Wilderness Therapy Under Fire: Balancing Claims of Abuse with Advocates’ Calls for Reform

This year has been turbulent for wilderness therapy programs, with claims of abuse conflicting with their mission to help struggling teens and adults.

Three headline-making documentaries—Netflix’s “Hell Camp: Teen Nightmare” and “The Program,” and Max’s “Teen Torture, Inc. all released within the past 12 months—have highlighted troubling accounts of mistreatment and operational failures. On June 6, Paris Hilton testified before the House Ways and Means Committee, sharing her own experience at a program featured in the Netflix films. 

Meanwhile, advocates for wilderness therapy marked a milestone: the 25th anniversary of the National Association of Therapeutic Schools and Programs (NATSAP). The Bowie, Maryland-based organization champions these wilderness programs as alternatives for fostering resilience and emotional growth, even as it acknowledges the need for reform. 

Advocates, including NATSAP, cite decades of research showing long-term mental health and behavioral benefits.

“We’ve got studies and research from around the globe, not just within the field, that continue to point to just how effective this form of treatment is now,” Derek Daly, the incoming president of the NATSAP board of directors and co-founder of Legacy Treatment Center and Juniper County Recovery.

This collision of perspectives has placed the industry at a tipping point with its future dependent on whether it can address its flaws while preserving its promise. 

Wilderness therapy programs take a unique approach: participants are removed from their daily environments and placed in remote wilderness settings, where they engage in challenging activities like hiking and camping alongside group therapy and therapeutic interventions. Advocates said that the combination of physical rigor and therapeutic support creates a catalyst for growth.

Nazurana Limaye, who spent 112 days in Trails Carolina at age 17, said her experience was transformative.

“It wasn’t just about my own mental health—it helped me reconnect with my parents,” she said, adding that the program improved her ability to communicate her feelings and emotions. Limaye said the outdoor setting and group dynamics provided a unique space for self-reflection and growth.

Laura Mills, an independent researcher for the NATSAP, points to decades of evidence supporting wilderness therapy.

“Dozens of articles in peer-reviewed journals highlight the mental, behavioral, and relationship benefits of wilderness therapy,” she said.

Mills said many programs promote evidence-based techniques such as cognitive behavioral therapy and measure outcomes for up to two years post-treatment.

Daly said that wilderness therapy programs have a safety record that far exceeds many inpatient facilities, with only four reported deaths in accredited programs over two decades compared to thousands in hospital settings.

However, critics say these successes do not tell the whole story. The industry is largely unregulated, with significant variation in the quality of care and oversight across programs.

Hilton’s testimony about the abuse she says she endured at a residential treatment center brought national attention to these programs’ darker side.

“When I was 16 years old, I was ripped from my bed in the middle of the night and transported across state lines to the first of four youth residential treatment facilities,” Hilton told the House Ways and Means Committee.

“These programs promised ‘healing, growth, and support,’ but instead did not allow me to speak, move freely, or even look out of a window for two years,” she added.

Cost is another barrier. With fees often exceeding $50,000, wilderness therapy remains inaccessible to most families.

“It’s largely been reserved for the wealthiest among us,” Daly said.

For middle- and lower-income families, this often means resorting to other mental health options, which may be less effective or unavailable.

Limaye said the industry needs careful reform rather than outright condemnation. “Each program should be reviewed individually,” she said.

“Not all wilderness therapy programs are bad or harmful.” Mills agreed, stressing the importance of listening to all experiences—both positive and negative—to improve the industry.

“We don’t want to repeat the past if it wasn’t helpful,” Mills said.