Riding the wave into wellbeing: A qualitative evaluation of surf therapy for individuals living with acquired brain injury
Open accessAbstract
Nature has long demonstrated the capacity to facilitate wellbeing. Interventions involving the natural environment such as surf therapy, are increasingly being used to facilitate aspects of wellbeing in clinical populations. However, explorations of how nature-based interventions such as surf therapy may be used to promote wellbeing in the context of neurorehabilitation are missing from the peer-reviewed literature. Here we characterize the experience of a five-week surfing intervention involving fifteen adults living with the psycho-social and cognitive sequelae of acquired brain injury. Insights were analysed using reflexive thematic analysis, which highlighted the importance of seven overarching themes, including: 1) Connection to Nature, 2) Facilitating Trust and Safety, 3) Managing and Accepting Difficult Emotions, 4) Facilitating Positive Emotion, Meaning and Purpose, 5) Building Community through Social Connection, and 6) Positive Change. Barriers and opportunities (theme 7) were also identified as components on which clinical services may be improved. We present a theoretical model for the benefits of surf therapy in people living with acquired brain injury (ABI) based on these themes and reflections on findings from the wider literature. Findings emphasise the importance of leveraging community partnerships to augment the holistic model of neurorehabilitation and potential implications for service redesign are discussed, focusing on recent developments in wellbeing science.
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A group-based surf therapy intervention for people with acquired brain injury involving a partnership across academia, healthcare and community-based organizations may facilitate a cascade of mechanisms supporting positive change.
“For instance, we found that a group-based surf therapy intervention for people with acquired brain injury involving a partnership across academia, healthcare and community-based organizations may facilitate a cascade of mechanisms supporting positive change (Wilkie et al., 2021; Gibbs et al., 2022).”
From The Complex Construct of Wellbeing and the Role of Vagal Function (2022) · cites this paper as Gibbs et al., 2022
The Methods (Intervention; page not provided) describe group-based surf therapy for people with acquired brain injury delivered through a healthcare–community partnership. The Conclusions (page not provided) propose that the intervention can facilitate a cascade of mechanisms for positive change. Our copy does not establish that academia was a partner in delivering the intervention. (LLM, conf=0.84)
Experimental — accuracy not yet measuredSurf therapy programs for adults and children provide physical benefits, including helping with brain injury, post-hip surgery recovery, cerebral palsy, and Autism Spectrum and Down Syndrome symptomatology.
“Surf therapy programs for adults and children provide physical benefits, including helping with brain injury, 2 post-hip surgery recovery, 8 cerebral palsy, 9 and Autism Spectrum and Down Syndrome 9 symptomatology.”
From The Groundswell Community Surf Therapy Intervention for At-Risk Women and Changes in Body Acceptance, Resilience, and Emotional Regulation (2024) · cites this paper as [2]
The science of wellbeing has given rise to interventions designed to improve wellbeing in people living with chronic conditions, for whom interventions have typically focused on reducing illbeing.
“The science of wellbeing has given rise to new opportunities including interventions designed to improve wellbeing in people living with chronic conditions (e.g., Tulip et al., 2020; Wilkie et al., 2021; Gibbs et al., 2022), for whom interventions have typically focused on reducing illbeing.”
From The Complex Construct of Wellbeing and the Role of Vagal Function (2022) · cites this paper as Gibbs et al., 2022
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Walter, K. H., Sarkisian, G. V., Martinez, G., & Ward, P. B. (2020) · Global Journal of Community Psychology Practice · doi:10.17161/gjcpp.v11i2.20682 · Cited by 8 · see citing works
Martindale, R., Marshall, J., Ferrier, B., & Ward, P. B. (2020) · Research Output (Edinburgh Napier University) · Cited by 6 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- [52]Csikszentmihalyi M., Abuhamdeh S., and Nakamura J., Flow, in Flow and the foundations of positive psychology. 2014, Springer. p. 227– 238.
- [81]Fredrickson B.L., Chapter One—Positive Emotions Broaden and Build, in Advances in Experimental Social Psychology, Devine P.and Plant A., Editors. 2013, Academic Press. p. 1– 53.
