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SURF THERAPY | ISTO | Kris Primacio


SURF THERAPY is defined as a method of intervention that combines surfing instruction and group activities to promote psychological, physical, and psychosocial wellbeing.


The International Surf Therapy Organization (ISTO) has become a global collective of the world's leading surf therapy practitioners, clinicians, researchers, and influencers, harnessing the power of collaboration and the ocean to advance the use of surf therapy. ISTO facilitates understanding through research, promotes better practices, and advocates for surf therapy to be used globally as a mental and physical health intervention. ISTO's mission is to create inclusive access to safe surf therapy worldwide, and its vision is universal acceptance of surf therapy through prescription. Their most significant contribution to the sector is facilitating high-impact research on the effectiveness of surf therapy in the first-ever academic journal dedicated to surf therapy research.

Photo Credit: Tony Zan @thetonyzan

ISTO was founded in 2017 in Cape Town, South Africa, to unite and empower surf therapy programs to address mental health issues in a rapidly changing world. After meeting in Cape Town in 2017 and Jeffrey's Bay in 2018, over 250 pro surfers, scientists, researchers, nonprofit organizations, and volunteers met again in 2019 in Los Angeles, CA. The symposium explored topics such as "The Intersection of Surf and Science," "Women Pioneers of Surf Therapy," and "Growing the Global Evidence Base for Surf Therapy." In 2020 the ISTO Virtual Symposium, "MAKING WAVES: Through Inclusion, Diversity, and Equality in the Lineups," brought together prominent changemakers in the surf therapy sector to discuss the past, present, and future of this unique approach. The event hosted a wide array of transdisciplinary panelists to discuss the mental health benefits of surfing, creating safe spaces for Black, Indigenous, and People of Color (BIPOC), also featuring the first all-Spanish speaking panel, five all-female panels along with the first surf therapy program to prioritize first responders, and a session dedicated to Native Americans and the Indigenous land around your favorite surf breaks.


This year's ISTO 2021 Global Conference is being held in Cornwall, UK, with virtual and in-person options hosted by The Wave Project. The event will take place over three days, from October 6th - 8th leading to a Global Paddle Out for World Mental Health Day on October 10th. Dr. Marialidia Marcotulli (Founder of Withitgirl), Asha MaGee (Director at Withitgirl), and Sachi Cunnighman (Documentary filmmaker and Professor of Multimedia Journalism at San Francisco State University) will be hosting a conversation about Women in the Water + Trust + Wellness on October 8 @ 7:30 AM PST. Register here for the Virtual Seminars and Workshops.

Kris Primacio with a young woman learning to Surf by Timothy Reed Murphy @timothy_reed_murphy

WITHITGIRL checked in with Executive Director Kris Primacio, about her journey to ISTO and the impact, importance, and future of ISTO.


How did you get involved with ISTO?

I, alongside 16-other people, became the Co-Founders of the International Surf Therapy Organization (ISTO) in 2017. I was the Program Manager with Carly Rogers, as the Program Director for JMMF (a surf therapy program that operates in Manhattan Beach (serving at-hope youth) and at Camp Pendleton (serving active-duty military, working with the Wounded Warrior Battalion). We received an invite to join 7-other surf therapy programs (from around the world) in Cape Town, South Africa. After a week of brainstorming about growing the surf therapy sector in a significant, collaborative, and inclusive way, we established ISTO.

As a co-founder and a volunteer Board member of ISTO, I helped coordinate the 2018 Conference in Jeffrey's Bay, Africa. We all shared common goals, but understandably, the contributors (the word we use rather than 'members') were primarily focused on their programs after the conferences. We needed someone at the helm to solely drive ISTO's mission, and I was elected to take on the challenge.

The rest is history, as they say.


Photo Credits: (L) @jeffbertingphoto (M) @brookeadamscreative (R) @jeffbertingphoto

The surf and professional spaces have been influenced mostly by men, and this is changing, with more girls and women learning to surf and pursuing higher education and accreditations. Tell us more about your role as a woman surfer and running a surf nonprofit?

