SLIDE 1
Workshop on Essential Counseling Skills for the Athletic
by Leonard Zaichkowsky, Ph.D. Frank Perna, Ed.D, Ph.D Jim Howland, LCSW Boston University
SLIDE 2 Workshop Objectives
- Learn the range of psychological reaction to injury.
- Recognize physical rehabilitation as an opportunity
to facilitate significant learning and development
- Identify critical self-regulation skills to be
developed during rehabilitation.
- Generate practical methods of facilitating critical
psychological skill development in injured athletes.
- Differentiate between typical emotional response to
injury, and more severe psychological distress.
- Understand the importance of referral to a mental
health counselor/psychologist
SLIDE 3 The Range of Injuries
“Simple”-quick recovery
To
“Nasty” –long term recovery or career ending
SLIDE 4 Model of Appraisal of Injury and Adjustment
Cognitive Appraisal
(interpretation of injury)
Personal Factors
(disposition/history)
Situational Factors
(environmental characteristics)
Emotional Response
(anger, depression, relief)
Behavioral Response
(adherence to rehabilitation)
SLIDE 5 Psychological Process Models
Grief / thanatological Cognitive appraisal/risk models
Emotional response Appraisals Events Behaviors
SLIDE 6 Signs of Problematic Adjustment
Depression, confusion,
apathy, mood swings, withdrawal
Obsession with playing
again
Denial - “no big deal” Dwelling on minor
complaints
Feelings of guilt/letting the
team down
Dependence on trainer or
h b
SLIDE 7
Normal emotional responses
TEMPORARY
Sadness Feelings of isolation Irritation Neutral Unmotivated Frustration Anger Decrease in appetite Minor sleep disturbance
SLIDE 8
Abnormal/Clinica l Range
Ongoing Temporary
Rapid weight loss or gain, or disordered eating pattern Change in appetite Rage Anger Frequent crying or emotional outbursts Frustration Apathetic Unmotivated Numb Neutral Explosive Irritated Withdrawal Feeling isolated Depression Sadness
Normal/Subclinical Range
SLIDE 9 Rehab as an opportunity
Unique challenges
Achievement required, no awards Personal accountability
Unique access
Daily One-on-one “present other” in struggling
Time
SLIDE 10 What’s the difference?
Injured athletes
Greater negative affect Lower self-esteem Higher levels of depression
Course of emotional state
From negative to positive Degree of shift dependent upon actual &
perceived rehab success
SLIDE 11 How & why you are KEY!
Perception of AHCPs by athletes
Robbins & Rosenfeld, 2001
– AT’s provide more support than coaches – AT’s social support positive effects Social support Uncertainty reduction
via supportive communication
Reduces:
– Ambiguity – Complexity – Unpredictability
Provides:
– Increased feelings of personal control – Realistic alternatives to a stressful situation Skill
SLIDE 12
Effective Communication
Good communication skills build trust,
rapport, and respect
Establishment of a strong relationship Active listening -
clarifying/paraphrasing
Empower the athlete Nonjudgmental empathy
SLIDE 13
Listening Support
Nonjudgmental listening EX:
SLIDE 14
Psychological Skills Development
Perseverance Patience Positive self-talk Communication Courage Goal setting & attainment Engagement Ownership/responsibility
SLIDE 15
Types of Social Support
Multidimensional concept (Richman et al., 1993 )
SLIDE 16 Emotional Support
Provider acts in caring & comforting
ways
Consistency Believability
EX:
SLIDE 17
Emotional Challenge
Challenge made to athlete to help
him/her evaluate attitudes, values, feelings
Accountability EX:
SLIDE 18
Reality Confirmation Support
Confirming the athlete’s perspective on
the situation
EX:
SLIDE 19
Task Appreciation Support
Appreciation of athlete’s efforts EX:
SLIDE 20 Task Challenge Support
Perceived challenge of the athlete’s way
- f thinking about an activity to
motivate him/her to greater involvement
Reframing EX:
SLIDE 21
What does it take?
Courage Connection Communication
SLIDE 22
Referral
Have a counselor / psychologist in
mind
Introduce the notion of a referral gently Discuss what it might look like Facilitate a first meeting
SLIDE 23
Some Skills Needed by Injured Athletes
goal-setting decision-making relapse prevention training self-monitoring stress management use of social support
