The Role of Sport Psychology and Sports Psychiatry

Introduction

Athlete mental health (MH) symptoms and disorders have emerged as a major focus within athletic/sports organizations, international and national sport governing bodies, and the sports medicine environment. This focus has resulted in the development of multiple consensus statements and guidelines regarding MH issues in athletes and articles aimed at increasing awareness and reducing stigma. The sport psychology and sports psychiatry fields have been leaders in this effort. The inclusion of sport psychologists and sports psychiatrists within the sports medicine team can provide athletes with additional support in dealing with MH issues and psychological factors that affect their functioning in both sports and life.

What Is Sport Psychology?

Qualifications of a Sport Psychologist

• Influence of history: SP has emerged from its roots in motor learning and kinesiology research and applications of clinical and counseling psychology principles to athletic settings. As a result, there are a range of SP practitioners, from academicians and researchers in exercise and sport science to applied/clinical or counseling psychologists.

• US Olympic and Paralympic Committee (USOPC): In the early 1980s, the USOC created a registry of sport psychologists. Over the years there have been ongoing efforts to expand the registry to include only those practitioners who meet the standards and certain criteria in their educational training and supervised practice in SP. USOPC Registry members are often involved in consulting with elite/Olympic athletes or teams or serve as regional referrals to athletes or teams.

• Association for Applied Sport Psychology (AASP)—Certified Mental Performance Consultant (CMPC) status: AASP reviews and approves individual credentials, coursework, and experience, certifying that these consultants meet the standards in their educational training in sport science and psychology. Consultants can teach athletes specific mental, behavioral, psychosocial, and emotional control skills for sports and physical activity. Consultants with clinical or counseling training are qualified to work with athletes who have MH symptoms or disorders.

• Importance of licensure: For clinical issues and/or emotional disorders in athletes, a referral to a licensed mental healthcare provider is essential; a referral to a provider who has experience in working with athletes is optimal. Other providers/practitioners may offer “sport psychology consultation,” focusing on mental skills training or performance enhancement. Qualified clinical or counseling psychologists may also provide performance enhancement consultation. The title of “psychologist” is typically one that requires licensure by states; therefore, practitioners identifying themselves as “sport psychologists” should be licensed and have competency (education and training) in the field of sport and performance psychology.

Sport Psychologist Roles

• A psychological skills training consultant typically educates athletes or teams about mental skills that enhance performance. These skills include goal setting, relaxation, imagery or visualization, positive self-talk, arousal regulation, increased concentration/focus, precompetitive routine/mental preparation, adaptability/handling pressure, time management, and general communication skills. Team consultation can enhance communication and cohesion among athletes.

• A licensed clinical or counseling sport psychologist may provide the same services that a psychological skills training consultant can, but they can also provide assessment and interventions to athletes dealing with MH symptoms and disorders. Assessments can include the following:

  • Assessment or diagnosis of a presenting issue and identifying etiology and/or contributing factors, which may include acquiring a detailed understanding of personal and sport-specific issues or problems.

  • Interview, behavioral observation, psychological testing, neuropsychological testing, and completion of inventories or questionnaires.

  • Integration of an athlete’s predisposing factors, precipitating factors, and current maintenance factors.

  • A specialized role for a clinical sport psychologist with training and experience as a neuropsychologist involves evaluation and consultation regarding sport concussion. This role involves evaluation of neurocognitive, emotional, and reported physical symptoms after a concussion. Sport neuropsychologists may use neuropsychological testing to assess cognitive status and provide inputs to team physicians and/or the sports medicine team (see Chapter 45: “Head Injuries”). In addition, sport neuropsychologists can evaluate, and in certain cases treat, the often overlooked emotional symptoms of concussion.

What is Sports Psychiatry?