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Certified Athletic Trainers’ Experiences With and Perceptions of Sport Psychology Services for Student-Athletes
Abstract
Nine (5 female, 4 male) certified athletic trainers (ATs) from a National Collegiate Athletic Association Division I institution participated in semistructured interviews about their experiences with sport psychology services and perceptions on the potential role of sport psychology consultants (SPCs) in student-athlete development. Through consensual qualitative research procedures, 3 domains were constructed: knowledge of availability and understanding of sport psychology services, perceptions of sport psychology services for injury rehabilitation, and use of sport psychology services for sport performance. Interacting professionally with SPCs, working with sport teams that use sport psychology services, and receiving mentorship from senior ATs who have "bought in" to sport psychology were identified as underlying factors that influenced ATs' knowledge and use of services. Recommendations for how SPCs can nurture collaborative relationships between themselves and ATs are also provided.
... On the other hand, the psychological preparation of the student-athletes is rarely done by professionals, so the coach has an important role to play in this area of training too. There is evidence that certified athletic trainers interact with sport teams that use professional psychology services or are mentored by senior trainers with knowledge in sport psychology (Zakrajsek et al., 2018). But this does not always qualify them as the most suitable people to evaluate and take measures for the management of the mental state of athletes. ...
The main objective of this study was to assess the presence and the level of anxiety
in the case of students who practise competitive sports. There were 102 participants
(27 females and 75 males) who were selected from within the students of the Faculty
of Physical Education and Sports. At that time, all the students were practising
sports at professional level. The Sport Competition Anxiety Test (SCAT) was applied
and the results showed that the average level of anxiety in the group was low. It was
not related to the athletes' experience or to the competition level, but to gender
and/or type of sports. The female athletes presented a significantly higher level of
anxiety (p=0.0011), and the athletes who practise individual sports were also more
anxious compared to those who practise team sports (p=0.0355). Those involved in
training performance athletes should apply specific methods of lowering anxiety,
particularly, to these categories. When the anxiety level has a negative effect on one
or more aspects of athletic performance, is the moment when anxiety steps into the
vicious circle.
... As the results of this legislation become more apparent now, years later, and as athletes' diverse psychological needs become more recognized, there will likely be a greater demand for interprofessional collaboration (Newman et al., 2019). In fact, when an interprofessional team with distinct mental performance and mental health professionals does exist, those within NCAA athletic departments (e.g., athletic directors, athletic trainers) have recognized the differences between services and expressed value for each type of service (see Eckenrod, 2019;Zakrajsek et al., 2018). Thus, by the time of publication, there may be more athletic departments with providers. ...
... However, despite the merits of this body of research in helping to provide an evidence base to support injured athletes' recovery, a critical appraisal of the literature soon reveals that sport injury psychology researchers have predominately focused on the impact of injury on the athlete and how members of the multidisciplinary team can come together to support the athlete (e.g., Arvinen-Barrow & Clement, 2019). For example, researchers have explored how physiotherapists can help injured athletes with their psychological, emotional, and behavioral responses to injury (Clement, Arvinen-Barrow, & Fetty, 2015) and their adherence to rehabilitation programs (Zakrajsek, Fisher, & Martin, 2018). However, Wiese-Bjornstal (2009) reported, "Injury affects more than the injured; it often also holds health-related consequences for the network of family, friends, teammates, coaching staff and even the larger communities" (pp. ...
The aim of this chapter is to provide a critical review of the literature pertaining to the physiotherapist–injured-athlete relationship. To date, sport psychology researchers have largely only considered how physiotherapists can help injured athletes’ recovery. I argue in this chapter that at least three knowledge gaps remain: (a) the physiotherapist as a “performer” in their own right, (b) appreciation of a more dyadic understanding of the relationship, and (c) accounting for how the wider sporting culture influences transactions between physiotherapists and injured athletes. The chapter begins with a brief introduction explaining the importance of researching this relationship, especially considering the close bond that physiotherapists and injured athletes can form during rehabilitation and throughout their athletic careers. The chapter then explores and critically examines the three identified knowledge gaps further by drawing from other fields of research (e.g., sports medicine, sociology of sport). The chapter then closes with future research areas, which include looking at multiple levels of analysis when studying interpersonal relationships, broadening the conceptual and methodological focus from the individual to a cultural and relational understanding, and developing theoretical frameworks that can be used to further our knowledge and understanding of the physiotherapist–injured-athlete relationship. Critical questions to provoke debate and discussion are also offered.
