When Metaphor and Experience Collide

When Metaphor and Experience Collide


We go into the wilderness to engage our senses, to connect with nature. We feel the ground beneath our feet, taste the crisp air, listen to the wind through the trees, hear the calls of nature, and see a new world before us. Wilderness provides a lens to work with and within our experience. Outdoor excursions and adventures at Confluence tie together metaphors used in clinical work to lived experience. With this sentiment in mind last week our group set off on a new adventure - dog sledding through the forests and fields of the snowy Vermont landscape.


Not a single person, participant and mentor alike, is distracted as the instructor explains how to interact with the sled dogs. She explains, “Verbal and non-verbal cues are essential to a safe and healthy relationship with the dogs; be sure to invite them to you instead of moving towards them; let them have a chance to get a first impression.” In much the same way these methods of relation are essential in everyday life, in our community, and in our individual relationships. She continues, “Dog sledding is 75% taking care of the little things each and everyday, and 25% pure joy while sledding. If we don’t do the 75% first, then we can’t have the fun.”

“Everybody ready!” is all it takes for the team of Siberian huskies to know that it’s time to focus, look forward, and begin thinking and working as a team. Similarly the command peaks our participant’s awareness and attention. All eyes are trained intently on the dog teams harnessed to two sleds in front of us as the Mushers begin to explain how our adventure is to unfold.

"Pedigree indicates what we should be. Conformation indicates what we appear to be. But performance indicates what we actually are." - Author Unknown

“Let’s go!” The team knew it was coming. It’s the command to act as one, and pull towards a common goal. At Confluence each and every activity offers participants an opportunity to build on the therapeutic work they are doing. With a team of huskies leading the way participants now see how together a group can attain heights one alone cannot. The therapeutic milieu at Confluence is designed to engender the same approach. Together the group forms a collaborative effort — individual participants supporting one another, contributing to the community, providing help to develop paths forward, over and past obstacles.


Excursions give us the opportunity to pull together towards a team goal. At the farmhouse we have taken care of the 75%, participants have attended therapeutic modules, folded their laundry, woken up on time, and engaged in therapy. Cutting through the crisp air and falling snow, hearing the barks of the dog team and the gentle directions from the musher, it is evident their work has culminated in a moment of joy. There is no longer metaphor, this is real.

— Foster


Comfort, Discomfort, Avoidance and Engagement

Comfort, Discomfort, Avoidance and Engagement


Recently, a parent of a participant at Confluence called me on a Friday evening, a night after the group had left for what was his son’s first wilderness excursion. He was concerned about his son sleeping in the wilderness. Although he and I discussed our safety measures and protocols, staff training, and daily communications, he was concerned for his son’s comfort.

Granted, wilderness was something of a foreign concept for the family. From the north shore of Chicago and with no backcountry experience at all, his concern is understandable, but also interesting to me. It wasn’t for his son’s safety that he was concerned. “I just want to make sure he will be comfortable,” he explained.

I’ve spent hundreds of nights sleeping in sleeping bags under tarps working in wilderness programs and in tents or on the ground on my own adventures. There is no question, it isn’t the most comfortable way of getting a night’s rest. Some nights are more like a series of interrupted naps, then a night’s sleep. Uncomfortable, perhaps. Invaluable, absolutely.

One of the core features of mental illness is an underlying pattern of avoidance in which people develop increasingly complex strategies to avoid feelings of discomfort. Uncomfortable experiences inevitably arise. These may be internal experiences such as worry, nervousness, sadness, anger or inadequacy. Or they may be external experiences such as loss, failure, rejection, traumas or physical challenges.

When these undesirable experiences inevitably arise we are faced with two distinct choices. We can engage and connect or we can avoid and restrict. Avoidance leads to missed opportunities to heal and grow. Along with this comes the shame, disappointment and worry associated with not living a values driven life. This spirals into increasingly entrenched symptoms.

Engaging discomforts and learning to be with our experiences, no matter what they bring, provides a strategy to turn the volume down on our suffering. There is a bit of a paradox here. The more we battle with our discomforts, the more they battle back. The closer we are to them, to more we learn to feel, share and be with these intolerable experiences, the more tolerable they become. The experiences don’t change. We do.

