Development of the athlete: A resource manual for clinicians working with elite adolescent male athletes

Over recent decades, adolescent athletic participation has grown in the United States. The rise in participation means that mental health clinicians who work with adolescents are likely increasingly coming in contact with young athletes facing issues directly related to sports. The issues facing adolescent athletes create additional challenges that should be addressed in treatment to improve overall psychological well-being and to promote healthy development. In order to best meet the general mental health needs of these clients, clinicians need to be aware of the unique stressors and issues they frequently face. A resource manual was created to guide clinicians working with elite male athletes between the ages of 12 and 18 years in order to help them realize the benefits and avoid the adverse consequences that may be associated with elitelevel sports participation. The manual was developed to be a resource for mental health clinicians seeking help in understanding the challenges faced by elite-level adolescent male athletes, guidance in identifying therapeutic interventions likely to be effective in addressing those challenges, and clarification of the mental skills training typically conducted by sport psychologists. The manual’s content was informed by both a review of the relevant scholarly literature and by interviews conducted with a former elite adolescent athlete, a sports psychologist, and a mental health clinician who has worked with male adolescent athletes. Following a discussion of some strengths, limitations, and potential modifications to the current manual, plans for evaluating and disseminating it are described. DEVELOPMENT OF THE ATHLETE MANUAL 1 Chapter I. Introduction Organized sports have been part of human experience for centuries (Tomlinson & Young, 2011). Throughout much of human history, people have participated in sports to reap a variety of physical, emotional and social benefits. The extant literature suggests two fundamental mechanisms through which these benefits accrue. Some, including mental and physical health benefits resulting from exercise and competition, may derive directly from participating in the sport itself. In addition to these direct benefits from physical activity, sports provide a context in which life skills applicable to other domains of functioning are acquired (Hansen, Larson & Dworkin, 2003; Theokas, 2009). These often derive from the ethos and social components associated with sports participation related to factors such as camaraderie, teamwork, and sportsmanship (Gould & Carson, 2008). Benefits of Sports for Participants Sports that require physical activity have been associated with numerous physical benefits including increased cardiovascular endurance, lower body fat and increased physical fitness (Haskell et al., 2007). Participation in physically active sports and exercise have also been implicated in the prevention of diseases including Alzheimer’s disease, Parkinson’s disease, heart disease, obesity and hypertension (Deslandes et al., 2009; Donaldson & Ronan, 2006; Haskell et al., 2007). Further, sports and physical exercise have been utilized in treatment and rehabilitation for a variety of physical and neurological disorders and diseases including stroke, various forms of cancer, diabetes, and osteoporosis (Kwakkel et al., 2004; Warburton, Nicol, & Bredin, 2006). In addition to physical health benefits, sports have been implicated in improving psychological health and well-being (Donaldson & Ronan, 2006). Participation in formal sport DEVELOPMENT OF THE ATHLETE MANUAL 2 is related to higher levels of perceived behavioral competence and a sense of mastery among participants (Donaldson & Ronan, 2006). Additionally, sports provide numerous self-concept related benefits including higher levels of self-esteem and self-efficacy (Donaldson & Ronan, 2006; Gould & Carson, 2008) as well as a stronger sense of social identity (Eccles, Barber, Stone, & Hunt, 2003). Research suggests that sports may also increase a participant’s resiliency and emotional regulation skills (Fredricks & Eccles, 2008; Hansen et al., 2003). Furthermore, reviews have suggested that exercise is an effective treatment for mild to moderate depression as well as the prevention of depression (Deslandes et al., 2009). Indeed, clinical evidence has demonstrated that exercise has a positive relationship with the outcomes of a number of disorders, improving quality of life for individuals with depression, Parkinson’s disease, and Alzheimer’s disease (Deslandes et al., 2009). There are also numerous social benefits that can be garnered from sports because of the context that competition provides. In addition to the development of sport-specific skills and competencies, sport is commonly considered a medium or tool through which other life skills are taught, including, but not limited to, teamwork and leadership (Theokas, 2009). Participants