Research and Advocacy
Since 2011, we have collaborated with experts, academic institutions, communities of practice and young people to pioneer the Take 5 Model [on which Surf Therapy is based]. A key feature of the Take 5 Model is its incorporation of youth-led research into community-based, mental well-being promotion and prevention.
We share our research to inform continuous improvement in our Surf Therapy programme delivery, as well as to strengthen the wider sector.
Initial Participatory Study
The initial participatory study – Initial Take 5 Model theory developed via consultation with adolescents through photo voice. The study highlighted the problem (toxic stress) and supported a process with adolescents to co-design the solution. Third spaces that gave access to safe spaces, caring adults and peers, accessible coping skills they could use at home and in their community, opportunities to have fun and master new things, and referrals to other services where needed.
5-Pillar Paper
The 5-Pillar Paper (now known as Take 5 Method) – documenting the development of the Take 5 Model between 2011 and 2024. The paper documents the process of developing the simple Take 5 teaching routine (energise, check in, Take 5, play/sport, check out) and outlines the development of associated training and supervision protocols to create competent coaches.
Baseline Study
The baseline study – explored whether the W4C referral process was effectively identifying adolescents who need the Surf Therapy (based on the Take 5 Model) service. Takeout: Adolescents entering Surf Therapy programmes in South Africa have elevated age-adjusted heart rate variability compared to age-related norms, suggestive of stress and an overgeneralized threat response.
Outcomes Paper
The Outcomes paper explored whether surf therapy works with adolescents growing up in high-stress environments in South Africa. Takeout: Participation in Surf Therapy leads to significant reductions in risk-taking behaviours and sensation-seeking among violence-exposed adolescents. Data also suggested that Waves for Change’s Surf Therapy increases participants’ sense of interpersonal closeness.
ASD Paper
The ASD paper outlines the programme that works with adolescents with autism spectrum disorder (ASD). Takeout: Adolescents with ASD experiences at W4C’s Surf Therapy programme were predominantly positive, and Surf Therapy can have a positive effect on the overall wellbeing of adolescents with ASD.
Learn, adapt, and share
Our Surf Therapy programme has scaled from employing 2 coaches and reaching 15 children annually in 2011, to employing 43 coaches and reaching 2,800 children annually in 2025.
The programme has shown evidence-based success in responding to the toxic stress pandemic in communities in the Western and Eastern Cape provinces in South Africa, providing an effective local solution to the local communities surrounding our 5 beach sites. Some of the research that has shaped Surf Therapy:
Scaling through Take 5
A study of Surf Therapy in post-conflict Liberia, underpinned by the Take 5 Model, explored the active ingredients that make these programmes effective. The research identified three key elements: the safe space created by the coach, which fosters social connectedness and play; the sporting domain, which offers respite from stress; and the transfer of behaviours from structured curriculum activities, which supports the development of self-regulation.
Sierra Leone – Take 5 Model
Study evidencing the use of Surf Therapy (based on the Take 5 Model) in supporting young people in post-conflict and post-epidemic contexts.
Takeout: We can transfer these ingredients to fellow surfing organisations. This provided a scaling approach, through training and supporting other surfing organisations to adopt the Take 5 Model, however, this did not provide a scaling model for reaching the most at-risk adolescents, in conflict or crisis, who are so often not close to the ocean.
ALIVE randomised control trial
Waves for Change is leading manual development, training and supervision of community sports coaches in this trial with academic partners such as Wellcome Trust, UCT and King’s College London. The trial is testing a self-regulation intervention which is substantially based on the Take 5 Method when combined with a range of physical activities (outside of surfing) to assess its feasibility as a prevention intervention for anxiety and depression amongst adolescents growing up in multidimensional poverty in South Africa, Nepal and Colombia. It is running from 2024-2027.
Open-source research
Over 470 million children and adolescents – one in six globally – are now living in areas affected by conflict (UNICEF, 2024). Millions of other adolescents are continuing to grow up living in multidimensional poverty, and the toxic stress pandemic has been recognised as a global priority.
Scalable solutions to assist adolescents with toxic stress are an urgent global focus and need to work for the world’s most underserved adolescents. As the Surf Therapy programme has reached capacity in scaling, we have spent the last 5 years testing the feasibility of the Take 5 Model (on which Surf Therapy is based) as a framework to be adapted and used by a range of sports, arts, cultural and play-based organisations and programmes around the world.
Our Research Partners
Waves for Change Surf Therapy and Partnerships work is underpinned by rigorous research in collaboration with:
