Many adventure therapists often partner with facilitators who are technical experts, although clearly the responsibility of providing a psychologically and physically safe therapeutic environment lies with the therapist. This chapter discusses foundational therapies. Adventure therapists are intentional in their prescription of activities and challenges. They are trained to: diagnose problems; assess clients’ strengths, potentials, and perceived limitations; and match appropriate challenges to aid clients in the change process. Foundational for much of psychotherapy are approaches emanating from the psychoanalytic and psychodynamic theories. Psychodynamic theories are thought to require more insight than behavioral theories. Reality therapy was an approach that could be taught to paraprofessionals and, perhaps because of the word “reality” in the title, it was thought by some to correspond with the natural and logical consequences inherent in adventure therapy. Systemic therapy attempts to address people in a relationship with others in their sphere and how well they interact.