Running head: SELF- EFFICACY: THE IMPACTS OF WILDERNESS THERAPY ON
URBAN ADOLECENTS
Self-Efficacy: The Impacts of Wilderness Therapy on Urban Adolescents
Morgan G. Miller
University of Montana- COUN 545
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Abstract
Within the U.S. population of 13-18-year old’s, 22.2% meet the criteria for severe distress or
impairment (Gabrielsen & Harper, 2018). Additionally, an urban upbringing can exacerbate
these mental health concerns in the adolescent population (Gabrielsen et al., 2018). That being
said, urban adolescents are at exceptionally high risk for low levels of self-efficacy. Self-efficacy
serves as a major protective factor for adolescents in general and can result in life-long mental
health implications if not attended to. This study examines the impacts of wilderness therapy on
levels of self-efficacy among urban adolescents. The two sample groups of urban and rural
adolescents will have 20 participants each. It is predicted that the urban group will show a
greater increase in self-efficacy over the rural sample. This study utilizes an eight-week
wilderness therapy intervention to compare the difference in levels of self-efficacy from pretest
to posttest. Conclusions and recommendations for future research are provided.
Keywords: self-efficacy, adolescent, urban, wilderness therapy
Running head: SELF- EFFICACY: THE IMPACTS OF WILDERNESS THERAPY ON
URBAN ADOLECENTS
Self-Efficacy: The Impacts of Wilderness Therapy on Urban Adolescents
Self-efficacy is a pivotal factor in the personal success’s and development of all people.
Self-efficacy is important for every age group, however its presence or lack thereof in the
turbulent time of adolescence can be a heavy predictor of one’s long term health (Tabak &
Zawadzka, 2017). Adolescent self-efficacy serves as an important protective factor for
preserving and/or protecting the mental health of young people (Tabak et al, 2017). Some of the
other benefits linked to self-efficacy in adolescence include, the varying health benefits,
academic achievement within the high school years, and the association “with health promotion
intentions and knowledge” (Margalit & Ben-Ari, 2014, p. 183). The positive impacts of
wilderness therapy on youths levels of self-esteem and self-efficacy have already been
established within the research (Harper, Russell, Cooley, & Cupples, 2007). The purpose of this
study is to examine how utilizing wilderness therapy will impact levels of self-efficacy among
urban adolescents over their rural counterparts.
Mental Health of Adolescents
According to Tabak and Zawadzka and WHO, mental health is described as “a state of
well-being in which the individual realizes his or her own abilities, can cope with the normal
stresses of life, can work productively and fruitfully, and is able to make a contribution to his or
her community…” (Tabak et al., 2017, p. 4). Tabak and Zawadzka highlight the severity of the
mental health epidemic stating that WHO’s data indicates one third of the population is affected
by mental health disorders every year (Tabak et al., 2017). Children and adolescents make up
20% of that one third of people needing assessment and intervention (Tabak et al.,
2017). Additionally, in American adolescents the incidence of a major depressive episode went
from 8.7% to 12.5% between 2005 and 2015, further demonstrating the prevalence and demand
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for treatment (Gabrielsen et al., 2018). An ever more disparaging statistic found that in the U.S.
22.2% of teens ages 13-18 meet the criteria for severe distress or impairment ranging from 14%
with mood disorders, 31.9% with anxiety, and 19.1% with behavioral disorders (Gabrielsen et
al., 2018).
Adolescence can often be a confusing, and stressful transition for many young people.
This time period marks many changes on a biopsychosocial level. The adolescent brain is
growing and changing at a speed that makes teens particularly vulnerable to social influences and
cues (Chervonsky & Hunt, 2019). Some of the most notable shifts for this developmental stage
includes a heightened attention on peer to peer interaction, friendship building, increased
experiences with bullying, and a growing need for autonomy (Chervonsky et al., 2019). That
being said, it is estimated of the adults with mental health disorders, half of them experience the
onset of disorders in adolescence (Tabak et al., 2017). Researchers Chattopadhyay and
Mukhopadhyay further stress the impact of mental health disorders and adolescence in their
study in which the primary objective was to assess and examine the mental health status and
level of self-efficacy of 20 participants identified as at risk for developing depression.
