Confluence Behavioral Health

            It can be somewhat hard to wrap your head around how many Wilderness Therapy programs there are in our country. The number of programs that are members of Outdoor Behavioral Healthcare Council is not big by any stretch of the imagination, but still might surprise individuals that are not familiar with the field. When I discovered the list of members programs, I was very surprised. This emotion was brought on by a few aspects. The first aspect was the unique distribution of program density across the country and that there are three programs within a two-hour range of where I live. Wilderness Therapy programs seem to be densely populated in Utah and Colorado, with some in the Pacific Northwest, the Southeast, and the Southwest, besides the few in New England.

            As I am fascinated by the ideas of hyper localism and discovering what I did not know was in my back yard, I wanted to pick the program that was closest to me. I was surprised to find the program Confluence Behavioral Health in Thetford, VT. Thetford is a town I am very familiar with as I have done trainings in the town and pass through it quite frequently. I never would have guessed that there was a wilderness therapy program in Thetford, and I was not aware of one. Now that I am better aware of wilderness therapy programs though, I feel like the area of Thetford is a great place to have a hybrid program, although there is not as vast of wilderness than in the west.

            Confluence Behavioral Health has only been a member of the Outdoor Behavioral Health Council since August of 2020, although the program was founded in 2018. They serve all genders but only young adults ranging from 18 to 28. The Outdoor Behavioral Healthcare Council states that “Confluence specializes in working with young adults and their families to navigate the complexities and challenges of today’s path to adulthood. Bringing together comprehensive assessment, evidence-based treatment and growth-oriented experiences, Confluence helps young adults heal and grow.” Their goal is too not only engage students but to guide them to live a compassionate and fulfilled life. Confluence utilizes the more traditional wilderness therapy concepts of transformative experiences and focuses on whole-person health creating balance. Some of the area’s participants will work in are skill building, connection creation, resiliency, and value exploration.

            Therapy comes into play in the program when the young adults work to understand strengths and challenges they face through direct work with a lead therapist. The Mentors, or what would be more traditionally called fields guides in other programs, are the support staff at the core of the experiences and programs. Clinical work and exploration are integrated using the mentors. The experiences are at a deeper level than what is imagined through outdoor programs. The focus on being away from distractions that would typically be in their lives, and using shared living space, the participants can strengthen the ownership their lives and begin to “create a direction for moving forward.”

The programs offered at Confluence Behavioral Health range from sixty to ninety days and are hybrid in nature. The reason they are hybrid is because they blend wilderness therapy treatment with residential treatment. Each week the students in the program spend four days in the wilderness on excursions and then three days in the residential facility. This hybrid model is very different than most of the western programs we have heard about in the Stories from the Field podcast. Confluence also claims to offer more individualized treatment for participants, psychoeducational curriculum, and of course experiential learning.

            One thought process that is unique to Confluence is their River Model. The River Model is a personal growth structure that supports their clinical treatment using the ideas of Headwaters, Stream, River, and Estuary. Headwaters focuses on settling in with orientation and rest. Stream is about starting out with introspection and engagement. Then there is River about gathering insight and exploration through searching around. Lastly, Estuary focuses on seeing beyond with foresight and awareness. Teaching a growth model that students can use in a more creative way equips them with understanding that can be applied to real world scenarios. It focuses in on understanding how everyone is at different levels of their growth stage at different times. Almost more importantly though, it teaches that effort is necessary to achieve growth. These lessons are crucial to the participates and are often not well understood by them before the program. To recognize that growth is an accomplishment and is necessary to move forward, the end of every stage is recognized through a ceremonial practice. The river is a metaphor that can be understood by most. Much like the growth model that is shown is the Brat Camp series, each stage builds upon the last and you must complete the first one to move on to the next. Like the transtheoretical model, growth is all part of the healing model.

