Applied Sports Psychology - Case Study Example

Case Study in Applied Sports Psychology Background Information: Lucy is worried and stressed. She confirms of experiencing performance anxiety attacks just prior to and during the competition. Lucy’s psychological state is marring her performance especially during international matches. Her present psychological state is currently impacting her performance to such an extent that her scoring ratio remains lower than what is expected for her. Her confidence has reduced so much that she thinks she is not good enough to be a netball player of international repute. She undergoes anxiety pangs and images of failure to perform at the crux of the moment. Somatic symptoms like muscular tension and butterflies in stomach have also been reported by Lucy during the interview. Problem Description: Lucy is an International netball player and plays goal attack. Though she performs well in club matches and training sessions, her performances in all the international matches remain bleak. Lucy is worried of the fact that if she continues to perform in the same way, she would probably have to lose her team’s confidence in her. This condition is leading Lucy to a deeper psychological syndrome. She is gradually losing self-belief and thinks that the coming international tournament due in just 8 months will be her last ever opportunity in the arena of international sports. Lucy finds it difficult to cope up with the pressure of performing well in International matches. She experiences weakness prior to the competition. For the treatment of Lucy, it is important to have a thorough understanding of all her symptoms. Anxiety manifests in many different ways. These symptoms can be broadly classified into Somatic, Behavioral, Emotional, Cognitive and Defensive mechanisms. The physical symptoms of anxiety include chest and muscular pain as reported by Lucy. Behavioral symptoms of anxiety experienced by Lucy include restlessness and pacing. Cognitive behavioral mechanisms like fear inducing thoughts; inability to concentrate and obsessive thinking of failures is leading Lucy to a confusing state of mind. The word ‘anxiety’ stems from the Latin word anxius. Anxiety is a response for a perception of threat, clearly distinguishable from fear, which is understood as a physiological response to a stimulus. The unpleasant sensations result from a stimulus. John Raglin and Yuri Hanin points out that ‘similar’ stimulus may be ‘perceived as a beneficial challenge to one individual, threatening to another, and neutral to the third’. The cognitive state anxiety has usually a negative effect on the athletic performance which may continue to affect the performance throughout, especially at crucial moments (Cashmore, 2002, pp 24-25). There is a good review on sports related articles especially on stress related emotion, for researches and practitioners is based on emotion-performance relationships. The context is entirely related to the emotional aspect of the idiographic (individualized) perspective and therefore is becoming a well-recognized aspect in every field of applied psychology including sports. There is a general consensus among research scientists that prediction of an athletic performance in the field of sports psychology should be based on positively (pleasant) and negatively toned (unpleasant) emotions rather than on pre-competition anxiety. Substantial empirical works show the testimony to the fact that negative emotions do not always harm an athletic performance (Hanin, 2000, pp.37-43). Emotions like anger, anxiety and tension may sometimes be beneficial for competition. These studies are in accord with observations and evidence that highly skilled athletes can use the relatively high anxiety levels to their advantage. On the other hand findings also lay emphasis on the fact that too much pleasant emotions can sometimes hinder good performance (Hanin, 2000) Pre-competition anxiety as reported by Lucy in the interview is an important stress related emotion, although it is only a part of the emotional mix that influences the performance of the athlete. Research on the emotional experience related to athletic performance has a variety of serious implications. These are: firstly, to identify individually optimal and dysfunctional emotional trait. Secondly, predict emotion-performance relationship and thirdly, emotion regulation associated with activated emotional states. Intervention Justification: Intervention may be defined as an action in order to modify a distinct class of a characteristic action. Intervention strategies or methods to incorporate the changes involve taking sessions with a counselor/ medical therapist, anti-anxiety medication and by practicing yoga/deep breathing. The effectiveness of the treatment is specific to the diagnosis, the extent