Benefits of surf therapy for children with disability in South Africa: A single case story

Roxanne Davis^1,2,3,4*Angus Hunter^5,6,7,8Yumna Albertus^10,11,2,9Theresa Lorenzo^10,12,2,4,9

• ¹University of Cape Town, Cape Town, South Africa
• ²University of Cape Town Faculty of Health Sciences, Cape Town, South Africa
• ³University of Cape Town Division of Disability Studies, Observatory, South Africa
• ⁴Department of Health and Rehabilitation Science, Division of Disability Studies, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa, Cape Town, South Africa
• ⁵University of Stirling Faculty of Health Sciences and Sport, Stirling, United Kingdom
• ⁶University of Stirling, Stirling, United Kingdom
• ⁷University of Aberdeen School of Medicine Medical Sciences and Nutrition, Aberdeen, United Kingdom
• ⁸University of Aberdeen, Aberdeen, United Kingdom
• ⁹University of Cape Town, Rondebosch, South Africa
• ¹⁰Health through Physical Activity, Lifestyle and Sport, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa, Cape Town, South Africa
• ¹¹University of Cape Town Department of Human Biology, Observatory, South Africa
• ¹²Department of Inclusive Practices Africa, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa, Cape Town, South Africa

Introduction: There is a well-established association between physical activity and positive health and wellbeing outcomes, however, evidence on the effectiveness of surf therapy as a therapeutic intervention for children with disabilities remains limited. This article presents a longitudinal case narrative of Rowan, one of five children who participated in a structured surf therapy programme in the Western Cape province of South Africa as part of a broader PhD study involving 35 participants across multiple stakeholder groups. This case was purposefully selected to highlight in-depth individual experience over time. Method: A qualitative participatory research approach was used to explore the benefits of a surf therapy programme from the perspective of children. The research design was a longitudinal exploratory case study underpinned by interpretive phenomenological analysis of themes and sub-themes. Data were gathered through three open-ended narrative interviews with each child over a one year period. Findings and Discussion: The key theme: “An ambassador’s journey of change” describes the child’s experience of and perspectives on the benefits of surf therapy under three sub-themes: ‘Surfing has taught me to be more myself’; ‘Re-shaping my worldview’ and ‘Now I like to be (am) stress free’. The mental, physical, social, and emotional health benefits of surf therapy for one child at micro, meso, exo and macro systems levels are discussed, highlighting the relevance of Social-Ecological Model of Disability and the Community-Based Rehabilitation Guidelines of the World Health Organisation to facilitate disability inclusion. Conclusion: The case story of Rowan illustrates how an inclusive surf therapy programme supports the health, development, and relational wellbeing of children with disabilities by reshaping their worldview and strengthening self-confidence. The programme enabled the mastery of new skills that extended beyond the ocean into their homes, schools, and broader ecological systems. This study advances surf therapy research by offering rare longitudinal evidence from a Global South context. It demonstrated how multisystem mechanisms of change, rooted in disability inclusive and community-based frameworks, inform more responsive practice, programming, and policy processes.