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Live Licensed or Die: The Why and the How

Live Licensed or Die: The Why and the How. UNH- TAPG Conference June 23, 2007 Will White LCSW, LADAC. Outline of the Talk. Welcome to New Hampshire- State Motto- Live Free or Die- Background Warm up activity Learning Style Whys HB 1738 Concerns

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Live Licensed or Die: The Why and the How

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  1. Live Licensed or Die: The Why and the How UNH- TAPG Conference June 23, 2007 Will White LCSW, LADAC

  2. Outline of the Talk • Welcome to New Hampshire- State Motto- Live Free or Die- • Background • Warm up activity • Learning Style • Whys • HB 1738 • Concerns • Avenues for Licensure- individual & program • Questions

  3. Why • Early history- • Growth of programs • Media exposure • Accidents and deaths in programs • Increase in licensed programs • Increase in licensed providers • Lack of research • The blurring of lines due to definitions of programs- Wilderness, Boot Camp, Emotional Growth, Outdoor Behavioral,… • Checks and balances

  4. Early History • The bad old days where, in some programs, punitive tactics where used. • Chronicled in “Loving them to Death” article in Outside Magazine, October 1995 by John Kauker. • Although these programs were the exception and not the rule. Programs need to be transparent, self-critical, licensed

  5. Growth of Programs • Adventure/wilderness/OBH programs have been around for fifty years. • There are over 116 OBH in existence. (Russell, 2007) • The majority of programs are less than twenty years old. • Models are various- Base Camp, expedition, residential, integrated expedition. • Of Outdoor Behavioral Programs identified by Russell 33.8% are owned by for profits.

  6. Media Exposure • When adventure therapy is shown on television or in magazines it is about what went wrong or what is funny. Some exceptions • Brat Camp- The good, the bad and the ugly • Books- :” Help at Any Cost” Maia Szalavitz, “Shouting at the Sky” Gary Ferguson.

  7. Incidents, accidents and fatalities in programs • From the years 2001-2004 the rate of therapeutic holds, runaways, injuries, and illness steadily declined. (Russell, 2007) • OBHIC related programs that 3.0 fatalities for every 1 million user days in the field. (Russell, 2007). • Yet fatalities happen. (As they do in RTC, boarding schools, high schools, etc..) • Wilderness is not safe • Population is a challenging one.

  8. Increase in licensed programs • More states have licenses for Adventure Therapy (Utah, Oregon) • Some states are developing them (Colorado, Montana) • New England programs tend to work under different license such as RTC or Inpatient. • National License available- JCOH, CARF • Of NATSAP members of the Adventure Therapy programs 87% are licensed by their state. • Study or 63 OBH programs 53 said they were licensed in the state they

  9. Why are some programs unlicensed? • Good question! Some Responses: • “Unavailable”- Solve it through being CARF, JCOH • “Do not want someone telling them how to do things.” • “Psychotherapist are “ruining” what we used to do”.

  10. Lack of research • “paucity of research” Russell, 2007 • Difficulty of research due to various models • Evidenced Based…. • Yet often the therapy used in conjunction with the outdoor experience is often researched including cognitive behavioral, Mutisystemic therapy, dialectical behavioral therapy.

  11. Blurring of lines • General public (and even people in the field) has a challenge in defining the difference between boot camp, wilderness, adventure therapy, outdoor behavioral, etc.. • General public may view us all as “like Outward Bound” or “boot camps” • There is consolidation of programs and many are owned by larger corporations who have varied levels of care.

  12. Checks and Balances • Having a license welcomes oversight • Having a licensed professionals working for your organization encourages dialogue when ineffective or questionable interventions are used. • Licenses for individuals and programs gives a clear line of responsibility for treatment methods.

  13. HB 1738 • Proposed by Congressman George Miller from California- • This bill is still in committee and is currently being investigated by the GAO. • Review of the bill.

  14. Concerns • Name of bill. • Needing to follow license regulations of program state and student state. This is very difficult in New England. Creates more bureaucracy.

  15. Avenues for licensure • Individuals- should be licensed by your state to the highest level possible. If you specialize than get the specialty license (for example substance abuse-Licensed Alcohol and Drug Abuse Counselor). • Programs should be licensed by the state the program is in. Should consider federal licensure by Joint Commission on Accreditation for Healthcare (JCOAH) or Commission of Accreditation of Rehabilitation facilities • AEE is a good accreditation but is not (at present) therapeutically focused.

  16. Questions???

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