A grounded theory exploration of programme theory within Waves of Wellness surf therapy intervention

Figures & data

Table 1. Initial interview schedule (questions added to initial schedule as part of concurrent data collection and analysis are in italics).

Please tell me about your experience of surfing alongside the Waves of Wellness.

Can you talk me through your process of getting involved with Waves of Wellness?

When you look back your initial experiences surfing, are there any events that stand out in your mind?

Can you describe to me how you felt when you caught your first wave?

Can you expand on the emotions you feel at the beach and in the water?

Can you describe to me what it was like meeting with new people at the beach?

Can you describe to me your experiences of the atmosphere at the beach?

How would you describe yourself as a person at the beach?

Can you tell me what surfing now means to you?

Can you tell me about working alongside the Waves of Wellness surf mentors?

Can you describe to me your expectations of surfing prior to starting? (Follow up: How, if at all have these changed?)

Is there anything else you think I should know to understand the Waves of Wellness Foundation?

Is there anything you would like to ask me in relation to anything we have discussed?

Can you tell me about any expectations you had prior to taking part in Waves of Wellness?

Can you tell me about any sensory experiences you felt on the beach and in the water?

How would you describe the beach setting for mental health discussion in comparison to a more traditional setting?

Can you tell me about having access to clinical expertise in a non-clinical setting?

Can you tell me about your experience of mindfulness with Waves of Wellness?

Can you tell me about any elements from Waves of Wellness that you still use, if any?

How would you describe your experience of wiping out (falling off) during surfing?

Table 2. Programme theory components in Waves of Wellness.

Themes	Sub-Categories	Categories	Domains
Removing judgement around topics brought up or contribution to discussion	Non-Judgmental Environment	SAFE SPACE	Mental Health by Stealth
Removing judgement around ability or pace of learning surfing
Contributing at own pace
Seeing facilitators taking part in discussions sharing from their own life experience	Participatory Facilitation
Feeling like facilitators were invested
Breaking down power relationships within intervention structure
Avoiding stigma associated with mental health in conventional setting
Realising not alone in struggles	Challenging Isolation	SOCIAL SUPPORT
Recognising variety of mental health and its prevalence
Forming lasting relationships and support through programme
Thanking/affirming peers sharing of lived experiences	Peer Celebration
Celebrating progress both in discussions and in the water in a similar manner
Learning about and trying tools to support own mental health	Peer Learning
Sharing in other participants lived experiences
Fidgeting with the sand/feeling the sun/hearing beach noises as grounding during mental health discussions	Sand Fidgeting/ Aquatic Immersion	SENSORY GROUNDING
Favouring natural sensory grounding to artificial/sterile options
Feeling better from sensory experiences (note this may represent an independent pathway to respite)
Recognising mindfulness is more than meditation	Clarifying Mindfulness
Trying to surf or swim mindfully at the session
Maintaining mindful activities post intervention
Feeling sense of accomplishment while surfing	Realising competency	MASTERY	Surfing Benefits
Reinforcing accomplishment through peer celebration/support
Translating sense of accomplishment into wider life
Surfing demanding focus leaving no space for negative emotions in the moment	Demanded Focus/Flow	RESPITE
Experiencing feelings comparable to flow state indicators (temporal distortion, ecstasy, clarity and intrinsic reward)
Letting go in water after potentially heavy discussion topics	Immediate Respite
Feeling release at the end of session, compared with other mental health support without option for release
Continuing to surf for respite in life outside intervention	Ongoing Respite

Data availability Statement

Due to the nature of the research and ethical considerations supporting data is not available.