Generalisation in relation to qualitative research has rarely been discussed in-depth in sport and exercise psychology, the sociology of sport, sport coaching, or sport management journals. Often there is no mention of generalizability in qualitative studies. When generalizability is mentioned in sport and exercise science journals it is often talked about briefly or highlighted as a limitation/weakness of qualitative research. The purpose of this paper is to provide a detailed discussion of generalisation in order to dispel any misunderstandings or myths about generalizability in qualitative research and offer guidance about how researchers might consider generalisation. It is emphasised that it is a misunderstanding to claim that qualitative research lacks generalizability. It is highlighted that statistical types of generalizability that inform quantitative research are not applicable to judge the value of qualitative research or claim that it lacks generalizability. Reasons as to why researchers might consider generalizability in qualitative research are then offered. It is emphasised that generalisations can be made from qualitative research, but just not in the same way as quantitative results are. To help guide how generalisation might be considered, four different types of generalizability are presented: naturalistic generalisation, transferability, analytical generalizability and intersectional generalizability. Practical strategies are also offered for considering generalizability when seeking to publish qualitative research or reflect on already published work. The paper concludes with a set of recommendations to support high quality and rigorous qualitative research for scholars – including journal editors and reviewers – in relation to generalizability.
The primary purpose of this study was to assess National Collegiate Athletic Association (NCAA) Division-I (D-I) certified athletic trainers' (ATCs) perceptions of the benefits of sport psychology services for managing the performance demands of practice and competition (e.g., dealing with pressure, building confidence, improving focus). A secondary purpose was to examine ATCs' support for hiring sport psychology consultants (SPCs) in athletic departments. A total of 659 (341 males, 318 females) NCAA D-I ATCs completed a web-based survey that assessed the aforementioned perceptions and support. ATCs rated the following sport psychology services as most beneficial: managing anxiety and emotion, improving focus, dealing with pressure, and building confidence. Nonparametric testing was used to analyze the influence of personal and situational variables (e.g., gender, previous SPC experience) on ATCs' ratings. ×2 analyses indicated that female ATCs, those willing to encourage SPC service use, and those having previous positive experiences with SPCs rated the benefits of services significantly higher than males, those less likely to encourage service use, and those with negative experiences (p ≤ .001). Logistic regression analysis revealed that gender, work experience, previous encouragement of athletes to seek mental training, and previous positive SPC experiences predicted ATCs' support for employment of SPCs (p ≤ .0001). Findings suggest that positive experiences were important prerequisites for obtaining ATCs' support for and encouragement of SPCs and their services. Building positive relationships by interacting effectively with ATCs and providing services that complement their efforts may facilitate the integration of SPCs within NCAA D-I athletic departments.
This study used a consumer marketing approach to investigate the market for sport psychology positions in National Collegiate Athletic Association (NCAA) institutions. Athletic administrators' (AA) preferences for various sport psychology positions were compared based on time commitment, affiliation, payment, services, and clients. Results indicated that AAs were most attracted to positions that included (a) part-time commitment, (b) athletic department employment, (c) payment via annual salary, (d) both performance and mental health related services, and (d) work with athletes, teams, and athletics staff members. Over two thirds of the 478 AAs sampled were interested in hiring a sport psychology professional to fill that position. It was concluded that the field of sport psychology collaborate across disciplines and emphasize multiple options for meeting the perceived needs of NCAA athletic departments.
The epidemiological transition calls for redefining the roles of the various professionals involved in primary health care towards greater collaboration. We aimed to identify facilitators of, and barriers to, interprofessional collaboration in primary health care as perceived by the actors involved, other than nurses.
Systematic review using synthetic thematic analysis of qualitative research. Articles were retrieved from Medline, Web of science, Psychinfo and The Cochrane library up to July 2013. Quality and relevance of the studies were assessed according to the Dixon-Woods criteria. The following stakeholders were targeted: general practitioners, pharmacists, mental health workers, midwives, physiotherapists, social workers and receptionists.
Forty-four articles were included. The principal facilitator of interprofessional collaboration in primary care was the different actors' common interest in collaboration, perceiving opportunities to improve quality of care and to develop new professional fields. The main barriers were the challenges of definition and awareness of one another's roles and competences, shared information, confidentiality and responsibility, team building and interprofessional training, long-term funding and joint monitoring.
Interprofessional organization and training based on appropriate models should support collaboration development. The active participation of the patient is required to go beyond professional boundaries and hierarchies. Multidisciplinary research projects are recommended.