Chattopadhyay and Mukhopadhyay findings reinforce Tabak & Zawadzka’s by statings that
“Half of lifetime diagnosable mental health disorders starts by age 14, this number increases to
three fourths by age 24” (Chattopadhyay & Mukhopadhyay, 2011, p. 148)
Urban youth and mental health
Gabrielsen and Harper’s study on the role of wilderness therapy for adolescents in the
face of global trends of urbanization and technification (2018) provides limited and valuable
insight on urban youth. The study points out that in the last 10 years the number of people
cohabiting in urban areas has exceeded the population of people living in rural environments
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(2018). Additionally, that statistic is said to change by 2050, with a whopping 84% on an urban
global scale (2018). This particular study defines urban areas as those referring to towns, suburbs
and cities with a high density of man-made structures (2018). There is ample research examining
the impact of urban upbringing on mental health.
According to Gabrielsen and Liev the negative mental health repercussions include
schizophrenia, mood disorders, anxiety, and a reduced ability to process social stressors
(2018). Gabrielsen and Liev further illuminate the deficits of urban living for teens, when they
point out that urbans settings rarely present themselves with environments or opportunities that
foster serenity and presence of mind. These emotional states are facilitators of “self-awareness,
introspection and contact with one’s emotional system, all key factors for making congruent and
health-promoting adjustments to one’s life (McGeeney, 2016)” (2018, p. 412).
Self- Efficacy
Self-efficacy is defined as an individual's ability to organize and act on tasks required to
yield an identified accomplishment or achievement (Tabak et al., 2017). Many consider it an
essential inner resource and a factor in determining one’s health (Tabak et al., 2017). It is a
known protective factor against symptoms of depression, (Chattopadhyay et al., 2011), stress
(Tabak et al., 2017), and anxiety (Bai, Kohli, & Malik, 2017). It contributes to the prevention of
other mental health issues in adolescence, and is linked to subjective feelings of happiness, a
sense of well-being, and the perceived feeling of having social support (Tabak et al., 2017). Selfefficacy in teens is known to promote to pro-social behaviors, civic engagement, and increase the
propensity for academic success (Tabak et al., 2017).
One of the primary roles self-efficacy plays that inherently influences all the
aforementioned characteristics pertains to decision making (Bai, et al., 2017). Levels of self-
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efficacy are linked to one’s decision making skills, and how one approaches problems (Bai et al.,
2017). Ones self-efficacious beliefs are what control “human functioning through cognitive,
motivational, affective and decisional processes (Bandura, 1997)” (Tabak et al., 2017, pp. 3-4).
These processes influence whether a person perceives their own abilities in ways that are either
enhance or debilitate hinder the self (Tabak et al., 2017). This in turn, affects their emotional
well-being, their aptitude to for perseverance when faced with difficult situations, and the
ultimately the decisions or choices they make in those difficult situations (Tabak et al., 2017).
Bai, Kohli, and Malik’s explorative study on mental health and its relationship between selfefficacy and hope among female college students provided further insight on the
conceptualization of self-efficacy. In particular, that one’s level of self-efficacy dictates the
likelihood that they will rise to a challenge. A person with high levels of self-efficacy are more
likely to concede a challenge, while those with low levels are prone to evade perceived
challenges (Bai et al., 2017). Researchers also found that those with high levels of self-efficacy
attribute their failures to unfavorable environments or situations or a lack of effort or energy of
their own doing (Bai et al., 2017). Conversely, those with low levels of self-efficacy attribute
failure to a perceived deficiency in ability and are likely to lose confidence in their ability to
achieve (Bai et al., 2017). When examining success, those with high levels are able to
acknowledge that their achievement is a result of their ability, while those with low levels are
prone to credit luck or external factors for their achievement (Bai et al., 2017).
