Breaking the surface: Psychological outcomes among U.S. active duty service members following a surf therapy program

Walter, Kristen H.; Otis, Nicholas; Ray, Travis N.; Glassman, Lisa H.; Michalewicz-Kragh, Betty; Powell, Alexandra L.; Thomsen, Cynthia J.

doi:10.1016/j.psychsport.2019.101551

Cited by 24 publications

(55 citation statements)

References 27 publications

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“…A primary consideration was to develop study methodology that would allow for the main study hypothesis to be appropriately examined (i.e., to determine whether physical activity that occurs in water has enhanced benefits for reducing depression symptoms relative to physical activity that occurs on land). Additionally, the literature on surf therapy often lacks methodological rigor and we wanted to build not only upon our previous work [75], but also the state of the science within the field. Specifically, we wanted to address design limitations regarding incorporation of a comparison group, use of a longitudinal design, and inclusion of multiple methods of data collection.…”

Section: Design and Methodsmentioning

confidence: 99%

“…Not only was it imperative that the study include a comparison group, but we carefully evaluated several options. Data from the program evaluation phase of our surf therapy study (which used a single-group design) demonstrated significant improvements in psychological symptoms, as well as increases in positive affect and decreases in negative emotions [75]. Because significant changes in outcomes were observed for most of the study variables, we wanted to compare surf therapy and an active control condition rather than a minimal contact condition.…”

Section: Design and Methodsmentioning

confidence: 99%

“…[28]. Results from our previous research showed significantly decreased depression and anxiety symptoms, as well as increased positive affect, immediately following engagement in a surf therapy session [75]. In order to assess the immediate effects of both surf and hike therapy, participants in the current RCT complete brief assessments immediately prior to and following their respective activity sessions.…”

Section: Design and Methodsmentioning

confidence: 99%

“…An over-reliance on self-report data is another limitation of prior research on surf therapy outcomes. Four studies [34,75,81,82] have examined the psychological effects of surfing, of which three [75,81,82] collected quantitative data using validated measures. Furthermore, all four studies used only self-report measures, which are subject to biases due to variations in question interpretation, socially desirable responses, and the like.…”

Section: Design and Methodsmentioning

confidence: 99%

“…We assumed an effect size of d = 0.40, with α = 0.05; 1-β = 0.90; and r = 0.40 between repeated measures. The effect size of d = 0.40 was derived from the program evaluation phase and reflects the most conservative value found for pre- to post-program changes in depression [75]. Using these parameters, the estimated required sample size was N = 83.…”

Section: Design and Methodsmentioning

confidence: 99%

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Comparison of surf and hike therapy for active duty service members with major depressive disorder: Study protocol for a randomized controlled trial of novel interventions in a naturalistic setting

Walter

Otis

Glassman

et al. 2019

Contemporary Clinical Trials Communications

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Many active duty service members suffer from major depressive disorder (MDD). Although traditional treatments exist, alternative approaches may also be effective in treating depressive symptoms. Previous research has shown that physical activity has significant positive effects on depression symptoms in individuals with MDD, and that these benefits may be enhanced when physical activity occurs in a natural environment. Even though physical activity (i.e., hiking, walking) in natural environments has been shown to reduce depressive symptoms, water-based activity occurring in a natural environment (e.g., surfing) may produce even greater improvements in depressive symptoms. We detail an ongoing randomized controlled trial (RCT) comparing the efficacy of surf therapy and hike therapy with respect to immediate and longer-term psychological, physical, and functional outcomes in active duty service members with MDD. We describe the methodological development of this RCT evaluating novel treatment approaches and discuss considerations for evaluating physical activity interventions in a naturalistic setting.

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Section: Design and Methodsmentioning

confidence: 99%

Section: Design and Methodsmentioning

confidence: 99%

Section: Design and Methodsmentioning

confidence: 99%

Section: Design and Methodsmentioning

confidence: 99%

Section: Design and Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Comparison of surf and hike therapy for active duty service members with major depressive disorder: Study protocol for a randomized controlled trial of novel interventions in a naturalistic setting

Walter

Otis

Glassman

et al. 2019

Contemporary Clinical Trials Communications

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Overcoming Adversity and Stress Injury Support (OASIS): Evaluation of Residential Treatment Outcomes for U.S. Service Members with Posttraumatic Stress Disorder

Walter

Kohen

McCabe

et al. 2021

Journal of Traumatic Stress

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Research on residential posttraumatic stress disorder (PTSD) treatment has predominantly focused on the U.S. veteran population, whereas limited research exists regarding active duty service members. The present study evaluated outcomes among service members who received treatment in the Department of Defense's only residential PTSD program, Overcoming Adversity and Stress Injury Support (OASIS). Over a 5‐year period, 289 male service members with combat‐related PTSD received treatment in the program. Service members completed an initial assessment and weekly PTSD and depression self‐report measures during the 10‐week program. Multilevel modeling results demonstrated statistically significant reductions in PTSD. On average, participants reported a 0.76‐point reduction on the PTSD Checklist, B = −0.76, p < .001, for each additional week of treatment. Pretreatment symptom scores and fitness‐for‐duty status predicted PTSD symptoms across time. Weekly changes in depression symptoms were not statistically significant; however, a significant Time × Pretreatment Depression Severity interaction emerged. Service members with higher baseline levels of depression severity showed larger reductions in depression symptom severity than those with lower levels, B = −0.02, p = .020, although a sizeable minority continued to retain symptoms at diagnostic levels. Depression symptom change was not related to any other treatment‐ or service‐related variables. Differing trajectories were found between service members whose symptoms improved over the course of residential treatment and those who did not. The results indicate that there were larger improvements in PTSD than depression symptoms and highlight the need to optimize care provision for service members with severe PTSD or comorbid symptoms.

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Mapping the landscape: surf therapy program delivery

Brennan,

Stain,

Marshall

2024

Journal of Outdoor and Environmental Education

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Surf therapy is a structured intervention which utilizes surfing as a vehicle to achieve therapeutic benefit (International Surf Therapy Organization [ISTO], 2019). Surf therapy is presently delivered internationally within a diverse array of contexts and populations. Despite the publication of many internal evaluation studies, little research has examined themes common to the process of surf therapy across programs. The present study recruited a sample of ISTO-affiliated surf therapy programs (n = 33) to engage with an online survey, Mapping the Stoke, examining core aspects of surf therapy structure and process internationally. Findings indicated both similarities across current program delivery internationally, with examples of primary similarities including target age (adolescents and young adults) and population (mental health), recruitment (self-referral), and structure (group sessions), geographic delivery (major cities) and challenges (funding). Areas of greater diversity included support staff (roles/qualifications), therapeutic aims, measures (outcome) and therapeutic structures. The present study outlines concrete structures and processes which appear integral to the delivery of surf therapy across cultures.

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Breaking the surface: Psychological outcomes among U.S. active duty service members following a surf therapy program

Cited by 24 publications

References 27 publications

Comparison of surf and hike therapy for active duty service members with major depressive disorder: Study protocol for a randomized controlled trial of novel interventions in a naturalistic setting

Comparison of surf and hike therapy for active duty service members with major depressive disorder: Study protocol for a randomized controlled trial of novel interventions in a naturalistic setting

Overcoming Adversity and Stress Injury Support (OASIS): Evaluation of Residential Treatment Outcomes for U.S. Service Members with Posttraumatic Stress Disorder

Mapping the landscape: surf therapy program delivery

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