Adventure therapy (AT) is a widely utilized treatment modality applied to a range of clients including adolescents, adults, and families defined as "the prescriptive use of adventure experiences provided by mental health professionals, often conducted in natural settings that kinesthetically engage clients on cognitive, affective, and behavioral levels." Despite increasing use of AT in professional practice and associated research, there remains a "black box" with regards to understanding how and why AT works and for whom it works. Substance use disorders are common {20.5 million Americans age 12 or older had a substance use disorder in 2015), and opioid addiction including abuse of prescription pain relievers and heroin accounts for approximately 10% of these substance use disorders. (2 million of the 20.5 million Americans with a substance use disorder in 2015 had a disorder involving prescription pain relievers and 591,000 had a disorder involving heroin) (5). The primary objective of this Capstone project was to further understanding of how and why AT works in the treatment of addiction, with the goal of shedding light on the AT "black box." A second objective of this project was to lay the groundwork for the developing an AT rock climbing program for use in the treatment of addiction.