This paper considers the definitions, role, and use of metaphor in adventure therapy. It provides an overview of theoretical perspectives on metaphor and the related ways in which metaphor is used in adventure therapy. Research on the use of metaphor in counselling and from neuropsychology and linguistics is applied to a model of metaphor use in adventure therapy. This draws upon the practical application of a metaphor processing model and examines four key stages of metaphor development in outdoor and adventurous activities: assessment, selection of activities, framing of activities, and debriefing. In conclusion, evidence-based recommendations for the use of metaphor development within adventure therapy are provided and the need for both training on the use of metaphors for adventure therapists and a strategic research agenda in this area is highlighted.