In the language of behavioral science, working with and through discomforts encourages us to build response flexibility. This process emphasizes the capacity to make choices that are consistent with goals and values in the context of all that life has to throw at us. We can’t manage the external world to feel better inside. Rather, we learn to be close with our thoughts, feelings, and relationships as a way of healing.

As I shared some of these ideas briefly with this father, and reminded him of our weekly coaching call to process through his concerns, he reflected on his own parenting. For so long, he had arranged his time and efforts to smooth the road for his son. The bumps, he realized, aren’t the obstacle. They are the opportunity. The goal, we agreed, at least for the next several weeks, wouldn’t be to create an environment without discomfort. The goal for our work together and with his son, would be to engage these discomforts and build the skills to live with creativity, adaptability, and resilience.


Settling into the Winter Rhythm

Settling into the Winter Rhythm


There’s a reason people flock to the mountains of Vermont each winter. So too winter is a wonderful time to be at Confluence. The short days and cooler temps have a steady focus about them. The snow covered fields and crisp blue skies bring us back to a calmer pace. There is a quietness here when the leaves are down and the birds have flown.

It can be easy to think of winter as the time of year we settle for being inside and at Confluence we certainly have a cozy farmhouse for the days the group is on the property. But winter is for adventure. We push through the natural feeling to hibernate by spending time outside each day and by continuing winter wilderness excursions into the forests and mountains despite colder temps and snow.

Through partnerships with Vermont-based land stewards such as the Vermont Institute of Natural Science (VINS), Merck Forest and Farm and others our excursions go out to locations where we can provide access to activities and wilderness, but also provide the comfort and protection of cabins, canvas tents and yurts complete with walls and wood stoves. This means we have a space to sleep, cook and eat and to be out of the elements after we have completed the days activities in the snow, mountains and forests. Outdoor adventure in the wintertime is both challenging and fun.

Our winter trips require careful planning, ongoing attention to moods, minds and bodies and a safety-first mentality. That framework creates a perfect metaphor for wellness, building a clear connection between the wilderness experiences and the work participants at Confluence are doing. In addition, the inherent challenges of the cold create opportunities to build resilience, develop motivation and self-efficacy.

The extra effort of winter wilderness programming pays off. The group develops a close bond. They learn to help each other and rely on others for support. The challenge of cold weather excursions helps participants move quickly into the heart of their emotional work. It is hard to “fake it” through when the experience encourages each to be so real. The slow deliberation, planning, and ongoing monitoring facilitates intentionality in everything we do.

Sure, winter may appear as a harder time to take the first steps towards treatment. Yet persevering past the urge to hibernate and taking the first steps to being outside of the comfort zone are when real opportunities for growth present themselves. We at Confluence encourage you to take the first steps.

– Foster

Changing with the Seasons

Changing with the Seasons


It seems late to be recognizing the end of summer, but it’s been an extraordinary fall here in Vermont. To give you a sense of the weather we enjoyed over the past few weeks, we harvested tomatoes past peak foliage and September saw temperatures in the 80’s throughout the month and 70’s were the norm all October. We’re just now putting the garden to bed for the season.

The summer was incredible here in the mountains. Despite a rainy start, things dried out in mid-June which put the garden in full swing. Our weekly Excursions took us backpacking, paddling, and biking throughout the Green Mountain state and in the Adirondacks. Our groups covered ground and water learning not just about the world around them, but the world within. Each participant charted a course toward growth, addressing challenges and finding the place where health and self converge.  

This summer was a growth period for our program as well. We served families from all across New England, New York, and New Jersey as well as from Pennsylvania, Maryland, North Carolina, and Illinois. In early July we brought on Dr. Caitlin Kinnart as a lead therapist and expanded our mentor team with three new hires, added some support staff and completed some facilities improvement projects.  

I recently spoke with a participant we worked with earlier in the summer. He spent three months at our program and completed our follow-up coaching for six weeks. He called to check in and let us know how he was doing. After years of struggling to finish school and find work, years of conflict with his family, and years of feeling like he could not find a way forward, he told me he was hopeful again. He began working part-time, re-enrolled in school, found an apartment and was following through on his home-plan goals. It wasn’t all easy, but he said he had the confidence to see his way through the tough spots.

