America’s controversial ‘troubled teen’ wilderness therapy camps - and why survivors like Paris Hilton want to stop them

Kyra Frankowski was 14 years old when her parents decided they didn’t know what to do with her.

Four days after entering the new year in 2014, she was ripped from her home in Ohio and dropped off at a camp in rural Utah which promised to disrupt years of “behaviour problems”.

Upon arrival, she was stripped of her belongings, clothes, piercings - anything that showed signs of personality.

In the four months that followed, she spent every second of every day in the wild, hiking until her feet bled, eating dehydrated foods that left her constipated for weeks, bathing with a bucket and sponge, and sleeping wrapped in a plastic tarp.

This was Ms Frankowski’s experience with “wilderness therapy”, a treatment that purports to help teens overcome behavioural and mental health issues through exposure to nature.

Since the founding of the first wilderness therapy programme in 1990, hundreds of thousands of American teens have been sent to live outdoors for weeks at a time with a goal of disrupting and permanently replacing unhealthy behaviour and thought patterns.

Proponents of wilderness therapy - referred to in the medical community as outdoor behavioural healthcare - say it can help teens heal from trauma, conquer challenges and  “find their true selves”.

But for many like Ms Frankowski, this therapy did exactly the opposite. Critics say the treatment lacks scientific support and can leave lasting scars as teens are often enrolled into programmes without their consent and are subjected to cruel conditions throughout their stay.

“There are ways that I was violated and humiliated as a child in this programme that I wouldn’t wish on my worst enemy,” Ms Frankowski tells The Independent.

“Basically, wilderness therapy programmes are dangerous, unregulated money-machines. They advertise as therapeutic opportunities for ‘at-risk’ youth, offering to ‘challenge’ kids with ‘survival skills.’”

“In reality, they take a vulnerable, untrained kid out of their environment with or without their consent, and place them in a wild environment with undertrained and undereducated staff, and it often runs rampant with abuse and neglect of all kinds.”

Ms Frankowski is part of a growing movement to overhaul wilderness therapy programmes so that other teens don’t have to go through what she did. Over the past two years, Ms Frankowski has built a 131,700-strong following on her TikTok account @yeahitsnatural with videos educating about the dangers of wilderness therapy.

TikTok became a popular venue for teens to share their stories about wilderness therapy in 2020 after socialite Paris Hilton opened up about the trauma she endured when she attended a programme at age 16 in her documentary This Is Paris.

For Ms Hilton - heiress to the Hilton hotel empire whose name became synonymous with wild partying in the early 2000s - wilderness therapy was part of a years-long journey through the so-called “Troubled Teen Industry” (TTI).

Breaking Code Silence (BCS), an organization dedicated to raising awareness about TTI, defines it as “a network of privately-owned, powerfully punitive, and often wilderness-based therapy programs, residential treatment centers, therapeutic boarding schools, group homes, boot camps, and faith-based academies”.

The industry is a big money-maker, according to BCS, bringing in roughly $50b each year.

BCS sheds light on the range of TTI abuses by offering survivors a chance to share their experiences in an essay collection called Survivor Stories. The collection features more than 100 essays, some accounts dating back to the 1990s.

‘We help bring your family back together’

The primary trade group in the wilderness therapy industry, the Outdoor Behavioral Healthcare Council (OBH Council), boasts 22 member programmes around the US.

These programmes, accredited by the Council, advertise treatment for a range of “conditions,” from depression to autism to traumatic brain injury.

Their websites are typically geared toward parents, promising to heal familial issues by tackling challenges faced by teens.

For example, the website for RedCliff Ascent in Utah states: “Your teen will discover the person they are inside, helping them strengthen broken relationships. We help bring your family back together.”

For Alicia Harris, wilderness therapy worked exactly as advertised when she attended the Anasazi Foundation’s programme in Arizona in 2017, although it was rocky at the start.

