Authors: Michael Amrhein1, Harald Barkhoff2, and Elaine M. Heiby3
2Department of Kinesiology & Exercise Sciences, University of Hawaiʻi at Hilo, Hilo, HI, USA
3Department of Psychology, The University of Hawaiʻi at Mānoa, Honolulu, HI, USA
Harald Barkhoff, PhD
Dean College of Health Sciences and Human Services
California State University, Monterey Bay
100 Campus Center, Ocean Hall A, Rm. 101
Seaside, CA 93955
Michael Amrhein, Ph.D., is a licensed clinical psychologist in Maryland and Hawaiʻi, and an independent researcher who graduated from the University of Hawaiʻi at Mānoa in 2016. His research interests focus on the intersection of sports psychology and spirituality, and he currently works full-time as a clinical practitioner in Ellicott City, Maryland.
Harald Barkhoff, Ph.D., is a tenured Professor and current Chair for the Department of Kinesiology & Exercise Sciences at University of Hawaiʻi at Hilo. His areas of research interest include the role of spirituality in sport and exercise, particularly of ocean sports in indigenous environments.
Elaine M. Heiby, Ph.D., is a Professor Emerita of Psychology at the University of Hawaiʻi at Mānoa. Her research areas include culturally sensitive psychological assessment, mood disorders, health and sports psychology, spirituality, and scope of practice issues.
The effects of an ocean surfing course intervention on spirituality and depression
Although there is very little research on the psychological aspects of ocean surfing, preliminary evidence suggests that engaging in this sport has mental health benefits (2, 12). The current study, using a pre-test post-test quasi-experimental design, aims to examine the effects of a surfing course intervention on the mental health indicators of spirituality and depression. Fifty-four participants (46 new surfers and 8 regular surfers) were recruited over two semesters from four sections of a one-credit surfing course at the University of Hawaiʻi at Hilo. Participants were asked to complete a pre-test assessment at the beginning of the course examining demographics, spirituality, and depression. Participants were also asked to complete a post-test assessment at the end of the course consisting of the same measures, coupled along with a scale of spiritual surfing experiences. New surfers demonstrated a significant increase in overall levels of spirituality from pre-test to post-test. Additionally, for the entire sample of both new and regular surfers, scores on the spiritual surfing experiences scale were positively and significantly correlated with overall levels of spirituality. No significant changes were observed from pre-test to post-test on measures of depression, possibly due to a restricted range of scores. The results suggest that participating in a surfing course may contribute to an individual’s development of overall spirituality. Limitations, future research directions, and applications for sport are discussed.
Key Words: mental health, ocean sports, well-being
There is a great deal of anecdotal information regarding the mental health and spiritual benefits of ocean surfing (e.g., 18), but a dearth of clinical research involving surfers as participants. Spirituality is generally considered to involve a personal search for a purpose of existence, which involves a connection with beliefs, values, and practices that provide meaning to life (17). The results of establishing a sense of spirituality often include a heightened sense of physical and emotional well-being, awareness and acceptance of hardship and mortality, and a sense of peace and empowerment (17). Two previous correlational studies yielded a significant relationship between participation in ocean surfing and lower levels of depression and anxiety than the general population (2, 12). Amrhein et al. (2) also found that surfers report fair to high levels of spirituality. Spiritual development has been deemed to be one index of mental health (e.g., 3, 9, 17).
Research has also assessed the utility of surfing as a preventative approach to social and health problems in at-risk children (14). Preliminary qualitative evidence from the children, parents, and staff members of a program in Australia identified as “Sunset Surfers” suggests that the children who engaged in the sport demonstrated increased self-esteem and a new enthusiasm for overcoming and mastering challenges (14). One case study also suggested that learning to surf was associated with reductions in physical pain, stress levels, and depressive symptoms (10). The same study noted that learning to surf also led to positive effects for treating polytrauma, a condition whereby concurrent brain and other physical injuries can result in psychosocial and cognitive impairments (10). A feasibility study (16) and a separate qualitative study (6) have similarly suggested benefits of a surfing intervention for combat veterans experiencing post-traumatic stress disorder. In a recent literature review, Moreton et al. (13) encouraged additional research exploring potential causal mechanisms that contribute to the therapeutic effects of ocean surfing. Among hypothesized mechanisms, the authors argued the need to further investigate the spiritual aspects of ocean surfing.
