233. wilderness therapy doesn’t work… so why are we still sending our kids??! feat. dr. will dobud

Sep 28

listen to this episode:

today’s guest is dr. will dobud— a social worker, researcher, and educator who has worked with adolescents and families in the united states, australia, and norway. he is dedicated to improving adolescent therapy outcomes and promoting safe, ethical practices and is an advocate for youth impacted by america’s troubled teen industry.

in this episode, we break down the dangers of the troubled teen industry and why adolescents deserve better mental health care options.

we talk about:

what inspired will to advocate against the troubled teen industry (tti)
how tti programs are organized to reduce legal responsibility
why gen z mental health is still so bad despite efforts to help
wilderness therapy + how it became so popular
who gets sent to wilderness therapy programs + why
the lack of oversight + government regulations over the tti
how tti programs market themselves + why it’s not accurate
if stigma plays a role in getting adolescents proper mental health care
whether the tti can ever truly be reformed
ways to improve mental health care for gen z

Mentioned:

SHOP GUEST RECOMMENDATIONS: https://amzn.to/3A69GOC

About She Persisted

She Persisted is THE Gen Z mental health podcast. In each episode, Sadie brings you authentic, accessible, relatable conversations about every aspect of mental wellness. Expect evidence-based, Gen Z-approved resources, coping skills (lots of DBT), insights, and education in each piece of content you consume. She Persisted offers you a safe space to feel validated and understood in your struggle while encouraging you to take ownership of your journey and build your life worth living.

a note: this is an automated transcription so please ignore any accidental misspellings!

Sadie: [00:00:00] Welcome to She Persisted, the Gen Z Mental Health Podcast. I'm your host, Sadie Sutton. Let's get into it.

Will: you cannot force therapy onto people. That is torture.

where were the adults to actually know what they were regulating, what they were accrediting, what you're doing is of stealing childhood. You're taking this under the guise of mental health care.

We have to dismantle this narrative of sitting idly by, while the troubled teen industry dominates.

Kids were dying. The programs were awful.

You are misleading the public. You are misleading the concerned parent who is going to pay for that program.

How many near misses were there that someone could have stood up and raised their voice and we not have hurt kids?

Every year, this industry receives over $23 billion in funding and enrolls over 120,000 miners in their programs. Yet it is one of our most unregulated and dangerous industries. Yes, I'm talking about the [00:01:00] trouble teen industry, and here is everything you need to know. Hello. Hello and welcome back to She Persisted. If you've listened to the podcast, before, you'll know that I am a survivor of the troubled teen industry. I spent 14 months at a therapeutic boarding school in Montana called Chrysalis School.

Despite all the mental health challenges I've navigated, that was the lowest of lows. We will link other episodes about the trouble teen industry and about my experience there in the show notes.

But I want you to know that this hits incredibly close to home. As someone who plans to become a psychologist, one of the most shocking and disheartening things in the field of psychology is how the troubled teen industry exploits minor mental health problems for their gain.

And what's even more shocking is how they've been doing it so virtually, unchecked and unregulated for decades. One of my goals, both in my career and with the podcast is to raise awareness about these programs and provide actual, reputable mental health resources for kids and teens who are struggling like I once was, and have access to compassionate [00:02:00] evidence-based care.

I was unique in that I saw both sides of the spectrum. I had the best of the best mental health treatment at three East McLean Hospital and a number of local resources I utilized and the other side of the spectrum, the triple teen industry. This episode offers an unfiltered look at the trouble teen industry. We talk about how these programs run, how they've managed to scam families and kids for over 80 years, and what mental health options should actually be available for kids instead. Our guest today is Dr. Will de Budd, a social worker, researcher, and educator who has worked with adolescents and families in the United States, Australia and Norway. He's dedicated to improving adolescent therapy outcomes and promoting safe ethical practices and is an advocate for youth impacted by America's troubled Teen industry. His book. Kids These Days, Understanding and Supporting Youth Mental Health is out September 30th. Eighth, and it is all about why most attempts to help teenagers fail and what we can do about that.

So if this conversation resonates with you and you're left wanting more, head to the link in the show notes to order kids [00:03:00] these days.

This is an incredibly meaningful conversation, and I hope it serves as a warning for teens and their parents on avoiding these programs, and also inspiration for people who want to pursue a career in psychology and ethical ways to practice adolescent mental health care. So with that, let's dive in.

Sadie: Well, Dr. Deb Budd, thank you so much for joining me on Super Resisted. This has been so long in the making. I am really excited for this conversation. I think it's one that not a lot of people are having, but should be. And so I wanna start with your background because if others have not spent tens of hours on Google Scholar, going on a deep dive, looking for literature gaps with trouble teen industry and finding your articles and just absolutely loving the work that you're doing, can you give us some background about how you ended up in academia, why you became interested in studying this intersection of like kids outdoor therapy, mental health, benefits of being in nature, how you got to where you are today?

Will: Sure. [00:04:00] So I grew up with quite a outdoorsy childhood. , I grew up going to summer camp and had pretty turbulent teenage years. I would say. I was couch surfed from therapist to therapist all the time. And when I turned 18, I wanted to do something different and I wanted to, I guess, I don't think I ever had a bad therapy experience per se.

I had a lot of bad therapy, but nothing where I was like, I was like, oh, therapy's really interesting to me. So I started studying social work. I started working on at therapeutic programs. And I did that from about 2005 to 2012. And I was a bit of a golden child of wilderness therapy because I went and worked everywhere.

I just wanted to be a field guide for the rest of my life. And people said, will you cannot make Burger King wages and live in the woods for half your life, , forever. So go to go to [00:05:00] college and get a social work degree. And I did that and I met my now partner Renee, and she was in Australia. I went to Australia and I worked at a adventure therapy program there, a large nonprofit working with drastically different clients than I met at the troubled teen industry programs.

