Surf therapy

Domain XV · Nature, philosophy, social & rites of passage

What it is

Surf therapy is not a single psychotherapy but a family of programmes. ISTO's 2019 definition, as cited by Benninger et al. (2020), describes it as "a method of intervention that combines surf instruction/surfing and structured individual and/or group activities"; Brennan, Stain and Marshall (2024)…

Format

• Programme format across the field. Programme length in the reviewed studies ranged from a single day to six months, most often weekly sessions over several weeks. In a 2024 survey of 33 ISTO-affiliated programmes, most ran a closed block with a set start and end, most delivered in groups, and the…
• Version A: The Wave Project (UK). For young people aged about 8 to 21, mainly referred by professional services (for example CAMHS, social services, schools, mental health charities). Stages: (1) referral; (2) a free course of six weekly weekend sessions, with transport where needed, in which each…

Who practises it, and how they are trained or regulated

• Surf therapy is not a single psychotherapy but a family of programmes. ISTO's 2019 definition, as cited by Benninger et al. (2020), describes it as "a method of intervention that combines surf instruction/surfing and structured individual and/or group activities"; Brennan, Stain and Marshall (2024) cite ISTO's wording as a structured intervention that uses surfing "as a vehicle to achieve therapeutic benefit".…
• How change is thought to happen. In The Wave Project programme theory, two core mechanisms are self-selected pacing and progression while surfing, and the creation of an emotional and physical safe space at the beach; these are made possible by waves that offer many challenge levels, by removing perceptions of failure and pressure, and by physical and emotional support from mentors, and they lead to mastery, respite…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Over-sharing by referrers; a young person agreeing only to please. Working: a written, client-owned sharing agreement.
• Grief or a dip in mood after the block; continuation blocked by cost. Working: a concrete next step the client has chosen.
• Mismatched pairs; a child who cannot tolerate being relied on; rough play. Working: partners check on each other unprompted.
• Statements that are self-critical or unrealistic. Working: specific, achievable statements the client uses after graduation.
• Inability to name any strength (a clinical sign worth exploring in therapy). Working: strengths stated in the young person's own words.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.