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Mountain Bike Trail Therapy

We as mountain bikers all know the benefits of being outside and riding our bikes but this has now been backed up by science. Following our successful pilot project, we are breaking new ground by delivering a holistic approach to positive health outcomes through our Mountain Bike Trail Therapy programme.

Profile Paul Mac Farlane Credit Finlay Anderson


We are delighted to launch our film 'Recovery' on the Vimeo platform as a pay-per-view to help raise further funds for the Scottish MTB Health Fund and into our Trail Therapy programme - in turn, giving more people access to the programme and allowing us to train more volunteers to support it.

Did you know it costs £75,000 to run the Trail Therapy programme for a year? You may think that donating a small amount will not scratch the surface. However, if the MTB community embraces the Scottish MTB Health Fund we will use our expertise in match funding to unlock further investment and get more people across Scotland supported and on their way to recovery by bike.

For only £3, you can watch our full film - WATCH NOW!

We oversee the national strategy for mountain biking in Scotland which 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. There 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. The goal was 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.

Why mountain biking though?

In the pilot, goal-setting exercises were coupled with some social and psychological tool-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.

Much of this clinical preparation comes from a therapy style called Dialectical Behavior 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.

MTB TT NHS Lanarkshire 01

Sometimes the trails give you a sign that you are on the right path

What is FLOW?

The MTB Trail Therapy project is designed to improve people’s Wellbeing. We do this by improving people’s physical fitness and mental health using an innovative technique called FLOW therapy. Using FLOW, we can measure the improvement of participants Wellbeing. FLOW therapy is an acronym for the following:

F=Focus/mindfulness, bring present in the moment and filtering out the extraneous impacts of our lives. We use the trails and features on these trails in conjunction with being in nature and noticing where we are and how we feel.

L=Learning new skills improves confidence and esteem. Developing our mtb skills is part of the learning journey. We also teach how to understand our emotions, how to regulate these emotions and apply this into our decision-making process to make dynamic risk assessments and keep ourselves safe, challenge ourselves and be open to unexpected events that happen to us.

O=Others helps us to be part of supportive and inclusive community where mtb is the core element of connecting with other likeminded people. People with mental health issues tend to self-isolate and the imposed C19 isolation measures have exacerbated loneliness. We aim to improve people’s confidence and esteem to be part of networks where folk can enjoy new pursuits and open themselves up to receiving and giving support.

W=Wellbeing, this is sense of how we are at a given point in time. Wellbeing is dynamic and can change depending upon people’s physical fitness and mental health. We aim to improve people’s wellbeing by using the above and measuring this using the Warwick Edinburgh Mental Wellbeing Scale WEMWBS.

Stress and fear can affect the way anyone communicates. Learning to better conduct yourself in these situations while experiencing those feelings when riding will help you do so in your day to day life.

What happened next?

We wanted Scotland to be a place where everybody thrives. We wanted 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.

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.

The data strongly indicated that significant improvements in the elements of mental recovery are achieved through this type of intervention, a finding which is absent in many of the more traditional community-based interventions.

This information and the demonstrable effectiveness of this programme, enabled us to secure a significant level of funding to ensure continued support for this type of intervention, and the Trail Therapy programme was born!

South Lanarkshire

Training began in earnest for the clinical team as soon as Covid allowed and it has paid off; four of the clinical team are now qualified mountain bike leaders at the Fundamentals level.

Most excitingly, one ex-service user is now also qualified at Fundamentals level and is now supporting the Team on a voluntary basis to deliver led rides in-house. Mountain biking is forming part of his recovery strategy, he has embraced the leadership role and is a great peer mentor and advocate of the Trail Therapy programme.

The newly qualified leaders are embarking on a new phase of opportunities by working alongside coaches at the Endura Lifecycles Trust where participants are improving their mtb skills and wellbeing using the FLOW approach.

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Partnership Working with Endura Lifecycles Trust and NHS Lanarkshire


The Tayside programme is now up and running with 8 volunteers recruited and training being put in place for all. We had an amazing response to our request for volunteers and have a varied and amazing cohort, some with experience within the mental health arena either personal or through family members and others just super keen to volunteer their time.

Some are already mountain bike leaders, others are beginning their journey, all will be supported by ourselves through Paul, our Trail Therapy Leader and Christine Fox, our MTB Leadership Development Officer.

The Tayside programme is very strong with multiple groups and participants referred onto Trail Therapy from organisations such as NHS Tayside, Dundee Cycle Hub and HaVeN Dundee to name a few. Self referrals from individuals are common and welcomed. The MTB TT continues to grow, creating a strong recovery community with a focus around mountain biking and the natural environment.

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Developing a supportive recovery community is key

The future

We hope that this programme can be rolled out across Scotland and the rest of the UK. It links into national (Scottish) agendas such as NatureScot’s Our Natural Health Service initiative, responding directly to the mental health crisis we are facing and lays 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.

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We would not be able to run this amazing project without the help, support and funding from these partners.

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