And I felt duped. I thought that the, the first time I had a outpatient client, I went, wait, hold on a second. They can leave and. They, they don't have to be here. They can just, we're not in the middle

Sadie: of nowhere. Like, like

Will: they're not in the middle of what, we're not stealing their shoes and we're not, we tell them

Sadie: what time it is.

Will: We don't tell them how long the hikes are. What are we doing here? And I looked back and thought, how could adults have taken a social work student and teach them this was the right way to work? And so in essence, what that started is all of my con I was very confident [00:06:00] working with young people and I was also really confident as a young staff, I, I was, I was very good at calling bullshit on things where I thought, they're not gonna, we don't need to take their boots.

They're not gonna run away. It's snowing and we're in the middle of nowhere. Yeah. Like I was, because I had grown up in such a different outdoor experience. But, so one of the things is it led me. I was just so curious about how psychotherapy worked, and in essence, a lot of my research about critiquing the troubled teen industry, there's a big component of it that is about safety, no doubt about that, and ethics and not harming children.

There's also a big part of that, this is just bad therapy. This is, you cannot force therapy onto people. That is called torture. So

yeah, there's

a big component. When I learned more and more about how therapy works, then I started reading the, the wilderness [00:07:00] therapy literature also, and I went, these people don't have a psychotherapy 1 0 1 understanding of, of how to do this work.

Mm-hmm.

And so what got me really riled up was actually trying to progress. Research about outdoor therapies because we all get, I mean, we all get lumped in to what the troubled teen industry is doing.

Yeah.

And so I started saying, we need to draw a line in the sand, and we actually have to all become better researchers.

because we have to dismantle this narrative of sitting idly by, while the troubled teen industry dominates all adventure therapy literature. So that to me was we have to write because our, passion for outdoor therapy work will vanish if we're stuck under the umbrella of the worst style of this work.

Yeah.

And part of that. [00:08:00] Is bridging research and practice and put it, when we put those two things together, what we have to realize is not everybody needs outdoor therapy. Not everybody needs to be kidnapped from their home and thrown into a therapeutic boarding school What we need is to kind of believe less in our treatments and more in the people that we wanna work with and, and the people that we wanna say that we're helping.

And the funniest thing is that the, all the research for a hundred years about therapy endorses that a hundred percent. And what do we still do? We still believe that the trees are talking to people and they're healing them while we simultaneously torture them in the outdoors. It's, it's ludicrous. It makes no sense.

And, , I just, I, I don't know. I guess I was born with such an oppositional attitude where I view writing. As a protest I read something and I go, Hmm, that sounds like bullshit. I'm gonna write something about it. [00:09:00]

Sadie: Yeah. Yeah. I've thought so much about how pronounced a troubled teen has become and how independent it is of traditional psychology, especially after we originally connected.

Mm-hmm. And my understanding, and like my current school of thought is that it just operates completely independently. It's not like it was a sector of some psychology research that has been done. It just is completely independent and yet labels itself, it's treatment mental healthcare research. And so as a result, the field of psychology and treatment doesn't take accountability or responsibility or oversight or interest in this industry despite the fact that the people that we serve and work to help and that are struggling and, Need guidance are unbeknownst to them going down this path of something that's not even remotely research backed or mm-hmm. Can be described as treatment. , And I completely agree with you that that's exactly the opposite of what should be occurring. Like if we do have these ways of [00:10:00] evaluating, if interventions are effective and we know how to look at what's happening and saying this is wrong and this is why, based on what we know, we should be the ones having those conversations, , and passing commentary and criticism when necessary on what's going on there.

And yet that hasn't happened in the past 80 years, which we're gonna dive into. ,

Will: Let, let me say something to this, 'cause this is really interesting and I wrote a substack about this with Nevin Harper, who's someone I write with a lot. There was a, a, a German sociologist Ulrich Beck, who wrote about.

Concept of organized irresponsibility.

Mm-hmm. Which

I love, and I used it as a metaphor for the troubled teen industry where you have licensing bodies, the joint commission, state licenses, accreditation, mental health professionals who are trained and licensed and have all their clinical hours that they need.

And whenever anything bad [00:11:00] happens at a troubled teen industry program, somehow no one has the responsibility for it.

Sadie: Yeah.

Will: So it looks organized. It looks like there's a lot of oversight. You know, these are regulated programs, but still, how has this not changed?

Sadie: Yeah.

Will: And so this organized irresponsibility to me is a really interesting way to think about it. Which, how can, for instance, the National Association of Social Workers have licensed social workers writing about endorsing the legalized kidnapping of children when those social workers have no legal right to hold a child against their will.

Yeah. Like that has so many checks and balances. But these programs have operated in this gray zone of are we a school, are we a hospital? Are we a correctional facility?

Mm-hmm.

And so there's, it all looks good on paper. But the truth is it's totally [00:12:00] irresponsible what is happening.

Sadie: Yeah. Yeah. And we're gonna get into how we can even like map out and understand the scale of irresponsibility and why what's happening is irresponsible.

But I wanna touch , something you mentioned, which is that we do know a good amount about what does work for young adults and what works from a mental health intervention perspective. , We know that there are ways to help teens that are struggling. And your book talks a lot about why the ways that we attempt to quote unquote fix teenagers don't work. That they fail, , and. I think we can kind of just continue in this conversation understanding that we know that Gen Z's struggling, unprecedented rates of mental health challenges.

Although what's really interesting, as far as I know, we're smoking less, we're drinking less. Mm-hmm. And I think teen pregnancy is down, which is fascinating, is people will be like, well, people just don't socialize with each other. But I'm like, there's some good things happening maybe.

