This study examined the wilderness therapy process in order to better understand how the intervention effects change in problem behavior of adolescent clients. A review of literature reveals multiple definitions of wilderness therapy, numerous studies evaluating treatment outcomes, and a need to focus research on how the process facilitates change. This study investigated four established wilderness therapy programs using a multisite case study approach and a variety of qualitative data collection methods to carefully examine the wilderness therapy experience of 12 clients in four wilderness therapy programs. Findings indicate that physical exercise and hiking, primitive wilderness living, peer feedback facilitated by group counseling sessions, and the therapeutic relationship established with wilderness guides and therapists were key change agents for adolescents. These factors helped adolescents come to terms with their behavior and facilitated a desire to want to change for the better.