The outcomes chart below is interactive. Click around to learn more about the transformative results of our wilderness therapy program.
Ages 9-13
- Anxiety/ Depressed
- Withdrawn/Depressed
- Aggression
- Attention
- Rule Breaking
- Social Problems
- Body Complaints
- Thought Problems
- Externalizing
- Internalizing
Anxiety/ Depressed
percentage of sample with significant symptoms
Treatment timeline
Over two-thirds of youth, between the ages of 9-13 presented with significant symptoms of anxiety and depression upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, with only 20% of the sample continuing to report depressive and anxious symptoms.Withdrawn/Depressed
percentage of sample with significant symptoms
Treatment timeline
Forty-nine percent of youth, between the ages of 9-13 presented with significant symptoms of withdrawal and depression upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly (8% of the sample continued to report internalizing symptoms).Aggression
percentage of sample with significant symptoms
Treatment timeline
66.1% percent of youth, between the ages of 9-13 presented with significant symptoms of verbal and physical aggression upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, with only 5% of the sample continuing to report symptoms of aggressive behaviors.Attention
percentage of sample with significant symptoms
Treatment timeline
38% percent of youth, between the ages of 9-13 presented with significant symptoms of attention-related issues upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, with only 10% of the sample continuing to report attention-related challenges.Rule Breaking
percentage of sample with significant symptoms
Treatment timeline
35% percent of youth, between the ages of 9-13 presented with significant symptoms of rule breaking behaviors upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, with only 5% of the sample continuing to report rule breaking behaviors.Social Problems
percentage of sample with significant symptoms
Treatment timeline
45% percent of youth, between the ages of 9-13 presented with significant symptoms of social problems upon their arrival at Trails Carolina. Problems included loneliness, difficulty making and keeping friends, and excess dependency on others, for example.. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, with only 17% of the sample continuing to report social problems.Body Complaints
percentage of sample with significant symptoms
Treatment timeline
44% percent of youth, between the ages of 9-13 presented with significant symptoms of body complaints such as muscle aches, stomach discomfort, headaches, and fatigue upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, with only 15% of the sample continuing to report body complaints.Thought Problems
percentage of sample with significant symptoms
Treatment timeline
52% percent of youth, between the ages of 9-13 presented with significant symptoms of thought-related issues upon their arrival at Trails Carolina. Problems included self harm, repetitive behaviors, distractibility, sleep disruptions, and unusual behavior. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, with only 27% of the sample continuing to report thought related issues.Externalizing
percentage of sample with significant symptoms
Treatment timeline
55% percent of youth, between the ages of 9-13 presented with significant symptoms of externalizing behaviors (rule-breaking and aggressive behaviors generally) upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, with only 5% of the sample continuing to report externalizing behaviors.Internalizing
percentage of sample with significant symptoms
Treatment timeline
68% percent of youth, between the ages of 9-13 presented with significant symptoms of internalizing behaviors (anxiousness, withdrawal, depressiveness, and physical complaints generally) upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, with only 25% of the sample continuing to report internalizing behaviors.*Data provided by parents on the Achenbach System of Empirically Based Assessment.
Achenbach, T. M., & Rescorla, L. A. (2001). Manual for ASEBA School-Age Forms & Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.
Ages 14-17
- ADHD
- Disruptive Behavior
- Depression/Anxiety
- Suicidal Thoughts
- Peer Conflict
- Sleep
- Substance Use
- School
ADHD
ADHD - Parent Respondents
percentage of sample with significant symptoms
Treatment timeline
67% percent of adolescents, between the ages of 14-17 presented with significant symptoms of ADHD upon their arrival at Trails Carolina. At graduation and one year following graduation from Trails, the majority of adolescents’ symptoms had improved markedly (18% and 20% of the sample continued to report symptoms of ADHD at graduation and at the 12-month follow-up assessment, respectively).ADHD - Student Respondents
percentage of sample with significant symptoms
Treatment timeline
28% percent of adolescents, between the ages of 14-17 presented with significant symptoms of ADHD upon their arrival at Trails Carolina. At graduation and one year following graduation from Trails, the majority of adolescents’ symptoms had improved markedly (8% and 12% of the sample continued to report symptoms of ADHD at graduation and at the 12-month follow-up assessment, respectively).Disruptive Behavior
Disruptive Behavior - Parent Respondents
percentage of sample with significant symptoms
Treatment timeline
42% percent of adolescents, between the ages of 14-17 presented with significant symptoms of disruptive behaviors upon their arrival at Trails Carolina. Examples of these disruptive behaviors included stealing/shoplifting, running away, verbal aggression, and noncompliance. At graduation and one year following graduation from Trails, the majority of adolescents’ symptoms had improved markedly (11% and 26% of the sample continued to report symptoms of disruptive behaviors at graduation and at the 12-month follow-up assessment, respectively).Disruptive Behavior - Student Respondents
percentage of sample with significant symptoms
Treatment timeline
25% percent of adolescents, between the ages of 14-17 presented with significant symptoms of disruptive behaviors upon their arrival at Trails Carolina. Examples of these disruptive behaviors included stealing/shoplifting, running away, verbal aggression, and noncompliance. At graduation and one year following graduation from Trails, the majority of adolescents’ symptoms had improved markedly (10% and 7% of the sample continued to report symptoms of disruptive behaviors at graduation and at the 12-month follow-up assessment, respectively).Depression/Anxiety
