PURPOSE: To describe the rationale and components of Farm-based Therapy (FBT) as well as examine its preliminary efficacy. METHODS: FBT consists of five empirically supported components, or hands-on experience, sustainability, the life cycle, community, and mindfulness, that were developed in collaboration with clients, their caregivers, and clinicians. We explored the preliminary efficacy of FBT for improving anxiety and mood in new clients, and their parents, using the Revised Child Anxiety and Depression Scale (RCADS). RESULTS: We found that participants (N = 45) reported that their overall depression and anxiety (i.e., total RCADS score) improved after three months of FBT as well as the following RCADS subscales: social phobia, general anxiety, and obsessive and compulsive disorder, but not on separation anxiety, panic disorder, and low mood subscales. Parents reported that their children, or clients of FBT, improved on overall depression and anxiety (i.e., total RCADS score) as well as all subscales of the RCADS with the exception of separation anxiety. CONCLUSION: Our preliminary findings suggest that FBT may be an effective treatment for depression and anxiety and especially for social phobia, general anxiety, and obsessive and compulsive disorder. Future studies are needed to replicate these findings in larger samples, with longer follow-up and compared to other active treatments.