learn ways of handling conflict with other people as well as working effectively with teammates, coaches, and other adults (Gould & Carson, 2008; Zimmer-Gembeck & Skinner, 2008). Thus, multiple aspects of intrapersonal and interpersonal development are promoted by participation in sports. DEVELOPMENT OF THE ATHLETE MANUAL 3 Objectives and Current Status of Sport Psychology Researchers and clinicians alike have sought to identify specific ways to help athletes realize the various benefits conferred by sports participation. As a result, the field of sport psychology developed to further the scientific bases underlying athletic performance and its association with various components of well-being. The American Psychological Association (APA) defines sport psychology as "the scientific study of the psychological factors that are associated with participation and performance in sport, exercise and other types of physical activity” (as cited in Portenga, Aoyagi, Cohen, Balague, & Harmison, n.d., p.3). According to the Association for Applied Sport Psychology (AASP), a primary goal within the profession involves working to facilitate optimal involvement, performance, and enjoyment in sport and exercise (as cited in Aoyagi, Portenga, Poczwardowski, Cohen, & Statler, 2012). In pursuit of these objectives, the work of sport psychologists encompasses several different theories and interventions in working with athletes, including mental skills training for peak performance, contextual issues for consultation in sport settings, developmental and social aspects of sport, and biobehavioral bases of sport and exercise (Stapleton, Hankes, Hays, & Parham, 2010). However, despite the rapid growth of sport psychology and increases in the number of published research articles on sports psychology treatments, relatively little attention has been paid to the application of sports psychology to adolescent athletes. Aims of the Chapter The initial goal of the current chapter is to describe the field of sport psychology. This will entail outlining the history of sport psychology, including brief discussions of the growth of research regarding treatment and the bases of modern sport psychology. The chapter will also examine some current limitations of sport psychology research, including the lack of studies DEVELOPMENT OF THE ATHLETE MANUAL 4 devoted to working with adolescent athletes. Finally, the chapter will examine the apparent need for sport psychology services for young athletes given rising rates of adolescent sport participation and competition. In addition to describing the field of sport psychology, the chapter will discuss current issues and challenges facing adolescent athletes that may affect their development and overall well-being. Further, the chapter will specify potential risks involved in sports participation. Finally, the chapter will discuss the rationale and aims for the proposed project. Overview of Sport Psychology Historical origins. The origins of sport psychology are often traced back to Coleman Griffith, a psychologist and college professor who, in the 1920s and 1930s, focused on the performance of athletes as it related to psychological factors (e.g., emotional health, stress, anxiety) (Aoyagi et al., 2012). In addition to working clinically with athletes, Griffith wrote numerous publications on the emotional psychology of athletics and eventually worked as a consultant for numerous professional and college teams (Weinberg & Gould, 2010). In the 1960s, Bruce Ogilvie’s work with athletes, like that of Griffith had its foundations in clinical psychology but emphasized performance skills training (e.g., imagery, behavioral rehearsal) rather than psychological factors of athletes (Aoyagi et al., 2012). The work of Griffith, Ogilvie and other early psychologists working with athletes was not empirically based but was conducted as an extension of their training as clinical psychologists. That is, their work emphasized the mental aspects of competing at the highest level of competition by focusing on either developing an athlete’s overall well-being or specific psychological factors more directly related to performance. DEVELOPMENT OF THE ATHLETE MANUAL 5 It was not until the 1960s and 1970s that sport psychology research began in academia, beginning in kinesiology departments (Aoyagi et al., 2012). Whereas previous work with athletes focused largely on their global well-being, this kinesiology-based work was designed solely to enhance performance. The research being conducted in kinesiology involved a range of studies regarding how motivation, emotion and other psychological processes affected the performance of athletes. Concurrent with the early work in kinesiology departments, sport psychology was utilized by clinical psychologists, who worked with athletes to overcome their psychological problems in order to enhance overall well-being (Aoyagi et al., 2012). While performance enhancement may have been a byproduct of treatment, the focus of clinical psych