Depression/Anxiety - Parent Respondents
percentage of sample with significant symptoms
Treatment timeline
67% percent of adolescents, between the ages of 14-17 presented with significant symptoms of depression and anxiety upon their arrival at Trails Carolina. At graduation and one year following graduation from Trails, the majority of adolescents’ symptoms had improved markedly, based on parents’ report (15% and 0% of the sample continued to report symptoms of depression and anxiety at graduation and at the 12-month follow-up assessment, respectively).Depression/Anxiety - Student Respondents
percentage of sample with significant symptoms
Treatment timeline
36% percent of adolescents, between the ages of 14-17 presented with significant symptoms of depression and anxiety upon their arrival at Trails Carolina. At graduation and one year following graduation from Trails, the majority of adolescents’ symptoms had improved markedly (10% and 7% of the sample continued to report symptoms of depression and anxiety at graduation and at the 12-month follow-up assessment, respectively).Suicidal Thoughts
Suicidal Thoughts - Parent Respondents
percentage of sample with significant symptoms
Treatment timeline
53% percent of adolescents, between the ages of 14-17 presented with significant suicidal thoughts upon their arrival at Trails Carolina. At graduation and one year following graduation from Trails, the majority of adolescents’ symptoms had improved markedly, based on parents’ report (15% and 10% of the sample continued to report symptoms of suicidal thoughts at graduation and at the 12-month follow-up assessment, respectively).Suicidal Thoughts - Student Respondents
percentage of sample with significant symptoms
Treatment timeline
37% percent of adolescents, between the ages of 14-17 presented with significant suicidal thoughts upon their arrival at Trails Carolina. At graduation and one year following graduation from Trails, the majority of adolescents’ symptoms had improved markedly (11% and 10% of the sample continued to report symptoms of suicidal thoughts at graduation and at the 12-month follow-up assessment, respectively).Peer Conflict
Peer Conflict - Parent Respondents
percentage of sample with significant symptoms
Treatment timeline
68% percent of adolescents, between the ages of 14-17 presented with significant peer conflict upon their arrival at Trails Carolina. At graduation and one year following graduation from Trails, the majority of adolescents’ symptoms had improved markedly, based on parents’ report (21% and 14% of the sample continued to report peer conflict issues at graduation and at the 12-month follow-up assessment, respectively).Peer Conflict - Student Respondents
percentage of sample with significant symptoms
Treatment timeline
28% percent of adolescents, between the ages of 14-17 presented with significant peer conflict upon their arrival at Trails Carolina. At graduation and one year following graduation from Trails, the majority of adolescents’ symptoms had improved markedly (13% and 7% of the sample continued to report peer conflict issues at graduation and at the 12-month follow-up assessment, respectively).Sleep
Sleep - Parent Respondents
percentage of sample with significant symptoms
Treatment timeline
25% percent of adolescents, between the ages of 14-17 presented with significant sleep disruption, including insomnia and hypersomnia upon their arrival at Trails Carolina. At graduation and one year following graduation from Trails, the majority of adolescents’ symptoms had improved markedly, based on parents’ report (4% and 7% of the sample continued to report sleep disruption at graduation and at the 12-month follow-up assessment, respectively).Sleep - Student Respondents
percentage of sample with significant symptoms
Treatment timeline
23% percent of adolescents, between the ages of 14-17 presented with significant sleep disruption, including insomnia and hypersomnia upon their arrival at Trails Carolina. At graduation and one year following graduation from Trails, the majority of adolescents’ symptoms had improved markedly (10% and 3% of the sample continued to report sleep disruption at graduation and at the 12-month follow-up assessment, respectively).Substance Use
Substance Use - Parent Respondents
percentage of sample with significant symptoms
Treatment timeline
67% percent of adolescents, between the ages of 14-17 presented with significant symptoms of substance use upon their arrival at Trails Carolina. At graduation and one year following graduation from Trails, the majority of adolescents’ symptoms had improved markedly, based on parents’ report (47% and 30% of the sample continued to report substance use issues at graduation and at the 12-month follow-up assessment, respectively).Substance Use - Student Respondents
percentage of sample with significant symptoms
Treatment timeline
45% percent of adolescents, between the ages of 14-17 presented with significant symptoms of substance use upon their arrival at Trails Carolina. At graduation and one year following graduation from Trails, the majority of adolescents’ symptoms had improved markedly (27% and 9% of the sample continued to report substance use issues at graduation and at the 12-month follow-up assessment, respectively).School
School - Parent Respondents
percentage of sample with significant symptoms
Treatment timeline
47% percent of adolescents, between the ages of 14-17 presented with significant issues related to school upon their arrival at Trails Carolina. . Examples of these challenges included truancy, disengagement, feeling criticized or performing poorly. At graduation and one year following graduation from Trails, the majority of adolescents’ symptoms had improved markedly , based on parents’ report (8% and 6% of the sample continued to report school related issues at graduation and at the 12-month follow-up assessment, respectively).School - Student Respondents
percentage of sample with significant symptoms
Treatment timeline
18% percent of adolescents, between the ages of 14-17 presented with significant issues related to school upon their arrival at Trails Carolina. . Examples of these challenges included truancy, disengagement, feeling criticized or performing poorly. At graduation and one year following graduation from Trails, the majority of adolescents’ symptoms had improved markedly (7% and 3% of the sample continued to report school related issues at graduation and at the 12-month follow-up assessment, respectively).Data provided by parents on the youth version of the Treatment Outcome Package (TOP).