Wilderness Therapy
The current literature on wilderness therapy suggests that there are a variety of ways to
define treatment and inconsistent information around the origins of the practice. According to
Margalit and Ben-Ari, wilderness therapy (WT) originated in the 1920’s and was intended to
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serve as a rehabilitation program for at risk adolescents (2014). Kurt Hahn’s “Outward Bound”
model originating in the 1940’s was the catalyst for the popularizing style of treatment.
(Bastemur, 2019)
Across the literature, the term wilderness therapy (WT) is also known as and/or
synonymous with terms such as adventure- based counselling, adventure therapy, outdoor
behavioral healthcare, wilderness experience programs, wilderness adventure therapy, bush
adventure therapy, outdoor adventure intervention, and therapeutic camping (Bowen & Neill,
2013). WT has been described and characterized in a myriad of ways. With the primary focus
being experiences that are typically in natural or outdoor environments that are intended to
stimulate clients cognitively, behaviorally, and affectively (Bowen et al., 2013). Harper, Russell,
Cooley, and Cupples add to the definition stating that WT merges outdoor recreational
adventure, living, skill building and activities with both individual and group counseling (2007),
(Bettmann, Tucker, Behrens, & Vanderloo, 2017). There are some fundamental characteristics of
WT that distinguish it from other forms of therapeutic treatment. The first and most obvious
characteristic is the inclusion and role nature plays in the therapeutic process, as well as “the use
of perceived risk to heighten arousal and to create eustress (positive response to stress)” (Bowen
et al., 2013, p. 28). Additionally, the inclusion of the process of kinesthetic learning, or
“meaningful engagement” (Bowen et al. 2013, p.28)
The literature on this topic highlight broad range of beneficial therapeutic returns to the
WT approach. Numerous studies have found that physical activity alone can reduce symptoms of
depression (Chattopadhyay et al., 2011). Margalit and Ben-Ari point out that for teens in
particular, having the outdoors as the therapeutic setting contributes to the healing process and
plays off of the inherent tendencies of adolescents of self-disclosure and spontaneity (2014).
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Their article also suggests that the model most WT programs are derived from naturally address
the communication challenges many adolescents face and is influential in overcoming the
inherent challenges associated with having limited communication skills such as the sharing of
ones thoughts and feelings, and overall cognitive and emotional openness (2014). Bowen
identifies the goals of WT as cultivating psychosocial skills, addressing psychological problems
by increasing and enriching one’s psychological resilience or decreasing behavioral issues
(2007). A particularly notable benefit of WT is its immunity to readiness for change (Bettmann
et al., 2017). It has been shown that an adolescents readiness for change is not needed to still to
successfully reduce mental health symptomology (Bettmann, et al., 2017),(Margalit, D. et al.).
Wilderness therapy and self-efficacy
Unfortunately, there seems to be limited literature on the mental health status of urban
adolescents, and the effects of wilderness therapy on that specific demographic. This gap in the
research provokes the question of the effects of WT on self-efficacy for urban adolescence.
Though WT has been utilized with various demographics with a variety of issues, it’s primary
target group is typically at risk adolescents. Its growing popularity with this demographic is
impart due to the inherent logistical and financial limitations associated with WT such as length
of treatment, and distance traveled to receive treatment (Harper, et al., 2007).
Given the nuanced and experiential nature of WT, it is often an ideal fit for many
adolescents in the acquisition of self-efficacy. Just by being in an unfamiliar environment that
requires the building of new skills and approaches to new challenges they are likely
unaccustomed to, makes it a high predictor of increased self-efficacy. Margalit and Ben-Ari
share that the promotion of self-efficacy can be addressed by WT because it gives teens
situations and opportunities to engage triumphantly in varying activities that present as
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challenges (2014). Furthermore, engagement in WT is influential in the promotion of selfefficacy and is shown to increase levels of self-efficacy and self-concept following the
participation in WT (Margalit et al., 2014). Self-efficacy and autonomy are the fundamental
developmental markers of the decision-making process for adolescents. (Margalit et al., 2014)
Therefore, there is significant worth in participation of WT because it promotes cognitive
autonomy and self-efficacy and imposes valuable implications for preventing the participation in
risky behaviors as well as cessation of said behaviors (Margalit et al., 2014). Additionally,
Margalit and Ben-Ari found that group work within the context of WT promotes opportunity for
teens to actively help one another, which in turn increases their self-esteem and self-efficacy
(2014).