Spirituality has been associated with surfing, both anecdotally (18) and in previous research (2). Baker (3) argues for a number of mental health benefits connected to spirituality, including stronger identity development, higher perceived quality of life, more capable coping abilities, and a tool of empowerment to overcome obstacles. Spirituality can also provide a sense of meaning, peace, and connectedness (17). Several studies have demonstrated the effectiveness of spiritually-oriented psychotherapies in treating a number of psychological issues, including depression, anxiety, and anger management difficulties (15).
While a consensus definition of spirituality has yet to be established, in this study spirituality is defined in terms of five cognitive and emotional components, as agreed upon by Amrhein et al. (2). First, there is a sense of subjective connectedness with nature or the environment, other living beings, and a higher power. Second, there is a feeling of heightened self-awareness. Third, there is an awareness of a transcendent reality beyond the normal confines of time and space. Fourth, it provides the individual with feelings of inner peace and harmony and a sense of meaning and purpose in life. Fifth, it includes the belief that consciousness persists after physical death.
Given the evidence supporting the mental health benefits of exercise, particularly activities which take place outdoors or involve a mindfulness component (4, 8), surfing should be explored as a potential intervention (16). Taking place in an outdoor, natural, aquatic environment, ocean surfing is a sport that combines elements of physical exercise and mindfulness or spirituality. Based on the research supporting the psychological benefits of exercise, spirituality, and mindfulness, the combination of these elements in the sport of ocean surfing could lead to an effective intervention for psychological problems and disorders.
While there are many different forms of recreational wave riding, surfing is predominately defined as the act of paddling on one’s stomach on a surfboard as an ocean wave approaches, moving to a standing position as the wave begins to break, and being propelled forward as the wave continues to move.
In the current research, a pre and post-test was administered to college students enrolled in an ocean surfing course to measure their overall levels of spirituality and depression. The researchers anticipated a significant increase in levels of spirituality (Hypothesis #1) and a significant decrease in levels of depression (Hypothesis #2) after the surfing course intervention. Additionally, the researchers anticipated a significant correlation between spiritual surfing experiences and post-test mental health measures of spirituality and depression (Hypothesis #3).
Participants were recruited from students enrolled in KES145, which is a one-credit ocean surfing activity course offered through the Kinesiology and Exercise Sciences (KES) Department at the University of Hawaiʻi at Hilo. Since only participants who completed both the pre-test and post-test measures were included for the study, the final sample included 54 participants out of 71 initial student volunteers. Participants ranged from ages 18 to 63, with the mean age being 23.59 (SD = 7.43) years old. The sample included 57.4% female participants (n = 31) and 42.6% male participants (n = 23). In terms of ethnicity, 33.3% of the participants self-identified as Caucasian, 27.8% as mixed ethnicity, 9.3% as Japanese, 9.3% as Hispanic, 5.6% as Hawaiian or part-Hawaiian, 3.7% as Chinese, 3.7% as Filipino, 3.7% as Korean, 1.9% as Pacific Islander, and 1.9% as Portuguese. In this sample, 14.8% (n = 8) of participants indicated that they had surfed “regularly” prior to the start of the course (referred to as regular surfers), while 85.2% (n = 46) denied surfing “regularly” (referred to as new surfers).
Demographic Questionnaires. A pre-test 10-item demographic questionnaire was used to obtain participants’ self-generated identification code, age, sex, and ethnicity. It was also used to assess participants’ surfing habits (if any) prior to the class. Participants’ identification codes were obtained again at post-test.
Spirituality. The overall level of spirituality was assessed through the Spirituality Assessment Scale (SAS; 11) during pre-test and post-test. The SAS is a self-report measure containing 28 items rated on a scale from 1 (strongly disagree) to 6 (strongly agree) with higher total scores indicating greater spirituality. The measure has met or exceeded the threshold of criteria for internal consistency, construct validity, and criterion validity (11).
