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In the 1960s OB came to the United States through the OB school in Colorado (Parker 1992; see Outward Bound USA). Outward Bound programs in Colorado and other schools quickly began to use Outward bound as an adjunctive experience work with adjudicated youth and adults (one of the first programs in 1964 offered recently released prisoners a job at Coors Brewery if they completed a 23 day course). In the late 70's Colorado Outward Bound developed the Mental Health Project. Courses were offered to adults dealing with substance abuse, mental illness, being a survivor of sexual assault and other issues. In 1980 Stephen Bacon wrote the seminal text in Adventure Therapy "The Conscious Use of Metaphor in Outward Bound" which linked the work of Milton Erickson and Carl Jung to the process of Outward Bound.

Project Adventure, adopted the OB philosophy in a school environment and brought the ropes course developed at the Colorado Outward Bound School into use at schools. Project Adventure staff including Karl Rohnke are credited with developing many of the cooperative games, problem solving initiatives, trust activities, low elements, and high elements. PA first emerged in Hamilton-Wenham High School in Massachusetts in 1972 with a principle named Jerry Peih, son of Robert Pieh founder of the Minnesota OB School. Jerry Peih wanted to bring the concepts behind the Outward Bound schools, developing self-esteem and self-confidence through mentally and physically straining and stressful situations, to classrooms (Aghazarian 1996; Blanchard, 1993; Dickens, 1999; Gillis & Simpson, 1992; Glass, 1999; Maizell 1988; Parker 1992; Schoel, Prouty, & Radcliffe, 1988; Ziven 1988). PA programs were often used at part of the health curriculum in PE programs.

Eventually Paul Radcliffe, a PA trained facilitator and school psychologist, Mary Smithy a PA staff member along with a social worker from Addison Gilbert Hospital, started a 2 hour weekly outpatient group. Eventually this model was incorporated into school psychological services and was called the Learning Activities Group (Schoel, Prouty, & Radcliffe, 1988). This later grew into Adventure-Based Counseling (ABC), a project adventure term that reflects the therapeutic use of adventure activities (Gillis & Simpson, 1992).