Russell and Walsh, and Margalit and Ben-Ari’s studies provide the most evidence
supporting the idea that WT increases self-efficacy. Margalit and Ben-Ari’s study specifically
examined the effect of WT programs had on teens self-efficacy and cognitive autonomy (2014).
Their study’s sample size was comprised of 93 at risk adolescent males ranging in age from 1416 that attended boarding schools in Israel (2014). Participants either participated in either a fulllength WT intervention, a partial WT intervention or a control condition, however random
assignment did not occur (2014). Their findings exhibited that the participants in the full-length
intervention showed a significant increase in the desired outcome of cognitive autonomy and
self-efficacy over those who were in the partial participation group (2014).
Russell and Walsh’s exploratory study of wilderness adventure programs for young
offenders in Minnesota also found legitimate evidence supporting the efficacy of self-efficacy in
WT. Their study was comprised of 33 males and 10 females (mean age =15) of which 60% were
white, and 40% were considered non-white. In the analysis of the study, their results confirmed
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what the literature already supports, showing a significant increase in self-efficacy (Russell &
Walsh, 2011).
Purpose of study
The research on wilderness therapy is limited and lacking, however it appears that there
is a general consensus among the bodies of work that WT is beneficial for general well-being
and increases self-efficacy. Unfortunately, as stated earlier, there appears to be little to no
research done on the efficacy of wilderness therapy on the specific demographic of adolescents
growing up in urban areas, despite a demand for mental health services among this demographic.
Furthermore, Bettmann points out the limited information on specific gender differences among
WT participants (2017), and Neil and Bowen’s metanalysis of WT studies found limitations with
regards to the availability of studies overall generalizability, heterogeneity, and “type of data
provided by empirical studies, and the methodological quality of studies” (2013, p. 41).
The purpose of this study is to explore the relationship between self-efficacy and
wilderness therapy and its potential impacts on urban youth. The research question guiding this
investigation is, does wilderness therapy have a more significant impact on urban youth’s selfefficacy as compared to rural youth’s self-efficacy? I hypothesize self-efficacy will significantly
increase with the implantation of wilderness therapy for adolescents ages 13-18. This increase
will be more significant for urban youth over rural youth.
Methods
Participants
This experiment will be comprised of 40 adolescents varying in ages from 13 to 18. Fifty
percent of the study’s participant pool will be made up of adolescents who have been raised in
and are still currently living in urban areas across the United States. Conversely, the other 20
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participants will be made up of adolescents who have been raised in and are currently still living
in rural settings across the United States. For the sake of this study, urban will be defined as a
city with a population over 800,000 people with a minimum density of 1,000 people per square
mile. Rural will be defined as towns with less than 10,000 people with a population density of
500 people per square mile.
For the process of selecting participants in an urban area, the top ten most populated
cities in the United States were identified and selected with the exclusion of cities in the same
state to provide a more diverse spread of participants. Rural adolescents will not be targeted by
region however will need to meet the requirements of rural living. The rural participants will also
vary, having 20 different people from ten different states.
Participants will be recruited through multiple social media platforms. Advertisements
will be intended to target both adolescents and parents. The recruitment approach paired with the
spread of cities and towns from at least 10 different states will yield a comprehensive
representative group in regard to gender, age, education, ethnicity and socioeconomic status of
America’s urban and rural adolescents.