Sitting back this morning, reflecting on the warmer months, I’m so grateful for the opportunity to do this work, to see the change in the young adults we serve and to see the families we work with come together in new ways. As the seasons change and what-was-supposed-to-be-fall leads us into winter, it’s easy to think that these transitions come easily. But sometimes, the change is the result of a brave step forward. Even when it’s hard to let go of old ways, making the decision to move forward opens up a whole new world of possibilities.  

- Bill


Fresh from the Farm and Field

Fresh from the Farm and Field


Spring has finally come to Gove Hill. The last few days have been spectacular with temperatures reaching into the high 70s with bright blue skies. With over 40 inches of new snow in March alone, the arrival of spring is much deserved and appreciated by participants and staff alike. Although we are enjoying the sun and warmth now, we are prepared for all seasons and conditions and we certainly took advantage of what winter brought as well.

The participants and mentors at Confluence were able to enjoy three of the best ski days of the season. Twice we were on the slopes immediately after 24+ inches of snow fell. The group chased the powder at three of Vermont’s best downhill ski resorts and two cross-country ski areas as well.

In addition to ski trips, we spent time at yurts nestled in the shadow of Vermont’s iconic Camel’s Hump. The group had warm nights around a wood stove, cooking in the camp kitchen and restful nights on the yurts’ bunks. Their days were filled with snowshoe treks to backcountry cabins and shelters along Vermont’s Long Trail. The excursion culminated in summiting Camel’s Hump on a perfect blue sky day.

Confluence excursions are not only about fun and adventure. They provide a very real opportunity for participants to support their therapeutic work. Excursions, with their inherent challenges and opportunities for successes, foster confidence and help build resiliency.

“I was nervous. I didn’t think that I was capable of making my own shelter and sleeping in it. When I have these thoughts I usually just avoid doing it, but this time I did it. And it was awesome!”

These were the words of a participant after returning from an overnight excursion at a state forest. Participants were expecting to winter camp, but they weren’t expecting the 14 inches of snow on the final night. They set up shelters and thrived as individuals and as a group in a situation that in the past may have caused doubt, fear and anger. Instead they found confidence, excitement and camaraderie.

Back on the Farm, the group has been hanging Vermont’s iconic sap buckets to collect sap and boiled down nearly 100 gallons into 2.5 gallons of maple syrup. In addition, we’re planning out our new frisbee golf course and upcoming summer excursions. With anticipation we're awaiting mountain bike trails to dry out and the waters of the rivers to warm up so we can get out on our bikes and in our canoes.

It’s an exciting time to be here at Confluence. We look forward to connecting with new participants and wishing our alumni the best as they continue their wellness journeys.

- Foster

Three Branches To Mental Health

Three Branches To Mental Health

Last week a family visiting Confluence was seeking to better understand our treatment approach. They were well informed and prepared to ask discerning questions to identify what the program does and why the approach is effective. With the help of a referring professional they had whittled us down among a few other options and their task now was to see which of the programs really aligned with the support that would best benefit their son.

Like other programs, Confluence offers a strong clinical foundation in a structured therapeutic milieu. Our clinicians bring expertise and sophistication to their work with participants. We have well trained staff that bring depth and intentionality to the experiences.

Unlike other programs our hybrid wilderness therapy and residential experiences combine the powerful impact of outdoor experiences with real world skills that help young adults better manage their day-to-day lives and launch into independence.

What is most unique, and what got to the heart of our visitor’s question, is our treatment approach. Confluence treatment model is rooted in three methods that help participants move forward. 

1. Reduce symptoms: Individual, group and experiential therapy help participants reduce and eliminate the negative symptoms they are experiencing and heal from the specific mental health challenges they are confronting.

2. Build the infrastructure of wellness: Structured activities, written assignments, and behavioral interventions support participants in developing the mindsets, communications patterns, practices and routines that support positivity, productivity and health.

3. Character development: Relational strategies and a focus on the exploration and development of the self support participants in building honesty, resilience, responsibility and connection.

This approach acknowledges a fundamental reality that is often missed in treatment programs. It isn’t enough to simply feel less bad. Conversely, it isn’t enough to feel better if it comes at the expense of relationships, capacities and integrity.

