Paris Hilton’s Activism Is Harming Kids
Sensational stories and online outrage have dismantled wilderness therapy—one of the most effective interventions in adolescent mental health.
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About the Author
Facets (a pseudonym) is a former wilderness therapy guide. His writing can be found on his Substack.
Over the past twenty years, public perceptions of an adolescent mental health intervention known as “wilderness therapy” have shifted dramatically. Once viewed as a tough-love approach for out-of-control, manipulative teens, it’s now often portrayed as a predatory and unregulated industry that preys on vulnerable children.
One need only compare the 2005 BBC reality-show Brat Camp with Netflix’s 2023 documentary Hell Camp to see this evolution. Brat Camp frames its subjects as, well, brats getting what they deserve. Hell Camp, by contrast, centers on misunderstood kids being shipped off to a traumatic and dangerous boot camp that—if it doesn’t kill them—only makes them worse. If only the truth were so simple.
While both shows reduce the issue to cartoonish extremes, Brat Camp is clearly entertainment—a reality TV show. Hell Camp, however, positions itself as a serious documentary and aligns with a growing movement to reform adolescent mental health care—one that is often, if not predominantly, shaped by misinformation and outrage. After recounting harrowing and sometimes deadly stories from long-defunct treatment programs, Hell Camp ends with a stark warning: “This year, thousands of children will take part in a wilderness therapy camp.” As shocked as viewers may be after watching this documentary, they might be equally shocked to learn that in 2023 (the year of the documentary’s release) nowhere near “thousands” of children attended such programs programs in the U.S., and none were legally operating in the manner portrayed in the film.
Hell Camp’s sensationalist narrative has been echoed by major media outlets like The New York Times, Rolling Stone, The Guardian, and USA Today, which have all published sympathetic pieces about teenagers allegedly traumatized by wilderness therapy programs in the so-called Teen Treatment Industry, or “TTI.” As with the Netflix documentary, these articles often move seamlessly from discussing abusive and deadly wilderness therapy programs from the 1980s through early 2000s to viral social media stories—mostly from teen girls—recounting their more recent experiences of alleged abuse and neglect in TTI facilities.
Among the most prominent voices is Paris Hilton, who has transformed from infamous rich bad girl (notorious for her 2003 The Simple Life catchphrase, “That’s hot”) into the de facto queen of anti-TTI activism. Following Hilton’s lead, others have leveraged platforms like TikTok to become influencer-activists on what has become a hub of adolescent online protest. While some frame their efforts as calls for reform, a closer look reveals a broader aim: total abolition of the TTI. One telling example is found on the “Safe Treatment Facilities” page of the TTI-survivor advocacy group Breaking Code Silence, which simply reads, “404: The page you are looking for cannot be found because there are no safe TTI facilities,” accompanied by a link encouraging users to “Explore Safer Treatment Alternatives.”
Having worked with at-risk youth in wilderness therapy and residential mental health programs for nearly a decade, I believe that in trying to “end TTI,” groups like Breaking Code Silence—and activists like Hilton—are not seeking accountability, but avoiding it. Like most people, I oppose abusive and exploitative wilderness boot camps, which rightly no longer exist. But these activists would have you believe that such programs are still widespread, and that if you’re not vigilant, your struggling child could be the next to be abused, traumatized, or even die. The reality is quite different.
What Is ‘Wilderness Therapy,’ Really?
Towards the end of my tenure as a guide in wilderness therapy (WT), too-online kids often arrived terrified, convinced they were entering an abusive, military-style program in which they would be “scared straight.” For some, it took days to relax and realize that wasn’t what we were doing. From an outside perspective, I can understand the confusion. WT can mean anything from the extreme scenarios depicted in Netflix’s Hell Camp documentary to simply walking through a park and appreciating nature.
To address these definitional ambiguities—and to distance themselves from a history of abusive wilderness boot camps—a group of WT programs came together in the mid-1990s to form the Outdoor Behavioral Healthcare Council (OBH Council), which works to ensure best practices and conducts evidence-based research. Research on OBH member programs defines wilderness therapy “an intervention in which clients are immersed in wilderness for extended periods and engage in individual and group therapeutic work that focuses on self-reflection, coping mechanisms, interpersonal communication, physical and mental challenges, identity development, and skill development.”
This kind of WT was designed for adolescents whose behaviors are serious enough that parental conversations, at-home solutions, and other traditional therapy treatments have failed. These behaviors might include school refusal, violence toward family members, self-harm, risky sexual activity, drug use, and more. In such cases, the immersive and experiential nature of WT is well-suited to deliver natural and logical consequences that can help interrupt destructive behavioral patterns.