“The first couple of weeks I was there I cried every day and didn’t understand how hiking five to 10 miles a day was supposed to cure my depression,” Ms Harris told The Independent.

“After three weeks of carrying 30 pound backpacks all over the Arizona desert, making primitive fire for every meal, and carving spoons out of wood, I already felt a change in myself. I felt a change in my heart.

“The physical challenges represented my emotional challenges and I continued to walk forward in my life. I still don’t know how to explain why Anasazi helped me so much, but it just did. It did for every other girl in the group, too.

“Going without simple necessities such as deodorant, toothpaste, toilets, shampoo, et cetera, made me appreciate so much in life. I saw the world differently after Anasazi. I finally had an appreciation for life and the world wasn’t so terrible anymore.”

Ms Harris voiced her appreciation for Anasazi in a TikTok video last year, which featured photos of her smiling through tears of joy when she was reunited with her parents at the end of the programme.

Her experience stands in stark contrast to the stories shared in the BCS essay collection.

‘Neglect and abuse’

Many survivors described how they were sent to programmes after suffering sexual abuse, “deliquent” behaviour such as skipping school and excessive partying, or their parents finding out they were on the LGBTQ+ spectrum.

Several told how they were ripped from their beds in the middle of the night by strangers sent by programmes to escort them to nature sites, where most or all of their personal items were taken away.

While in the programmes, survivors described being forced to do physical labour - often construction projects to improve the camps themselves - and being sent out on days-long hikes in the woods.

Many developed serious medical issues that went untreated, many tried to run away and many were driven to thoughts of suicide.

Ms Frankowski penned her own survivor story for the BCS collection, detailing the three months she spent at the Second Nature Wilderness programme in Utah in 2014.

Asked why she was sent to the programme, Ms Frankowski told The Independent the answer would vary “depending on who you ask”.

In middle school, she was hospitalised three separate times for self-harm and suicide attempts. She underwent individual and group therapy, but she said: “Despite this, my ‘behavioural problems’ persisted.”

“My relationships with my family and friends were dysfunctional and toxic, and I had found myself in an abusive relationship with a boy my age who took my innocence and sexually assaulted me,” she said.

“I was absolutely miserable, and it was affecting everyone around me that I cared about. My parents didn’t know what to do.”

That’s when a psychiatrist recommended she undergo residential treatment - which she refused. Her parents then decided she would go to wilderness therapy - whether she wanted to or not - after she was arrested for shoplifting a bracelet.

Ms Frankowski said her parents told her they could take her to the programme themselves or have someone transport her from her home in Ohio. She chose the former.

Upon arrival, she said: “I was forced into an invasive and humiliating squat-and-cough strip search where the staff giggled at me from the corner of the room.

“They removed all of my piercings and my personal items, and handed me a very basic, brightly coloured change of clothes and a massive backpack that I nearly couldn’t lift, and I was driven two hours in the dark into the desert by strangers.”

When she reached her campsite she was told not to speak to anyone, before being wrapped in a tarp to sleep alongside staff. “This was called ‘burrito position’ or ‘tarping’ and happened on several occasions - the staff were co-ed,” she noted.

“The next morning when I struggled through our hike through the snowy mountains due to my asthma, I was ridiculed by the staff and had to stop several times before I was allowed my inhaler,” she recalled.

It only got worse from there, she said.

“Throughout my time at Second Nature, I witnessed and experienced neglect and abuse,” she said.

“‘Cleaning’ consisted of rubbing things with dirt. We had ‘billy baths’ every few weeks, which was essentially a sponge bath, using a dirty bandana, in the winter with a bucket of water and hand soap.

“We were given few changes of clothes which were often covered in holes from burns and falls, and only a few changes of underwear, which were washed infrequently.

“I don’t remember seeing or hearing of any water purification methods, but we were given a few gallons for the whole group at each site we went to.