Some preliminary screenings to the sample group will be necessary given the nature of
the experiment. Applicants will need to meet the urban and rural living requirements, as well as
the age requirement. Both groups (urban and rural) will have no more than ten participants that
identify as the same gender. As an example, of the 20 rural participants, no more than ten
participants will identify as female, male, or gender non-conforming.
Exclusionary criteria for the experiment may also include psychosis, schizophrenia, or
schizoaffective disorder. Additionally, adolescents with conduct disorders or with a history of
violence or sexual assault will be unable to participate. Physical limitations, such as a reliance on
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a wheelchair or crutches, or any problem requiring prolonged or intensive medical care or
monitoring like eating disorders severe enough to require a feeding tube, diabetes, and postural
tachycardia syndrome may also be unfit for the study.
Participants will be offered a $100 incentive for their participation in the experiment,
with $50 being given upon completion of the initial pre-test assessment and the additional $50
being given after the WT trip upon completion of the post-test assessment. All participants and
their parents go will go through a formal informed consent process. Though consent will be
required of parents or legal guardians of the participants, assent from the participants themselves
will be necessary for participation as well.
Instrumentation
Chen et al.’s New General Self-Efficacy Scale (NGSE).
Developed in 2001, Chen’s New General Self-Efficacy Scale aligns itself with the
definition of general self-efficacy: “one’s belief in one’s overall competence to effect requisite
performance across a wide variety of achievement situations” (Scherbaum, et al., 2006, p. 1050).
The assessment is quite brief, and typically takes about three minutes to complete on average
(Stanford SPARQtools, n.d.). This particular scale is made up of eight statement items using a
five-point rating scale. The rating scale is broken down as 1= Strongly Disagree, 2= Disagree,
3= Neither Agree Nor Disagree, 4= Agree, and 5= Strongly Agree. Examples of the eight
statement items include “I will be able to successfully overcome many challenges” (Stanford
SPARQtools, n.d.) and “I will be able to achieve most of the goals that I set for myself”
(Stanford SPARQtools, n.d.). Higher scores indicate higher levels of general self-efficacy
(Scherbaum, et al., 2006).
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Scherbaum, et al. states that for this particular measuring tool the preliminary
psychometric evidence fairs well (2006). Additionally, the internal consistency of the responses
to the items featured in the assessment are fairly high for exploratory research (Scherbaum, et al.,
2006). The cutoff for exploratory research for internal consistency is .70 while Chen’s et al.
ranges from .85 to .90 (Scherbaum, et al., 2006). Going further, Scherbaum, et al. states that the
stability coefficient raging from r= .62 to r=.65 are fairly high for “trait-like individual
difference variables” (2006, p. 1051).
Procedure
Upon meeting the preliminary requirements, and giving informed consent and assent,
applicants names will be placed into two groups based on their urban or rural upbringing. Names
will be pulled at random. No more than two participants from the same grouping (urban or rural)
can be from the same state thus if a third name from the same state is selected it will be
discarded. Additionally, if ten applicants who identify as male, female, or gender nonconforming from either group have already been selected, any further selections from that same
group will also be discarded.
Once the selection process is complete, the New General Self-Efficacy Scale will be
administered in a group setting on the first day of the program. All participants will then embark
on a eight week empirically based wilderness therapy program called Second Nature.
Participants will partake in the Utah based program that identifies self-efficacy as a primary
focus. The clinical director and facilitator of the program has been quoted on the American
Physiological Association website as stating that "A big part of this experience is helping
students experience for themselves a greater sense of self-efficacy and internal locus of control”
(DeAngelis, 2013, p. 48). Staffed by three doctoral level psychologists and five more mental
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health professionals the program will utilize evidence-based practices to treat all 40 participants
on an identified goal. Upon completion of the program, participants will take a post-test utilizing
the same measurement scale.
Statistical Analysis
An ANOVA will be used to compare changes in mean scores of the two groups from pretest to post-test (p < .05).