, But other than that, we're kind of on [00:13:00] the up and up in a bad way, which is that depression, anxiety, loneliness, all these things are mm-hmm. Are rising for Gen Z. And yet we've never had more research, there's never been more resources, there's never been more advocacy in this space, but it's not working.

And so I'd love to get your, thoughts on, what isn't working, because it's not for lack of trying, like there's so much going on. There's so much research, there's so much conversation, there's so many options out there, and yet we've never seen higher rates of mental health. So why, why are we even in this position?

Will: Yeah. This, I think is one of, this is where I sound like a conspiracy theorist a little bit so for instance, school and, and kind of compulsory education is a very new thing and I'm not advocating that school stinks or anything. But what ended up happening was thinking of school like Benjamin Franklin mastered the printing press [00:14:00] and didn't go to high school.

Right? So there's this essence of kids need something. They need something that we have to offer them. Yeah. So children are treated always as passive empty vessels. Mm-hmm. That have to be filled by somebody else's knowledge.

Sadie: Yeah. And that's new. Like you look at historical portraits and you'll see like.

Kids dressed as adults. Treated as adults. Like when you look at how in media we portray kids, it's fascinating to see how infantalized they are now. They're

Will: so infantalized and, and this gets into, when it gets to mental health is first off, we live on planet mental health. you know, like when you were studying psychology, I remember my first psychology class, the teacher walked in and said, you're gonna learn about OCD and you're all gonna think you have OCD.

Right? You do not have OCD. It's

Sadie: a white coat syndrome. Yeah.

Will: Yes. You're all gonna read these ideas and start internalizing everything.

Sadie: Mm-hmm.

Will: So [00:15:00] in the early days of the early 19 hundreds, kids were all in factories. Right. Yeah. They were all working. It stunk. They were sick. It was brutal. They made no money 'cause they couldn't unionize 'cause they were kids.

and social workers, pastors, advocates said, we gotta get these kids out of factories, not for an ethical reason, because it's bad for childhood not to play, not to adventure, not to have fun, not to socialize. What we replace that with is the school. And so what happens in school is school is really good for good students.

Yeah. It really sucks for people like me who are oppositional and annoying to teachers and can't sit still. And so at the same time as we replaced the factory with the classroom, psychiatry was booming. And what happened? Is social work, a profession [00:16:00] that was started under the, the, the spirit of democracy, of doing things together, of stop putting people in ghettos and siloing, everybody come together and do things.

Everything got overshadowed by psychiatry. Now, I am not an antip psychiatry person. I'm very critical of it. But psychiatry had to do something in order to maintain legitimacy, which is create books of disorders. you have to know what's wrong with people in order to have, any kind of, value for your profession.

Yeah.

Now, what's sad to me is that all the other helping professions followed suit. Mm-hmm. Social work. You know, we, we, we wanna look at everybody's traumatized. But in the nineties, everybody was chemically imbalanced. Like, we fall for these trends of what's wrong with people. Yeah. And for how much we talk about the importance of being [00:17:00] strengths-based.

The truth is, all I hear about is our theories of pathology, of what's wrong with people.

Sadie: Yeah.

Will: Look no further than just blaming the phones. Like, it's so boring.

Mm-hmm.

You know? Yeah. The TV was gonna rot your brain too, and the calculator means no one's good at math anymore.

Mm-hmm. And Elvis shook his hips too much. Like, we look back at these things and we go, this is such a boring narrative that kids can't figure it out. Yeah. And so one of the, the fascinating things is I do think there is really something going on. But I don't think it's between the ears of children and young adults.

Yeah. I think it's something deeply cultural and look no further than watching the news. And what do you see? You see othering of people nonstop. That's a red person, that's an anti-vax person. That's a this person. And it's [00:18:00] such a thin description of complicated ideas that it's, to me, young people not having sex as often or not going out drinking as often.

We've scared the shit out of them.

Sadie: Yeah.

Will: Because we've imposed our own anxieties onto young people.

Sadie: Yeah. Well it's a very adaptive response on Gen Z's part. Totally.

Will: I would be terrified. And so I think there's something deeply sociocultural political. That is way more at play here than there's something wrong with the kids.

Sadie: Yeah.

Will: And so not to harp on the phones, but when I read articles about when you phone free schools, right. And I read an article and a teacher was writing and saying, it was the first time the kids said hello to me when we got rid. And I was sitting there going, you must be a really engaging teacher.

Like I, I've never had to ask a young like, Hey, can you please put your phone down? Yeah. Like it's, it's remarkable to me that and this is like [00:19:00] the joke of the title of our book, kids these days, the last words of the book is adults these days. Right? Yeah. It's nothing about the kids because if there's something wrong with the kids, that's about the environment that we've created as adults.

Yeah. So for instance, we have a chapter about environmental toxins, which was an arena. I had no interest of getting into, but we talked to a, a leading expert, a top 1% sighted scholar in the world about environmental toxins. And what he said, it just resonated with me so much that the, the saying can canary in a coal mine, you bring a canary into the coal mine because they sense the fumes before the human does.

Yeah.

Right. So when the canary starts freaking out, it means get the hell out of the coal mine.

Yeah.

This is what we're doing with kids. They're freaking out and what are we doing? Medicating, intervening, and we're trying to force them to fit into this [00:20:00] environment that isn't good for them.

Sadie: Yeah.

Will: And so that part to me was the deeply troubling aspect of kids.

If there's something wrong with kids these days, the solution isn't to sedate them through childhood. I think there's something much more simple, which is figure out what they want to do and do more of it.

And that is where you asked me a question about how that, we know how therapy works and the, the most simplest thing my mentor Scott Miller said to me is, engagement predicts outcome.

The therapeutic alliance predicts engagement.

Sadie: Yeah.

Will: So if, if everyone's unhappy, look to your relationship with those people and then find out how to engage them in something.