Who Staff Wilderness Therapy—and Why That Matters
The WT staff who work directly with program participants are not only highly trained in backcountry skills and therapeutic techniques, but also some of the most inspiring and interesting people I’ve ever worked with. These are individuals who choose to spend 8 to 16 days at a time in the wilderness with at-risk youth. While some had impressive conventional credentials (Ivy League degrees, advanced academic backgrounds), most were remarkable in ways that don’t show up on résumés but that make all the difference in connecting with teens. Many staff were former clients of the programs and believed deeply in their effectiveness. Some were therapists who wanted to do work that was more experiential and impactful. Some were retired ranchers and farmers from big families who were adept at teaching skills like building fires and backcountry living. And many staff were idealistic young people who had thru-hiked the Appalachian Trail or undertaken similar challenges and simply believed in the power of the outdoors to heal and liked working with kids.
What united these diverse individuals—at least those who stayed beyond a few shifts—was the ability and willingness to build authentic relationships with highly challenging adolescents, often under difficult and demanding physical conditions.
How the Program Works
Staff were responsible for facilitating the program, which typically lasts one to three months for each participant. It consists of two interventions: the wilderness component and the therapeutic component. Staff guide participants on expeditions, hiking from site to site through backcountry terrain. Each week, students engage in therapeutic work during their free time and days off from hiking. While the program includes the hard work of living outdoors—hiking, cooking as a group, and enduring all kinds of weather—these are not the main objectives. The goal is to explore what these challenges evoke emotionally and psychologically in the students, which we are then able to discuss.
Students are taught communication tools, such as the “I feel” statement, which they can use to express their emotions to the group. With staff support, each group develops its own code of conduct, setting expectations for behavior, chores, manners, and consequences. Staff enforce these group norms and provide appropriate consequences when rules are broken.
Therapeutic sessions cover topics like accountability, freedom and responsibility, wellness, shame, healthy versus unhealthy relationships, meditation, and mindfulness. Individual therapy varies widely but is often creative and experiential. For example, an anxious student who avoids speaking up might be tasked with leading the group for a day and reflect on what emotions surfaced as they were leading. A student mourning the loss of a loved one might be given an “empty chair” assignment, where they imagine their loved one sitting across from them in an empty chair and express all the things they wish they could still say if they were present.
Students also complete practical assignments tied to backcountry living skills. These range from tracking food and water intake to carving a personal wooden spoon or making fire with a traditional bow drill. Such activities are valuable for both behavioral observation and as tools for personal reflection.
As students live in the backcountry and engage in therapy, staff document observations and share them with the therapist, who conducts weekly individual sessions to reflect on the student’s progress and set goals for the upcoming week.
Real Progress: What Wilderness Therapy Achieves
Over time, students begin to see tangible signs of progress. Even after one week, many have provided for themselves in meaningful ways: they’ve carved a spoon, stayed warm at night, pitched a shelter, or begun to confront fears like darkness or insects. After a few weeks, the growth is even more pronounced. Students can start a fire without a match—some in seconds—cook nutritious meals, and stay comfortable in varied conditions. By the end of two to three months, many can now teach others how to build a fire, carve intricate objects like bowls, rings, flutes, guitars, or chess pieces, prepare full meals for the group, and mentor newer students on how to manage their gear effectively.
Students also experience significant social and emotional growth. After one week, they begin learning how to clearly describe their emotions in a group setting and discover they are capable of asking for help with tasks they are unable to do. After just a few weeks, students have experienced, communicated and worked through many frustrations related to backcountry living and interpersonal dynamics. Many have faced and worked through conflicts—both with peers and staff—and built trust by relying on the group to meet their needs. After two to three months, students have shared difficult and vulnerable experiences with the group, staff, and their families, and have developed healthier ways of handling conflict through the many interpersonal challenges that arise in a small group living closely together.
We would often say that students are ready to leave when they felt truly comfortable in the program—and reaching that point required real change. With noticeable progress each week, by the end of their stay, students are often unrecognizable to themselves. Most take deep pride in having accomplished something few others ever will. And perhaps most profoundly, many have confronted—whether consciously or not—whatever they were most afraid of. While this has been my personal experience, the research supports it as well.
What the Research Shows
A meta-analysis of post-treatment outcomes of nearly 2,400 WT participants in OBH Council-accredited WT programs found significant improvements across six target areas: self-esteem (g = 0.49), locus of control (g = 0.55), behavioral observations (g = 0.75), personal effectiveness (g = 0.46), clinical measures (g = 0.50), and interpersonal measures (g = 0.54). The effect sizes are considered medium—typical of behavioral health interventions—but remarkable given that WT is designed for adolescents who have not responded to other forms of treatment. One study found that adolescents in WT improved 2.75 times more than those receiving at-home medication management and psychiatric care.
