The dissociative mechanism of change in wilderness and adventure therapy; Psychological harm and possible malpractice

Wilderness therapy (WT) programming in the US has employed involuntary treatment using cognitive or adaptive dissonance for decades. Cognitive dissonance occurs when people face situations that do not confirm their expectations. Past WT participants have protested that involuntary, inescapable, and harsh conditions harmed them through PTSD and subsequent dissociation. This argumentative study compares dissonance and dissociation using a critical realist and argumentative research process using publicly available information. Using the confronting coercive WT model to illuminate concerns clearly, we argue that dissociation is a response recorded in the design of these WT practices and participant statements and is often mistaken for dissonance. Deliberate use of forced cognitive dissonance during involuntary treatments aligns with the conditions that may cause dissociation. Therefore, planning to enforce cognitive dissonance during WT is likely to be harmful and, given this potential, may be regarded as malpractice