In April 1994, Bob and Sally Bacon stood in a Phoenix mortuary, grieving over their son Aaron's emaciated body. A month earlier, they'd had him hauled from bed and taken to a Utah wilderness therapy program that promised to help the 16-year-old kick his marijuana habit and regain his passion for life. Instead, North Star employees confiscated Bacon's sleeping bag on below-freezing nights and withheld food for days. When he fell ill and begged for help, he was accused of faking it. He was ridiculed for collapsing and soiling his pants. On March 31, Bacon died from a perforated ulcer.

The abuse and neglect that preceded his death sparked national outrage. Scores of publications, including High Country News, condemned wilderness therapy and called for a crackdown on the outdoor boot camps under whose care a dozen "at-risk" teens had died by the mid-'90s. Criminal investigations ensued, state funding dried up, and insurance companies began excluding wilderness therapy from their mental health coverage.

Yet the public scrutiny was also a wake-up call – a "kick in the butt" for reputable programs to band together and promote a more compassionate approach, says Danny Frazer, co-founder of Open Sky Wilderness Therapy in Durango, Colo. Over the last decade, poorly run programs have been largely edged out by better standards and state licensing, and the industry's safety record has improved. Teens enrolled in a recognized wilderness therapy program are now far less likely to land in the emergency room than teens who play football or snowboard, and programs more commonly use yoga and meditation than militaristic marches through the desert.

But despite years of working to redefine wilderness therapy as legitimate treatment, the tragedies of the past continue to haunt even practitioners who never endorsed North Star's harsh methods. "The general public doesn't really get the difference" between boot camps and "true" wilderness therapy, says Gil Hallows, a lean, charismatic 60-year-old who ran Utah's Aspen Achievement Academy for 16 years and now directs Legacy Outdoor Adventures. Nor, for a long time, did the mainstream mental health industry.

Now wilderness therapy may have reached a turning point. At the 2013 Wilderness Therapy Symposium in Boulder, Colo., University of New Hampshire researcher Michael Gass held up a copy of the American Psychological Association's most recent magazine. The cover story was a glowing review of wilderness therapy. "My initial reaction to this was, 'Yes! The time has come!' " Gass said triumphantly. "My second reaction was, 'We're not ready!' "

"Wilderness therapy" is a nebulous term, and even those who practice it have a hard time agreeing what it means. But they do agree on what it is not: Militaristic programs that try to break kids down to build them back up – a practice psychologists say can scar already-struggling teens.

Ideally, wilderness therapy combines traditional counseling with healthy living and outdoor skill-building. For teenagers and young adults struggling with eating disorders, substance abuse, mental illness, trauma and other challenges, it's often a last resort after conventional therapy or rehab have failed. Yet while programs often teach survival skills like building fires without matches and sleeping under tarps in inclement weather, Outward Bound they are not. Staff are trained to restrain violent outbursts, and students are sometimes put on suicide watch. At night, their shoes are collected so they can't run away.

Yet proponents believe that the confidence and resilience gained in the wild can inspire transformations that weekly therapy sessions under fluorescent lights cannot. The idea was first popularized by a 1968 course at Utah's Brigham Young University called "Youth rehabilitation through outdoor survival," followed by state-funded initiatives aimed at reducing recidivism among adjudicated and drug-addicted youth. By the early '90s, the industry was booming with both private and publicly funded programs.

"In the beginning, it just seemed like a good idea," says Hallows. "Take kids into the woods with competent, caring adults, and good things would happen."