WT has also demonstrated effectiveness across a wide range of symptoms and demographic categories. Male and female adolescents with anxiety, depression, oppositional behaviors, and substance use disorders reported significant improvements. Parents, notably, reported even greater perceived gains in their children’s progress—gains that were maintained after an 18-month follow-up.
In an ironic twist, adolescent girls and “sexual minorities” (those who identify as something other than male or female) show the biggest improvements from WT, even though they are the most likely to criticize the treatment on social media. In fact, females are much more likely than males to show significant improvement. One study found that distress scores among females decreased 49 percent more than males participating in WT. Yet, despite such superior outcomes relative to males, females are significantly underrepresented in WT programs, comprising 30 percent or fewer participants across more than 20 studies I reviewed.
In my experience, WT is a more popular choice for adolescent boys than girls for several reasons. First, boys are more likely to display overtly defiant behavior—often a primary trigger for initiating treatment. Second, WT continues to suffer from its association with “boot camps,” a perception reinforced by sensationalist media portrayals. Even after parents are educated about the therapeutic nature of the program, many struggle with guilt, especially when considering sending their “little girl” to “boot camp.”
Third, and perhaps most consequential, is the fear of relational backlash. A recurring theme in anti-Troubled Teen Industry (TTI) activism is the sense of betrayal adolescents feel when their parents send them to treatment. Parents—like professionals working with these youth—must wrestle with the threat of public blame and shaming. At one program where I worked, therapists and staff who worked with girls were doxxed by former clients. While I personally enjoyed working with girls due to their comparatively richer emotional processing, I often felt more at ease with boys, who were less likely to frame themselves as victims or seek revenge after the fact. Just like parents, treatment programs may be more hesitant to hold girls accountable for fear of indirect retaliation.
Adolescent activists opposed to WT frequently cite what they consider abusive or neglectful conditions: cold nights, exposure to insects and animals, bad weather, strenuous hikes, and sleeping on hard ground. But according to a Utah state database that tracks safety in teen treatment programs—Utah being home to the highest concentration of evidence-based programs over the last 30 years—WT remains one of the safest options for adolescent care. Of the nine WT programs listed in the database, seven had recorded “rule violations,” which can be filed by anyone when a rule is broken. Only two programs exceeded the state average of two violations per program. And most of these violations were minor, such as failing to submit reports on time.
These data align with my own experience. The two WT companies I worked for were the most professionally run, well-managed, and safest behavioral health treatment settings I’ve encountered. For instance, WT maintained strict “sight or sound” supervision at all times—something that wasn’t always the case in the residential and inpatient facilities where I’d previously worked. If a participant went to the bathroom, they were required to call out their name every five seconds to confirm their safety. Participants deemed at risk of self-harm were kept within arm’s reach of staff at all times.
Part of this vigilance was practical—we knew that if we failed to keep kids safe, we’d lose credibility quickly. But more importantly, it arose from our strong culture of communication and feedback. We were in the business of teaching healthy communication, and we modeled it in everything we did. Constructive daily feedback on staff performance wasn’t optional—it was expected.
The Death of Wilderness Therapy and Its Consequences
I applaud the WT programs and staff who have chosen to work with girls. They tried their best, despite the costs. Today, the only WT program in Utah operating near full capacity is—perhaps unsurprisingly—an all-boys program. Most other WT programs are disappearing from the adolescent mental health treatment landscape as public and institutional support rapidly erodes. In the past year alone, five of the nine WT programs in Utah have closed. With just four remaining, the state now falls well below its 10-year average of 11 licensed programs.
Like any good moral panic, the “End TTI” movement is more focused on finding scapegoats than fostering meaningful reform. WT makes an easy target because it superficially resembles the harsh boot camps dramatized in shows like Hell Camp. But WT is also being scapegoated precisely because it has proven highly effective in treating anxious, defiant, and social media–addicted teens. Unsurprisingly, rebellious teens who resist boundaries are eager to eliminate a treatment model that actually challenges them. Unfortunately, giving in to the demands of End TTI activists has not only dismantled WT—it has undermined the broader field of residential mental health treatment.
A Dangerous Overcorrection
Spurred by emotional testimony from activists like Paris Hilton, the Utah Senate passed sweeping legislation in 2021—around the same time society flirted with ideas like abolishing the police during the height of COVID-era disorientation. Some of the new regulations were helpful, such as more frequent site visits by regulators and stricter background checks for staff. But much of the legislation was a clumsy attempt to soothe the guilt of lawmakers shocked to learn that abuse had occurred on their watch.