Sadie: Yeah.

Will: But you cannot force engagement.

Sadie: You, you talked about these interventions aren't working and we also mentioned that in the beginning that there are [00:21:00] quote unquote interventions for people that are labeled at, at risk or struggling, , that are actually causing harm. So for people that. Haven't been to wilderness, aren't familiar with the trouble teen industry.

Can you kind of give us that quick overview of like, what are these programs, how are they different from like the work that you're currently doing or evidence-based interventions?

Will: Mm-hmm. So sort of, the up and up of the troubled teen industry, and let's start with wilderness therapy, which is often the first program that many people are sent to.

Mm-hmm

hmm. Wilderness therapy grew in popularity in many ways out of corrections. And so it was a correctional approach and alternative to incarceration of youth.

A lot of it, was informed by Outward Bound, which is wonderful and for the most part. Great ideas

Sadie: and isn't it interesting how people choose to go there?

Will: Yeah. Yeah. They choose and they want to engage and um, they It's, yeah, it's a miracle. So what ended up happening, and I [00:22:00] I do think it's this simple is that it made a lot of money.

And so if we go back to the nineties and the late eighties with youth crime out of control, it made sense that this correctional intervention flourished.

Sadie: Yeah.

Will: What happened is we turned our sites into mental health and so young people that didn't go to school, young people that were substance using, , self-harming, these programs were popping up when other therapy wasn't working as a.

Well, we'll take your young person and we'll keep them safe for a minimum 28 days in the woods, which is, that's the way, , the Army funded mental health care for soldiers 28 days, one moon cycle. Hardly an evidenced.

Sadie: Yeah. It's

Will: just, it's four weeks. Right. So these programs grew and what started happening is parents, particularly anxious parents and also quite affluent parents [00:23:00] could fund for their child.

And in some cases, I know I differ with some of the survivor community on this, where I can understand why a parent would do this. Yes. Because they're, they've been, they've been duped. The hard part is there's no advocate for the child. Mm-hmm. That's a, that's another talking point I think. So these programs grew.

And what also grew simultaneously were residential treatment facilities, therapeutic boarding schools. And in the early two thousands, they all got slammed because by the government kids were dying. The programs were awful. And what they did is they just sort of rebranded and everything went from wilderness therapy to outdoor behavioral healthcare.

And it was like, well, the outdoor behavioral healthcare were the safe ones.

Sadie: Yeah.

Will: But they were all the same players that were there from the start. And so, and when

Sadie: you say same players, it's like same location, same staff. Everything is identical. It's just a different name. Yes.

Will: Just a [00:24:00] different name.

That's right. And then they got backed by private equity firms and, and conglomerates and so they just persisted and, and, and stayed around. And so what happens, it's, it's actually almost like a playbook. a parent can ring a wilderness therapy program and say, my kid is outta control.

Well, first they

Sadie: Google, what do I do? And they're served up a perfect website saying, yes, we have this evidence-based, this works. Here are the parent testimonies. Like, we've done this for 80 years. they seek help and they're served this up on a silver platter, being told exactly what they wanna hear.

Will: Exactly. And then what if I can't get my child to the program? Don't worry. We'll come and get them. It's better if we do this at night and that's safer and quicker. And then, I mean, I encourage everybody, if you go to YouTube, you can YouTube Dr. Phil Transport, and they filmed a transport where you can [00:25:00] see a bunch of.

Mental health professionals endorse this practice. Yeah. Like it's remarkable to me. So kid goes to the woods for about an average 90 days, about 500 US dollars per day. We're talking an exorbitant, you know, you're remortgaging your home here, 90 days in the woods. And then this thing happens that is incredible, at the end of this so-called very effective treatment, that child needs to go to longer residential care and then they wind up in a therapeutic boarding school or a residential treatment center for two more years.

So what we've done, and I think, I think teenagers are hard. I get it. I've been one. I probably still am one. What you're doing is kind of stealing childhood. You're stealing going to prom, a first kiss. learning to drive, like you're taking this under the guise of mental health care. [00:26:00] And I don't mean that to say these young people aren't struggling and have really big family conflict, but I've also done the research that there are many kids that are drinking beer and skateboarding, and it's like, that kid sounds awesome that are sent to a residential treatment facility.

Sadie: Yeah. Come

Will: on. it doesn't add up.

Sadie: Yeah. How does that happen? And this is something you've talked about in the research you've done, where a lot of the kids that are admitted and treated in this, insanely intensive context or subclinical, like, what does that mean? How do they get there? Like, why, why would someone even be placed in that sort of context when they're not even depressed or anxious or suicidal or whatever it is?

Will: Yeah. And, and we wrote about this, , in a response to a paper. That was saying, no, there's safe ways for us to transport these children, which is ridiculous. Right? Yeah. And what I wrote is these programs will take anybody, except for [00:27:00] anyone actually warranting an invo, like someone who is, , experiencing anorexia at a level where they're gonna die tomorrow.

Yeah.

Yes. Do everything you can to keep them alive. Mm-hmm. If my child was standing on the edge of a bridge every night, I would do anything to keep that child alive. Yeah. If your kid is skateboarding and drinking beer, we cannot take them involuntarily. Yeah.

Sadie: Like

Will: it's, and it's human rights, this is one of the concerns with treating mental health as medicine, what happens is if I know I have the intervention, I am going to impose it on everybody.

Under the virtue of helping, but it might not be helping.

Sadie: Yeah.

Will: Homogenizing everybody into the best researched or the most popular intervention is still not a good idea.

Sadie: Mm-hmm.

Will: And we see this with, for instance, social emotional learning programs in schools when they're rolled out over [00:28:00] whole districts.

What we find in clinical trials is the kids who are forced to engage in these usually cognitive behavioral interventions without anyone thinking, do they all need this? What happens is the kids who can just go to school as usual are better off than the ones who are intervened with.

