Rehab Centers that Offer Wilderness Therapy

Wilderness therapy for addiction is a structured, nature-based approach that some rehab centers offer as a component of treatment. It’s usually used in conjunction with evidence-based care, such as cognitive behavioral therapy, and isn’t considered a standalone method for treating addiction or mental health conditions.

This guide explores what to expect from a wilderness-based rehab program, including who it’s for and how to vet programs to ensure quality and clinical fit for your needs. It also examines current research on whether wilderness therapy rehab centers provide effective treatment and the safety considerations involved.

Wilderness therapy occurs in rural or seemingly rural outdoor settings. Groups may venture into forests, mountains or other locations, often hiking, camping and spending time outdoors while participating in individual and group therapy to work on coping skills and build confidence.

However, wilderness therapy isn’t a simple camping trip; it’s outdoor behavioral therapy that integrates evidence-based clinical approaches with nature elements and some level of adventure. It’s also not the same as adventure therapy. Adventure therapy involves activities such as ropes courses, kayaking or rock climbing as add-ons or excursions from traditional treatment centers, while wilderness therapy is more likely to include daily outdoor living tasks.

There’s also a difference between wilderness therapy and wilderness activities, which may be offered in traditional residential rehab programs. For example, if you spend time in a residential center for therapy and other treatment but participate in kayaking or hiking outings on Fridays, those are wilderness activities.

Regardless of whether you’re looking at wilderness therapy, adventure therapy or a traditional rehab with wilderness activities, ensure the program has:

• Licensed clinical oversight for therapy and any medication-assisted treatment, if applicable
• Documented treatment plans and goals
• Safety protocols and emergency readiness policies for outdoor therapy and activities

Wilderness therapy for substance abuse may fit into an inpatient or outpatient level of care. At a recovery center, wilderness therapy may be an optional add-on or a focus of that campus. In some cases, it might represent an intensive step-down treatment after inpatient medical detox or traditional residential rehab.

In any of these situations, wilderness therapy should be a component of residential treatment, not a replacement for clinical methods — even if therapy and other wellness programs take place in unique outdoor or rustic settings.

A strong integration of clinical treatment typically includes:

• Assessment by licensed therapists and individualized treatment planning that focuses on addiction and mental health treatment goals
• Evidence-based treatment methods, including cognitive behavioral therapy, family therapy and relapse prevention classes, that help translate skills built in wilderness settings to real-world recovery
• Aftercare planning that creates a plan and support system to help you continue with your recovery journey after discharge

While providers can offer a lot through wilderness therapy for addiction recovery, it’s not a replacement for medical detox or medication management when those are needed.

As a specific treatment approach, wilderness therapy for substance abuse isn’t the right choice for everyone. Like any other program, it might work for some people but not others.

Wilderness rehab may work for you if:

• You don’t engage well in traditional office-based or group settings and feel more comfortable with others when you’re working toward something actively together.
• You’re an outdoorsy person who enjoys or is interested in camping, hiking, fishing and similar activities.
• You often learn deeply through experiences, particularly when under the stress of survival requirements or healthy competition.
• You’re looking for wilderness therapy for young adults that’s designed for teens and college-age individuals and addresses co-occurring mental health concerns.

Whether wilderness therapy is right for you comes down to personal choice, but it may not be an ideal fit for people with serious medical concerns, mobility limitations or psychiatric symptoms that require a more intensive level of care.

Wilderness-therapy-informed rehab programs are organized treatment environments, so don’t expect unstructured camping or survival scenarios. In expedition-style programs, you may camp and travel through the wilderness for all or part of your stay, and daily living tasks, such as cooking, setting up camp and hiking, are integrated with — and sometimes part of — therapy and skill-building.

Those who enroll in residential-style programs with wilderness components may live in a lodge-style location and spend scheduled blocks of time outdoors. Usually, residential-style programs afford greater access to medical staff and traditional indoor therapy settings.

With either type of location, a typical week should include clinical recovery work, active experiences and time for reflection. When possible, loved ones may be involved in family therapy in person or through virtual sessions.

Common treatment sessions and activities include:

• Individual therapy sessions
• Group therapy sessions and peer support groups
• Coping skills and relapse prevention training
• Outdoor activities and challenges to help build communication and resilience skills
• Treatment planning and goal setting
• Meditation, reflection and journaling time
• Discharge planning

Experiential therapy in addiction treatment can be helpful for people who enjoy learning through doing. It can also be beneficial for those who have trouble engaging in traditional environments.