© The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Context:
Despite the Psychosocial Strategies and Referral content area, athletic trainers (ATs) generally lack confidence in their ability to use this information.
Objective:
The current study's primary purpose was to determine (a) perceived psychological responses and coping behaviors athletes may present to ATs, (b) psychosocial strategies ATs currently use with their athletes, (c) psychosocial strategies ATs deem important to learn more about, and (d) ATs' current practices in referring athletes to counseling or sport psychology services.
Design:
Mixed-methods study.
Setting:
Online survey containing both quantitative and qualitative items.
Patients or other participants:
A total of 215 ATs (86 male, 129 female), representing a response rate of 22.50%.
Main outcome measure(s):
The Athletic Training and Sport Psychology Questionnaire.
Results:
Stress/anxiety (4.24 ± 0.82), anger (3.70 ± 0.96), and treatment adherence problems (3.62 ± 0.94) were rated as the primary psychological responses athletes may present upon injury. Adherence and having a positive attitude were identified as key determinants in defining athletes' successful coping with their injuries. The top 3 selected psychosocial strategies were keeping the athlete involved with the team (4.57 ± 0.73), using short-term goals (4.45 ± 0.67), and creating variety in rehabilitation exercises (4.32 ± 0.75). The top 3 rated psychosocial strategies ATs deem important to learn more about were understanding motivation (4.29 ± 0.89), using effective communication (4.24 ± 0.91), and setting realistic goals (4.22 ± 0.97). Of the sample, only 59 (27.44%) ATs reported referring an athlete for counseling services, and 37 (84.09%) of those who had access to a sport psychologist (n = 44) reported referring for sport psychology services.
Conclusions:
These results not only highlight ATs' current use of psychosocial strategies but also their desires to increase their current knowledge and understanding of these strategies while caring for injured athletes.
Primary care is the central pillar of health care. The increasingly complex health needs of the population and individual patients in a changing society can only be met by promoting interprofessional collaboration (IpC) within primary care teams. The aim of this Position Paper of the European Forum for Primary Care (EFPC) is to analyse how to improve IpC within primary care teams. Clarification of the concept is the first step. Conditions to improve IpC are based on the education of healthcare professionals, adapting human resources, the occupational structure and the skill-mix in primary care. These conditions, dependent on contextual factors, have a major influence on the development of IpC. They can be developed and organised at different levels: national, regional or team level. A framework is also needed to evaluate the level of collaboration within teams. Examples of good practice throughout Europe issued from the EFPC network illustrate this.
ObjectivesDespite the gradual growth of psychology of injury literature, thus far few studies have investigated physiotherapists' personal experiences in using psychology in their work. Therefore the purpose of this study was to explore the physiotherapists' personal experiences in using psychological intervention techniques as part of sport injury rehabilitation.DesignThis study adopted a qualitative approach when exploring chartered physiotherapists' personal experiences in using psychological intervention methods in their work with injured athletes. Semi-structured interview schedule was devised and the data obtained was analyzed by using the Interpretative Phenomenological Analysis (IPA; Smith (1996)).MethodsSeven (4 female, 3 male) physiotherapists working in sports medicine in the United Kingdom participated in the interviews.ResultsFollowing the IPA analysis, the physiotherapists in this study were very open about their lack of formal training in sport psychology, and appeared to be knowledgeable and comfortable in using goal setting and encouraging social support. Familiarity with, and experiences of using other techniques (i.e., imagery, relaxation, and self-talk) seemed to be less apparent. The physiotherapists also stressed the importance of ‘gut-feeling’ and experiential knowledge.ConclusionsThe study provides a valuable insight into physiotherapists' real-life experiences in using psychological interventions. Based on the findings, it can be recommended that further training on a range of psychological techniques would be useful.
Despite team building (TB) methods having their roots in organizational development (OD), this theoretical background has been seldom applied in sport. The purpose of this study was to provide chronological narrative review of the recent (1997-2008) sport-related research on team building. A total of 28 articles were reviewed. The findings suggest that team building has a positive effect on group functioning, especially increasing group cohesion. It was also apparent that thus far, the team building research in sport is mostly focused on cohesion. In conclusion, it would be advantageous for researchers to familiarize themselves with the existing organizational development research tradition. This could assist in establishing a clear definition and a solid theoretical framework for team building in sport, as well as preventing sport researchers making the same mistakes made in work organizations. By doing so, team building, and the development of group functioning and performance, could become an even more promising area for sport science research
The authors reviewed the application of consensual qualitative research (CQR) in 27 studies published since the method's introduction to the field in 1997 by C. E. Hill, B. J. Thompson, and E. N. Williams (1997). After first describing the core components and the philosophical underpinnings of CQR, the authors examined how it has been applied in terms of the consensus process, biases, research teams, data collection, data analysis, and writing up the results and discussion sections of articles. On the basis of problems that have arisen in each of these areas, the authors made recommendations for modifications of the method. The authors concluded that CQR is a viable qualitative method and suggest several ideas for research on the method itself.
