Adolescent mental health issues have been on the rise in the United States for decades. When prescribed care is beyond what is offered at home with local resources, adolescents typically enter inpatient or residential treatment. Research on adolescents in treatment has confirmed that when families are more involved in treatment, the family unit experiences increased and prolonged benefits. Although residential treatment programs report that family-centered practice is the best emerging practice, there is an insufficient amount of research on how to deliver family therapy.

This qualitative phenomenological study, based on Bowen’s Family Systems theory, focused on anxiety reduction and differentiation for individuals in the family system of adolescents in wilderness therapy. Which therapy modalities and skills families perceive to be best to decrease anxiety and increase differentiation of self once the adolescent returns home was explored. Families were recruited from Elements Wilderness, a wilderness therapy program in Eastern Utah for males aged 13 to 17. To be included, the adolescent must have returned home instead of attending another program afterward and must have been home for six weeks to six months. Six families (18 people) participated in multi-family-member interviews conducted over Zoom video.

Although the families were not familiar with Bowen Family Systems concepts, they did recognize the theory’s patterns in their relationships. Family members attributed face-to-face family therapy and experiential activities as the most beneficial to increase differentiation in their family. Bibliotherapy was a notable mention. Families described letter writing, mediation-led therapy, and being outdoors together as helpful for reducing anxiety. Skills that families attributed to increased differentiation included the adolescent’s increased self-sufficiency and family members’ improved communication skills. Parents described boundary setting and contracting as the most helpful to decrease anxiety after reunited.

Since wilderness programs indicate family-centered practice as the best to increase success once the adolescent is back home, programs need to make face-to-face family experiences an expectation of enrollment. Programs can increase the ways they utilize nature and experiential activities to facilitate family learning and growth. Future studies should include other wilderness programs, larger participant pools, and more gender-inclusive programs to enrich the family therapy in wilderness therapy body of knowledge.