In recent years, there has been a major shift towards bringing nature-based interventions (green therapy) into the mainstream of activities improving the psychological well-being of the population. Various interventions generally based on practising mindfulness in nature and training in psychosocial skills are also increasingly integrated into psychiatric rehabilitation. In Poland, the most commonly used therapeutic intervention involving contact with nature has traditionally been horticultural therapy (also known as social and therapeutic horticulture). A variety of therapeutic methods with an established status in other European countries, for example mountain hiking, forest bathing/shinrin-yoku, wilderness therapy, outdoor therapy or adventure therapy, are not sufficiently well-known in Poland. A specific type of therapeutic intervention based on contact with nature is therapy in the mountain setting, which taps into the potential of interventions based on mindfulness, climate therapy, and occupational therapy. The paper outlines the principles of organisation, therapeutic factors, and conditions determining the effectiveness of therapeutic mountain hiking, also known as mountain therapy or psychosocial mountain therapy. In addition, the paper aims to provide an overview of the tasks facing the therapist/guide. Mountain therapy has a strictly defined therapeutic goal which is pursued in a specific mountain environment. It is important to highlight that the effectiveness of therapeutic methods and the plan of the mountain hike are supported by sufficiently strong empirical evidence. The authors propose their own therapy programme in a mountain environment, complete with the preconditions and consecutive stages of the therapeutic process. Multiple research-documented benefits of the mountain setting in psychiatric rehabilitation may convince specialists to incorporate this therapeutic modality more widely into their practice, especially in the context of restrictions related to the current epidemiological situation.