“For food, we ate things like dehydrated beans and rice, cold-hydrated oatmeal and powdered milk, and tortillas with string cheese.

The food wrought havoc on Ms Frankowski’s digestive system, to the point that she didn’t relieve herself for weeks. After the issue caused her to lose feeling in her hands and feet, staff finally listened to her pleas for professional help.

She visited a clinic a few hours away and was sent back to the camp the same day with prune juice.

The experience wasn’t any better for the other teens in her group, she said.

“Occasionally, a group member would refuse to continue hiking due to exhaustion, and we were forced to carry them and their heavy pack the rest of the way. When sick, students were forced to continue hiking, and given a warm cup of tea - if they were lucky,” she recalled.

Group therapy sessions were carried out by staff “with little to no mental health training”, who berated the teens to the point that Ms Frankowski saw one of her peers flee the camp in fear one night.

“We had to read extremely personal and vulnerable therapy assignments and letters from our families in front of the group and take constant verbal attacks disguised as ‘feedback’ with no complaints,” she said.

“Our letters to our families were heavily monitored, however, as staff would watch over our shoulders and we were told that our letters would not be sent if it was deemed ‘inappropriate’ - if we were honest or complained about the conditions.

“There were also issues between other group members – one night, a group member snuck off and found some of our toothbrushes, urinated on them, and put them back without saying a word.”

The stories Ms Frankowski shares publicly don’t show the full picture, she said.

“Some of the worst parts, I don’t feel completely comfortable sharing.”

The one aspect of the programme that did live up to its promise was the nature itself.

“Up until that point and to this day, I have never experienced such natural beauty. There aren’t words to describe the scenery out there.”

Ms Frankowski’s time at Second Nature finally came to an end in early April, when she was left with one last bad memory.

“After three months of close to no contact with my family, I was denied the traditional graduation ceremony – where your family is allowed to join from home – because I hadn’t ‘earned it,’” she said.

Like many other survivors, including Ms Hilton, Ms Frankowski’s time in wilderness therapy was followed by a stay at a residential treatment center with more grueling conditions.

She spent the better part of the next two years at Eva Carlston Academy, which is viewed as another cog in the TTI machine.

The Independent’s requests for comment from multiple wilderness therapy programmes including RedCliff Ascent and Anasazi went unanswered.

What the research says - and doesn’t say

Wilderness therapy has been the subject of dozens of scientific studies examining the effects on participants. But questions have been raised about the reliability of many of those studies due to how they were funded.

One of the most widely-cited studies cited by the programmes was published by Dr Michael Gass of the University of New Hampshire (UNH) in 2011, which looked at outcomes from 12 programmes under the Outdoor Behavioral Healthcare Council that year.

The study found that participating in wilderness therapy carried a much lower risk of injury than “normal everyday activities”, such as sports.

Another study published by Dr Gass the same year found that OBH resulted in significant positive changes in all areas examined, including behavioural dysfunction, social problems, interpersonal relations and interpersonal distress.

Dr Gass is the head of the Outdoor Behavioral Healthcare Center at UNH, which was created in 2015 with sponsorship from the OBH Council — the trade group that oversees wilderness therapy businesses.

The OBH Council website features a database of more than 136 publications on wilderness therapy. Seven researchers from the OBH Center are listed as authors on more than 100 of those publications.

Experts questioned the quality of the OBH Council’s research database in a 2017 article by Undark. They noted an absence of follow-up studies examining the long-term effects of wildlife therapy, as well as a lack of studies with a control group that did not participate in the programme.

The Undark article also questioned potential conflicts of interest in publications, highlighting one 2018 study led by Redcliff Ascent’s executive director Steven DeMille that was described as “groundbreaking” by the OBH Center.

A journal published by NATSAP has drawn similar scrutiny, as critics say it promotes research that touts the effectiveness of the very programmes that fund the organisation.

Dr Emmanuel Monneron, a psychiatrist and consultant to BCS, condemned research featured in the NATSAP journal in an August blog post.

