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Research-Proven Results

In 2016, Open Sky concluded our tenth year of data collection in the study of our outcomes. Our empirical research shows that Open Sky is extremely effective at helping our adolescent and young adult students, and that our students maintain these gains for months after graduating.

 

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 young adult students.

 

Empirical Research: Much More than Satisfaction Surveys

Most programs conduct satisfaction surveys with their students and families at the end of treatment. 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.

 

Open Sky Research Outcomes

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 outcomes, we found that our adolescent students’ average score is 92 upon arrival and 31 after graduation. 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!

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 to stay within the normal community range.

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

 

Substance Abuse and Addiction Issues Improve

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

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 one year post-treatment (Myers & Brown, 1996). The higher abstinence-focused coping scores of our teen students one year after Open Sky indicate their greater resiliency to relapse. Higher scores also indicate Open Sky’s effectiveness in helping our students overcome their substance and addiction issues.

 

Problem Behaviors Decrease

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

 

Summary of Open Sky Research

Most of our adolescent and young adult students make behavioral, interpersonal, and mental health gains while overcoming substance abuse and addiction issues. Our research shows that our students are getting better across multiple dimensions and maintaining these improvements well after departing Open Sky. We will continue to measure the impact of what we do and refine our program to best serve our students and their families.

 

In More Depth: 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, p. 277) 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.” 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 toward ever-increasing numbers of out-of-home placements for adolescents.

Even as 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, data are scarce regarding numbers in treatment and the efficacy of that treatment. 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 the continued effectiveness of this kind of treatment and for which types of students and families it 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 (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). This is true even as 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, scant literature addresses wilderness or outdoor therapy models with adults (Kelly, 2006).

Open Sky conducts research with both adolescent and young adult students.

 

Adolescent Research

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:

  1. 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.
  2. 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.
  3. 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.
  4. 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:

  1. 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 6 times (arrival, graduation, 3 months after graduation, 6 months after graduation, 12 months after graduation, and 24 months after graduation).
  2. Adult Attachment Scale (Collins & Read, 1990). This 18-item self-report survey is designed to provide information regarding parents’ feelings about relationships, which are useful in determining for which families wilderness treatment is most effective. Parents are asked to complete this measurement at arrival only.

 

Young Adults

Our young adult study (for those 18 and older) is a longitudinal one-group design, following every student and family for two years after graduation. We ask our young adult students to complete questionnaires 6 times: at arrival, graduation, 3 months after graduation, 6 months after graduation, 12 months after graduation, and 24 months after graduation.

Young adult students are asked to complete four measurements:

  1. 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.
  2. 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.
  3. 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.
  4. 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 young adult students are asked to complete one measurement one time:

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

In More Depth: Research Results

Open Sky has presented research results at professional and educational events and conferences such as that of the Independent Educational Consultants Association (IECA).

Areas of Impact

Open Sky transcends traditional wilderness therapy by delivering an experience greater than the sum of its parts: treatment for the whole family, a powerful and transformative experience, a focus on total health and well-being, and an unyielding belief that everyone has the capacity to thrive.