The Role of Sport Psychology and Sports Psychiatry


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?


  • The American Psychological Association (APA) and APA Division 47 (Society for Sport, Exercise and Performance Psychology) defined sport psychology (SP) as including:

    • Helping athletes apply psychological principles to achieve improved or optimal sport performance and MH.

    • Increasing knowledge regarding the impact of sport/exercise and physical activity on psychological development, health, and well-being over the lifespan.

  • SP is seen as a proficiency that uses psychological knowledge and skills to address the well-being of athletes, developmental aspects of sports participation, and systemic issues within sports settings and organizations.

  • In a multidisciplinary context, SP is increasingly seen as a strong component of the sports medicine team.

  • Psychology has played a well-established and vital role in physical medicine and rehabilitation (PMR) programs; hence, its application in sports medicine is natural.

  • There are increasing references to psychological factors or the influence of emotional/MH factors on physical health and sports injury recovery and performance.

  • Although it is clear that physical injuries, illness, or disease can directly affect athletic performance and/or participation, psychological factors (broadly defined to include behavioral, emotional, or cognitive patterns; personality variables; developmental or adjustment issues; or diagnosable clinical issues) are also critically important to optimal athletic performance and injury recovery.

  • Within the sports medicine team, sport psychologists can be involved in psychological care and consultation with athletes at all levels of competition.

  • Sport psychologists use their training and experience to provide a unique contribution to the sports medicine team in dealing with injuries. They can address factors (e.g., stress) that may influence the risk of injuries and the psychological factors related to recovering from injury. Sport psychologists can help in the management of concussion patients with prolonged/persistent symptoms, many of which are often associated with emotional or psychological or psychiatric factors.

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?

Definition and Qualifications

  • A sports psychiatrist is a licensed physician who has completed medical school and residency training in an accredited psychiatry residency training program. They may have completed additional fellowship training in a variety of accredited subspecialty areas (e.g., addiction psychiatry/medicine, child and adolescent psychiatry, psychosomatic medicine, etc.), noting that sports psychiatry is not an accredited subspecialty of psychiatry.

  • Their area of clinical focus is most commonly the diagnosis and treatment of MH symptoms and disorders in athletes. They may also work with athletes on psychological performance enhancement and may work with nonathletes and athletes on the use of exercise as a preventive measure and treatment for MH symptoms and disorders.

  • Sports psychiatrists ideally will have furthered their education and training in the field of sport and MH, such as through obtaining the International Society for Sports Psychiatry Certificate of Additional Training in Sports Psychiatry, through the International Olympic Committee’s Diploma Program on MH in Elite Sport, and/or through mentored clinical experiences with experienced sports psychiatrists in the field.

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