On a football field in Boston, several kids gather for an unlikely purpose: supporting each other in group therapy.

At the mention of group therapy, it’s easy to imagine it taking place across a seated circle in a quiet room. But this group therapy is no ordinary mental health program — it involves sprinting, catching footballs, and learning to run defense.

In fact, at first glance, a session might look like any other practice time for young athletes because just like any football team, they run drills, develop strategy, and work on throwing a perfect spiral.

But in these sessions, their coaches aren’t just coaches — they’re therapists. And the teams are made up of kids who have experienced child abuse, incarceration, PTSD, or other challenges.

A Doc Wayne practice session. Photo by Doc Wayne.

For struggling kids like these, traditional talk therapy — which involves a stranger’s office and opening up about issues that are difficult to discuss — often feels too intimidating.

“Many kids don’t want to talk about their issues or don’t really know how to talk about their issues,” explains David Cohen, CEO of the nonprofit Doc Wayne. “They certainly, in many cases, don’t want to sit down at a desk or in a room and talk to a clinician.”

Unfortunately, this is part of the reason why so many kids don’t get the mental health support they need. Of the 1 in 5 kids under the age of 19 who experience mental illness, only an estimated 20-25% are receiving mental health treatment.

That’s why, in order to truly help children, sometimes you need to meet them where they feel comfortable — even if it’s on a football field.

Susan Wayne, who has worked for decades with low-income youth, knows this firsthand. In fact, that’s why she founded Doc Wayne in 2002.

A coach and participant. Photo by Doc Wayne.

She had seen many young people struggle well into adulthood due to lack of proper treatment for their mental illnesses. She also knew how difficult it is to engage youth who don’t thrive in traditional talk therapy.  

But it wasn’t until the death of her brother, Dr. Eli Wayne, a pediatric surgeon and sports enthusiast, that she came up with the idea of a nonprofit named in his honor that would help these kids by combining both of his passions — health and sports.

Research shows that team sports can reduce symptoms of depression and boost kids’ ability to deal with stress, and also that young athletes also tend to have higher levels of confidence and mental wellness.

And that’s how Doc Wayne’s programs, which fuse athletics and mental health care, came to be developed.

One such program is a sports-based group therapy called Chalk Talk.

Here’s how it works: Say a kid gets frustrated after missing a shot in basketball. Instead of letting them get excessively angry or bottle up that frustration with no solution, their coach is there to help them figure out how to channel anger in a healthy way, such as learning from this mistake in preparation for the next drill.

Photo by Tamarcus Brown/Unsplash.

Rather than using clinical terms that kids can’t relate to, like “emotion regulation,” the coach uses coaching language like “step to your strengths.” While the terminology is different, the therapeutic concept behind it is exactly the same, allowing the children to engage in a way that they might not otherwise.

In other words, sports allow the kids to deal with their issues — such anger or impulsivity — without feeling like they’re being forced to.

And that’s why research on this kind of sports-based therapy shows that it is just as effective in supporting mental health as traditional psychotherapy. Participants are learning to deal with their issues using the the same strategies they’d develop through traditional therapy.

Chalk Talk also helps build trust with kids who have experienced repetitive or ongoing trauma, like much of the youth at Doc Wayne. They do this by playing team sports such as soccer, flag football, basketball, and indoor rowing, where they can learn to support each other as teammates.

Photo by Doc Wayne.

This is reinforced when the kids circle up at the end of a session to give each other shoutouts — for instance, complimenting someone’s dribbling skills.

“Everything that we do is all about the team aspect,” says Cohen. “It’s all about learning skills in life that you’ll need to carry on so you can be a contributing member to your own community.”

He continues, “They have to learn how to show up and be present and ... respectful and have empathy for others.”

Today, Doc Wayne helps about 300 children a week — and these kids are seeing a big difference in their lives.

According to research on the nonprofit, they're showing lower rates of aggression and an increased ability to integrate into their communities.

Not only that, but kids are more likely to stay in sports-based therapy because they actually enjoy it. The no-show rate among kids for traditional talk-based therapy sessions is around 40% but at Doc Wayne, it’s only around 20%, according to Cohen.

“Sometimes you’ll see kids actually loving therapy,” he adds, because at Doc Wayne, healing goes hand-in-hand with their favorite sport.

Photo by Doc Wayne.

Cohen remembers observing one boy who wasn’t interested in engaging with the group. For about 15 minutes, the boy sat on the sidelines while the other kids practiced drills with their coach. Then, for another 10 minutes, he threw a ball against a wall by himself. Finally, he quietly joined the group.

He was allowed to do so on his own terms, and Cohen says that’s what helped him discover his own willingness to engage.

For many of the kids who come to Doc Wayne for help, simply having a supportive adult to depend on is a luxury.

That’s why this organization is so helpful: It helps give these kids a reliable support system so that they can begin to trust others to help them through tough times.

“Their lives … have been disrupted in so many ways,” says Cohen. “[So] we make sure that we’re there, that we earn the trust … week in and week out.”