This chapter explores the question of how adventure therapy (AT) works. It deals with an examination of a theoretical model of adventure therapy, and concludes with examples of practical program models of AT. The theoretical work on the development of a model to conceptualize the AT process began with an article that Russell and Farnum wrote for the Journal of Adventure Education and Outdoor Learning. The Physical Self factor of the AT treatment milieu consists of therapeutic factors arising solely from physical interaction through the activities and process of being in a natural environment. The program began operation in 2009, and employs a program director, clinical team, alumni coordinators, and therapeutic staff who work directly with the clients on basis. The therapeutic relationship, driven by the client, to support the client’s needs, with the lead clinician, staff, and peers forms the core of the treatment model being delivered by Enviros Shunda Creek.