Sadie: Yeah.

Will: And so it's not like that's harmful on the level of troubled teen industry, but what we see at the end of it is just because this sounds like a good idea.

It doesn't mean it is a good idea in the long run and in the toxins literature, we, they, they call this a regrettable substitution. Mm. So for instance, people used to fall asleep smoking in their homes, like their couch on fire, burn everything down. I love this

Sadie: anecdote.

Will: So we put flame retardants in everything

Sadie: because cigarettes lobbied against putting a label on the box saying, actually this thing that catches on fire is highly flammable.

Please don't smoke and fall asleep and catch your house on fire.

Will: And so then we put flame return in everything. And [00:29:00] guess what? We had birth defects galore.

Sadie: Mm-hmm.

Will: It was solved one problem, but created another. Yeah. Regrettable substitution. So the trouble teen industry is, first, I think that it gets into a deeper cultural discussion about how we think about children and young people.

That there's a notion that that should be locked away somewhere is remarkable to me. At the same time, I guess this gives me hope is what Paris Hilton did. By really coming out and talking about it, it created the greatest revenge of the clients. it's, it's so, empowering. Yeah. That for the mental health community once again, and we wrote about this in the book, to go back to a different topic as well, it showed that still the most important factor when it comes to mental health is the people that someone like me works with.

Mm-hmm. It's not me. [00:30:00] we have treated clients of as passive recipients, as neglected factors, where the truth is, they are the wild card of all of this. And so what we're seeing now is these troubled teen industry programs are closing.

Why? Because of the kids. Mm-hmm. Because they knew that was wrong.

Sadie: Yeah. What

Will: happened to me was wrong. And so for mental health professionals, I think even those with no affiliation to the troubled teen industry, it's a very important lesson that you maintain a serious focus on what are my clients experiencing?

'cause you can think what I'm doing is wonderful. And at the end of the day, they could go. That was horrible.

Sadie: Yeah. Yeah. And

Will: I was, I didn't, I didn't want to talk about that. I was forced to talk about that. I did not want to be put on that medication, but the person in power convinced me

mm-hmm. Of

this. So, in essence, a big part [00:31:00] of this is I don't think many people really understand how much power you really have, where your client has no idea what's in store.

And so we need to go slowly.

Sadie: Mm-hmm.

Will: Much slower of a process. , and so that's the, the part where the troubled team, like people will say about my research, like, will, you've implicated that the research is so positive because it's industry funded.

And I go, yeah, but we all say that when Marlboro does their own research or Coca-Cola does their own re Yeah, we all say this but it's just not okay when it's in the mental health world.

Sadie: Yeah.

Will: And so, . That's one of the, I mean, that's the organized irresponsibility. Mm-hmm. the research looks good.

Yeah. But if you have a, a general understanding in reading bullshit. Yeah. You can go, oh, hold on a second.

Sadie: Yeah. They're

Will: lying

Sadie: for sure. And I wanna get your, your thoughts there, but I just, every time you say something, I'm like, the common thread is engagement predicts outcome. And you think about the research that's been produced.

Who's most [00:32:00] engaged in that? It's the programs themselves. And so we see the outcome there. Yes. You talked about the work in advocacy, that really started in a big way with Paris Hilton. The level of engagement there has led to that outcome. And even Gen Z, like one of my biggest. Theories there is that we lack agency on a huge scale.

The belief that we can make change in our own lives or as a society, like our actions will not have an impact. And so when you're not engaged in those things, you don't see that outcome. I wanna get your, your thoughts on this, the research side of things, because it's really fascinating situation and it is organized irresponsibility. It's a, a failure of psychology, from my perspective, and this is why we connected, because I've gone on so many Google Scholar rabbit holes being like, surely someone must have done some type of research. There must be some information, like this has been going on for 85 years. Wilderness therapies have been around for 85 years. How could we have hundreds of thousands if not millions of kids going through [00:33:00] these programs, receiving these treatments, using federal funds, state funds, school district funding, these things, insurance covering these treatments and not know if they work or not, not have, , true rigorous evaluation of these interventions.

And I'm really curious your thoughts there on like how is it even possible that we don't have research on what is happening and then. Why don't we have any information on potentially the harm that's caused, , which is what, what we need and what we should have and what would happen if this was a medical intervention, it was a medication that was being taken, or a surgery that was being done, or any of these other domains that you've mentioned, , or mental health care is just for some reason gets a double standard.

Will: It's, you're absolutely right. but What happens is we live in evidence-based times and you have to pretend that these are medical interventions.

Sadie: Yeah.

Will: So what happens is we keep measuring, you know, the outcomes of these things without [00:34:00] actually really thinking about what we're measuring.

Sadie: Mm-hmm.

Will: So the first study I did with Nevin, I had been talking about how there's no difference in outcomes based on the type of therapy. I'd been arguing there for about 2012 and I had this, like, I woke up in the middle of a night sleep and I went, I should probably research this about outdoor therapy.

Like, I'm just saying it. Yeah. I haven't really looked. And so we found every time outdoor therapy was compared in a study, and these are not great studies, of course, every time it was compared to an indoor intervention, what we found no difference in outcomes.

Sadie: Mm-hmm. I

Will: got accused of misrepresenting data for that.

I was like, it's not my data. I read your papers.

Sadie: Yeah.

Will: You know, so we still have to believe in our intervention. It's like I have the answer outdoors is the answer. Why aren't more things outdoors? Why is it where the truth is? So what happens is when we think we have the intervention and our intervention [00:35:00] is better, why isn't everybody working outside? Isn't this, you know, it's wonderful. What happens is we'll start researching from a vanity perspective of I have to prove my intervention is the best.

Sadie: Mm-hmm.

