Beyond Surfing: Why Scotland, and a Wave Pool, is a Turning Point for Surf Therapy

Dr Jamie Marshall is Chair of the International Surf Therapy Organization (ISTO)

“If there’s one message for health decision-makers, it’s this: surf therapy works, and it’s a relatable model for upstream, community-based care. In my research, I call it ‘mental health by stealth’. Participants don’t experience a clinic; they experience surfing, held within a deliberately designed physical and emotional safe space.”

This year, I’m supporting two firsts for the International Surf Therapy Organization (ISTO): our global gathering is coming to Scotland, and our practitioner workshops are moving from the ocean into a wave pool. That isn’t novelty; it’s strategy. Controlled waves spark innovation in training, enhance inclusivity, and help us validate and scale what works, so surf therapy can move from “promising” to a mainstream model of care.

Scotland’s surf-therapy story is remarkable. As a proud Scot and the world’s first PhD holder in surf therapy (2022), I’ve seen our progress first-hand: established programmes changing lives, a deep research partnership with Edinburgh Napier University, and a wave pool built with wellbeing at its heart.

Our summit has two parts. From 22-24 October, we’ll run hands-on workshops at Lost Shore Surf Resort. The summit then moves to Edinburgh Napier University on 25-26 October for two days of evidence, discussions and collaborations.

Our theme, “Beyond Surfing,” asks us to look outward: how surf therapy intersects with physical activity and sport, community psychology, and lifestyle psychiatry. We’re exploring diverse methodologies, disciplines, populations, and geographies - pushing the boundaries of what surf therapy can learn from, and offer to, wider health and wellbeing.

Wave-pool workshops matter because repeatability does. In the sea, conditions shift by the minute; in a pool, waves arrive on cue. That control lets us enhance innovation, embed adaptive approaches, and train coaches consistently. It doesn’t replace the sea; it complements it. The pool fosters learning, confidence, and access; the ocean provides progression and a powerful connection with nature.

ISTO’s mantra “go far, go together” shapes our workshops. Organisations from around the world help each other tackle shared challenges, swap what works, and are honest about what doesn’t.

The research programme extends the same bridge. Keynotes from Dr Simon Rosenbaum (a leading voice on exercise and mental health) and Dr Easkey Britton (renowned for her work on ocean and human health, gender, and social transformation) set an ambitious tone. We’ll consider surf-therapy findings alongside work on physical activity, adaptive and physical rehabilitation, and the broader blue health agenda.

If there’s one message for health decision-makers, it’s this: surf therapy works, and it’s a relatable model for upstream, community-based care. In my research, I call it ‘mental health by stealth’. Participants don’t experience a clinic; they experience surfing, held within a deliberately designed physical and emotional safe space. That safe-space design is one of our most transferable insights.

The vision is clear: a flexible, evidence-based approach recognised as routine care, not a niche add-on. Flexibility matters - from a young person with social anxiety to a veteran living with PTSD. We also need a bedrock of best practice and measurement so commissioners can engage with confidence.

Scotland is well placed to lead. ISTO’s network spans 140+ programmes across six continents, and UK services, particularly in Scotland, are already leading globally in referring to surf therapy. Lost Shore’s Surf Lab, run in collaboration with Edinburgh Napier University, is innovating with new services, ranging from dyspraxia support to perimenopausal wellbeing. Momentum extends beyond ISTO. My role with the Olympic Refuge Foundation Think Tank shows global sport-for-good leaders view this as a model for scalable impact, inclusion, and robust measurement.

My ask to health, social care, and education leaders: come and see it in action. Join us at Lost Shore to observe sessions, meet practitioners and participants, and test how this could fit locally. Then sketch a practical pathway - identify referral partners, secure an accredited delivery team, and adopt a light-touch outcomes set. Start small, measure well, iterate quickly.

Even if surfing feels unlikely in your context, the playbook still applies: purposeful safe spaces, joyful movement, strong community, and consistent measurement. That is upstream care at its best - engaging, empowering, and proven to change behaviour where it counts: to people’s lives.

Dr Jamie Marshall is Chair of the International Surf Therapy Organization (ISTO) https://intlsurftherapy.org/