To assess, on a national level, the views of chartered physiotherapists with regard to the psychological content of physiotherapy practice.
A postal survey to a national list of sport injury and physiotherapy clinics was employed.
A total of 361 responses were included in the descriptive statistical and qualitative analyses.
The Physiotherapist and Sport Psychology Questionnaire (PSPQ).
On average, physiotherapists felt that athletes were psychologically affected 83% of the time when injured. Key psychological characteristics were also identified in athletes who cope/do not cope successfully with their injuries. Physiotherapists reported using psychological techniques in their work and expressed the need for further training in the field. Only 24.1% of the physiotherapists stated having accesses to accredited sport psychologists.
Results suggest that UK physiotherapists possess practical experiences and good awareness for psychological aspects of injuries and acknowledge the importance of treating a range of psychological conditions.
Sport injury rehabilitation has moved from predominately physical treatment to a more holistic care. However, limited research has explored the views and experiences of those involved in such an approach. The purpose of this study was to preliminarily investigate sport psychology consultants’ (SPCs’) views and experiences of an interprofessional team approach to sport injury rehabilitation. A cross-sectional online survey previously used with athletic trainers was distributed via a US-based sport/exercise psychology list-serve (N = 1245). A total of 62 (27 men, 35 women, M age 38.2 years, age range: 22–73 years) participants with 10.6 (SD = 9.8) years of experience as an SPC were included in the final analyses. On average, SPCs felt that it was very important (M = 6.6; SD = 0.6) for athletes to have access to an interprofessional care team. Of the sample, 64.5% (n = 40) typically worked as part of an interprofessional care team 44.7% of the time. The SPCs (n = 28; 45.2%) also indicated that the primary treatment providers (e.g., athletic trainer, physical therapist) were typically serving as the primary point person for such teams. Since gaining entry to sport medicine can be an area SPCs struggle with, building effective working relationships with treatment providers can help promote and increase SPCs involvement in providing holistic, interprofessional care to athletes with injuries. To ensure athletes’ successful biopsychosocial return to sport, different individuals and professionals should work together for the benefit of the athlete by adopting holistic care during sports injury rehabilitation.
Nine certified athletic trainers (ATs) from one National Collegiate Athletic Association Division I institution participated in semi-structured interviews about their understanding of sport psychology and use of psychological strategies in their work with injured athletes. Through Consensual Qualitative Research (Hill, 2012 Hill, C. E. (2012). Consensual qualitative research: A practical resource for investigating social science phenomenon. Washington, DC: American Psychological Association.) procedures, three major domains were constructed: (a) Recognition of the common psychological challenges of injury rehabilitation; (b) Knowledge and understanding of sport psychology; and (c) Utilization of sport psychology skills and strategies for rehabilitation. While ATs utilized basic psychological strategies (e.g., goal-setting, reassurance) during injury rehabilitation, findings support the need for an interprofessional team approach to enhancing psychological recovery.
Context:
Certified athletic trainers (ATs) are responsible for integrating relevant professionals into the rehabilitation team to assist with the holistic care of injured athletes.
Objective:
To explore National Collegiate Athletic Association Division I (DI) ATs' experience with sport psychology consultants (SPCs), willingness to encourage athletes to use SPCs for injury rehabilitation, and perceptions of the benefits of sport psychology services.
Design:
Quantitative study.
Setting:
A Web-based survey was administered to a national sample of DI ATs.
Patients or other participants:
A total of 659 (341 men, 318 women) ATs completed the survey.
Main outcome measure(s):
Athletic trainers' experience with SPCs, willingness to encourage athletes to seek sport psychology services, and perceptions of the benefits of those services in injury-rehabilitation settings were self-reported using a rating scale that ranged from 1 (never or not at all) to 5 (definitely or extremely).