Potential benefits include:

• Improved stress tolerance and emotional regulation. Through outdoor structured challenges, you’re exposed to manageable levels of discomfort in a supervised setting, helping you practice real coping skills. Therapists often work alongside you to identify emotional triggers and guide you through grounding and problem-solving strategies. You can bring these skills into real-world situations post-treatment.
• Increased ability to maintain routines and attend to obligations. Many programs integrate daily routines and responsibilities, such as preparing meals, setting up camps or helping with sanitation or safety. By following consistent waking, sleeping and task schedules, you help rebuild healthy habits that may have been disrupted by substance use.
• Enhanced accountability and social connection. Small group settings in environments with some level of stress, such as the outdoors, require you to communicate and cooperate with others. You also process recovery steps in group settings, which can help reduce isolation and set you up to work well with others in your support network throughout your recovery journey.

Wilderness therapy benefits are typically stronger when outdoor activities are integrated into a comprehensive treatment plan that includes evidence-based approaches.

In 2021, the Washington State Institute for Public Policy conducted a systematic review of the literature on wilderness therapy. That means it examined existing research and attempted to draw conclusions about its effectiveness, costs and limitations.

It concluded that measurements of wilderness therapy outcomes are limited, and further research is required to truly understand the effectiveness of these programs. However, the relationship between nature and mental health has been studied extensively.

Some relevant findings include:

• Time spent in nature can improve mental health. Studies found that nature experiences can reduce anxiety and improve mood. According to a 2021 review of literature published in SSM – Population Health, nature-based interventions lasting 8 to 12 weeks and including 20 to 90 minutes of outdoor activity per session tended to produce the best impact.
• Nature experiences can improve physical health markers. Information published by University of California Davis Health indicates that being outside can help lower blood pressure and heart rate, reduce cortisol and ease muscle tension.
• Greenspaces improve cognitive function. Regular exposure to natural environments supports better attention, focus and working memory, according to the American Psychological Association.

While this type of research on the benefits of nature exposure suggests wilderness therapy effectiveness, it isn’t a single uniform intervention. As you consider this approach to rehab and whether wilderness therapy works, ask programs about their own outcomes.

Questions to ask include:

• What percentage of people complete the program?
• What are follow-up outcomes?
• How does the program measure success?

Program quality varies, and the required oversight differs by state. Before committing to a program, ensure you’re comfortable with the quality of treatment offered and the center’s approach to safety.

Signals of strong oversight and wilderness therapy safety may include:

• State licenses, as required, and clinical accreditation through programs such as CARF or the Joint Commission
• Voluntary accreditation under programs like AEE’s Outdoor Behavioral Healthcare accreditation
• Licensed clinical staff
• Trained and accredited wilderness activity leaders, particularly for adventure activities like hiking, camping or white-water rafting

Red flags associated with greater wilderness therapy risks can include:

• Lack of licensed clinical therapies or unclear policies related to therapy and treatment
• Vague emergency plans or staff who are uncomfortable answering questions about safety or emergency protocols
• Hard sales tactics
• No clear plans for transition to aftercare
• Staff who won’t discuss outcomes or past results
• Numerous negative client reviews on Google or other websites

Start with these five questions when considering a wilderness therapy rehab:

• Is wilderness therapy integrated with evidence-based addiction treatment?
• What’s the level of clinical oversight, and who’s licensed to provide therapy?
• What safety systems exist, such as medical screening, emergency protocols and staff training?
• What licensing or accreditation does the program hold?
• What happens after discharge to support aftercare, relapse prevention and step-down options?

Once you feel comfortable with the clinical quality and safety of a program, move on to the cost of wilderness therapy. These programs can be costly, especially when you factor in potential travel and supplies.

Wilderness therapy insurance coverage may only cover clinical treatment sessions, so request an itemized estimate of charges. Ask the rehab center to verify your health insurance benefits to help you understand what may be covered and what you‘ll have to pay for out of pocket.

Wilderness therapy can offer meaningful treatment and may be a better approach for people who don’t engage well in traditional environments, provided activities are integrated with clinical therapy and supervised to support safety.

RehabNet can help you compare rehab options, including wilderness therapy, to find a program that may work for you. You can filter by level of care, insurance or co-occurring diagnoses treatment to create a shortlist of rehab centers that match your priorities.