Will: So in wilderness therapy, especially from the American troubled ten three perspective, what some of the researchers did was a very good start. They used the youth outcome questionnaire, great measure, widely used and. They started using that and then they could show wilderness therapy is really effective.

The problem is they stopped right there.

Mm-hmm.

Where they could have said, how do we get better? And what they'd learned, like the study you brought up that Nevin and I did with Doug, we could take the client's intake score and their perception. This is a young person who is sent away involuntarily, and they were asked, does it make sense for me to be in a therapeutic program?

We [00:36:00] could take that question and their intake score and predict their outcome. So that's the first few days of being in the woods. We could predict, is this a good place for you to be? We've never met these people.

Sadie: Yeah.

Will: Right. That is how you become a data-driven therapist. Your doctor ideally takes your blood pressure every visit.

Yeah. Even if you're there for something totally unrelated to blood pressure. They're doing that to make sure there's not something else that's really off here. And so the issue with wilderness therapy in the practice, and this, I think where the research has enabled this prac, they've given them talking points, given them ways to market.

They can use terms like evidence-based and empirically supported and all this, all these words that sound really good.

What happened in practice is your intake score, the client comes in, fills out the, I mean, the outcome question is 45 questions. It's way too long. It's, it's, it's thorough.

Sadie: But I mean, [00:37:00] they're not letting you leave unless you do it. So,

Will: and they're not gonna change the structure of the program no matter what.

Sadie: Yeah.

Will: So the only reason research was done was to prove that what they did worked.

Mm-hmm. Where

the truth is. What do we know about teenagers like unicef, United Nations? Funded research says if you're trying to fix teenagers and you're not treating them as resources and as important to the intervention, it's not gonna work.

Sadie: Mm-hmm.

Will: So we had the data to show we're going about this the wrong way and the data even supports it.

Sadie: Yeah.

Will: And so what was interesting when we did that study, I remember sitting in a meeting with the other researchers and I said, we should look at how many people are subclinical. 'cause I bet you we can predict who gets worse in care pretty easily.

Sadie: Yeah.

Will: And that's like, it wasn't hard to find this question, So I think when we're throwing around terms like [00:38:00] evidence-based, it's, we treat them as this noun, like a stamp of approval. Mm-hmm. Evidence-based. But the truth is, we should think of evidence-based as a verb. is what I'm doing evidence-based.

Sadie: Mm-hmm.

Will: Which usually means it's relational, taking into account cultural, perspectives and client preferences, having some consensus about why are we in this relationship together.

Sadie: Yeah.

Will: And if the, the interesting thing is if you don't know why you're in a relationship with your client in a professional relationship, newsflash, you don't know.

Sadie: Yeah.

Will: So stop it.

Sadie: Mm-hmm.

Will: That's a slippery slope to being quite an oppressive person. We need to know what they want. I mean, therapy is two people figuring out what the hell the other person wants, right? Yeah. So the interesting thing is this is deeply, in many ways, so simple, but the evidence has encouraged [00:39:00] bad practice.

And that was the part where I was like, we have to write because we have to deconstruct this.

Sadie: Yeah.

Will: To this day, if you go to Google Scholar and type adventure therapy in most things that come up are troubled teen industry programs.

Sadie: Yeah.

Will: So, you know, that's not who the majority of people working outdoors are.

Yeah. Right. We have

surf therapy with veterans. They don't have a lot of research. Forest therapy in Japan and South Korea is amazing. Again, a deeply cultural perspective. , People working with young people who, had their adolescents impacted by getting cancer, like taking them and giving them fun adventures and having, letting them meet other people with similar lived experience.

There's so many wonderful adventure-based ideas, but we're dominated by this practice that had the money to fund to get more research done.

Sadie: Yeah.

Will: So the most popular therapies are just the most researched.

Sadie: Yeah. Is that you think why this is [00:40:00] such an uphill battle. It's just the amount of financial resources in the troubled teen industry, like the fact that there's academic articles that are released saying that involuntary transport is ethical and here's how you like it.

It truly is an uphill battle. The fact that it's, do you think it's just funding is the reason?

Will: Well, no. I think it's the number of clients they have. Mm, that If I wanted to do a study of, let's say, surf therapy with veterans, how many people am I gonna find?

Sadie: Yeah,

Will: not many, but if I want, if I have a conglomerate of 17 programs that are all seeing a thousand kids a year, I now have data galore.

So big numbers, big data sets are a great book called Calling Bullshit, and it talks about big spreadsheets are a trap. That's how you get things like the happiest countries have the most heavy metal bands. Is it heavy metal creates happiness? Does [00:41:00] happiness create heavy metal or is it just a ridiculous correlation?

Sadie: Yeah.

Will: Right. So if you have big data sets in something like psychotherapy, which because humans are amazing, accidentally works for the most part, it looks like good data.

Sadie: Yeah.

Will: But if you say things, and this is in the peer-reviewed literature, if someone writes wilderness therapy is more effective for teenagers because of treatment completion rates, without saying anything about involuntary, what did they actually complete?

You are misleading the public. You are misleading the concerned parent who is going to pay for that program. so it, it looks good. On paper, but we have to know as, advocates for a safer and more effective practice that we have to do our homework to really know what are they claiming here.

Sadie: Yeah.

Will: Right. Because jail has good completion rates.

Sadie: [00:42:00] Yeah. And more rights than the trouble team industry.

Will: Yeah. Probably more playing. Yeah.

Sadie: Yeah. It's, it's so frustrating. This, again goes back to why I think psychology has failed in this aspect, because it's not the responsibility of the consumer and the parents and the child, themselves to be reading the methodology section of these articles and being like, oh, that actually doesn't make sense, or that outcome isn't justified.

