“When I Go There, I Feel Like I Can Be Myself.” Exploring Programme Theory within the Wave Project Surf Therapy Intervention

Abstract

Mental health issues in young people are a priority for health and social care. Surf therapy is an innovative intervention that may help address this health burden globally. While increasing evidence demonstrates the effectiveness of surf therapy, there has been limited exploration as to how it achieves its outcomes. Such theoretical exploration is important for service optimisation, monitoring and proliferation. This research aimed to adopt, for the first time, a rigorous grounded theory approach to explore underlying programme theory within the Wave Project surf therapy intervention. Participants (n = 22, 14 males and 8 females; mean age = 14 years, SD = 3.5, range 8–23) were interviewed about their intervention experiences. Data were analysed through constant comparative analysis and memo writing. Two core categories reflected mediators by which surf therapy may achieve its outcomes: “Self-Selected Pacing and Progression While Surfing” and “Creation of Emotional and Physical Safe Space at Beach”. Three antecedent (linking known inputs to core categories) and three consequent categories (linking core categories to associated outputs) were also identified. These demonstrate theorised pathways from known inputs to associated outcomes within the intervention. These important findings provide plausible evidence on how to optimise the Wave Project’s delivery in tackling mental health burden.

A Mixed Methods Exploration of Surf Therapy Piloted for Youth Well-Being in Post-Conflict Sierra Leone

“…These elements of the intervention align with previously mentioned priority areas for youth mental health in Sierra Leone [6]. The findings also triangulate with studies exploring surf therapy for youth mental health in different contexts [12], especially around the importance of a safe space, social support, and respite. The initial program theory expounded within the research carried out in Liberia provided the theoretical framework for the piloting of surf therapy in Sierra Leone.…”

“…Plausible mechanisms identified within the evaluation synthesis add strength to claims of the positive impact of surf therapy on participant well-being [16]. Identified mechanisms, including the provision of a safe space, respite, and peer support, align with prior research, which heavily informed the intervention design [11], alongside other research into surf therapy for youth [10,12]. The evidence of participant social and coping skills being recognized by other community stakeholders alludes to the successful implementation of a specific skill transfer model [22].…”

“…Each site worked with a different number of participants based on capacity. There was a broad spread of age ranges within the sample (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22), with an average age of 12.9 years. Attendance was captured using the Teampact app (https://teampact.co/ (accessed on 5 June 2021)), which uses facial recognition and session timers to promote transparency around intervention delivery.…”

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

“…It is important to note that the programs do not include a structured psychotherapy/therapy component; rather, engagement in the activity within the natural environment and social interaction/support are considered the therapeutic elements (e.g., Refs. [[34], [35], [36], [37]].…”

Sensing Water: Uncovering Health and Well-Being in the Sea and Surf

“…Although the mechanisms of how surf therapy contributes to well-being are not yet fully understood, the literature does suggest that learning to surf in a group context can help enhance a sense of belonging and identity through shared experiences in the surf (Godfrey et al., 2015; Hignett et al., 2017). In addition and central to any discussion of health and well-being is the importance of immersion in producing a sense of “respite” from everyday and acquired anxieties and disabilities (Marshall et al., 2019; Wheaton et al., 2017). Caddick et al.…”