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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.

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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.

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

What is DBT?

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. 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.

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!

Trail Therapy is now being delivered in Tayside and South Lanarkshire.

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.

The Fundamentals Award enables them to lead on beginner-to-moderate single track, ideal for Chatelherault and the current riding level of their patients. To allow for future progression, 3 of the team are also on the pathway for their Level 2 Mountain Bike Leadership Award which significantly increases their remit enabling them to lead more technical terrain as their patients increase in skill.

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 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.

Activity has started with Feeling Strong, Dundee’s youth mental health charity. All riders are complete newbies to the world of mountain biking but all have bags of passion and enthusiasm for taking on a new and exciting challenge.

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The trails are a place where art and nature come together to aid recovery.

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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