Kraus, D. R., Seligman, D. A., & Jordan, J. R. (2005). Validation of a behavioral health treatment outcome and assessment tool designed for naturalistic settings: The Treatment Outcome Package. Journal of Clinical Psychology, 61, 285 – 314.
Adopted Students – Parent Respondents
- Anxiety/ Depressed
- Withdrawn/Depressed
- Aggression
- Attention
- Rule Breaking
- Social Problems
- Body Complaints
- Thought Problems
- Externalizing
- Internalizing
Anxiety/ Depressed
percentage of sample with significant symptoms
Treatment timeline
67%of adopted youth presented with significant symptoms of anxiety and depression upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, based on parents’ report with only 19% of the sample continuing to report depressive and anxious symptoms.Withdrawn/Depressed
percentage of sample with significant symptoms
Treatment timeline
41% percent of adopted youth presented with significant symptoms of withdrawal and depression upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, based on parents’ report (5% of the sample continued to report internalizing symptoms).Aggression
percentage of sample with significant symptoms
Treatment timeline
60% percent of adopted youth presented with significant symptoms of verbal and physical aggression upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, based on parents’ report with 16% of the sample continuing to report symptoms of aggressive behaviors.Attention
percentage of sample with significant symptoms
Treatment timeline
38% percent of adopted youth presented with significant symptoms of attention-related issues upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, with only 12% of the sample continuing to report attention-related issues.Rule Breaking
percentage of sample with significant symptoms
Treatment timeline
54% percent of adopted youth presented with significant symptoms of rule breaking behaviors upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, based on parents’ report with only 1% of the sample continuing to report rule breaking behaviors.Social Problems
percentage of sample with significant symptoms
Treatment timeline
40% percent of adopted youth presented with significant symptoms of social problems such as loneliness, difficulty making and keeping friends, and excess dependency on others upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, based on parents’ report with only 9% of the sample continuing to report social problems.Body Complaints
percentage of sample with significant symptoms
Treatment timeline
39% percent of adopted youth presented with significant symptoms of body complaints such as muscle aches, stomach discomfort, headaches, and fatigue upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, with only 14% of the sample continuing to report body complaints.Thought Problems
percentage of sample with significant symptoms
Treatment timeline
52% percent of adopted youth presented with significant symptoms of thought related issues such as self harm, repetitive behaviors, distractibility, sleep disruptions, and unusual behavior upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, based on parents’ report with only 22% of the sample continuing to report thought related issues.Externalizing
percentage of sample with significant symptoms
Treatment timeline
50% percent of adopted youth presented with significant symptoms of externalizing behaviors (rule-breaking and aggressive behaviors generally) upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly, based on parents’ report, with 0% of the sample continuing to report significant externalizing problems.Internalizing
percentage of sample with significant symptoms
Treatment timeline
65% percent of adopted youth presented with significant symptoms of internalizing behaviors (anxiousness, withdrawal, depressiveness, and physical complaints generally) upon their arrival at Trails Carolina. One year following graduation from Trails, the majority of youth’s symptoms had improved markedly based on parents’ report with only 17% of the sample continuing to report internalizing behaviors.Data provided by parents on the Achenbach System of Empirically Based Assessment.
Achenbach, T. M., & Rescorla, L. A. (2001). Manual for ASEBA School-Age Forms & Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.
