Yes. We believe strongly that it does matter. Accreditation is not a guarantee that it is the right program for your child though. Accreditations standards and regulations vary from state to state but there are a few organizations that accredit organizations nationally. The organizations that we have included in our Directory do not all accredit but are generally considered reliable organizations in the space: the National Association of Therapeutic Schools and Programs (NATSAP); the Outdoor Behavioral Health Council (OBHC); The Joint Commission; Council on Accreditation (COA); and Commission on Accreditation of Rehabilitation Facilities (CARF). 

Because of the widely varying requirements from state to state, these accreditations and memberships are one tool to assess for safety and efficacy. 

The National Association of Therapeutic Schools and Programs (NATSAP) does not accredit. NATSAP is a membership organization that provides resources, puts on conferences, and encourages advancement and best practices. NATSAP requires each member “to be licensed by the appropriate state agency authorized to set and oversee standards of therapeutic and/or behavioral health care for youth and adolescents or accredited by a nationally recognized behavioral health accreditation agency and to have therapeutic services with oversight by a qualified clinician.” (https://natsap.org)

For wilderness therapy, OBH joined with Association for Experiential Education (AEE) to outline standards, procedures, risk management, and ethical guidelines for programs to follow. To join OBH, the program must be accredited by AEE within 2 years of joining. 

In addition, some accredited programs are members of the Sky’s The Limit scholarship program that can help fund wilderness programs. 

In general, these programs often have high turnover rates, as the work is challenging and often underpaid. Many of the folks working in this field do it because they care and have the drive to support youth despite the taxing nature of the work.

Another forefront part of discerning the quality of these programs are standards for safety.

Questions  to ask to better understand the quality of program staff include:

-What is the staff-to-student ratio?

-How long have the therapists been employed at the program?

-How many of the therapists are licensed?

-What is the average length of stay for the residential counselors working at the program?

-What kind of training is provided and required of staff? 

-What kind of evaluation process do you have for employees?

-Do you perform background checks? 

-What would you say is the hardest part of working for this program? 

-What is the best part of working for this program?

-What are your safety protocols? 

-Who do you report to when safety is mismanaged? 

-Would you recommend this program to your friends and family? 

This may be one of the most challenging questions to both ask and answer. Generally, yes, these programs are safe, and there are many guidelines and structures to maintain safety. That said, staff quality and experience vary. Most programs will physically restrain children if they believe it is necessary  for the safety of the child or those around them. Be sure to ask what those practices are. Programs can choose not to accept a child they deem to be an undue risk or feel they are not equipped to monitor adequately, for example.  

There has been increased media reporting around harm, and even deaths, at certain programs. It is worth noting that there is by far more coverage around traumatic experiences than positive experiences. This is part of the importance of committing to thorough assessments of any program you are considering. Ask about safety measures, surveillance, staff training, accreditations, and other elements. Although many of these injuries and deaths could have been prevented, keep in mind that for many youth making risky decisions, safety at home is not ensured either. 

It is honestly very confusing trying to figure out the various accreditations.  Because there are no federal regulatory standards, the only national bodies provide guidelines (although NATSAP has recently announced that they will require all members to be accredited by 2025) for care.  Regional accreditation generally provides more oversight and detailed guidelines for programs. That said, not all states or regions have regional accreditations which is why your search for programs may not only entail identifying programs with regional accreditations.   

Here are a few links explaining accreditation in a little more detail.

https://www.edsmart.org/regional-vs-national-accreditation/

https://www.indeed.com/career-advice/career-development/national-vs-regional-accreditation

https://www.allkindsoftherapy.com/blog/accredited-vs-nonaccredited-oh-my