I am a former staff member of Pathfinders, a wilderness, emotional-growth program which ceased operation in July due to an investigation into alleged negligence and abuse after two students contracted strep A virus in Colorado. I thought that your article on a Utah wilderness therapy program (-Tough love proves too much', HCN, 6/10/96) made some good points, though one thing you might have included is the dilemma of dedicated staff who are constantly making judgments. Though there are the more obvious issues of negligence, such as not recognizing a medical emergency, the daily decision of "how far is too far" is a difficult call to make when you work in a sort of vacuum. The culture of these programs is very intense and isolated, and even the most grounded of staff (me!) can find themselves overwhelmed with the power they are given.
We are required to take risks, since our job is to be successful where years of counseling, therapy, psychiatric intervention and medication have failed. Wilderness therapy programs are the cutting edge, and others should understand the fine line that we walk before shredding our reputations to bits.
Albuquerque, New Mexico