Results:
Logistic regression revealed that the availability of SPCs, previous encouragement to athletes to seek sport psychology services, and previous positive interactions with SPCs predicted the ATs' willingness to encourage athletes to use these services (P < .0001). The services ATs rated the highest for injury rehabilitation were managing anxiety and emotion, improving coping techniques, and building confidence (ie, confidence in returning to sport and building confidence). Chi-square analyses indicated that female ATs' ratings of perceived benefits were higher (P ≤ .001) than those of male ATs, and the ratings of ATs who were likely to encourage the use of SPCs were higher (P ≤ .001) than those who were unlikely to encourage SPC service use.
Conclusions:
Athletic trainers in our study who had previous positive SPC experiences were most likely to use SPCs and their services during the injury-rehabilitation process. Possible implications are offered for how ATs interested in sport psychology services might call on SPCs to complement their work with injured athletes.
Surveyed 115 athletic trainers (aged 18–48 yrs) on the use of psychological strategies with injured athletes. Ss responded to Likert rating scales (developed in a pilot study with 26 similar Ss) on athlete characteristics, efficacy of psychological strategies, and perceived importance of trainer knowledge about psychological strategies. Ss distinguished between athletes coping most vs least successfully with injury on characteristics of willingness to listen, positive attitude, intrinsic motivation, and willingness to learn about the injury and rehabilitation techniques. Trainers rated effective psychological techniques for facilitating athlete recovery as good interpersonal communication skills, positive reinforcement, coach support, and keeping the athlete involved with the team. Using a positive communication style and setting realistic goals were some of the strategies rated as most important. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
"Psychosocial Intervention and Referral" is one of the 12 content areas established by the National Athletic Trainers' Association Education Council and is required to be taught in athletic training education programs (ATEPs). The perceived preparation of athletic trainers (ATs) in this content area has not been evaluated.
To explore the preparation level of recently certified ATs within the content area of "Psychosocial Intervention and Referral."
Qualitative design involving semistructured, in-depth, focus group interviews.
Interviews were conducted at 2 National Collegiate Athletic Association Division I institutions in 2 regions of the United States.
A total of 11 recently certified ATs who met predetermined criteria were recruited. The ATs represented a range of undergraduate ATEPs and current employment settings.
Focus group interviews were transcribed verbatim and analyzed deductively. Peer debriefing and member checks were used to ensure trustworthiness.
The ATEPs are doing an adequate job of preparing ATs for many common communication and interpersonal issues, but ATs report being underprepared to deal with athlete-related issues in the areas of motivation and adherence, counseling and social support, mental skills training, and psychosocial referral.
Limitations of undergraduate ATEPs regarding preparation of athletic training students within the "Psychosocial Intervention and Referral" content area were identified, with the goal of improving athletic training education. The more we know about the issues that entry-level ATs face, the more effectively we can structure athletic training education.
Health professionals (ie, physical therapists, athletic trainers) can play an integral role in the psychological recovery from injury.
To examine health professionals' perceptions of the roles they play and their influence on the psychological recovery of their clients.
A qualitative design using semistructured interviews that were transcribed and analyzed using interpretational analyses to reveal themes.
4 rehabilitation clinics specializing in sport- and physical-activity-related injuries.
18 participants (17 physical therapists, 1 athletic trainer) with a mean age of 36 years.
Using thematic coding of the interview data, general-dimension data themes identified were centered on the roles of rapport builder, educator, and communicator. Health professionals perceive that they play important roles in the psychological recovery of their clients in spite of a lack of professional training in psychology and strive to create a caring and supportive environment. Results demonstrate the perceptions of the roles they play and the influence they have on the psychological component of the recovery process.
To assess athletic trainers' perceptions with regard to (a) their role in counseling athletes, (b) how qualified they felt to address counseling issues, and (c) current training room procedures for providing psychological services to athletes.
A 47-item, open-ended survey was administered to Division I certified athletic trainers who volunteered to participate.
Fourteen Division I certified athletic trainers (mean age, 33 yr; range, 24 to 47 yr) volunteered to participate in the survey. They included five head athletic trainers, five assistant athletic trainers, three graduate assistants, and one associate director of athletics and sports medicine.
Survey results were tabulated and reported in percentages.
Athletic trainers felt that their roles went beyond the care and prevention of athletic injuries, yet they did not necessarily feel qualified to counsel athletes. Most athletic trainers were familiar with on-campus student support services to which student athletes with personal issues could be referred for assistance, but none had access to a sport psychologist.
It is recommended that the NATA include counseling preparation in curriculums and that continuing education be offered to provide certified athletic trainers with current information and skills for delivering psychological services to athletes.