Depression. The Beck Depression Inventory-II is an established instrument used to measure the level of depressive symptoms among participants during both pre-test and post-test (BDI-II; 5). Recommended cutoff scores are 0-13 indicating minimal depression, 14-19 indicating mild depression, 20-28 indicating moderate depression, and 29-63 indicating severe depression. Reliability of the BDI-II has been established through internal consistency and test-retest analyses while criterion validity was supported by correlations with other scales designed to measure similar constructs (5).
Spiritual Surfing Experience. During the post-test assessment, each participant was asked to identify how frequently he or she experiences the sensations of 13 typical descriptors of surfing experiences on the Spiritual Surfing Experience Questionnaire (SSEQ; 2). Sample descriptors from the scale include “Heightened Focus,” “Connection with Nature,” and “Meditative.” Responses to each item ranged from 1 (very rarely) to 5 (very often). Possible scores on this scale range from 13-65, with higher scores reflecting more endorsement of surfing-specific indicators of spirituality. Amrhein et al. (2) reported content and construct validity evidence for the SSEQ.
Prior to data collection, the study was approved by the University of Hawaiʻi at Mānoa Committee on Human Studies Institutional Review Board. Participants were recruited from four sections of the KES145 course over two semesters. Recruitment took place during the course’s scheduled meeting time, and participation in the study was voluntary. Participants were offered one bar of surfboard wax for their participation.
All four sections of the surfing course were taught by the same experienced surfer and licensed ocean lifeguard who had taught the course previously. The primary goals of the course were to teach the fundamentals of surfing and provide an opportunity for surfers of various levels to safely improve their surfing skills. The course also promoted learning related to surfing etiquette, appreciation for the ocean, and water safety. The course ran over the length of an 18-week semester.
The first three meetings of the course took place in the classroom and swimming pool, with time spent introducing the class, organizing car rides to the beach, gathering contact information, reviewing ocean safety and awareness information (i.e., riptides, formation of waves, potential marine hazards) and completing a pool swimming test. The fourth course meeting time consisted of an ocean swimming test, which was a requirement before students were permitted to attempt surfing. All participants in the sample passed the two swimming tests. The course met once per week for 90 minutes, but, due to an estimated 30 total minutes of transportation to and from the beach, the class typically would spend one hour at the beach each meeting.
Following the initial four course meetings, the 14 remaining classes were held at Honoliʻi Beach Park in Hilo, Hawaiʻi, which was chosen due to its proximity to the University of Hawaiʻi at Hilo’s campus, consistent waves, and presence of lifeguards. Only six surfboards were available to the students due to limited resources, and students would rotate turns in the water. On average, it was estimated by the instructor that each student typically spent 15-20 minutes attempting to surf each course period.
After agreeing to participate, students were administered an initial pre-test survey packet, which was estimated to take approximately 15 to 20 minutes to complete. The survey packet included an informed consent form, the pre-test demographic questionnaire, the SAS, and the BDI-II. Signed consent forms were removed from completed surveys and kept in a locked filing cabinet separate from the completed questionnaires. Post-test assessment was conducted on the last day of class and included the post-test demographic questionnaire, the SSEQ, the SAS, and the BDI-II. Pre-test and post-test responses were matched using the identification codes.
Tables 1 and 2 report the means and standard deviations at pre-test and post-test, respectively, for scores on the SAS, BDI-II, and SSEQ for new surfers (n=46), regular surfers (n=8), and the total sample (n=54). The Tables also report internal consistency estimates (Cronbach’s Alpha) for the total sample on each measure that are in the expected range of measurement error (11, 5, 2).