of which can be said to be meaningful when only it is examined by a series of co-related evaluation. Intervention is to be delivered in order to raise self-awareness in the client (Hemmings & Holder, 2009, p.2; Bentall, 1996, p.4). The psychological manifestation of stress from findings reveal that the theme consisted of certain emotional responses (e.g., anger, frustration, upset) and certain negative cognitions (e.g., self-doubts, negative decision making and also reduced confidence or self belief (Olusoga, Butt and Hay, 2010, pp. 276-278). The results were obtained from interviewing twenty-five raw data themes from interview transcripts, each representing the distinct stress related response. Dialectical Behavior Therapy (DBT) formulated by Linehan promises to help clients accept their emotions and emotional experiences (Corey, 2009, p. 270). The practice of acceptance is a way of seeing reality as it is, without distorting facts, without any judgment and also without being able to hang on to a certain experience or trying to get rid of one. It is a close end involvement of getting accustomed to the present moment without separation of oneself from the ongoing interactions. Cognitive Behavior Therapy (CBT) is implemented by psycho-therapists as a set of empirically grounded clinical intervention in such cases (Corey, 2009, p. 317). Despite being a new age therapy, CBT is a widely recognized ‘treatment of choice’ among the practitioners. Evidences suggest effectiveness of this therapy in curing depression and panic disorder (Holmes, 2002). CBT is a short-term structured therapy wherein the progress of the patient is continually monitored through a planned agenda. A typical course on CBT takes around 12-24 sessions, followed by a few concluding sessions to ensure the quality of gains received after the shared sessions. Each session may cost around $50-$160 (Anderson, 2012). The best part of the CBT sessions is that it is based on the principle of ‘collaborative empiricism’ i.e. rather than the practitioner being seen as the expert on the client’s experience and characteristics, it is a shared exercise between the doctor and the patient. The patient and the therapist work together to resolve the issues /problems faced by the patient; in the words of Beck et al., “The cognitive therapist implies that there is a team approach to the solution of a patient’s problem: that is, a therapeutic alliance where the patient supplies the raw data (reports on thoughts and behavior….) while the therapist provides structure and expertizes on how to solve problems. The emphasis is on working on problems rather correcting deficits or changing personality” (Eagle & Warrel, 2007, pp.340-341) There are ample empirical evidences that provide scope for helpful athletic experience generated by strong unpleasant emotions like stress, panic, anger and tension help the performer facilitate more energy driven focused attention and if this energy is well- channeled in the process of executing the task can considerably postpone fatigue. In other words, coping with the competitive stress does not only mean to alleviate the negative forces, but also using it to enhance performance (Hanin, 2000). Delivery of Intervention: Delivery of intervention is a crucial way of communicating the issues faced by the client. One of the planning methods could be to audiotape the initial five sessions and then evaluate the improvements in the following sessions by keeping a cut-off score as an indicating acceptable quality of the therapy analysis for a particular patient, depending on the magnitude of improvements to be gained through psycho-analysis. Such practices may be carried out by taking Lucy to the field with dummy players on several occasions. Most of the psychological interventions generally flow from certain non-specific factors but crucial for therapeutic treatment like trust, optimism, care and hope. These elements are completely exploited through the therapeutic alliance between the patient and the doctor (Gleeson & McGorry, 2004, p.16). The quality of the patient-therapist relationship is a vital resource for evaluating the progress of the patient. Bulk of all research pertaining to psychology is mostly patient-oriented although the personality characteristics of a psycho-therapist also play a crucial role in the process of treatment. Psycho-therapy is regarded as an art because of its inter-personal nature of rendering therapeutic services (Caligor, Bromberg & Meltzer, 1984). Most often, the personality characteristics of the psychotherapist is regarded as the most important of all variables associated with the effectiveness of the therapy (Bandura, 1958, pp 333-336). According to the ‘Social Learning Theory’ of Bandura, a common cognitive mechanism leads to certain defensive mechanisms. To diagnose and