Background: Adventure therapy (AT) is a term that includes therapies such as wilderness therapy and adventure-based counseling. With growing empirical support for AT, the diversity of studies make it difficult to attribute outcomes to specific treatment factors. Objectives: Researchers explored whether AT, often perceived as an alternative therapy, works because of AT's unique components, or whether factors shared by all therapies were responsible. Methods: A scoping review was undertaken utilizing a search of major databases, unpublished dissertations, and a hand search for direct comparison trials matching AT with another therapeutic intervention. Results: 881 publications were identified. 105 quantitative studies were included following a title and abstract review. Only 13 met the full inclusion criteria. Little to no differences were found to isolate specific therapeutic factors. Conclusions: We discuss the implications of these results considering the movement toward evidence-based practice and recommend future research to eclipse our current understanding of AT.