Academics
- School Functioning
- Missed School
- Trouble finishing
- Felt Criticized
- Neglect Due To Substance Abuse
- Felt Excited
- Felt Acknowledged
School Functioning
School Functioning - Parent Respondents
percentage of sample with significant symptoms
Treatment timeline
Before enrolling at Trails, 46% of parents reported that their child struggled with issues related to functioning in school. One year after leaving Trails, the number of parents reporting that their children experienced these symptoms reduced by 87%.School Functioning - Student Respondents
percentage of sample with significant symptoms
Treatment timeline
Before enrolling at Trails, 22% of students reported issues with school functioning. One year after leaving Trails, the number of students reporting these issues reduced by 87%.Missed School
Missed School - Parent Respondents
percentage of sample with significant symptoms
Treatment timeline
Before enrolling at Trails, 48.5% of parents reported that their child was missing school a lot of the time. One year after leaving Trails, this issue was reduced by 94%.Missed School - Student Respondents
percentage of sample with significant symptoms
Treatment timeline
Before enrolling at Trails, 33% of students said that they missed school a lot of the time. One year after leaving Trails, the number of students reporting these issues reduced by 92%.Trouble finishing
Trouble finishing - Parent Respondents
percentage of sample with significant symptoms
Treatment timeline
Before enrolling at Trails, 54% of parents reported that their child had trouble finishing homework a lot of the time. One year after leaving Trails, this issue was reduced by 69%.Trouble finishing - Student Respondents
percentage of sample with significant symptoms
Treatment timeline
Before enrolling at Trails, 19% of students said that they had trouble finishing homework assignments. One year after leaving Trails, the number of students reporting these issues reduced by 59%.Felt Criticized
Felt Criticized - Parent Respondents
percentage of sample with significant symptoms
Treatment timeline
Before enrolling at Trails, 16% of parents reported that their child felt criticized in school. One year after leaving Trails, this issue was reduced by 82%.Felt Criticized - Student Respondents
percentage of sample with significant symptoms
Treatment timeline
Before enrolling at Trails, 17% of students said that they felt criticized in school. One year after leaving Trails, the number of students reporting these issues reduced by 85%.Neglect Due To Substance Abuse
Neglect Due To Substance Abuse - Parent Respondents
percentage of sample with significant symptoms
Treatment timeline
Before enrolling at Trails, 22% of parents reported that their child neglected school due to substance use. One year after leaving Trails, this issue was reduced by 95%.Neglect Due To Substance Abuse - Student Respondents
percentage of sample with significant symptoms
Treatment timeline
Before enrolling at Trails, 4.5% of students said that they neglected school due to substance use issues. One year after leaving Trails, no students reported experiencing this issue.Felt Excited
Felt Excited - Parent Respondents
percentage of sample with significant symptoms
Treatment timeline
Before enrolling at Trails, 28% of parents reported that their child felt excited about school. One year after leaving Trails, this number more than doubled.Felt Excited - Student Respondents
percentage of sample with significant symptoms
Treatment timeline
Before enrolling at Trails, 52% of students said that they felt excited about school. One year after leaving Trails, 24% more students felt excited about school.Felt Acknowledged
Felt Acknowledged - Parent Respondents
percentage of sample with significant symptoms
Treatment timeline
Before enrolling at Trails, 78% of parents reported that their child felt acknowledged at school. One year after leaving Trails, this percentage increased by 16%.Felt Acknowledged - Student Respondents
percentage of sample with significant symptoms
Treatment timeline
Before enrolling at Trails, 78% of students said that they felt acknowledged at school. One year after leaving Trails, this number increased by 16%.*Data provided by parents on the Academic subscale of the youth version of the Treatment Outcome Package (TOP). Kraus, D. R., Seligman, D. A., & Jordan, J. R. (2005). Validation of a behavioral health treatment outcome and assessment tool designed for naturalistic settings: The Treatment Outcome Package. Journal of Clinical Psychology, 61, 285 – 314.
Does Wilderness Therapy Work?
Trails Carolina has partnered with the Center for Research, Assessment, and Treatment Efficacy (CReATE; Asheville, NC) and the Arkansas Institute of Developmental Science to develop a research initiative, exploring the clinical presentation, therapeutic outcomes, and impact for youth and families involved in wilderness therapy programming.
Both students and parents reported significant changes in behavior and symptoms–in both the youth and the family–from enrollment at Trails to one full year after graduation.
This ongoing research initiative is assessing youth, parents, and families about a wealth of issues, including mental health symptoms, syndromes, and behavioral problems observed at four specific time periods:
Upon admission to Trails Carolina
At graduation from Trails Carolina
Three months after graduation from Trails
One year after graduation from Trails
The research initiative utilizes a variety of assessment tools, including the Treatment Outcome Package (TOP), the gold standard for measuring response to therapeutic interventions, and the Achenbach System of Empirically Based Assessments.