Psychosocial Interventions for the Prevention of Injury in Dance

In this thesis, I investigated aspects of the multi-component stress and injury model, which Williams and Andersen (1998) suggested could be applied in areas beyond sport. Two studies (Studies 1 and 2) were carried out with the goal to develop interventions, which were tested for their efficacy in the reduction of injuries, in a third study (Study 3). The purpose of Study 1 was to investigate whether psychosocial factors, such as stress, anxiety, social support, and coping skills, could predict injuries (frequency and duration) among 105 ballet dancers (101 females; 4 males), using a regression design. The dancers were professional ballet dancers (n = 27), university ballet students (n = 19), and ballet institute students (n = 59), with a mean age of 20.46 years (SD = 5.50). They completed a modified version of the Adolescent Perceived Events Scale (APES) and Sport Experiences Survey (SES), which address life and dance stress respectively, the Sport Anxiety Scale (SAS), the Athletic Coping Skills Inventory-28 (ACSI-28), and a social support for dance measure. Frequency and duration of injuries were recorded for a 10-month period after completion of the psychosocial measures. From the correlation matrix of psychosocial scales and injury, I selected for regression analysis variables that showed at least moderate correlations with the frequency and duration of injury (i.e., peaking under pressure, goal setting/mental preparation, freedom from worry, confidence, negative dance stress, negative life stress). One regression analysis identified freedom from worry and confidence as significant predictors for frequency of injury. A second regression analysis identified freedom from worry and negative dance stress as significant predictors for duration of injury. In Study 2, I examined the sources of stress and coping strategies of Korean professional ballet dancers, using in-depth interviews. Dancers (N = 20) were interviewed to identify the stressors they experienced and the coping strategies they used during practice or performance. Using inductive content analysis, I identified four major sources of stress that emerged from the data: physical (i.e., physical appearance, poor physical condition), psychological (i.e., desire, slump, personality), social (i.e., relationship with a dance director and other dancers), and situational factors (i.e., performance demands, finance). The results demonstrated that physical appearance (e.g., maintaining particular body type, keeping low body weight) was a preeminent problem. I also found that three general dimensions for coping were psychological strategies (i.e., individual cognitive and emotional strategies, avoidance strategies), behavioural strategies (i.e., dysfunctional behaviour, hobby activities, social interaction, dance related behaviour), and physical relaxation. The coping strategies mentioned most frequently in this study belonged to the behavioural strategies dimension. In particular, the dancers employed dysfunctional behaviour (e.g., overeating, drinking alcohol) to cope with stress. Identification of sources of stress and coping strategies not only help to identify the specific stressors and coping skills surrounding dance environments, but also provide a basis for designing intervention programs, which may help reduce stress through developing coping skills. The purpose of Study 3, the final study, was to examine the effects of two psychological interventions designed to prevent injury among dancers by enhancing coping skills. Participants were 35 ballet dancers. They were assigned to three conditions, control (n = 12), autogenic training (n = 12), and a broad-based coping skills condition, including autogenic training, imagery, and self-talk (n = 11). The 12-week interventions were designed on the basis of quantitative and qualitative results from the previous studies in the thesis. For weeks 13 to 24, participants were asked to practice their respective intervention three times a week. During the 24-week period (12 weeks training plus 12 weeks practice) training staff at the dance academies recorded injuries on a record sheet each day. Participants wrote injury records by themselves for another 24 weeks. Multivariate analysis of variance (MANOVA) and univariate tests for each dependent variable showed that the broad-based coping skills condition enhanced coping skills, in particular: peaking under pressure, coping with adversity, confidence and achievement motivation, and concentration. Separate analyses of covariance (ANCOVA), one using pre-intervention injury frequency as the covariate and one using pre-intervention injury duration as the covariate revealed that dancers in the broad-based coping skills condition spent less time injured than those in the control condition. Overall, results indicated that the broad-based coping skills intervention was effective for enhancing targeted coping skills and reducing injury occurrence among Korean ballet dancers, supporting Williams and Andersen’s (1998) model of stress and injury. Because the broad-based coping skills was an intervention designed for particular Korean ballet dancers, based on quantitative and qualitative research, this intervention program may not be applicable to Western dancers. For future research, I recommend the approach I employed in this thesis, as the basis for designing effective and efficient interventions for dancers.