The paper addresses two significant risk management considerations in conducting an adventure program in a therapeutic setting: the potential hazards of psychiatric medications and psychological emergencies. Focusing on the potential hazards of psychiatric medications, the first section discusses climatic conditions (heat, cold, and sun) and the limitations of propranolol, phenothiazines, tricyclics, or antiparkinsonian medications on program activities. The symptoms of orthostatic hypotension, dystonia, akathisia, pseudo-parkinsonism, and tardive dyskinesia are discussed. The second section discusses two types of psychological emergencies: primary (symptoms are produced by emotional illness) and secondary (the behavior is a manifestation of a medical problem). Basic guidelines for properly labeling and managing a problem as either medical or psychological are outlined. These basic guidelines cover three steps: (1) assessment procedures--a mental status examination to assess cognitive functioning, indicators of emotional distress, and a symptom assessment; (2) intervention--observation, evacuation, interviews with individual, and outcome; and (3) evaluation of intervention--evacuation of individual and use of incident as a learning experience. (NQA)