In 2018, Scottish Cycling’s Developing Mountain Biking in Scotland project ran a successful pilot program to study how mountain biking can be used as part of mental health treatments. Building on the pilot’s success, DMBinS has just announced a new initiative to expand the project, headed by Paul MacFarlane, who is both a mental health worker and a mountain biker and who was hired specifically as the new Trail Therapy Mountain Bike Leader.
As the project was in development, I reached out to Scottish Cycling to understand more about the 2018 pilot study that provided the foundation for the new Trail Therapy program.
What was the motivation behind the study?
We convened a meeting with partners in the area where we are based, at Glentress in the Scottish Borders. At that meeting, we met a fantastic occupational therapist and mountain biker to progress an idea she had to provide a therapeutic approach within a non-clinical environment to promote the use of self-management skills to improve patients’ physical and mental health. Mountain biking was seen as the ideal activity to meet her client’s needs.
The project’s aim was to share the joys and obtainable challenges of mountain biking with folks who have an existing mental health diagnosis and to assess its effect on people’s overall mental health, both on the trail and in their everyday lives after the ride. Also to help the individuals involved grow in confidence, improve social interactions, establish skills of self-regulation and accelerate their road to well-being.
We were keen to help this programme to happen by delivering the weekly sessions. We wanted to understand if mountain biking aided people’s recovery from a period of mental ill health, how we as leaders could learn from the experience, and, using our role within mountain biking in Scotland, how we could take these learnings and spread them across the country.
What do you think is special about mountain biking as a tool for mental health?
We as mountain bikers all know the benefits of being outside and riding our bikes but this was backed up by science. In the pilot, goal-setting exercises were coupled with some social and psychological skill-building discussions between clients and therapists to help connect the challenges that would come across on the trail with the mental health obstacles that the clients were working to overcome.
The clinical preparation was informed by a therapy style called Dialectical Behaviour Therapy (DBT). The research team agreed that mountain biking was an ideal activity because the sport requires mindful focus, and resilience, and provides consistent challenges to overcome, in the form of undulating terrain, obstacles on the trail, inclement weather, mechanical issues, and instant decision making.
The four main elements of Dialectical Behaviour Therapy are mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. Mountain biking requires focus and mindful awareness just to stay on your bike. We are also exposed to distress tolerance by the challenges presented as we ride and learning to understand that those challenges will eventually pass is crucial. Emotional regulation is important for people whose emotional states are less stable than others, and on the bike, supported by skilled therapists, they can work on controlling their more extreme feelings about what is happening around them.
Tied directly to emotional regulation, interpersonal effectiveness refers to our ability to assert our needs and desires in a kind way while interacting with other people. Stress and fear can affect the way anyone communicates, and learning to better conduct yourself in these situations while experiencing those feelings while riding will help you do so in the rest of life.
What is your main takeaway from the study?
Initial analysis of the impact of the 2018 pilot programme, by Assoc. Prof. Tony Westbury of Edinburgh Napier University, showed that the participants developed their personal coping strategies, interpersonal effectiveness through social contact and mutual support with fellow participants and ride leaders, self-regulation and distress tolerance. Accepting the limitations of a small-scale pilot, the data strongly indicated that significant improvements in the elements of mental recovery highlighted in the literature; connectedness, hope and optimism, identity, meaning and empowerment, can be achieved through this type of intervention, a finding which is absent in many of the more traditional community-based interventions.
We want Scotland to be a place where everybody thrives. We want to reset how Scotland thinks about wellbeing and health. Well-being cannot be created and sustained by the NHS alone. High quality and equitable healthcare and health protection services are vital in improving and maintaining health, addressing health inequalities, and improving our nation’s mental health.
With a mental health crisis looming, it is so important that community organisations and others work together to improve Scotland’s health and to empower people and communities.
The legacy to a successful programme and robust evaluation is an additional tool with which to tackle mental health issues going forward. Since the end of the initial pilot, we have been working hard to try to secure funding to develop the programme, work on the findings and find suitable partners to offer further programmes where there is an identified need.
How could mountain biking be used more widely as a therapeutic tool? Are you planning more research regarding mountain biking and mental health?
Demonstrable effectiveness of this programme has enabled us to secure a significant level of funding to ensure continued support for this type of intervention, but we are not quite there yet. We are currently working to close a funding gap to develop future projects and we hope to be able to launch a new programme really soon.
Any project we develop will be a starting point for new preventative and therapeutic approaches, taking full advantage of Scotland’s amazing natural environment. It will link into national (Scottish) agendas such as NatureScot’s Our Natural Health Service initiative, responding directly to the mental health crisis we are facing and as a project will lay the foundations for a structured, rigorously evaluated, nature-based solution to support our health service going forward.
It is vital that any future projects are subject to a robust evaluation because these are essential in demonstrating how structured interventions such as this deliver real health outcomes. Only with robust evaluation can we demonstrate success not only for funders but equally importantly, for those within healthcare settings looking to alternative ways to manage the increasing mental health care pressures. We hope to continue to work with Assoc Professor Tony Westbury of Edinburgh Napier University to deliver the evaluation.
The full Trail Therapy press release follows.
Paul MacFarlane, a highly qualified mountain bike leader with a breadth of experience delivering sessions to adults and young people alike, will take up the post in mid-April. Paul, who is also a mental health first aider, will be working in partnership with the NHS and Green Health Partnerships in Dundee and South Lanarkshire, delivering mountain biking sessions to two distinct client groups.
The nature-based project will help support and consolidate the therapeutic techniques delivered by mental health professionals within formal and informal healthcare settings to accelerate recovery, under the banner of ‘Trail Therapy.’
NatureScot is the main funder of this project which follows on from a successful pilot delivered by DMBinS and partners in the Scottish Borders in 2018.
The project will also be supported by Trek Bikes.
For more information on the project please contact Christine.email@example.com