Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5516_Библиотеки_им_академика_М_И_Перельмана

wilderness therapy, the relationship between the patient and the thera­peutic environment is the central relationship. As previously described, the patient populations are teenagers or young adults with a back­ground of conflict between themselves and authority figures. These pa­tients often view traditional therapists as authority figures and transfer their distrust of authority figures onto them, which hinders their expe­rience in traditional therapy. In wilderness therapy, the “natural conse­quences experienced in wilderness living allow staff to step back from traditional positions of authority to which the client is accustomed” (Russell 2001, p. 74). Instead of patients being expected to follow the rules of authority figures, their self-care and personal responsibility are facilitated by natural consequences in the wilderness. This allows au­thority figures to no longer be seen as oppositional to the patients’ goals but as teammates to reach common goals and overcome natural obsta­cles. Additionally, these patients who have had multiple experiences with mental health care often perceive a societal stigma toward mental health treatment. This stigma is avoided by moving treatment to a wil­derness setting (Russell and Phillips-Miller 2002). The most current definitions require that wilderness therapy be performed in an unfamil­iar wilderness environment. This is not limited to the woods and can in­clude desert, mountain, and ocean landscapes that are remote and foreign to the patients (Fernee et al. 2017). The most important aspect of the location in which wilderness therapy is practiced is that it is novel to the patient, so it presents a new set of challenges and experiences.