to evaluate a person undergoing stress, the doctor requires a set of skillful understanding of the complexities of human behavior (Bandura, 1977; Jalvis, Holford & Griffin, 2003, p.49). The quality of active listening to both what the patient has to say about oneself and the doctor thinks of the situation and also the undercurrents of unspoken feelings between them help in the rapport building process (Sadock & Kaplan, 2007). A natural part of the learning of any activity is making mistakes. Halden-Brown (2003) explains a unique form of coping up with performance errors. It is important that one accept the performance errors with resilience. Solomon & Becker (2004) created a four-step process which sportspersons can relate to, to overcome performance errors with the following sequence. The ability of transforming performance errors into a well defined skill set can be learnt by any athlete (Halden-Brown, 2003). A = Acknowledge the error and the frustration it has caused. R = Review the play and determine how and why the error occurred. S = Strategize a plan to make the necessary corrections for the future. E = Execute and prepare for the next event. (Karageorghis and Terry, 2012) The delivery of intervention includes a range of assessment modes that are available to an applied sports psychologist through summary obtained from interviews, questionnaires (i.e. pen and paper assessments) and also observations. The cumulative strengths and weaknesses of the different modes available through the various sources help to triangulate findings of subsequent intervention decisions. Once the decisions are made, the applied sports psychologist can then feel confident to intervene with the client using a range of techniques or methods through which the psycho-analysts aim to influence the psychological skill, performance and well-being of the client (Hemmings, & Holder, 2009, p.2). Application to Lucy: In this particular case with Lucy, it is suggested that, initially a few counseling sessions be provided to her, so that it is understood as to exactly how many sessions will be required for her complete cure. CBT will emphasize on motivating Lucy to talk openly to the therapist. Exercises like yoga and deep breathing should have to be accommodated in the primary sessions of the CBT and her recovery of mental condition can be evaluated through a questionnaire or a psycho-metric test take up at regular intervals of 7 days. The benefits of yoga and deep breathing help to relieve stress by lowering the blood pressure. Focusing on breathing helps to calm the mind and activates certain chemical responses in the brain and body (Rhoden & Schein, 2010, p.222). Positive self-talk will give a boost to the confidence during interactive sessions of CBT. Besides this, Lucy should be given an opportunity to raise her confidence in a particular arena which makes her feel the comfortable to work on. Identifying some of the positive qualities in her will surely make a difference in the way she feels about herself. This would further enhance her performance gradually. Therefore, if Lucy was experiencing unwanted feelings and behaviors, it is important to identify the thinking that is causing the feelings and behaviors and to learn how to replace this thinking with thoughts that lead to more desirable reactions. Lucy should have to be provided training modules on confidence build-up and also positive thinking strategies to feel good about the environment she lives. This can be done by writing own thoughts and expressions in a diary. In one of the following sessions of CBT, a task would be to design a therapy to eliminate strong negative aspects enumerated by Lucy in her diary. This can be a shared talking session between the therapist and Lucy. Music in particular has a strong effect on the relieving stress because it helps relax muscles and activities certain chemicals in the body. Music and relaxation therapy can be included in between sessions. Simple relaxation techniques like such as massage therapeutic touching help patients to calm their allaying anxiety (Kotsirilos & Sali, 2011, p.286). Interactive therapy sessions should be chosen over drug therapy for this case with Lucy. Evaluation: Assessment of the dimension of gains obtained after the complete session could be formulated by the performance level reached after completion of the sessions. The most handy assessment tool to identify the positive outcome is the happiness quotient of the client. Performance accomplishments provide the best possible efficacy information since it develops on the sense of personal mastery experiences. Empirical test conducted on subjects pertaining to this theory (Baumeister, 1999, p.296), shows that different approaches of treatment alter the level of self-efficacy and more dependable the source it is likely that there