Cited by
Sorted by citations
The Complex Construct of Wellbeing and the Role of Vagal Function
Wilkie, L., Fisher, Z., & Kemp, A. H. (2022) · Frontiers in Integrative Neuroscience · doi:10.3389/fnint.2022.925664 · Cited by 18 · see citing works
“The science of wellbeing has given rise to new opportunities including interventions designed to improve wellbeing in people living with chronic conditions (e.g., Tulip et al., 2020; Wilkie et al., 2021; Gibbs et al., 2022), for whom interventions have typically focused on reducing illbeing.”
BackgroundSelf-citationLeeson, R., Collins, M., & Douglas, J. M. (2023) · Disability and Rehabilitation · doi:10.1080/09638288.2023.2246377 · Cited by 18 · see citing works
Wilkie, L., Fisher, Z., & Kemp, A. H. (2022) · Sustainability · doi:10.3390/su14159605 · Cited by 17 · see citing works
Self-citationIsham, A., Morgan, G., & Kemp, A. H. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1205991 · Cited by 18 · see citing works
Self-citationExercise-based rehabilitation in and with nature: a scoping review mapping available interventions
Busk, H., Ahler, J. R., Bricca, A., Holm, P. M., Poulsen, D. V., Skou, S. T., & Tang, L. H. (2023) · Annals of Medicine · doi:10.1080/07853890.2023.2267083 · Cited by 14 · see citing works
Improving Student Wellbeing: Evidence From a Mixed Effects Design and Comparison to Normative Data
Kemp, A. H., Mead, J., & Fisher, Z. (2022) · Teaching of Psychology · doi:10.1177/00986283221112428 · Cited by 12 · see citing works
Self-citationAn Introduction to the Complex Construct of Wellbeing, Societal Challenges and Potential Solutions
Kemp, A. H., & Edwards, D. J. (2022) · Springer eBooks · doi:10.1007/978-3-031-18329-4_1 · Cited by 10 · see citing works
Self-citationTowards a Culture of Care for Societal Wellbeing: A Perspective from the Healthcare Sector
Gibbs, K., Fisher, Z., & Kemp, A. H. (2022) · Springer eBooks · doi:10.1007/978-3-031-18329-4_4 · Cited by 10 · see citing works
Self-citationWhat's next for wellbeing science? Moving from the Anthropocene to the Symbiocene
Mead, J., Gibbs, K., Fisher, Z., & Kemp, A. H. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1087078 · Cited by 8 · see citing works
Self-citationMoran, R., Sperandei, S., Peel, N., Gray, T. L., & Reis, A. C. (2024) · Mental health and physical activity · doi:10.1016/j.mhpa.2024.100629 · Cited by 7 · see citing works
Mapping the landscape: surf therapy program delivery
Brennan, M., Stain, H. J., & Marshall, J. (2024) · Journal of Outdoor and Environmental Education · doi:10.1007/s42322-023-00152-2 · Cited by 6 · see citing works
Denneman, R. P. M., van Bezeij, T., Kal, E. C., Marshall, J., & Pisters, M. F. (2024) · Disability and Rehabilitation · doi:10.1080/09638288.2024.2320265 · Cited by 7 · see citing works
Harrod, A., Benzon, N. R. V., & Limmer, M. (2023) · Area · doi:10.1111/area.12867 · Cited by 6 · see citing works
Place attachment, wellbeing, and conservation in surf destination communities
Mach, L., Rothrock, E., Stark, S., & Nahmias, J. (2024) · Frontiers in Sustainable Tourism · doi:10.3389/frsut.2024.1387081 · Cited by 5 · see citing works
La surf thérapie, un outil innovant de réhabilitation psychosociale !