Results
It is expected that rural and urban samples will have significantly different levels of selfefficacy after the eight-week wilderness therapy program. Self-efficacy scores for the rural group
will be (μ=2.45) at baseline while self-efficacy scores for the urban group will be (μ= 2.40) at
baseline. Self-efficacy scores post intervention for the rural group will be (μ = 3.95) at post-test.
Self-efficacy scores post intervention regarding the urban group will be (μ = 4.65) at post-test
(See Figure 1.1 for chart). This statistical differences between groups will be analyzed using
ANOVA.
While both groups are expected to increase in levels of self-efficacy, it is expected that
significant differences will exist between the two groups (p < .005) with the urban group
showing a greater increase over time compared to the rural group. The results show that the
average NGSE mean score increased 1.5 points for rural participates and 2.25 points for urban
participants. Therefore, the results confirm the hypothesis that the urban participants gained more
self-efficacy over time than their rural counterparts.
Discussion
The results of this study are anticipated to indicate that WT will be more effective in
increasing levels of self-efficacy among urban adolescents over rural adolescents. These results
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will help lay the foundation for research regarding effective practices for increasing self-efficacy
through WT for urban youth. Community outreach programs, school curriculum, and summer
camps could be developed incorporating the findings of this study. Utilization of evidence-based
practices would enhance the advocacy and outreach efforts of community organizations and
provide support for funding requests and applications for grants.
Additional tests on the data would be useful to explore correlations between environment,
demographic and changes in self-efficacy based on variables such as age, gender, family
background, family income, etc. Indicators might be identified that could inform more focused
follow-up interventions for change. It is expected that urban participants will start with lower
levels of self-efficacy as compared to rural participants, however, finish the intervention with a
larger increase in self-efficacy levels than their rural counterparts. In regards to gender it is
expected that female participants will demonstrate more change in their self-efficacy compared
to male participants.
There are some major limitations of the study that are pertinent to include within this
section. One of the primary limitations to this study and other WT studies is the fairly exhaustive
list of exclusionary criteria. This list includes excluding applicants that suffer from psychosis,
schizophrenia, or schizoaffective disorder. Adolescents with conduct disorders or with a history
of violence or sexual assault. Applicants with physical limitations, such as a reliance on a
wheelchair or crutches, or any problem requiring prolonged or intensive medical care or
monitoring like eating disorders severe enough to require a feeding tube, diabetes, and postural
tachycardia syndrome may also be unfit for the study.
Another limitation to consider is low SES participants may be relied on as an additional
resource in their homes. These resources could include providing free child-care for younger
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siblings, contributing financially to the family income or fulfilling the role of second parent.
Serving this role may have prevented many from volunteering for the study and subsequently
may have impacted the sample of urban youth involved.
Limitations may also include the consideration that eight weeks is a long period of time
where any unknown event could take place to disrupt the study. Lastly, maturation could affect
the outcome of the study since students are still growing and maturing given the age of
participants.
Further research is needed to confirm the expected results and extend them with inclusion
of categories beyond just urban and rural adolescents. This study could be continued by
monitoring the participants into adulthood to see what happens to levels of self-efficacy over
time and how that impacts their levels of academic and professional success. Will their levels of
self-efficacy be sustained, increase, or decrease in the years after the intervention? Further
studies on how much or little WT is needed to increase self-efficacy and how to implement that
in more urban school settings would be beneficial. Furthermore, researching specifically what
about WT increases self-efficacy and harnessing that for more wide-spread application in a more
accessible way could undoubtably serve to be valuable.
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Running head: SELF- EFFICACY: THE IMPACTS OF WILDERNESS THERAPY ON
URBAN ADOLECENTS
New General Self-Efficacy Mean Scores
Figure 1.1
5
4,5
4
Mean Average
3,5
3
2,5
2
1,5
1
0,5
0
Pre-Test (μ)
Rural Group
Post-Test (μ)
Urban Group
Figure 1.1. Mean scores from the rural participants of and urban participants respectively
demonstrating the change from pretest to posttest on their general levels of self-efficacy on the
using the New General Self-Efficacy Scale
20