I rarely think about my gender until I'm in the lineup and reminded of my inferiority. I don't want a guy to paddle around me and take my waves because I'm a girl, but I also don't want them to feel like they need to give me a wave because I'm a girl - as if I wouldn't be able to get one without their generosity. Still today, men/boys dominate the lineups, and thankfully, that is changing. I happen to surf at a break, where the number of female surfers is growing exponentially, and that's hopeful, but on big days, it's still just me and 10-guys. I've learned to hold my own and that a smile goes a long way. There's an unspoken level of respect that either happens or doesn't, and if it does, then everybody is having fun and catching waves. If it doesn't happen, it's dangerous for all.

As a female CEO of a surf therapy nonprofit, I feel right at home because, in our sector, 59% (*based on an ISTO survey) of surf therapy programs are led and established by women. Still, I would have benefited tremendously from being exposed to more women leaders and Hawaiian/Filipina leaders at that. I didn't grow up seeing women, especially Hawaiian/Asian women, in positions of power. For that matter, I rarely saw them on TV, at the movie theater, or in magazines. Representation is so important - if you don't see it, it's hard to believe you could ever be it.

As a proud Hawaiian/Filipina woman CEO, it is an absolute honor to be working in the sector of surf therapy and supporting a new paradigm inevitably for mental health treatment. And if I can inspire young girls/women that look more like me, that's equal to getting barrelled - the holy grail of surfing!

We spoke about access to surf and barriers to entry for many people, especially parts of the world where traveling to surf/access to surf is not an option. How does ISTO address this?

Surf therapy offers an evidence-based and cost-effective form of both up and downstream healthcare using nature's already proven to heal properties and therapeutic elements of being physically active through surfing. Conventional therapy includes psychotherapy and medication. We are advancing the conversations to add an alternative method of treatment - surfing. NGOs and nonprofits prioritize the most underserved communities (i.e., Refugees, BIPOC, LGBTQIA+, Veterans, Addiction, Autism, Homelessness, etc.), thus making what was otherwise costly and unattainable accessible. So by the very nature of surf therapy programs and their vast inclusion, we grant the means and access to surf.

Photo Credit: Kris Primacio by Alex Gabrielidis @alexis_gabrielidis_surfphoto

As a water woman, what advice can you give girls and women who want to learn to participate in surfing and water sports?

Surrounding yourself with phenomenal water women is a start. If you want to surf, immerse yourself in the wealth of resources available today; books, podcasts, and documentaries to learn more about the culture. You are who you choose to associate yourself with, the books you read, your Netflix playlist, the movies you watch, the music and podcasts you listen to, and the social media you follow. If you define surfing as only standing up on a surfboard, you've got some homework still to do.

When I first began surfing at 41-years old, I bought and borrowed every book, watched every movie, played WSL's 'Fantasy' Surfer because I watched every contest, and volunteered at surf therapy programs to be near surfing. You don't need to be as extreme as me, but you'll feel more confident in the lineup and more connected to the sport's heritage. And don't forget to give lots of love to the indigenous people who surfed before you at your local surf break.

Photo Credit: Manhattan Beach (2019) by Kelly Hayden @kellihayden

What does sisterhood mean to you, and what is a withitgirl withitwoman?

Sisterhood is a family you choose. My only Superpower is surrounding myself amongst fierce, funny, intelligent women (especially seasters) who lift each other up and vehemently defend and support one another.

A withitgirl withitwoman recognizes her value, respects her mind, body, soul, and nature, and therefore protects all of it. She shares her values often because the world becomes a better place when your values and actions align.

My values:

I value a genuine love for what I do in life (at work & play).

I value purpose over happiness.

AND kindness over credentials

AND I want to contribute to something meaningful.


Kris's playlist: SURF THE WAVE NOT THE EXPECTATION


Additional Information and Links

ISTO Website and 2019 Annual Impact Report

ISTO Conference Cornwall, UK Information, Registration, Agenda

Journal Community Psychology Practice (JCPP): Surf Therapy around the Globe Issue

JCPP: Surf Therapy: A Scoping Review of the Qualitative and Quantitative Research Evidence

JCPP: Surf Up Youth Mental Health

ISTO Surfline Article

The New York Times: Catch the Wave of Well-Being

SURFER Today: Surf Therapy: A new way to treat stress, anxiety and PTSD


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