Chevrier, F., Ordonez, A., Geours, J.-M. S., Geours, S. S., & M’Baïlara, K. (2023) · L information psychiatrique · doi:10.1684/ipe.2023.2552 · Cited by 4 · see citing works
Franceschi, L., Small, N., Goldsby, T., Goldsby, M., Padamada, S., Ziegler, M. G., & Mills, P. J. (2024) · Global Advances in Integrative Medicine and Health · doi:10.1177/27536130241278970 · Cited by 3 · see citing works
Arroyo, P., Wilkie, L., Davies, E., Fisher, Z., & Kemp, A. H. (2024) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2024.2356891 · Cited by 3 · see citing works
Self-citationNorwood, M. F., Aplin, T., & Gustafsson, L. A. (2025) · Journal of Environmental Psychology · doi:10.1016/j.jenvp.2025.102612 · Cited by 6 · see citing works
Gibbs, K., Fisher, Z., Denner, K., & Kemp, A. H. (2025) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2025.2516560 · Cited by 2 · see citing works
Self-citationMakanjuola, A., Wallace, C. A., & Lynch, M. (2025) · Wellbeing Space and Society · doi:10.1016/j.wss.2025.100310 · Cited by 1 · see citing works
Theories of wellbeing, practical applications and implications for coaching
Fisher, Z., Wilkie, L., Hamill, A., & Kemp, A. H. (2024) · Routledge eBooks · doi:10.4324/9781003319016-4 · Cited by 1 · see citing works
Self-citationGahlot, A., Krch, D., & Goverover, Y. (2024) · OTJR Occupational Therapy Journal of Research · doi:10.1177/15394492241288134
Where the Tides of Life Make Sense: Insights from Surfers in Hong Kong
Blaine, J. (2025) · American Journal of Sports Science · doi:10.11648/j.ajss.20251301.12
Davies, K., Fisher, Z., & Kemp, A. H. (2025) · International Journal of Qualitative Studies on Health and Well-Being · doi:10.1080/17482631.2025.2595847
Self-citationTo Surf or Not to Surf: Risk Tolerance in Polluted Blue Spaces
Brown, D. L. (2026) · Springer eBooks · doi:10.1007/978-3-032-09377-6_9
Knowles, N., Ladwa, A., Price, L., Wright, K. A., Gillison, F., Harrison, J. T., & Anderson, R. (2026) · Advances in Mental Health · doi:10.1080/18387357.2026.2644914
SurfSync: Towards the Design of Wearables to Enrich Surfing
Montoya, M. F., van Rheden, V., Patibanda, R., Overdevest, N., Saini, A., Wu, J., Wang, H., Dugas, P. O. T., & Mueller, F. (2026) · Designing Interactive Systems Conference · doi:10.1145/3800645.3812942
SÁ, J. M., Silva, A. J., Monteiro, D., Garrido, N. D., & Rodrigues, F. F. (2026) · Sport Sciences for Health · doi:10.1007/s11332-026-01837-z
Riding waves of inclusivity: A scoping review of adaptive surfing interventions
Zamith, J., Gabriel, R., Britton, E., Cruz, G., Moreira, H., & Silva, B. (2026) · Advances in Rehabilitation · doi:10.2478/advrehab-2026-0012
Mas, M. T., de Prado-Bert, P., Bragg, R., Pálsdóttir, A. M., Luciano, J. V., Cook, P., Domènech-Panicello, C., Howarth, M., Cristóbal-Narváez, P., Montero‐Marín, J., et al. (2026) · Open Research Europe · doi:10.12688/openreseurope.24389.1
- Authors
- Gibbs, K., Wilkie, L., Jarman, J., Barker-Smith, A., Kemp, A. H., & Fisher, Z.
- Affiliations
- Morriston Hospital (GB)
- Corresponding author
- Kemp, Andrew H.
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2022-04-07
- Volume
- 17
- Issue
- 4
- Pages
- e0266388
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC8989185
- OpenAlex
- W4226073231
- Cited by
- 31
- References
- 100
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 8 · 2023: 7 · 2022: 5
- FWCI
- 2.45
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- welsh government - ‘integrated care fund wales’
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Urban Green Space and Health
- Social Sciences › Psychology › Social Psychology › Outdoor and Experiential Education
- Social Sciences › Psychology › Social Psychology › Recreation, Leisure, Wilderness Management
- Keywords
- surf therapy, acquired brain injury, well-being, nature-based interventions, neurorehabilitation, nature connection, trust and safety, emotion regulation, positive emotions, meaning and purpose, social connectedness, community, service redesign, holistic rehabilitation
- MeSH terms
- Neurological Rehabilitation, Adult, Brain Injuries, Emotions, Humans, Sports
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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