A 1975 Dartmouth Outward Bound Mental Health Project, begun with a pilot project for disturbed adolescents, has evolved into an ongoing treatment option in three separate clinical settings for psychiatric patients and recovering alcoholics. Outward Bound consists of a series of prescribed physical and social tasks where the presence of stress, uncertainty, and the need for problem solving, communications, and immediate judgment provide situational analogues for problematic areas in the patient's daily life. The Outward Bound session consists of traditional activities such as individual and group problems solving activities, ropes course, rock climbing, hiking, orienteering, canoeing, and cross-country skiing. Patients in the diagnostic categories of schizophrenia, mood disorders, neurotic and personality disorders, alcohol and drug abuse, and adjustment disorders have participated in the program conducted by a treatment team consisting of an attending physician, resident physician, nursing staff, social service, and activity therapy staff. Follow-up studies of participating patients indicate that Outward Bound was a very positive experience which increased patients' self-esteem. These studies support the postulates that performance accomplishments are an influential source of information and that, when perceived to be of great magnitude, these accomplishments tend to be generalized to other situations in which performance had formerly been inhibited due to feelings of personal inadequacy. (NEC)