Adventure therapy, as a distinct and separate form of psychotherapy, has become prominent since the 1960s. Influences from a variety of learning and psychological theories have contributed to the complex theoretical combination within adventure therapy. The underlying philosophy largely refers to experiential education. Existing research in adventure therapy reports positive outcomes in effectively improving self-concept and self-esteem, help seeking behavior, increased mutual aid, pro-social behavior, trust behavior and more. Although there is considerable and growing research evidence indicating positive outcome there is some disagreement about the underlying process that creates these positive outcomes.
Many different terms have been used to identify the diverse methods of treatment in the wilderness environment. Ewert, McCormick, & Voight, (2001) distinguished between adventure therapy, wilderness therapy, and outdoor experiential therapy. According to them, adventure therapy uses outdoor activities involving risk and physical and emotional challenge. Wilderness therapy usually refers to the use of primitive methods in wilderness contexts requiring adaptation or the ability to cope. Outdoor experiential therapy is outdoor treatment to promote "rehabilitation, growth, development, and enhancement of an individual's physical, social and psychological well-being through the application of structured activities involving direct experience" (Ewert et al., 2001, p. 109). The latter may be part of a residential treatment program. More recently, adventure therapy has evolved to include the use of adventure activities supported by traditional therapy. Often adventure therapy is conducted in a group or family context, though increasingly adventure therapy is being used with individuals. Adventure therapy approaches psychological treatment through experience and action within cooperative games, Trust activities, Problem Solving Initiatives, High adventure, outdoor pursuits, and wilderness expeditions. Some believe that in adventure therapy there must be a real or perceived psychological and or physical risk generating a level of challenge or perceived risk. Challenge can be viewed as significant in eliciting desired behavioral changes. Positive behavior changes, which are synonymous with psychological healing, can occur through a variety of processes. For example, through the use of vicarious experience, verbal persuasion, and overwhelming mastery experiences, participants' efficacy in the adventure activity may be increased (Bandura, 1997). These increases may then be generalized to treatment outcomes within and across life domains (Bandura, 1997; Weitlauf, Cervone, Smith, & Wright, 2001; Cervone, 2005). Five factors can be used to promote generalization of efficacy across domains: overwhelming mastery experiences, identification of similar sub-skills, co-development of sub-skills, cognitive restructuring of efficacy beliefs and generalizing sub-skills (Bandura, 1997, pp 50–54). Debriefing or processing provides a context for implementing therapeutic techniques related to the desired outcomes. It typically involves a discussion where facilitators lead a discussion to help participants internalize the experience and relate it to therapeutic goals.
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