True health is dynamic and exists both within and between people. It requires the skills to engage actively in life, not just to mitigate suffering. Wellness is a process. It is an intentional act, and one that is strengthened by the support of others. By reducing symptoms, building the infrastructure of wellness and addressing character development, Confluence helps young adults build lasting change that is both profound and durable.

Each of these three approaches is an active and intentional aspect of Confluence’s treatment approach. This three branch model is integrated into daily life, the relationships and the activities in which participants engage. Together they form the clinical backbone of the program and bring together individual and group therapy, activities, experiences and milieu into a unified treatment experience.

- Bill

Combining Residential and Wilderness Settings

Combining Residential and Wilderness Settings

Milieu matters. It's where real change and personal development take place. Perhaps one of the most important aspects of the therapeutic milieu is the setting for care. The setting can be an effective mechanism for getting treatment at the right time, maintaining participant engagement in care and effecting positive clinical outcomes. But the treatment setting can also work against progress if it is too overbearing, not grounded in real world experience or too heavily reliant on metaphor. Confluence offers a unique blend of two different treatment settings – a traditional residential setting and a wilderness therapy experience. Alone both settings offer unique advantages that facilitate the treatment process, combined they offer a dynamic approach that brings together the best of both worlds. 

Full wilderness immersion treatment programs provide a therapeutic container allowing for intense levels of focus, which is remarkably effective in helping to break through resistance to the therapeutic process and also at revealing the consequences of maladaptive behavior patterns. Perhaps more importantly wilderness therapy offers the very real therapeutic benefits of natural environments and respite from more complex manners of living. Additionally, intentional activity, positive stress experiences and challenges help individuals grow, develop resilience and build self-esteem. 

On the other hand residential programs allow for a mix of comfort and support empowering individuals to be active in their own care. The setting creates an opportunity for individuals to focus on their treatment rather than worry about their environment and its latent consequences. Our home-like residential setting helps individuals by providing a healthy schedule, space for mindfulness-based stress reduction, nutrition and wellness practices, community connection, relationship development as well as time for fun and relaxation. The residential setting offers a more real backdrop to address life skills development and improve capacities for independent living.

Confluence wilderness therapy experiences are about using the outdoors to meet the prescriptive needs of participants. Those needs include the therapeutic benefits of the natural world, self-esteem building activities, creating patterns for healthy living and putting space in between the individual and the challenges experienced in everyday life. The wilderness allows participants to reset from the distractions and pressures of normal life and become empowered and more confident. 

The co-existing residential component at Confluence is designed to support treatment by lowering the threshold for participation in treatment. It cultivates a level of commitment or “buy-in” from those in a precontemplative stage of change, while not being too heavy handed for those already accepting of treatment or who are seeking treatment on their own accord. The program was specifically designed to support young adults and their families in these situations. 

As young adults who are experiencing challenges accept the need for treatment, the ‘buy-in’ created by our hybrid model helps deliver treatment when it is needed most and reduces the likelihood for more intensive intervention at a later time. 

It’s this blending of two approaches that makes Confluence effective and unique. Our approach to wilderness takes advantage of the inherent benefits of outdoor experiences and builds confidence while fostering empowerment. The residential setting increases participation and engages young adults in their care, while developing skills for life and independent living. The combination provides the setting where participants find both the capacity to achieve their clinical goals and the means to meet them. They find themselves hitting reset on their lives, becoming more engaged and developing new strategies for moving forward. Confluence's blend of wilderness and residential is a truly accessible process that readies participants for long term success.

– Foster

A Parent's Guide To Knowing When To Seek Care

A Parent's Guide To Knowing When To Seek Care


Families considering treatment options away from home are faced with a difficult challenge. Many parents wonder if out-of-home treatment is “too much” or they may worry about “sending their kids away.” Parents may be concerned that introducing the idea of treatment will compromise an already tenuous relationship with their young adult child. Thoughts such as “we made it this far” or “it isn’t that bad (today)” often battle with a real sense that things are out of control or just not getting any better. There is so frequently a dilemma between waiting too long or acting too early. Beneath this, a nagging belief that “we should be able to help him here” may create further uncertainty and hesitation.

These are common and valid concerns. This is not an easy decision. Encouraging a young adult child to take a break from their daily life back home and devote some serious energy to getting back on track may feel like one more daunting argument in the works. Our team at Confluence can support you in working through these dilemmas. We can help you determine if Confluence is an appropriate intervention and we can provide some strategies for introducing the idea to your daughter or son.

