Outcomes Research Study

In cooperation with the Center for Research, Assessment, and Treatment Efficacy (“CReATE”) and the Intervention Sciences Laboratory at the University of Arkansas, Four Circles Recovery Center recently announced long-awaited results of one of the most comprehensive treatment outcomes studies of its kind. Results of the multi-year, longitudinal study strongly support the use of wilderness-based interventions, such as those practiced at Four Circles Recovery Center, in treating young adults with substance use disorders and comorbid psychopathology. One year post-treatment, data shows that approximately 92 percent of participants reported persistent improvements in symptoms of substance abuse and dependence, while indicating that they acquired the necessary skills to better manage wellness and recovery.

Given the significant economic, emotional and health impact of substance use disorders, the study was conducted to advance our understanding of the effectiveness of outdoor behavioral healthcare (also known as wilderness therapy) in vulnerable populations, particularly among young adults with substance abuse and/or dependency.

The prospective, IRB (Institutional Review Board) approved, multi-site clinical study sampled young adults from three treatment sites: two wilderness-based treatment programs and one treatment-as-usual inclient program. The study assessed participants at five time-points over the duration of the study including admission to treatment, mid-point of treatment, treatment graduation, three months after graduation, and 12 months after graduation. The study design included multiple validated self-report instruments, standardized interviews with trained staff, and extensive evaluation of the frequency and severity of substance abuse.

Results show significant symptom remission across multiple life domains. Improved symptoms include those associated with substance abuse and dependency, including but not limited to impairment in relationships and overall functioning, negative consequences, cravings, and maladaptive coping–all secondary to substance use. Symptoms of co-occurring disorders also improved markedly, including, depression, anxiety, panic disorder, suicidality, and sleep disruption. Positive indices increased as well, including quality of life and healthy interpersonal functioning. During the longitudinal phase of the study, 71% of study participants are reporting persistent and positive treatment effects three months after graduation; one year following program completion, 62% of participants are maintaining treatment gains and successfully managing their recovery.

“These outcomes represent the continued hard work, persistence, and effort of many, many people,” said Sarah (Salli) Lewis, Ph.D., Principal Investigator, Director of the Research Division of CReATE. “With these data, the available evidence on the effectiveness of wilderness therapy is accumulating. This is a very positive step for the scientific and the treatment community alike. The empirical evidence for a wilderness-based model of therapeutic services has lagged historically behind the popularity of these programs. As we gain greater and more rigorous scientific data, we make critical advances in closing the gap between science and practice.”

These data are in the process of being submitted for peer review and publication in professional journals.

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We are affiliated with the following organizations, which provide accreditation, education, and training to ensure quality behavioral health and addiction treatment.
  • Commission on Accreditation of Rehabilitation Facilities (CARF)
  • National Association of Addiction Treatment Providers (NAATP)
  • National Association of Therapeutic Schools and Programs (NATSAP)
  • Outdoor Behavioral Healthcare Council
  • The Jason Foundation