Scottish Cycling Develops 'Trail Therapy' Mental Health Program

Apr 29, 2021
by Alicia Leggett  

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?


The role of Developing Mountain Biking in Scotland is to oversee a national strategy for mountain biking in our amazing wee country. The national strategy identified that mountain biking could work in a more proactive manner with our National Health Service. We weren’t seeing a lot of activity in this area and we were keen to progress a programme with research and evaluation built into it so we could study exactly how mountain biking could directly support good mental health.

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.

Paul MacFarlane, the new Trail Therapy Mountain Bike Leader
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.

bigquotesThe 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.

bigquotesStress 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.

bigquotesAccepting 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.

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.

bigquotesOnly 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.

The full Trail Therapy press release follows.

We’re announcing an exciting, kick start project where mountain biking and contact with nature will form the core of an innovative approach to help people suffering from a sustained or acute period of mental ill-health. Following an extensive selection process, Scottish Cycling through their Developing Mountain Biking in Scotland (DMBinS) project, have appointed a Trail Therapy Mountain Bike Leader to deliver the project.

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.’

bigquotesI am very much looking forward to taking up the role this month and beginning the process to ensure that ‘Trail Therapy’ is delivered as a complimentary technique to help those that need it. Now more than ever we need to be championing mental health and ensure that interventions to tackle the increasing stresses placed on the NHS and its support services are there when managing mental health issues. Community-based health initiatives are increasingly seen as the way forward, with NHS systems reaching the limits of their health-giving powers. We need an ever-increasing variety of tools within our mental health toolbox to support not only the individuals affected but the systems that currently try to care for them. This project connects participants to the benefits of ‘green exercise’ through mountain biking and offers one more tool in our toolkit.Paul MacFarlane, Trail Therapy Mountain Bike Leader

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.

bigquotesWe are delighted to have Paul in post to take Trail Therapy forward. This novel project takes full advantage of Scotland’s amazing natural environment as a setting for this preventative and therapeutic approach. It fully supports NatureScot’s Our Natural Health Service initiative and responds directly to the mental health crisis we are currently facing. As a partnership project, it will lay the foundations for a structured, rigorously evaluated, nature-based solution to support our health service going forward.Bridget Finton from NatureScot

The project will also be supported by Trek Bikes.

bigquotesAs a company we are delighted to be involved and support this project. We truly believe that bikes are a tool to vastly improve people’s lives and as an industry we have a real responsibility to be advocates for programmes such as this that harness the power of the bike. Worldwide, now more than ever, people are struggling with their mental health and we are proud to be part of such an innovative project that will grow and be able to help those that really need help.Jez Loftus from Trek

For more information on the project please contact Christine.fox@scottishcycling.org.uk



25 Comments

  • 55 0
 Not much more to say other than it sounds great. Biking is definitely my weekly therapy (or more often if I can).
  • 12 0
 It is the main reason why I ride.
  • 41 0
 The day I can deduct my mountain bike as a medical expense will be amazing
  • 14 0
 As medical equipment, bikes will now retail for 420,666.69 in the United States. I hope your insurance is willing to pick up the tab.
  • 2 0
 @vtracer: and that's for a basic Walmart "mountain bike... With Shoxxx!!".
Eek
  • 25 1
 I think the comments make it evident that many experience mountain biking as a positive activity for their mental health. I have worked in mental health and specifically with children and youth for about 15 years. Covid has been really challenging. The demand in my community has sky rocketed and the number of professionals skilled enough to do the work and support children and families in mental health crisis has stayed the same. It sucks. We are having to prioritize some really heavy stuff with little room to breathe. I think some stats recently from the States have found that almost 60% of adults, and these stats were a few months old, were endorsing moderate to high levels of depression up from about 7-11% pre-covid. I'm not sure if those echo the rates I'm seeing but the need is immense and has dramatically increased.

