This exploratory longitudinal case study aimed to identify practical adolescent and family outcomes following participation in a 21-day wilderness therapy program for adolescents with emotional, behavioral, and substance use problems. Results showed gender differences in presenting issues pre-treatment, significant positive changes assessed two-months post-treatment in family functioning, and adolescent behavior and mental health issues. Twelve-month assessments showed maintenance of positive outcomes coupled with deterioration in some aspects of family functioning and drug and alcohol use. Implications and suggestions for future research are discussed.

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Objective: To report on the role of nature in outdoor therapies through review and summary of existing systematic and meta-analytic reviews in an effort to articulate a theoretical framework for practice. Materials and methods: An umbrella review was conducted following systematic protocols PRISMA guidelines. Results: Fourteen studies met the inclusion criteria and represented five self-identified approaches: nature-based therapies, forest therapy, horticultural therapy, wilderness therapy, and adventure therapy. Clear and comprehensive descriptions of theory, program structure, and activity details with causal links to outcomes were mostly absent. Conclusions: A rigorous and determined program of research is required in order to explicit in-depth theories of change in outdoor therapies. Conversely, or maybe concurrently, a holistic theory of integrated relatedness may be developed as a parallel expression of support for nature in therapy while the explanatory science catches up.

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