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I’ve seen firsthand the surge in media coverage of athletes’ mental health, and the growing need for specialized mental health services at all levels of sports. Working as a concierge sports & performance psychiatrist with players across the NBA, MLB and NFL, I’ve seen the transformative power that working with a sports psychologist can have on an athlete’s wellbeing. Not only does this engagement positively impact an athlete’s professional life, it also benefits their personal life, as they learn how to deal with stressors and set healthy boundaries with those around them.
A multidisciplinary approach is often taken when addressing mental health issues in athletes, and these key professionals typically include sports psychologists, mental performance coaches, sport and performance psychologists, counselors, etc. “Incorporating a sports psychologist into the team environment dramatically increases the success of both the athletes and the high-performance teams that support them,” says Adam Loiacono, PT, DPT, CSCS, former Director of Rehabilitation for the NBA’s Phoenix Suns.
What is a Sports Psychiatrist?
Sports psychologists often work with individual athletes, sports teams, and organizations. When sports psychologists are placed in professional sports team settings, they often provide a variety of services, including education, workshops, policy development, emergency action plans, and individual services. Treatment interventions for athletes can include medication, psychological therapy, and lifestyle modifications.
“Sports psychiatrists are key members of the sports medicine and performance team and have broad responsibility for the overall management of the general health and mental health of athletes, coaches, team staff and their families,” says David R. McDuff, MD, author of Sports Psychiatry: Strategies for Life Balance and Peak Performance and a member of the International Olympic Committee’s Mental Health Working Group.
How do I become a sports psychiatrist?
According to the American Psychiatric Association, a psychiatrist is a physician or osteopath who specializes in the “diagnosis, treatment, and prevention of mental, emotional, and behavioral disorders,” while a sports psychiatrist is a psychiatrist with additional training and expertise in diagnosing and treating mental illness in athletes.
The International Society of Sport Psychiatry (ISSP), founded in 1994, has contributed greatly to the development of the specialty of sport psychiatry through its growing membership and collaboration with sports psychiatry clinical and research groups around the world, as well as the new national certification system by the American Board of Sport and Performance Psychiatry, which is also committed to advancing the field and maintaining the highest standards of certification, education, and professional practice for board-certified psychiatrists working in sport.
What is the primary role of a sports psychiatrist?
Sports psychiatrists provide mental health evaluations and diagnoses (commonly mood disorders, anxiety disorders, ADHD, substance use disorders, and eating disorders) for the athletic population. “To accurately assess the problem and diagnosis, we must consider the stressors and life contours unique to elite athletes,” says Victor Schwartz, MD, senior associate dean for health and student life at CUNY School of Medicine. Once the evaluation is complete, treatment may include medication use, providing psychotherapy, and recommending various lifestyle changes. “Treatment decisions must incorporate issues of flexibility of care, timing of drug testing, and special susceptibility to the effects of drugs that may be harmless in the general population but can be very confusing for elite athletes,” says Schwartz. I have seen how harmful it can be when athletes are treated by psychiatrists who are not board certified or familiar with sports psychiatry, with many complexities to consider, such as policies regarding controlled substances and the potential effects of drugs on performance.
Brady Howe, MS, ATC, CSCS, former vice president of health and performance for the NBA Phoenix Suns, explains the importance of mental health programs and policy development that sports psychologists bring to teams and organizations. “There are countless psychological obstacles that athletes and coaches experience in their pursuit of greatness, but with the help of a sports psychologist, team members can stay focused, be more resilient, maintain high levels of motivation, and ultimately optimize performance and consistency,” says Howe. Sports psychologists support all team members and athletes during mental health crises. To help teams prepare for potential crises, sports psychologists are often involved in creating mental health emergency action plans that are distributed throughout the organization.
Sports psychologists provide support and education to athletes, coaches, families, agents and others involved in supporting athletes. “Sports psychologists can also help address team and interpersonal dynamics that can be intense and complex in highly competitive environments, and they can help teams establish systems of care that better address the special needs of their athletes,” says Schwartz, who has served as a consultant for several years to the NBA’s Mind Health program, the NCAA, USOPC and the NFL.
Sports psychiatrists support high-performance staff “by educating them on the right tools, teaching recognition for certain emotional signs, and providing mental skills training to help better support the emotional journey that athletes endure,” says Loiacono. This subspecialty of psychiatry really helps prepare athletes and high-performance team staff psychologically to manage the high-pressure environment of sport.
Treating athletes requires a great deal of coordination of care with other professionals. “Working alongside team physicians, athletic trainers, mental performance consultants and strength and conditioning staff, sports psychologists are uniquely positioned to support optimal performance, life balance, stress control, injury recovery, substance abuse prevention and mental health and wellbeing,” says McDuff. “This interprofessional team approach is the future and will ensure the expansion of a holistic approach in a safe and supportive team environment,” he continues.
“The ultimate goal of team sports is to develop high-performance teams and cultural models that allow each athlete to succeed,” Howe said, and sports psychologists play a key role in helping progress toward achieving these goals.
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Disclaimer: I serve on the board of directors of the American Board of Sports & Performance Psychiatry, a 501(c)6 non-profit organization.
