This study reports the results of a five-year follow-up survey of private-pay outdoor behavioral healthcare (OBH) programs operating in the United States and Canada. A total of 65 of 102 programs identified as meeting certain characteristics responded to the survey and identified themselves as an OBH program that utilizes a clinical treatment model that primarily uses wilderness expeditions. The goal of the study was to determine industry trends by comparing the results of this study to results generated in a 2001 survey of OBH programs. An additional goal of the study was to discuss the findings in the context of recent reports on OBH and related programs concerning program management and practice. Key findings indicate that the number of OBH programs operating appears to have increased since 2001, and that the clear majority of these programs are state-licensed and half are accredited. Family involvement in programming has decreased, as has the number of families receiving co-pay to help alleviate the costs of treatment. Field instructor training and qualifications, supervision, and oversight of daily treatment and program operation, and drug detoxification practices at admission are all issues that warrant further investigation. A conclusion is made that care should be taken by policy makers and others when making broad generalizations that implicate all OBH treatment programs, when it appears that most programs are licensed, have licensed clinicians on staff, and adhere to best practices in treatment as identified by a variety of agency and association standards.