After a horrendous day of supporting kids struggling with depression, some who have experienced sexual abuse and/or physical abuse, and taking my last client of the day to the hospital as I did not feel they could keep themselves safe in the community I kind of hated the world. I did my usual self care of commuting by bike home (takes me about an hour and is a climb up from the river valley I work in to the mountain town I live in). I got home and it wasn't enough. The experiences of these kids were still bouncing around in my brain. I apologised to my wife and kiddos and let them know I needed a ride. My wife understood as this isn't our first rodeo and she gets the nature of some of the things I have to think about and vicariously experience throughout the day. I grabbed the bike and the dog and hit the trails back down. By the time I got to the bottom the world felt so much lighter. Some days it takes a lot to get out of your head and back into your body and finding a flow state on the bike does it for me.

I think programs like this are amazing. I think if we can be more intentional about the things that make biking rewarding we can really facilitate change in ourselves off the bike as well and support those arounds us to do the same. Well done and I would love to bring something like this to my community. As someone trained/certified in DBT, CBT, IPT, EFFT, and a crap load of other expensive mental health acronyms, with about 15 years of direct therapy/program development experience as well as being a certified MTB coach it does seem within my wheelhouse...now to find time to develop it for my area haha. If someone has more time and energy for this around me and wants to consult... get at me!
  • 21 0
 FEELING VERY VALIDATED
  • 13 0
 This is sick!
  • 13 0
 anti-sick! but yeah.
  • 8 0
 The days when my head is a mess can make cycling pretty tough. Doing an hour long climb with nothing but your thoughts sometimes feels overwhelming! But it's like forced meditation and I always feel better after coming back down.
  • 4 0
 Exercise can be a form of Zazenza Meditation, especially in mtb. Zazenza Meditation is all about experiencing the fundamental motions of movement and awareness of any particular activity and how the body is moving without it running around in your mind (I.E. classical sitting meditation). An enlightened Buddhist Monk once said "Samsara is Nirvana, it's how you perceive it"
  • 4 0
 @lehott: the problem that I have is since my rides are pedal all the way up then ride down, that the long slog up brings me so completely into the present moment that I'm confronted with all of my self inflicted suffering while trying to climb a mountain. Luckily I'm in a pretty good place right now but there were times when I was really suffering that half way up the climb I had to stop and break down into tears. Not saying that was a bad thing, just sharing my experience for anyone interested.

And that quote at the end totally resonates with me. I have benefited greatly from Buddhist thought, but do not consider myself a Buddhist because my interpretation of the mythology is as metaphor. In my interpretation rebirth is a metaphor for the cycle of suffering, and that nirvana (which ends the cycle of rebirth) is a metaphor for freeing yourself from that suffering.

And if anyone is reading this and curious to know more, I highly recommend the book the power of now. It didn't give me answers but helped me start asking the right questions. Also there are a number of talks on YouTube by the monk Gelong Thubten which are all outstanding. Those plus meditation saved my life
  • 6 0
 Fantastic, I hope this can be rolled out everywhere. I’ve often pondered that it is impossible to be depressed on an Mtb. You’re forced to be too present, especially at high speed with your heart pounding away at 155bpm
  • 8 0
 I know for a fact my mental health would be better if I was riding in Scotland
  • 5 0
 What a truly fantastic initiative.

Under normal times (if I can think that far back), a group of us from work always do a Thursday night ride out. Nothing crazy (not many good hills round here). However the rules are, get out, ride, chill and NO TALKING ABOUT WORK.
I can tell you that couple of hours having a chilled out ride once a week does absolute wonders for your state of mind, its certainly something that I have missed during this last year.

Now to show this article to my wife - to prove I'm not talking crap when I tell her I do this for my state of mind..... Big Grin
  • 7 0
 Incredible!! I'm so excited for all of the people that this will help Smile
  • 6 0
 Yes and yes to all of this!
  • 6 0
 Great idea!
  • 1 0
 A Good outlet for bottled aggression it is...if BMX tought me anything it is to not throw the bike while screaming, it will break or bend. A more levelheaded and sustainable approach is to pick a stick of just the right size and beat the bike with it, then you wont break it before you feel stupid about swinging it more. A joy for all and a great many dents saved in the bike, wallet and soul!
  • 4 0
 These guys get it.
  • 2 0
 Biking certainly helps me get through covid*


* f*ck covid
  • 1 0
 Can confirm it works on my mental!
  • 1 0
 Or maybe you need mental issues to mtb?

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