a paucity of data regarding both numbers in treatment and the efficacy of that treatment. Currently, only one large-scale study of wilderness treatment has been published in the peer-reviewed press. This study completed by Keith Russell (2003) examined the outcomes of 858 adolescents in a variety of different wilderness treatment programs. While his study contributed significantly to the literature, more research is needed to determine both the continued effectiveness of this kind of treatment and to determine for which type of students and families this treatment is most effective.

Notably, there is little research investigating adults in wilderness programs, with most of the existing literature focusing on psychological gains through Outward Bound or other wilderness adventure programs that are not therapeutic programs (Asher, Huffaker & McNally, 1994; Goldenberg, McAvoy & Kenosky, 2005; Hyer, Boyd, Scurfield, Smith & Burke, 1996; Kelly, 2006; Paxton, 2000). While these studies consider the short-term gains of wilderness treatment, no significant research has investigated the therapeutic processes or long-term benefits of wilderness programs for adult students (Paxton, 2000) even while adventure-based therapy programs continue to grow in popularity and size (Kelly, 2006). Wilderness and adventure therapies are increasingly used to treat adults with behavioral and substance abuse issues, however, little literature addresses wilderness or outdoor therapy models with adults (Kelly, 2006).

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In More Depth: Research Results Presentation by Joanna Bettmann, PhD, LCSW

Open Sky’s Former Research Director, Joanna Bettmann, PhD, LCSW, presented an educational session on Open Sky’s research results at the 2009 Fall conference of the Independent Educational Consultants Association (IECA) on Nov. 13th in Charlotte, North Carolina.

The session was entitled “What is the Evidence for Effectiveness of Wilderness Therapy Programs?” and included Open Sky’s three year research results. Dr. Bettmann’s presentation explored the evidence for wilderness therapy programs’ effectiveness and intended to provide participants with a solid understanding of the research base that underlies wilderness therapy programs and also which programs and for which types of children and young adults such programs are most effective.  Participants in this session also learned how we effectively evaluate Open Sky’s outcomes and what the industry still needs to learn about wilderness treatment’s effectiveness.

Download the entire educational presentation slides to learn more.

Read all of Dr. Bettmann's research publications here.

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In More Depth: Research with Adolescents at Open Sky

Our adolescent study is a longitudinal one-group design, following every student and family for two years after graduation. We ask adolescents to complete four questionnaires six times: at arrival, graduation, three months after graduation, six months after graduation, 12 months after graduation, and 24 months after graduation.

Adolescent students are asked to complete four measurements:

Youth Outcome Questionnaire 2.0 SR (Wells, Burlingame & Lambert, 1996). This 64-item youth self-report survey designed to gauge general mental health and functioning.

University of Rhode Island Change Assessment (McConnaughy, Prochaska & Velicer, 1983). This 32-item Likert-type survey is designed to assess readiness to change in mental health services students.

Adolescent Relapse Coping Questionnaire (Myers & Brown, 1990a; Myers & Brown, 1990b; Myers & Brown, 1996). This 34-item self-report measure is designed to assess temptation coping skills among adolescents with a history of alcohol and drug abuse.

Adolescent Attachment Questionnaire (West, Rose, Spreng, Sheldon-Keller & Adam, 1998).  This 9-item self-report questionnaire is designed to assess adolescents’ perceptions of relationships with parents.

Parents of adolescent students are asked to complete two measurements:

Youth Outcome Questionnaire 2.0 (Wells, Burlingame & Lambert, 1996).  This 64-item parent report survey is designed to gauge youth mental health and functioning from a parent perspective. Parents are asked to complete this measurement six times (arrival, graduation, three months after graduation, six months after graduation, 12 months after graduation, and 24 months after graduation).

Adult Attachment Scale (Collins & Read, 1990). This 18-item self-report survey is designed to provide information regarding parents’ feelings about relationships, which will be useful in determining for which families wilderness treatment is most effective. Parents are asked to complete this measurement at arrival only.

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In More Depth: Research with Adults at Open Sky

Our adult study (for those 18 years and older) is a longitudinal one-group design, following every student and family for two years after graduation. We ask our adult students to complete four questionnaires six times: at arrival, graduation, three months after graduation, six months after graduation, 12 months after graduation, and 24 months after graduation.

Adult students are asked to complete four measurements:

Outcome Questionnaire 45.2 (Wells, Burlingame & Lambert, 1996). This is a 45-item youth self-report survey is designed to gauge general mental health and functioning.

University of Rhode Island Change Assessment (McConnaughy, Prochaska & Velicer, 1983). This 32-item Likert-type survey is designed to assess readiness to change in mental health services students.

Addictive Disorders Screen – Revised (Howatt, 2006). This 56-item self-report instrument is designed to measure students’ propensity for addictive behaviors, such as drugs/alcohol, internet use, workaholism, etc.

