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This article details a 3‐year outdoor behavioral health care outcome study. Hierarchical linear modeling was used to analyze data from 186 young adults in a wilderness therapy program. Participants completed the Outcome Questionnaire–45.2 (Lambert et al., ) 6 times from Week 1 to 18‐month postdischarge follow‐up. Results indicated that clinically and statistically significant change occurred in treatment. Rates of change varied, and posttreatment scores remained stable, thus demonstrating that in‐treatment gains were maintained. Implications and recommendations for future research are discussed.

Over the last decade, wilderness therapy research has increased substantially in both quality and quantity and has begun to establish a base of evidence and literature. However, there is still much to be learned about the clients served and their clinical profile. The authors examined diagnostic data from discharge summaries of 929 clients (192 young adults and 737 adolescents) who enrolled in wilderness therapy at four sites across the nation. We explored trends and differences in primary diagnosis and overall prevalence of disorders according to gender and age. Central themes emerged such as the pervasiveness of substance issues, the overwhelming impact of Mood Disorders, and the clinical complexity of wilderness therapy clients. How these findings fit in with industry trends are discussed, as well as the conceptualization of behavioral issues from adolescent to adult populations, variances between adults and adolescents, and gender differences.

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