The result was a dramatic shift in how the state relates to mental health programs—moving from a facilitative to a punitive stance. Under the 2021 law, many actions that high school coaches and teachers routinely require—such as unpacking and repacking a backpack, known as a “pack drill”—are now prohibited. Such tasks are now considered repetitive movements that are “cruel, severe, unusual, or unnecessary practices on a child.” Similarly, telling a student they cannot eat for any period of time, such as in the middle of an activity, is now seen as “depriving the child of a meal.” Even a standard “time-out”—a staple of parenting—falls under the definition of cruelty, as it may withhold “personal interaction, emotional response, or stimulation.” In WT, we could suggest a time-out, but we weren’t allowed to enforce it if the child wanted to rejoin the group. While these practices are helpful for average children, they are essential for children who openly defy rules.
The most damaging new restriction from the 2021 legislation is the ban on any form of pain compliance, which is now classified as “cruel and severe.” At the programs where I worked, we used pain compliance in only one situation: during a physical hold, when a student posed a danger to themselves or others and continued to fight back against the staff while in the hold. In such cases, we applied a wrist hyperextension technique—sometimes called a “gooseneck”—in which the wrist is bent forward and the hand down. At the levels we applied it, the hold was medically safe but painful enough to de-escalate a dangerous situation quickly. It reduced the length of physical holds and minimized injuries to both students and staff. Without the ability to use pain compliance—and with no authorization to use chemical or mechanical restraints—WT programs cannot safely manage the very population they are designed to help: the most aggressive and treatment-resistant teens.
At the WT program where I worked after 2021, the impact of new legislation brought us closer than I’d ever experienced in a mental health setting to the proverbial scenario of “the inmates running the asylum.” Despite fewer students entering the program—and with us accepting “easier” cases than in years past—participants were increasingly able to get away with behaviors that had previously been unthinkable. The same chaos that parents had sought refuge from began to surface within the program itself.
When Staff Become the Victims
Ironically, even as former students took to social media to allege abuse by WT programs, I began to feel that the real abuse was being suffered by the employees—something the state of Utah doesn’t appear to track. Several of my coworkers and friends sustained injuries from physical restraints that lasted far longer than they would have under earlier standards. Staff were routinely cursed at, spat on, and physically assaulted. And yet, after Utah’s 2021 legislation, even when employees had the ability to impose consequences for abusive behavior, they often didn’t. Whether out of idealism, nihilism, or a kind of Stockholm Syndrome, many came to view the students as victims simply for being placed in wilderness therapy—a message reinforced by the students themselves, the state, social media, and popular media. If mistreating staff helped the students feel empowered, some employees seemed willing to accept that role.
As one might expect, staff turnover rose year after year. This led to more instability, diminished care for students, and a more dangerous environment for everyone involved. And yet, in a testament to the enduring power of the wilderness experience, I still believe many students grew and healed through the process of managing the challenges of life in the outdoors. But the program was far less effective than in previous years, in large part because the law had sharply curtailed our ability to establish a culture in which adults were clearly in charge.
A long-time girls’ therapist at my final program—someone who left during the height of this upheaval—once said to me in our last conversation, “The kids are winning.” Her comment struck me. She had always taken an egalitarian approach, and I never thought she’d frame our work as a competition. But I now realize I was naïve. Part of her effectiveness, I suspect, came from understanding that our work was, in some sense, a game—and one the kids were increasingly winning.
The Real Victims
The most immediate losers are the WT programs themselves and the clients they might have served. Insurance-driven 30-day stabilization programs have risen in their place, but they are no substitute for the kind of long-term intervention that WT provided to families at the end of their rope. WT was designed specifically for the child who couldn’t be helped by a short-term stay. Now, many of those children may find themselves in locked inpatient facilities, in the criminal justice system, or worse.
But the biggest losers, in my view, are the programs and families who could never afford WT in the first place. Residential treatment centers serving low- and middle-income teens are now tarred with the same brush as high-end WT programs. In Utah especially, they must operate under a law that severely restricts their ability to maintain a safe and effective program culture.
As the Breaking Code Silence website declares, “There are no safe teen treatment facilities.” That’s false—but it risks becoming true if the activists behind that message continue to prevail. These anxious teens and social media influencers have crafted a narrative in which they are the victims of a greedy and abusive industry. And if you don’t agree with their demands, you’re also an abuser. It’s been an effective strategy for the past decade, but if we want to stop hearing about a “teen mental health crisis” every day, we’ll have to learn to live with being called scary names.
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As somebody who did summer camp and hiking as a youngster I have no doubt these sorts of programs can be very helpful and it's unfortunate that legislators are overregulating them.
It's tragic that programs like these for young people are closing.More should be opening... and frankly, it is an excellent therapeutic approach that might even be modified for young drug and media addicted adults. Common sense and the recognition of our need to connect deeply to Nature and the pace and unnegotiable exigencies of the natural world have completely disappeared.