Wilderness and Adventure Therapy  

Wilderness therapy and adventure therapy are both mental health interventions that are typically geared toward at risk teens, or those with behavioral or mental health challenges for whom traditional therapy has been unsuccessful.

What are Wilderness Therapy and Adventure Therapy?

Both wilderness therapy and adventure therapy involve engaging teens in challenging physical activities that are intended to help them increase their resilience, self-reliance and self-esteem. Meeting physical challenges also helps teens develop positive interpersonal relationships through teamwork and through interactions with counselors and other team members.

Wilderness therapy takes place in an outdoor environment that is often remote and involves taxing physical activity such as camping out in the open with primitive provision and few physical comforts. It includes strict daily routines, long, arduous hikes and cooking food over an open fire. It often involves the setting up and taking down of a new campsite each day.

Adventure therapy can take place either outdoors or indoors, and while it also involves some challenging physical activities, these are more structured and less extreme. For instance, adventure therapy might involve navigating an outdoor ropes course or climbing on an indoor rock wall using a harness rather than climbing on rocks in the wilderness.

Adventure therapy doesn’t include overnight stays in the outdoors. It may be part of a daytime treatment program such as a partial hospitalization or intensive outpatient program, where it is used as a recreational component of treatment.

The main difference between wilderness therapy and adventure therapy is that wilderness therapy involves living outside for an extended period in a rugged, often difficult environment. The wilderness setting itself is used to develop the participant’s inner strength, grit, determination and perseverance. Adventure therapy is less strenuous. Additionally, adventure therapy activities may be included in wilderness programs.

Wilderness and Adventure Therapy Models and Techniques

Wilderness Therapy has two main models. In the expedition model, participants hike daily from one location to another, setting up a primitive camp in each location. This nomadic lifestyle takes place over two to three months.

In the base camp model, participants may hike daily for shorter distances or engage in other outdoor activities, such as canoeing, but they return each evening to a permanent campsite where they have showers and larger, more comfortable tent structures that may be heated in colder weather. Participants still engage in making campfires, cooking and experiencing communal living. Base camp programs often last between six and 12 weeks.

Wilderness therapy programs involve regular group counseling sessions and intermittent individual counseling sessions. Most programs have systems for maintaining communication between teen participants and their parents, such as letter writing and phone calls. Sometimes family counseling takes place through video conferencing.

Adventure therapy camps focus on challenging but fun activities and include group work that is focused on teamwork and problem-solving activities. The activities encourage teens to take personal responsibility for their behaviors and learn how to better manage their emotional responses.

These programs place more emphasis on successfully accomplishing positive behavioral change activities with less emphasis on exploring past dysfunctional behavioral patterns. The adventure activity itself is deemed to be therapy, so there is less time spent discussing a teen’s past issues. This follows an experiential therapy model that uses activities to elicit and heal emotional issues.

Adventure therapy techniques can include daytime outdoor expeditions and activities such as ropes courses, zip lines, obstacle courses and horseback riding. Many activities are group oriented. Others can be done solo, such as scavenger hunts and orienteering, wherea person navigates rough terrain using a compass and a map that leads them to various checkpoints.

What Can Wilderness Therapy Help With?

Benefits of Wilderness Therapy

Why is Wilderness Therapy So Controversial?  

Program Related Death and Abuse Reports

Wilderness therapy for teens has been controversial ever since its inception in Utah during the 1960’s. Wilderness therapy began as a survival skills training course at Brigham Young University in Utah and was expanded and made into a business by an alumnus of the university.

The first wilderness therapy program was billed as a “tough love” rehabilitation program for teens. Run by a former special forces officer, the program used military-like discipline and routines and taught teens survival skills in the Utah desert. The teens had to make a 500-mile hike carrying a heavy backpack, and they had to sleep on the ground.

Such strenuous activity and difficult conditions became the norm for wilderness therapy programs, and unfortunately from the early days of the programs through today, such conditions have led to deaths from exposure, dehydration, stroke and neglected medical issues.

In a 2001 article, the New York Times reported that there were 31 deaths reported at wilderness camps in the years between 1980 and 2001. A University of Pennsylvania journal, The Regulatory Review, reported in 2023 that some wilderness programs currently in business do not provide adequate counseling for participants and don’t have enough qualified mental health professionals.

However, it’s important to differentiate between these “wilderness camps” and licensed, accredited, and well regulated wilderness therapy programs that offer robust, evidence-based therapy programs for youth with mental and behavioral health challenges.

Need for More Oversight and Regulation

There are no centralized state or federal databases to track reports of abuse allegations or the closings and re-openings of wilderness programs following allegations. In 2022, a bill was introduced in Congress to create a framework to regulate wilderness programs, but it failed to get out of committee and was never passed.

Some states have stepped up to regulate their own wilderness programs. Utah passed one of the first state statutes to address many aspects of wilderness programs such as rules for providing protection from the elements and adequate water and food provisions for program participants.

In 1996, several wilderness programs joined together to form the Outdoor Behavioral Health Council, an industry organization that sets standards for best practices, effective treatment, and evidence-based research in the field of outdoor behavioral healthcare, including adventure therapy and wilderness therapy programs.

They also created the Outdoor Behavioral Healthcare Research Cooperative (OBHRC) to conduct research related to industry issues. In 2013, OBH joined with the Association of Experiential Education to create accreditation standards for outdoor behavioral healthcare programs. There are approximately 20 accredited wilderness therapy programs today.

Involuntary Transport Services

Another controversy for the wilderness therapy industry involves the practice of involuntary youth transport services. These services provide the means for getting about half of all the teens in wilderness programs to their program destinations.

Many parents rely on these transport services to come into their homes, often in the middle of the night, and coerce or forcibly take their teen to a program location because they feel that the teen would not willingly go otherwise. Some teens have reported being traumatized by this practice, and there are many social media stories covering this viewpoint.

However, some teens do not see the practice in that way, and some say afterwards that they are glad they were made to go into a program, even forcibly. A 2015 report in the Child and Youth Care Forum journal found that the use of a transport service had little effect on the outcome of the treatment for the 350 teens studied.

Limited Parental Communication and Access

Complicating the issue of possible neglectful or abusive treatment in wilderness programs is the fact that teens are cut off from the outside world, with no direct access to cell phones or other electronic devices, and they often have limited opportunities to communicate with family members.

Some programs only allow communication via letters, and these may be read by counselors or other program staff. However, this practice is less stringent today than it was in past years, and some programs now allow scheduled phone calls and video conferencing. Some also have scheduled family visitation days, especially in base camp model programs that are not as remote and rugged.

Despite these concerns, high quality wilderness therapy programs do exist and can offer proven results for teens who are struggling. Parents and caregivers who are considering an adventure therapy program for their teen must do their due diligence to find the program that is aligned with current best practices in adolescent mental and behavioral health care.

With the right program the outcome can be truly life changing for your teen.