“​​Even if these studies were not influenced by huge conflicts of interests (i.e. the studies being funded and published by an organization to promote companies funding that same organization…), they are far from being properly designed and not a single one of them is a double-blind, randomized, controlled trial,” Dr Monneron wrote.

“No matter what NATSAP claims, there’s currently no strong scientific evidence of the effectiveness of WT programs.”

A similar conclusion was reached in a 2017 report by Dr Nevin J Harper, a professor at the University of Victoria’s School of Child & Youth Care, who reviewed nearly 10,000 pieces of literature on wilderness therapy and identified “ethical concerns … [that] deserve further attention”.

In another report published in March 2020, Dr Harper stated the need for "Routine Outcome Monitoring," a method of looking at the effects of different psychotherapy treatments over time to identify areas of improvement, in the wilderness therapy field.

Lasting effects

The BCS Survivor Stories provide a subjective - albeit far from scientific - glimpse into some of the long-term effects teens experienced after wilderness therapy.

Many survivors describe feeling detached from their loved ones, desensitised to their own feelings and overall, adrift.

For Kyra, the first lasting effect that comes to mind is “trauma”.

“Upon leaving the programmes, I didn’t know anything about how to be an individual my age,” she said. “I know nothing about how to socialise or what ‘healthy’ kids my age were ‘supposed’ to do.

“I’d missed out on so many important steps in my adolescence and I felt simultaneously five years behind everyone and 10 years ahead. I felt completely alone in my experiences and in my life.

“I knew how to ‘bust’ a fire with sticks and rocks, but I didn’t know how to advocate for myself, how to deal with interpersonal conflict, or even how to make friends.”

Many of the issues that fuelled her enrolment in Second Nature came back even stronger, she said.

“I developed an eating disorder almost immediately upon returning home, which I did not have before, and it progressed to the point of almost needing to be institutionalised again,” she said.

“Upon returning home, I relapsed with self-harm and was involved in several toxic relationships.”

In the years since, Ms Frankowski has been working through everything with a therapist, but she says: “I still struggle to this day.

“I have deep, long-lasting emotional wounds from being sent to the programmes as well as what happened to me and my friends while in the programmes.

“I struggle daily with many of these lasting effects including agoraphobia, social anxiety, depression, nightmares, trust issues and irritable bowel syndrome.

“I’m still learning how to be a person in the real world again, even eight years after being sent away.”

Ms Frankowski’s recovery journey shifted in the fall of 2020 when she watched Ms Hilton’s This Is Paris.

“I was shocked that anyone – especially someone with such a powerful voice – was talking about this,” she said. “For so long I thought I was alone and I was always told to be careful not to tell anyone where I was during that time.

“Then, someone from my hometown posted about their experience on Instagram. I finally felt free from the weight of that silence. After talking to this survivor and a few other survivors who were posting on TikTok, I felt ready to start sharing.

“It was slow at first, but the more survivors I met and the more community that I found, some of whom have been here talking for decades now, the more accepted I felt as a former ‘troubled teen’ turned survivor.”

Ms Frankowski is now partnering with BCS in a bid to bolster regulation of wilderness therapy and other TTI programmes by introducing the Accountability for Congregate Care Act earlier this year.

The bill seeks to improve transparency in these programmes by “developing systems and infrastructure that will prevent catastrophic abuse and increase our understanding of evidence-based practices for youth in these settings”.

Since being introduced in the US Capitol by Ms Hilton in October 2021 with sponsorship from Rep Ro Khanna (D - California) and Sen. Jeff Merkley (D - Oregon), the bill has received backing from many children’s rights groups including the Beau Biden Foundation.

For Ms Frankowski, this bill is a vital step in a long road to preventing others from going through what she did.

“I do think the programmes need to be stopped altogether, but I believe that regulation and legislation is a step in that direction,” she said.