University of Texas, Austin. He wanted to know what was making the
approach successful while the other standard interventions—
cognitive behavioral therapy and medication—were falling short.
When Scheinfeld assessed 159 veterans, he found that Outward
Bound participants experienced 9 to 19 percent improvement in
mental health; vets in the control group showed no such gains. The
Outward Bound groups still showed the boost a month after the trips
ended.
Why did the trips work? Scheinfeld noted that the participants,
mostly male, tended to encourage each other to give counseling
another try and stick with it. “There were always a couple in each
group who were helped by counseling, and they became de facto
mentors,” he said. Because of this, the participants showed a greater
openness seeking treatment after the trips, and they were less likely to
drop out of treatment. Another reason for success: the trip itself,
being in the wilderness and part of a supportive group, counted as
extended therapy, and for many hours a day, not the usual one hour
per week offered by the VA. “It’s hard for these guys to sit in a room
with four walls and talk about their feelings,” said Scheinfeld. “It just
happens best when they’re in a natural setting. It draws them out.”
Other studies have shown similar results. Neil Lundberg of
Brigham Young University looked at twenty-two participants from
two Higher Ground trips in 2010. Compared to a similar group of
veterans on a waiting list, they showed significant decreases—of up
to 40 percent—in flashbacks, emotional numbing and hyperarousal
after the trips. But not everyone is convinced. Craig Bryan, a
psychologist and Air Force veteran who directs the University of
Utah’s National Center for Veterans Studies, remains skeptical of
nature-based treatment. Most of the studies out there, he said, are
small, lack a meaningful control group, and don’t follow participants
for very long. “It’s possible these treatments are better than existing
treatments, but we just don’t know,” he said. “We don’t have the data