Table 1. Pre-test Summary Statistics
|Scale||New Surfers (n=46)||Regular Surfers (n=8)||Total (n=54)||Cronbach’s Alpha|
|SAS||M=128.98; SD=16.47||M=130.5; SD=11.49||M=129.20; SD=15.75||0.90|
|BDI-II||M=10.28; SD=8.12||M=5.39; SD=6.53||M=9.56; SD=8.05||0.89|
*SAS = Spirituality Assessment Scale; BDI-II = Beck Depression Inventory II; SSEQ = Spiritual Surfing Experience Questionnaire
Table 2. Post-test Summary Statistics
|Scale||New Surfers (n=46)||Regular Surfers (n=8)||Total (n=54)||Cronbach’s Alpha|
|SAS||M=133.80; SD=18.70||M=134.05; SD=11.69||M=133.84; SD=17.75||0.94|
|BDI-II||M=8.50; SD=10.33||M=5.88; SD=6.29||M=8.11; SD=9.84||0.95|
|SSEQ||M=48.35; SD=6.28||M=52.13; SD=4.99||M=48.85; SD=6.19||0.74|
*SAS = Spirituality Assessment Scale; BDI-II = Beck Depression Inventory II; SSEQ = Spiritual Surfing Experience Questionnaire
Changes in Spirituality (Hypothesis #1) and Depression (Hypothesis #2)
Measures of spirituality and depression for participants who reported that they did not surf regularly prior to the course (new surfers) were analyzed to inspect the effects of the surfing course intervention. Students who reported that they surfed regularly prior to the course (regular surfers) were excluded from this section of the data analysis because they presumably have already experienced the effects of their surfing habits.
To determine whether any significant changes in spirituality and depression occurred from the beginning of the surf course to its termination, responses from new surfers on the SAS and BDI-II, at pre-test and post-test assessment, were compared through the use of paired sample t-tests. The results for Hypothesis #1 indicated a significant increase, t(45) = 2.99, p < .01, in the total scores on the SAS from pre-test to post-test. The effect size was calculated using Cohen’s d statistic (correlation between means = .81), with d = .45, which falls within the medium range (7). This result indicates that overall levels of spirituality significantly increased from the beginning of the surfing course to the end among new surfers, supporting Hypothesis #1.
In regard to Hypothesis #2, no significant decreases were found in total scores on the BDI-II, t(45) = -1.33, p = .19, from pre-test to post-test, although scores changed in the expected direction of lower depression after the surfing course. The effect size was calculated using Cohen’s d statistic (correlation between means = .54), with d = -.2, which is considered to be a small effect size (7). Hypothesis #2 was not supported.
Association between the Spiritual Surfing Experience and Mental Health Outcomes (Hypothesis #3)
Correlational analysis between the SSEQ, administered only at post-test, and the post-test scores on the SAS and BDI-II were performed with the total sample (n = 54) to determine if there were any significant relationships between the spiritual surfing experience and the mental health outcomes of spirituality and depression. The results for Hypothesis #3 indicated a significant, positive relationship between scores on the SSEQ and post-test scores on the SAS (r = .49, p < .01). However, no significant negative relationships were observed between the SSEQ and the BDI-II (r = -.08, p = .55). Therefore, Hypothesis #3 was partially supported.
The results of this study demonstrated that new surfers reported a significant increase in levels of spirituality after being exposed to an ocean surfing course intervention (Hypothesis #1). This finding holds noteworthy clinical and research implications. Spirituality has been correlated with positive mental health outcomes, such as feeling connected with others, having a sense of meaning and purpose in life, stronger identity development, and lower levels of clinical symptoms (3, 9). Given the positive characteristics associated with spirituality, identifying activities that promote development in this area are important for increasing an individual’s overall well-being (13). The results of this study indicate that ocean surfing may be an activity that contributes to these positive mental health outcomes. Additionally, this result holds implications for better understanding the previous findings that surfers report fewer symptoms of depression and anxiety than the general population (2, 12), as a growth in spirituality may account, at least in part, for these positive mental health characteristics. Similarly, it is worth investigating whether an increase in spirituality serves as a mediator in previous feasibility, qualitative and case studies that found surfing improved the functioning of at-risk children (14), those with polytrauma including brain injury (10), and combat veterans with post-traumatic stress disorder (6, 14, 16).
