Psychotherapy What Is Adventure Therapy? By Theodora Blanchfield, AMFT Theodora Blanchfield, AMFT Twitter Theodora Blanchfield is an Associate Marriage and Family Therapist and mental health writer. Learn about our editorial process Updated on August 26, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by David Susman, PhD Medically reviewed by David Susman, PhD David Susman, PhD is a licensed clinical psychologist with experience providing treatment to individuals with mental illness and substance use concerns. Learn about our Medical Review Board Print Rawpixel / Getty Images Table of Contents View All Table of Contents What Is Adventure Therapy? Types of Adventure Therapy Techniques What Adventure Therapy Can Help With Benefits of Adventure Therapy Effectiveness Things to Consider How to Get Started What Is Adventure Therapy? The practice of adventure therapy is the use of adventure experiences provided by mental health professionals, usually in natural settings. The encounters are meant to engage individuals, families and groups on physical, cognitive, emotional, and behavioral levels. It draws from learnings from the Outward Bound Process Model, which helps its participants overcome their self-limiting beliefs. A study of Outward Bound participants who had participated in a 21-day course found better outcomes for recidivism (refers to the likelihood that a person who committed a crime will do so again) than those teens who did an intensive outpatient therapy program instead. Types of Adventure Therapy There are three major types of adventure therapy: wilderness therapy, adventure-based therapy, and long-term residential camping. The structure of these three different types may vary wildly but the goals are the same: Wilderness therapy: This typically takes place in remote wilderness settings and in a small-group, multi-day format. The group remains the same throughout the process unless someone drops out. These programs are often modeled after Outward Bound.Adventure-based therapy: These programs are often hosted at or near where the person is being treated—usually for people who are in multi-day programs like an intensive outpatient program or residential treatment. The groups change as people come in and out of the facility, and sometimes the activities are more contrived (i.e., rock climbing walls at a treatment facility built specifically for therapeutic purposes rather than out in the “true” wild.)Long-term residential camping: This places people in outdoor camps or “mobile training units” (such as learning to sail on clipper ships) for a very long time, often a year, to teach them how to develop a positive peer culture, confronting problems inherent in day-to-day living and dealing with natural consequences of their actions. Nature-Based Activities Improve Mood and Limit Anxiety Techniques Adventure therapy is based on seven core tenets: Action centered therapy: Traditional therapy occurs somewhat in a vacuum, with one other individual in a room. Adventure therapy takes people outside and puts them in a more “holistic” environment, where body language can also be observed. Unfamiliar environment: Many people come into therapy resistant to change. This takes them out of familiar environments where it may be easier to—literally—take a different perspective. Climate of change: One of the purposes of adventure therapy is to introduce “eustress” (good stress) into people’s lives to show them evidence that they are capable of changing their behaviors and attitudes. Assessment capabilities: Seeing someone in a natural habitat, outside of a therapy room, helps the therapist get a full picture of someone they might not otherwise get in a therapy room—and be able to observe patterns that apply globally in someone’s lives manifesting in this way. Small group development: This helps people develop a community and take into account others’ needs and show proof of success. Focus of successful behaviors rather than dysfunctional behaviors/deficits: Often therapy may focus on someone’s weaknesses/dysfunction rather than their strengths or what they’re doing well. Altered role of the therapist: Often, this type of therapy makes people feel like the playing field has been leveled a bit since the therapist is participating in the same kind of challenges. What Adventure Therapy Can Help With Adventure therapy can help with a wide range of conditions,including: Anxiety Depression Trauma PTSD Grief Loss Eating disorders Substance use disorders Schizophrenia Benefits of Adventure Therapy Reduce feelings of suicidalityA decrease in feelings and symptoms of depressionFading sense of hopelessnessPromotes feelings of self-efficacy If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database. Effectiveness A meta-analysis (study of studies) of 197 studies about adventure therapy (with nearly 3,000 participants) showed that adventure groups showed greater change than those who either received alternate treatment or no treatment. Additionally, those who participated in the short-term adventure therapy treatment were able to sustain positive changes longer-term when they were evaluated around the six-month mark. Studies have shown an improvement in symptoms for at-risk youth and those with combat-related PTSD, body image issues,and more. Things to Consider Unfortunately, adventure or wilderness therapy is not often covered by insurance, and it can be very costly—an average of $500 per day but up to $1,000 per day for some programs. Because of this, it is inaccessible to many, though there are some grant programs available. Additionally, most of them are a major time commitment that not everyone may be able to make. Additionally, the private treatment program industry has had some reports of ethical issues,so it is important to really do your research. Some questions you might want to ask include: Do they treat the problem/issue/concern you’re looking for?How do they measure "success" for individuals?Are skills being taught that can be used in the “real world”?Are they members of the Outdoor Behavioral Healthcare Council, an accrediting body? Also, many of these programs are part of residential treatment or intensive outpatient programs—longer programs at a higher level of care—so this is a modality often not available for regular outpatient therapy. How to Get Started For starters, wilderness therapy is a very intensive type of therapy. Be sure you (or your child) have talked it through with your current therapist and have talked through the pros and cons, including if the rigors of this type of therapy are appropriate for you physically. As many or most of these programs are private-pay organizations, they will be marketing heavily when you begin searching for them online. A good place to start is with the programs listed in the Outdoor Behavioral Healthcare Council, which have been vetted. If you have picked a program, you can expect to do an intake session where you both will be making sure this is the correct fit for you or your child. Be prepared to discuss your (or your child’s) mental health history, including other programs or therapies or medications that you have tried in the past. A Word From Verywell Adventure therapy can be a very costly and time-intensive endeavor, so don't be afraid to advocate for yourself to make sure you get what you want out of a program. That said, it is also a one-of-a-kind opportunity, so also take time to be present in the experience. Risky Not Dangerous: Adventure Can Help Children’s Mental Health 9 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Gass MA, Gillis, Lee, Russell KC. Adventure Therapy: Theory, Research, and Practice.; 2020. Kelly FJ, Baer DJ. Outward Bound Schools as an Alternative to Institutionalization for Adolescent Delinquent Boys.; 1968. Cambridge Dictionary. Recidivism. Wilderness adventure therapy effects on the mental health of youth participants. Evaluation and Program Planning. 2016;58:49-59. doi:10.1016/j.evalprogplan.2016.05.005 Sturm J, Plöderl M, Fartacek C, et al. Physical exercise through mountain hiking in high-risk suicide patients. A randomized crossover trial. Acta Psychiatr Scand. 2012;126(6):467-475. Bowen DJ, Neill JT. A meta-analysis of adventure therapy outcomes and moderators. TOPSYJ. 2013;6(1):28-53. doi:10.2174/1874350120130802001 Gelkopf M, Hasson-Ohayon I, Bikman M, Kravetz S. Nature adventure rehabilitation for combat-related posttraumatic chronic stress disorder: A randomized control trial. Psychiatry Research. 2013;209(3):485-493. doi:10.1016/j.psychres.2013.01.026 BS SCA. Transforming body image through women’s wilderness experiences. Women & Therapy. 1994;15(3-4):43-54. doi:10.1300/J015v15n03_05 Rein R. Storms in Sunny States: Fraud in the Addiction Treatment Industry. Social Science Research Network; 2021. By Theodora Blanchfield, AMFT Theodora Blanchfield is an Associate Marriage and Family Therapist and mental health writer. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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