Waves for Change (W4C) is a mental health prevention program that combines surfing with evidence-based mind and body therapy for youth growing up in adverse environments in South Africa. Through access to safe spaces, caring and consistent mentors, and the provision of weekly surf therapy sessions, W4C teaches youth the skills to cope with stress, regulate behavior, and build positive relationships. Surf therapy is delivered by coaches from local communities who act as caring and consistent adults that youth can connect with and relate to. Waves for Change offers a blueprint for embedding sport therapy interventions within communities to address mental health in an accessible and stigma free way.