            Confluence Behavioral Health brings on a third part treatment, Hanover Psychiatry, to help include more offerings to participants of the program that need them. Hanover Psychiatry has offices in both Hanover and Concord, NH. “Services offered include neuropsychological assessments, psychiatric consultation and medication review. Neuropsychological assessments are valuable tools that inform Confluence clinicians treatment plans, help individuals better understand their strengths and challenges as well plan for discharge and follow-up care,” as stated on the Confluence website. This allows Confluence participants to access all medications they need to get well.

The list of treatments and approaches to therapy offered by the staff at Confluence is broad because of their individualized approach. To name a few of the focuses, the emphasis is put on creating an emotionally safe culture and strong relationship building. Their therapy treatment also reflects the type of program they are which is a short-term residential program designed to help with the transition to adulthood for young adult. They also work heavily on overcoming mental health challenges. Directly, the wilderness therapy they offer is not unlike to empirically based models that other programs utilize. I particularly enjoyed their understanding behind time in nature though. “Outside time in the natural world is a break for our brains. Fresh air and open spaces provide a reset. Uncluttered environments and distance from technologies give our minds a chance to re-calibrate, reorganize, and rest. It’s an opportunity to truly re-position and listen to oneself without the distractions of everyday life,” as stated on the website. Adventure based experiences have to ability to make a huge difference in the lives of many people. Not only does it help with resourcefulness, but it can also build up the resilience of a participant.

            Looking deeper into the types of participates that are at Confluence helps to better understand the program as well. As mentioned before Confluence participants are young adult in the age range of 18 to 28. The programs are specifically tailored to helping these young adults who are struggling with the transition into adulthood. Most of the programs we have been learning about in class have been tailored to teens struggling in their adolescents. Participants at Confluence may be dealing with the complexities associated with uncertainty in early adulthood through the challenges of social, educational, and professional life. Many of these young adults are struggling from the isolation of experiencing so much freedom and choice for the first time in their life.

            Since I have learned more and found out about the field of Wilderness Therapy, I have been intrigued. I feel like there is so much potential in the field whether that be in traditional roles or non-traditional roles. To be completely frank, working in a more traditional wilderness therapy program and being a field guide seems like a blast. It also seems super demanding and challenging though. I have discovered that I have a passion for part-time work because it allows me to do different things in addition to my other passions such as the outdoors. Although field guides work full time in most cases, it would be quite interesting to work seven days on and seven days off. That is a unique work schedule that does not happen in many jobs. On one hand, working seven straight days, more like twenty-four seven because when you are out in the wilderness you must constantly be on alert in case something happens, seems far more demanding than I am familiar with. Yet having a full week off afterwards would be incredible and feel like a mini vacation. Finding balance in a life of seven days on and seven days off seems especially challenging.

            Since Confluence is a hybrid program, I would imagine the seven days on to either be easier or that the program runs a much different schedule for their employees. After looking at some of their general job descriptions I found that the full-time mentors at Confluence do indeed work a traditional schedule. That is eight days/ seven nights on duty and six days off. It is a schedule I would consider but it would put me far out of my comfort zone, and I am not sure if the schedule would be ideal. In the field of wilderness therapy, you must have a strong balance in your hard skills and your social emotional skills (commonly referred to as soft skills). From learning about other programs, I would be concerned that I do not have enough hard skills or expertise with them to be efficient in the field. The only hard skills that were referenced in the description was experience with outdoor recreation activities. Other skills like shelter building, fire making, and knot tying, that I need a little practice with, were not mentioned. As far as social emotional skills are concerned, I feel like I have a great basis to begin with when working in leadership and group roles. These skills need to constantly be practiced though and honed for them to be effective. Lastly, Confluence is looking for someone with a bachelor’s degree in psychology, social work, counseling, or experiential education. I am an Interdisciplinary Studies major focusing on Sustainable and Diversified Entrepreneurship. Based on my experience in the outdoors, leadership development, and as a Student Assistance Program Coordinator, I would hope I am qualified for a starting role in wilderness therapy, but I do not have their desired degree.

Works Cited

Confluence, http://www.confluencevt.com/.

Outdoor Behavioral Healthcare Council, https://obhcouncil.com/members/page/2/.