While a significant increase in reported levels of spirituality was observed after completing the surfing course, no significant changes were found in regard to depression indicating that Hypothesis #2 was not confirmed. It should be noted that a small effect size (Cohen’s d = .2) was found in the non-significant decrease in reported levels of depression from pre-test to post-test. As seen in Table 1, this may be due to the relatively low scores on the BDI-II at pre-test. According to Beck et al., (5), the mean BDI-II scores at both pre-test and post-test are in the “minimal” depression range. Therefore, a lack of a significant decrease in depression scores following the surfing course intervention might be due to a floor effect in our sample of college students. Future research should examine whether participating in surfing leads to significant changes in reported symptoms with clinical populations, such as individuals who meet DSM-V criteria for a mood disorder (1), as previous studies have found a significant relationship between ocean surfing and depression (2, 12).
Participants’ reported spiritual surfing experiences were significantly positively correlated with overall spirituality at post-test, which supports Hypothesis #3 and replicates findings by Amrhein et al. (2). This finding suggests that being more mindful of and connected with the spiritual aspects of the surfing experience may enhance the effects of surfing on general spirituality. However, levels of spiritual surfing experiences were not significantly related to depression at post-test, which could again reflect restricted variance in depression scores.
Limitations of the pre-test post-test quasi-experimental design of this study should be acknowledged when considering possible implications of the relationship between participating in an ocean surfing course intervention and mental health outcomes. Without additional controls concerning the nature of the surfing course, it cannot be determined whether the increase in spirituality can be attributed to the act of surfing itself in this study. For example, participants in this study engaged in surfing as a group activity throughout the semester. Given that a component of our proposed definition of spirituality includes feeling a connection with others, having a shared experience with peers may have contributed to an increase in reported spirituality. Conversely, surfing in a group environment may negatively influence the spiritual experience in other ways, such as reducing the connection experienced with nature or a higher power, as an individual’s attention may have focused on the group experience. Future research should compare the effects of participating in surfing in a group versus solitary environment.
Furthermore, it is possible that components which contribute to the surfing experience, such as mindfulness or exercise, may be contributing to the effects found in this study. Other mindful activities such as meditation might also increase spirituality. Other forms of exercise, such as running, also might increase spirituality and future research should compare the effects of surfing with other forms of exercise upon spirituality.
In addition to no control groups, participants were not randomly assigned to the experimental condition. It is possible that a self-selection bias of participants choosing to enroll in this surfing course could have influenced the results, in that those interested in the course may be more prone to experience positive benefits from surfing than college students who choose not to take the course. Also, individuals more prone to depression may be less likely to have participated in this course, and it is also possible that these individuals may have responded differently to surfing, such as reacting with more fear. While this study provides the first quantitative evidence, to the authors’ knowledge, of the connection between surfing and increased spirituality, causation cannot be concluded from these results due to the lack of a full experimental design.
This study also fails to address individual and personality differences, such as sensation seeking or openness to experience, which may characterize the participants who are more likely to perceive the surfing experience as spiritual. Another limitation is that participant’s exercise habits before and during the course were not controlled for, making it uncertain how the overall amount of exercise may have impacted the results. There are also limitations associated with the utility of an ocean surfing intervention itself, as not everyone has access to the ocean and/or waves conducive to surfing.
Future research should seek to build upon the findings in this study and address the aforementioned limitations. In order to establish causality between surfing and an increase in spirituality, future studies should implement randomized controlled trials so that more definitive conclusions about the relationship between surfing and spirituality can be drawn. Research should also explore the possibility of using surfing as an intervention for clinical populations, which has been supported to date with case studies (e.g., 14). Finally, future research should address other individual and personality differences, such as sensation seeking, which may lead certain individuals to benefit more from surfing, as well as other mental health outcomes that may be influenced by participating in surfing.
APPLICATIONS IN SPORT
When using outdoor sports such as ocean surfing as a mental health intervention, practitioners/coaches should consider a holistic approach and the roles of nature and culture when selecting such interventions. Ocean surfing, which is one of the two official state sports of Hawaiʻi (the other one being outrigger canoe paddling), should receive special consideration as a possible intervention for residents of Hawai’i given its historical and present-day significance in Hawaiian culture. Physical, mental, emotional, and spiritual aspects of the athlete may be impacted by an outdoor sports intervention and need to be addressed as possible outcomes. The inherent variable nature of ocean surf also must be taken into consideration when planning to implement a surfing course intervention. The surfing course intervention used in this study was possible because of access to a beach with consistent surf.
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