Estimates of the mental health needs of adolescents far outstrip the resources of traditional mental health. The field of adventure therapy has the potential to help meet these unmet needs. It is argued that particularly in the United States and the United Kingdom, for adventure therapy to become a formal part of the mental health delivery service and thereby secure funding for innovative programs, the field will have to conform to the standards of other ancillary health care providers. In this way, high standards of staff training and credentials will be required, as will an evidence base that is consistent with models used by, among other organizations, the National Health Service. Advances have been made through the research efforts of groups like the Outdoor Behavioral Research Cooperative. Training and competency standards have also been developed. In addition to continued training and research, project RE-AIM offers a promising model to implement adventure therapy as a component of a comprehensive mental health delivery system.