Wilderness therapy is a growing treatment modality for adolescents presenting with a variety of clinical concerns, and wilderness therapy clinicians and referring mental health professionals must carefully consider the ethical issues that are unique to this modality. Following an overview of wilderness therapy as a mental health treatment, relevant ethical issues for mental health professionals are described and discussed, including the distinction between therapy and therapeutic experiences, the use of efficacious treatment, consent and confidentiality, therapeutic boundaries, a continuum of care and family involvement, and aftercare. A thorough reflection of the unique ethical issues faced by wilderness therapists is not only necessary, but will also assist in moving the field of wilderness therapy and outdoor behavioral healthcare forward in its establishment as both a recognizable and ethical treatment option.Keywords Wilderness therapy Á Outdoor behavioral healthcare (OBH) Á Ethics Á Adolescents Melanie, 15-years-old, opens up the pasta and takes the lid off the pot of boiling water. She leans over, puts her brown hair behind the ears, and tosses the noodles into the bubbles. She then picks up the long-handled spoon and begins to stir. Over the next 10 minutes, Melanie continues preparing the dinner with Katie and Megan. As the sun begins to set behind the trees, the discussion moves away from casual conversation with increasing intimacy. Megan, a licensed therapist, prompts a discussion that continues a conversation that began the day before. Melanie, staring into the churning water, begins to describe the way she felt the first time she made herself throw up after a school picnic 3 years ago. Although she has not purged in over 4 months, each meal confronts Melanie with renewed confusion, fear, and, at times, disgust. Megan offers comfort and support, as Katie reaches over and rubs Melanie's back. After several more minutes, the meal is ready and the others are called