But how do you know if an out-of-home treatment option is right for your son or daughter? Here are a few questions to consider:

  • Has your son or daughter been involved in other home-based treatment approaches with limited or no success?
  • Has your son or daughter not met some of the typical developmental accomplishments of their peers?
  • Have you noticed significant regression in their capacity to cope or handle challenges?
  • Has your son or daughter stopped being a problem solving partner in addressing the mounting challenges that are building up?
  • Does your son or daughter commit to changes that sound promising but not follow through on these commitments?
  • Are there mounting risks that exist in the home environment that are not being addressed?

If you’ve answered yes to any of these questions, we think Confluence could be an option for your son or daughter.

Confluence offers impactful wilderness therapy experiences with residential treatment that teaches real world skills directly applicable to home life. We are an emotionally safe, positive environment that nurtures behavioral, emotional and relational growth. Confluence is appropriate for a wide range of participants experiencing mental health, substance use and life adjustment challenges. We work with young adults who are looking to get “unstuck.” Our participants are voluntary and agree to participate in the wilderness excursions and are active participants in their own therapy.

Confluence helps young adults get back on track. We work with participants and their families to prevent things from spinning further out of control and to help establish healthy strategies for moving forward. Treatment at Confluence is short-term. During this time, we help unlock participants’ potential and build the infrastructure required to re-engage with life. The strong clinical focus, positive peer culture, and active lifestyle offer a dynamic treatment experience unlike that of other settings. The mix of experiential therapies, shared living, and talk-based treatments propels participants in a new direction towards health and wellness.

If your son or daughter is struggling and unable to move forward, we’d be happy to talk with you to determine if Confluence is a good fit. Parents can speak directly with our Admissions Director for further information by calling 802-727-0019.


Tributaries To Our Process

Tributaries To Our Process

This month Confluence hosted our first mentor training. Six individuals began getting to know one another, hesitantly sharing goals and life stories as they slowly became part of our team. I remember the feelings I had when I arrived at my first wilderness therapy job training. I was unprepared to open my emotional landscape, share my thoughts and participate as was expected. Mostly I was unprepared for the vulnerability I would let bare and the deep connections I was to develop with my co-workers and participants.

At Confluence, mentors are key to our program. They create a place of belonging, where each individual, mentor and participant, is a part of a greater whole. They challenge, support, teach and engage with  participants. They are the tributaries, bringing their strengths to Confluence’s current. mentors offer their empathic understanding derived from their diverse experiences.

Mentors understand the struggles faced by young adults coming to Confluence and are ready to listen, guide, laugh, work and play together to allow healing and growth to take hold. mentors are able to help because of their passion for the program and helping others. Mentors give and receive feedback about how they interact with co-workers and participants. It’s the same process we use with participants. We believe this is essential to healthy relationships–both professional and personal.

Mentors are skilled at identifying primary emotions and pushing participants to notice activating events and the emotions that arise. Mentors practice these skills because they know how hard it can be to change, to hear what others think and to accept emotions. They have felt the fear and difficulty of openly sharing hard truths so that they are better able to appreciate the participants struggle to do the same. This is true empathy–it’s the ability to not only wear someone’s shoes, but to know how difficult it is to put them on.

Mentors are actively involved in each task, each assignment and each part of the daily routine. Mentors and participants join together in the common goal of building strengths, honestly addressing emotions and forming relationships.

Working at Confluence carries a great responsibility. mentors work here because they have joined together in a common goal. They are passionate about the participants and the path they have chosen towards health. We look up to and admire mentors for their dedication to our participants. They understand how difficult this journey can be and have demonstrated patience, confidence and encouragement. When participants begin their journey here at Confluence the mentors make it abundantly clear that we are in this together, we all belong at Confluence.

As our training wrapped up hesitancies and uncomfortableness waned. None of the trainees wanted to leave. They felt closer to one another. There was a palpable sense of community. They had been through something together and emerged as stronger and more connected people. They were excited and ready to get working. It’s with this same approach we meet all of our participants. Come to our farm, experience the wilderness, change through therapy, heal relationships, grow as a person, emerge more confident and return to a better life and a stronger future.