Psychotherapy consists of talking with a psychiatrist, psychologist, or another health care provider to better understand your mental health challenges. During your sessions with a therapist, you will learn about and examine your moods, feelings, thoughts, and behaviors. Psychotherapy, though, is not the only path to healthier coping skills and a deeper understanding of yourself. The following four unconventional therapies might be more suitable than the usual talk in some situations.

Outdoor Behavioral Health Care

Previously referred to as Adventure Therapy or Wilderness Therapy, Outdoor Behavioral Healthcare is usually portrayed as “boot camps” for disturbed teens. Yet, this form of therapy is all grown up now and in recent years has been used as a therapeutic technique for a variety of participants, including adults suffering from PTSD, patients with substance abuse issues, couples wanting to reconnect, and families learning to work together as a group.

The common denominator of these experiences, as described by Steven M. DeMille and Marilyn Montgomery in a recent paper published in Contemporary Family Therapy, consists of an extended wilderness living experience; active use of a clients’ participation in the therapeutic process; continuous group living; formal group therapy sessions; individual therapy sessions; adventure experiences; the use of nature within the therapy process; and a strong ethic of care and support throughout the experience.

“Natural consequences experienced in wilderness living allow staff to step back from traditional positions of authority to which the client is accustomed,” wrote Keith C. Russell, a professor at the University of Idaho, in his own published paper on the topic.

In other words, nature itself becomes the teacher, delivering consequences with its every lesson. According to Russell, key components of these wilderness experiences include confronting fear and experiencing trust within a group. Adventure pursuits can be harnessed to enhance personal growth, he says, with selected activities aimed at creating change in specific behaviors.

While outdoor behavioral therapy is effective for many teens and adults, certain outfits use abusive or unethical techniques. Some programs are reputable, others not so much. Your insurance most likely does not cover these programs so you only want to spend your hard-earned dollars on a reputable program.

Anyone interested in a particular program, then, should turn to the Association for Experiential Education (AEE), which provides accreditation. To meet the standards of AEE, a Wilderness therapy program must supply evidence of its commitment to quality and safety, its belief in professional standards, and its continued resource allocation toward excellence and improvement.

Because accreditation is not a guarantee, the next step in checking out a program would be verifying staff credentials. Any licensed psychologist can be traced through state licensing boards. For more information, contact the Outdoor Behavioral Healthcare Center.

Flooding Therapy

A form of behavioral therapy, flooding is used to treat people with fears or phobias. Flooding is essentially exposure therapy on steroids: patients are exposed for a sustained period to whatever frightens them. For example, a therapist may take a patient who is afraid of driving onto a highway to expose them, in a controlled yet direct situation, to their fear.

Claustrophobia Laura lewis, cc by 2.0

According to Psychologist World, Thomas Stampfl pioneered his so-called “implosion therapy” in the mid-1960s as a technique for treating phobias. By bombarding his phobic patients with detailed descriptions of the situations they feared for up to nine hours, Stampfl discovered they lost their fear. Adding to this research, Zev Wanderer used biofeedback machines to monitor patients physiological response as they listened to these verbal descriptions of what they most feared. By concentrating on the phrases that sparked the most intense reactions, Wanderer was able to increase the effectiveness of the exposure and reduce the time needed for each patient, though patients usually returned for repeat sessions lasting at most half an hour.

The concept behind flooding is that exposure to the feared experience will evoke such a strong anxiety response that patients become exhausted and so let go of their irrational fears. While one advantage is flooding works quickly, sometimes the fear will spontaneously recur. In such cases, therapists may try systematic desensitization, where the process is more gradual and repeated.

Critics say such intense exposures could be traumatic to those struggling with extreme fear, but those who resort to this technique are usually experiencing a disruption in their life and are willing to try most anything. Yet, in a recent study of flooding, researchers proved phobic patients stress hormones remained at normal levels when they were confronting their phobias; despite the panic felt by a patient, this extreme therapy does not trigger an unusual physiological response and so cannot cause physical harm to a patient. In other words, the fear is entirely in the patient's head.


While many people think of hypnotists as sideshow performers, a skilled practitioner of this method helps patients change stubborn, unwanted behaviors by accessing the subconscious and planting suggestions for new behaviors and actions.

This work is achieved through guided meditation sessions. When extremely relaxed, we are most sensitive to suggestion so a hypnotherapist works to place us in a state of released tension. The underlying concept is that many of our rational and conscious decisions are products of the beliefs we harbor in our unconscious mind.

unconscious mind
Unconscious Mind Hartwig HKD, cc by 2.0

For example, you may want to lose weight and you may even know yourself to be capable of shedding the pounds; however, at the same time, you may not believe you can keep off the lost weight. As explained in this article by Jeffrey Rose, a hypnotherapist helps you clear your mind with relaxation exercises and then expertly guides you toward your goal of losing weight by offering recommendations for new behaviors. Essentially, your mind will incorporate the new suggestions into revised patterns of thought.

Hypnotherapists are also able to tap into and harness our unconscious already-existing mental resources, such as our survival instincts. By framing weight loss as necessary to your continued survival, for example, a hypnotherapist can plant the idea of proper eating deep inside your psyche. Going forward, then, it would be more difficult for you to eat too much and go against your life instinct.

Generally, hypnotherapy is used as an adjunct to standard psychotherapy. Currently, it is often combined with other treatment modalities, such as cognitive behavioral therapy.

Simulated Presence Therapy

An emotion-oriented intervention, simulated presence therapy is founded on attachment theory — how human beings respond within relationships when hurt, separated from loved ones, or perceiving a threat. Generally, this form of therapy is used with dementia patients. As described in the American Journal of Psychiatry, simulated presence therapy is delivered by way of a recording with voices of the patient’s closest relatives. Often, these recordings take the form of a telephone conversation, and usually the content references positive autobiographical memories. Audiotapes will then be played to reduce anxiety and challenging behaviors in a patient.

nursing home
Nursing Homes. Ann, CC by 2.0

So far, mixed results have come from experimental studies of this psychotherapeutic technique. One small study reviewed by the American Journal of Psychiatry found simulated presence therapy improved patients' social interaction and attention, while another experiment showed it led to significant decreases in agitation but no change in aggressive behaviors. The most hopeful of academic studies revealed a 91 percent reduction in problem behaviors however in a series of studies, one participant showed increased ill-being.

While the evidence is not yet convincing, simulated presence therapy continues to receive attention and study. Since behavior problems are high among those with dementia — one study reports 93 percent of nursing home residents displayed agitation at least once a week — there will always be a need for therapies other than drugs to help both the patients and their caregivers.