Like the fact that we as a field have not held them to a higher standard and said, okay, this is not actually a proper outcome. This is not evidence-based, like, here are all the weaknesses in this quote unquote intervention that you are. Administering to hundreds of thousands of kids, like I absolutely put that on academia's shoulders is it's our responsibility to do that work.

And we have not in the 85 years that it's been around, which is shocking because who else would be responsible for doing that?

Will: Yes. and this doesn't mean, I'm not saying this in the way that I think I'm [00:43:00] the world's greatest social worker, by no means. 'cause we've measured it and we know, when I started critiquing the troubled teen industry, I remember one day going out on expedition, , with the nonprofit. I started in Australia and it was myself, another staff, and let's say four young people.

And they came voluntarily, but no kid wanted to go camp. You know, it wasn't involuntarily on this level. They came,

Sadie: you're there, but you grumble.

Will: Yeah, they grumble. Just like all kids going. Yeah. No one's ever Googled my name and said, Hey mom, send me to go see will, you know? It's never happened.

Yeah. Yeah.

And I remember going out going, oh my gosh, if this goes poorly, I cannot any longer critique wilderness therapy and I had this light bulb moment of going my work, my clinical practice, which no one else cares about, has to be a demonstration about safe practice.

Sadie: Yeah.

Will: And it wasn't that I wanted to show off or anything like that.

It was that if we're gonna make fun of [00:44:00] every other therapist in the world, we have to hold ourselves to the highest account. And so what I think is scary and what has happened when you talk about how we haven't held our peers to a high standard. Every time I hear about a kid getting abused in child protection care, I just go, this person was paid by someone to harm children, and how many near misses were there that someone could have stood up and raised their voice and we not have

Sadie: Yeah.

Will: , We not have hurt kids

and so one bad actor in psychology that no one held to a high standard actually really hurts the collective of our profession. It hurts our legitimacy. And this gets into something really interesting about psychological services or social work services in the United States context therapists, we say, Why are people who could benefit from our services not engaging And then we think stigma. Well, it can't [00:45:00] be stigma if every bestseller is a fricking mental health bible.

Mm-hmm.

Right. Every non-fiction bestseller, atomic Habits, anxious generation. What happened to you boy raised as a dog?

We're in love with mental health.

Sadie: Yeah. Yeah.

Will: When people are interviewed, this is a big study from the a PA, like, 10 years ago, when people were surveyed, about a thousand of them. The reason they didn't engage in psychological services was the cost. Fair enough. But let me tell you, in the rest of the world, this shit is free.

Right. Cost. And then I don't believe it's effective. I don't believe in the science. So let's get rid of cost as something we can't fix. Yeah. Right. Until the system changes. If the science is dodgy. You we're not gonna convincingly tell people that it works.

Sadie: Yeah.

Will: Right. And so in essence, we keep reinventing the wheel as researchers and not progressing anywhere.

Mm.

You know, this is [00:46:00] another funny one in a new book. Searching For Normal, I think it's called,

he writes about how in medicine, you never suffer from a, like a cancer disorder, a cold disorder, a headache disorder, and all the mental health ones all have to prove to you their disorders.

Sadie: Yeah.

Will: You know, dissociation identity disorder, I promise you it's a disorder.

Attention deficit hyperactivity disorder.

General anxiety disorder. You know, where the other, you know, I had chicken pox as a kid. Didn't say chicken pox disorder. Mm-hmm.

Sadie: You

Will: know, it's kind of like chasing this legitimacy that we promise you what we're doing is important. I actually, and I do think, 'cause we had this experience in Maryland here where I am now, we had an intensive outpatient program and the amount of parents that would bring their kids to see us and say, I do not want a disorder, so I'll pay out of pocket so that my health insurance doesn't have my child with a labeled disorder on it.

Wow. [00:47:00] So if we could get rid of that part, A lot of people wouldn't be as apprehensive of going to see the worker that they know isn't gonna label your child.

Sadie: Yeah,

on the troubled teen front, I'm curious. Do you think that it's possible for the trouble teen industry to reform or just like, my perspective is that it's completely antithetical to its very existence. Like again, engagement, informs outcome and engagement is not at all a part of their treatment modality.

And so they can never reform to the point of being an evidence-based intervention because it's just the complete opposite of the model that they practice. Mm-hmm. But what are, what's your thoughts there?

Will: Yeah, I, I tend to agree with you where what they have done is, think about it the other way around.

They, they have tried to, like, imagine on a scale of zero to 100, they're here in hurting kids. Yeah. And they're trying to work their way back.

Sadie: Yeah.

Will: [00:48:00] Like, no, no. You need to start over.

Sadie: Yeah. Yeah.

Will: If you wanna stay in this field, I had a meeting once with a, a wilderness therapy organization, and I thought our writing would make a difference, right. And I had this meeting and I said to this organization, well, what would you do? They wanted me to consult to help them to get better. And I said, what would you change if you knew in two weeks all the young people could choose to go home if they wanted to.

And they, one of the directors laughingly said, well, will, we'd have to change everything. And I went, are you willing to? And they went, no. And I went, well, there you go.

Sadie: Yeah.

Will: . So I think regulation is, as a bit of an anarchist myself, I don't think it will help. Because it could have helped before.

Yeah. It should have helped before. , I see things like when I, we wrote about this in the [00:49:00] book, like the World Health Organization saying we need better access to gold standard treatments like EMDR and CBT. And why are they gold standard? Only because they're the most researched. Yeah. Are they more effective than anything else?

Sadie: EMDR is only the meditation piece. It's not even the EMD arts.

Will: Like the medicalized view of this ends up, , I think glorifying the role of the therapist and putting the client down.

Sadie: Yeah.

Will: And so. If we're gonna find a way to regulate that Sure. Get, get warmer sleeping bags. Don't put kids in bis. Yeah.