are greater chances of self-efficacy. The assessment measures to be administered in pre-treatment phase is again conducted a week after the first few sessions of treatment are accomplished. Efficacy expectation were measured prior to and after the post-test to examine the reciprocity of the results obtained. Supplementary follow-up sessions were provided to those subjects who failed to show up terminal results (Baumeister, 1999, p.296). By comparing the pre-intervention and post intervention data on self reliance and studying the behavioral pattern of the subject it can be accounted that post intervention results show a positive outcome on psychological influences of defensive behavior by enhancing the level of strength of the perceived self-efficacy. Lastly, to figure out the durability of the changes gained through therapy and congruence between the efficacy expectation and behavioral pattern, long after treatment, a final assessment of 1month following the final treatment can summarize the ultimate gains received in the process of the therapy. References 1. Anderson, C.A. (2012) Psychology Today, The Therapy Directory, available at: http://therapists.psychologytoday.com/rms/name/Conrad_A._Anderson_PhD,JD,MSW,LCSW,MEd_Gulfport_Mississippi_77821. (accessed on June 15, 2012) 2. Bandura, A. (1958),‘Phychotherapist’s Anxiety Level, Self-Insight and Psychotherapeutic Competence’ Reprinted from the Journal of Abnormal and Social Psychology Vol. 83 No.3, pp.333-336. available at: http://www.des.emory.edu/mfp/Bandura1956JASP.pdf (accessed on June 15, 2012) 3. Bandura, A. (1977) Social Learning Theory, Prentice Hall 4. Baumeister, R.F. (1999) The Self in Social Psychology, Psychology Press 5. Bentall, R.P. (1996) “From Cognitive Studies in Psychosis to Cognitive Behaviour Therapy for Psychotic Symptoms” in Cognitive Behavioural Interventions with Psychotic Disorders, New York: Routledge. 6. Caligor, L. Bromberg, P.M. & J.D. Meltzer, (1984), Clinical Perspectives on the Supervision of Psychoanalysis and Psychotherapy, Springer. 7. Cashmore, E., (2002), Sports Psychology: The Key Concepts. USA & Canada: Routledge. 8. Corey, G (2009). Theory and Practice of Counseling and Psychotherapy, USA: Thompson Brooks/Cole. 9. Eagle, A. and Worrell, M. (2007), "Cognitive Behaviour Theory", In, Cambridge Book of Psychology, Health & Medicine, Cambridge Univ Press 10. Hanin, Y.L. (2000) Emotions in Sports, Human Kinetics 11. Halden-Brown, S. (2003), Mistakes worth making: How to turn sports errors into athletic excellence. Champaign, IL: Human Kinetics. 12. Holmes, J. (2002), All you need is cognitive behaviour therapy? BMJ, 34 (7332): 288-294, available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122202/ (accessed on June 15, 2012) 13. Hemmings, B. & Holder, T, (2009), Applied Sports Psychology: A Case Based Approach. UK: Willey Blackwell. 14. Jarvis, P. Holford, J. & C. Griffin (2003), The Theory & Practice of Learning, Routledge 15. Karageorghis, C.I. and P.C.Terry, (2012), Balance intrinsic and extrinsic motivation for success, Available at: http://www.humankinetics.com/excerpts/excerpts/balance-intrinsic-and-extrinsic-motivation-for-success (accessed on June 15, 2012) 16. Kotsirilos, V., & Sali, L.V., (2011). A Guide to Evidence – Based Integrative and Complementary Medicine. Elsevier Australia. 17. Mueser, K.T. and H. Berenbaum, (1990), Psychodynamic treatment of schizophrenia: is there a future? Psychological Medicine, 20, 253-262 18. Olusoga, P. & Butt, J. (2010). Stress and Coping: A Study of World Class Coaches. Journal of Applied Sports Psychology,Vol. 22, 274-293. 19. Quality Assessment Methods in Classroom Learning Chapter 4 (n.d). available at: http://ati.pearson.com/downloads/chapters/Understanding%20School%20Assessment%20ch4.pdf (accessed on June 15, 2012) 20. Rhoden, C.A, & Schein. S.W., (2010).Bringing Down High Blood Pressure.London: The Rowman & Littlefield Publishing Group, Inc. 21. Spring, B. J. and Ravdin, L. (1992) Cognitive remediation in schizophrenia: should we attempt it? Schizophrenia Bulletin, 18, 15-21 22. Segal, S. P., Cohen, D., & Marder, S. (1992). Neuroleptic medication and prescription practices for mentally ill sheltered care residents. American Journal of Public Health, Vol. 82, No. 6, 846-852. 23. Sadock, B.J, & Kaplan. H. I. (2007). “The Patient-Doctor Relationship” In Kaplan & Sadock’s Synopsis of Psychiatry. Lippincott Williams & Wilkins 24. Solomon, G., & Becker, A. (2004). Focused for fast pitch: 80 drills to play and stay sharp. Champaign, IL: Human Kinetics. Appendices: 1) Checklist to be followed by patients (provided by Sports Psychologist). 2) Questionnaire on ‘How to Deal With Issues ’ in the field. Quality Assessment Technique: Source: Drawn from http://www.pbs.org (Quality Assessment Methods in Classroom Learning Chapter, n.d.) Read More