Wilderness programs apply wilderness therapy in the field, which can contain the following key elements that distinguish it from other approaches found to be effective in working with adolescents: 1) the promotion of self-efficacy and personal autonomy through task accomplishment, 2) a restructuring of the therapist-client relationship through group and communal living facilitated by natural consequences, and 3) the promotion of a therapeutic social group that is inherent in outdoor living arrangements. Where wilderness programs often fall short is their lack of family therapy, parental involvement, introduction to the young-persons recovery fellowship in the community, psychiatric assessments, and clinical expertise. For teens with a substance use disorder or co-occurring mental health issues, an intensive, gender-specific residential treatment program with a strong family component like Muir Wood’s can offer many more therapeutic resources than traditional wilderness programs.