Psychological Separation Inventory (Hoffman, 1984). This 138-item self-report instrument is designed to measure psychological individuation, the ability to establish oneself as healthily independent.

Parents of adult students are asked to complete one measurement one time:

Adult Attachment Scale (Collins & Read, 1990). This 18-item self-report survey is designed to provide information regarding parents’ feelings about relationships, which will be useful in determining which families wilderness treatment is most effective. Parents are asked to complete this measurement at arrival only.

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References

  1. Asher, S.J., Huffaker, G.Q., & McNally, M. (1994). Theurapeutic considerations of wilderness experiences for incest and rape survivors. Women & Therapy, 15 (3/4), 161-174.
  2. Collins, N.L., & Read, S.J. (1990). Adult attachment, working models, and relationship quality in dating couples. Journal of Personality and Social Psychology, 58 (4), 644-663.
  3. Curry, J.F. (1991). Outcome research on residential treatment: Implications and suggested directions. American Journal of Orthopsychiatry, 61 (3), 348-357.
  4. Edwards, J.K. (1994). Children in residential treatment: How many, what kind? Do we really know? In G. Northrup (Ed.), Applied research in residential treatment (pp. 85-99). New York, NY: The Haworth Press, Inc.
  5. Foster, E.M. (2002). Modeling child and adolescent psychiatric hospital utilization: A framework for examining predictors of service use. Children’s Services: Social Policy, Research & Practice, 5 (3), 151-173.
  6. Goldenberg, M., McAvoy, L., & Kenosky, D.B. (2005). Outcomes from the components of an Outward Bound Experience [Electronic version]. Journal of experiential education, 28 (2), 123-146.
  7. Goodrich, W. (1994). Research issues in adolescent inpatient psychiatry. In Ghuman, H.S., & Sarles, R.M. (Eds.), Handbook of adolescent inpatient psychiatric treatment (pp. 277-292). New York, NY: Brunner/Mazel Publishers.
  8. Hoffman, J.A. (1984). Psychological separation of late adolescents from their parents. Journal of Counseling Psychology, 31 (2), 170-178.
  9. Howatt, W.A. (2006). Addiction screening tools vs. addiction clinical measures: Introducing the Addiction Disorder Screen (ADS) -7. Counselor, 7 (1), 48-53.
  10. Hyer, L., Boyd, S., Scurfield, R., Smith, D., & Burke, J. (1996). Effects of Outward
    Bound experience as an adjunct to inpatient PTSD treatment of war veterans [Electronic version]. Journal of Clinical Psychology, 52 (3), 263-287.
  11. Kelly, V.A. (2006). Women of courage: a personal account of a wilderness-based
    experiential group for survivors of abuse [Electronic version]. Journal for Specialists in Group Work, 31 (2), 99-111.
  12. McConnaughy, E.N., Prochaska, J.O., & Velicer, W.F. (1983). Stages of change in psychotherapy: Measurement and sample profiles. Psychotherapy: Theory, Research and Practice, 20, 368-375.
  13. Myers, M.G., & Brown, S.A. (1990a). Coping and appraisal in relapse risk situations among substance abusing adolescents following treatment. Journal of Adolescent Chemical Dependency, 1, 95-115.
  14. Myers, M.G., & Brown, S.A. (1990b). Coping responses and relapse among adolescent substance abusers. Journal of Substance Abuse, 2, 177-189.
  15. Myers, M.G., & Brown, S.A. (1996). The Adolescent Relapse Coping Questionnaire: Psychometric validation. Journal of Studies on Alcohol, 57, 40-46.
  16. Paxton, T., & McAvoy, L. (2000). Social psychological benefits of a wilderness adventure program [Electronic version]. USDA forest service proceedings RMRS-P-15, 3, 202-206.
  17. Russell, K.C. (2003). An assessment of outcomes in outdoor behavioral healthcare treatment. Child and Youth Care Forum, 32 (6), 355-381.
  18. Smollar, J., & Condelli, L. (1990). Residental placement of youth: Pathways, alternatives and unresolved issues [Electronic version]. Children Today, 19 (6), 4-8.
  19. Wells, K. (1991). Placement of emotionally disturbed children in residential treatment: A review of placement criteria. American Journal of Orthopsychiatry, 61 (3), 339-347.
  20. Wells, M.G., Burlingame, G.M., & Lambertm M.J. (1996) Conceptualization and measurement of patient change during psychotherapy: Development of the Outcome Questionnaire and Youth Outcome Questionnaire. Psychotherapy: Theory, Research, Practice, Training, 33 (2), 275-283.
  21. West, M., Rose, M.S., Spreng, S., Sheldon-Keller, A., & Adam, K. (1998). Adolescent attachment questionnaire: A brief assessment of attachment in adolescence. Journal of Youth and Adolescence, 27 (5), 661-673.

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