And it's, it's just like removing the phones and then what.

Sadie: Mm-hmm.

Will: So I think in essence, the scariest part to me, and this is probably a bit sensationalist, and to alarming, the scariest part to me is that we need regulation for this.

Sadie: Yeah.

Will: With therapy we have all the power and that means we are at risk of abusing it all the time.

And so regulating something is not gonna change that.

Sadie: Yeah.

Will: The worst part to [00:50:00] me is that when this happens, the response, like for instance, when that boy was killed 2024.

Yes. February last year when that boy was killed, the response to me. From many people in, in my professional circles was not nearly enough. And if that boy had died in, let's say an EMDR program, do you think all the E MDR R therapists would sit oddly by and go, well, shit happens. Yeah, no, they'd go, that's not empty.

That's not a good thing to have happen. What do you? But they

Sadie: would say, how is it even possible?

Will: How's it even possible? Exactly. But in this troubled teen industry, it's so common

Sadie: that

Will: it's like, hmm, it happens. These people are at risk.

Sadie: Yeah.

Will: So I'm with you where, I don't know if they're gonna regulate their way through this.

I mean, the program where that boy died and that, that rattled me [00:51:00] so hard that, I mean, he was 12. It's ridiculous. that program only lost their license after that. that was a practice that every child went through at this program.

Sadie: Yeah.

Will: Sleeping in a bivy sec. A piece of alpine camping equipment.

I have bivy, I've slept in bivy my whole adult life. Every bivy comes with skull and crossbones on it. And what'd they do? Part of our program, every kid does this, and you just go, where were the adults to actually know what they were regulating, what they were accrediting, what are they licensing? What are, and, and that to me is where I'm with you.

Our professional associations have to have a bit more teeth.

Sadie: Yeah. In the

Will: game.

Sadie: Yeah. Wrapping up, in the book, you do offer some solutions because there are ways that we can help Gen Z. It's not all dooming gloom despite the many problems. Yes. With our mental health industry. Can you talk to me a bit about the framework that you outlined on, how we [00:52:00] can help youth that are struggling, , and, and approach this in a more effective way?

Will: So engagement is the big one. , We know that young people, the younger the person, the harder they are to engage in some sort of therapy. So start making therapy so boring.

do things together, be together. , And then the, the bigger cultural one is, as I said a bit earlier, like, I think the phones have a role to play in this.

but I think 24 Hour News has a bigger role to play in this, where we have scared the crap out of everybody about the world where it's the safest it's been ever. Right?

Sadie: Yeah.

Will: And even when you get hurt, the medical intervention is probably the safest that it's

Sadie: been ever.

Will: I think in many ways with young people is we haven't, and I'm not gonna say like, oh, it's cancel culture and all these talking points that we hear on the news, but in many ways we've, going back to infantalizing them, I think young [00:53:00] people can handle this stuff.

And so if we keep shielding them from complicated conversations, I think no wonder then when they're 20, they're all called fragile. I'm going, you did it.

Sadie: Yeah.

Will: It's not them.

Sadie: Yeah.

Will: And so for instance, when we talk about like safe places and, and in the book we call it like safe enough place.

A safe place is like a lighthouse. It tells you where safety is at the same time. That's so you can go take risks

Sadie: mm-hmm.

Will: And go push yourself and challenge yourself. So I think in many ways we could really bring back a culture, especially in the schools where kids can say whatever they want and we can go, that might be hurtful.

Tell me more. And, and learn about how to engage in democracy, which is inherently participating.

Sadie: Mm-hmm.

Will: How do you get someone to participate? You engage them.

Sadie: Yeah.

Will: But we've [00:54:00] started going democracy only happens every four years on a Tuesday in November. Yeah. No, it's all the time.

So in many ways, I think for, for, for young people, it's really hard because first off, social media tells you all your own beliefs anyway. And then we get siloed away. And I think we can really do our best to, inspire young people to participate, but that's gonna start with engaging them.

Sadie: Yeah.

Will: Because video games and all these dopamine hijacking things are way easier to engage in.

Sadie: Yeah,

Will: I know it too when I'm sitting around scrolling on my phone. Yeah. You know? Yeah. . And it also starts with not othering people as much. And so the, the less othering we can do, I think that's the better

Sadie: for sure.

Well, if people want to order the book or continue to follow along with your work on social media on Substack, where can they find you and support your work?

Will: Yeah, so my name and then all the Will Dobud and all [00:55:00] the social media stuff, You can go to kids these days book.com, , or pre-order it on Amazon as well.

If you order the book, you can flip me a message whether through the, social media or, through my email. And, you can join what we've called the, the launch team for the book, which what that means is you'll have access to chapters as we will drip feed you the book leading up to its release state.

And, it'll have a password protected area on the kids these days. Book website, which has parenting resources, access to research articles, if that's what you want to do. , Videos and interviews. And then when the book comes out, we'll have a virtual Zoom launch party. And so the experts that we interviewed for this book, hopefully some of them will be there and we can raise a glass and talk to them.

And, , but yeah, we really, we wanted that book to be a protest about, youth mental health and the system and, and how we've been up against uncooperative systems for a long time. , And as you've said and with your work, like [00:56:00] how, how is it that we get into clubs, whether it's the psychology club or the social work club, and then decide, hey, nothing can be done, let's just leave it as is.

Sadie: Yeah, yeah.

Will: And so in many ways it's a progressive book and it's, kind of an honest look at, , maybe we got some of this stuff wrong.

Sadie: Yeah.

Will: And I love that.

Sadie: Well, thank you so much for joining me. I'm so glad we got to have this conversation. Mm-hmm. And I know so many people are gonna be helped by this, , back and forth.

Will: Ah, thank you so much. It's wonderful to chat with you again.

Sadie: of course.

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