A Game Plan to Address Student-Athlete Mental Health and ...

A Game Plan to AddressStudent-Athlete Mental Healthand Substance Use Issues11th Annual University of MichiganDepression on College Campuses ConferenceFebruary 27, 2013Chris Carr, PhD, HSPPSt Vincent Sports PerformanceIndianapolis, IndianaBarb Hansen, LMSWAthletics CounselorUniversity of MichiganKenneth Chew, Jr., Psy.D., HSPPStudent Counseling CenterIndiana State UniversityMary WilfertNCAA Health and Safety

NCAA Structure and FunctionsCompetitive Safeguards and Medical Aspects of Sports

NCAA Membership PrinciplesPrinciple of Student-Athlete Well-Being Health and Safety: It is the responsibility of each member institutionto protect the health of and provide a safe environment for each of itsparticipating student-athletes.Principle of Sportsmanship and Ethical Conduct In order to promote the character development of participants, toenhance the integrity of higher education and to promote civility insociety, student-athletes, coaches and all others associated withthese athletics programs and events should adhere to fundamentalvalues as respect, fairness, civility, honesty and responsibility.

Critical Student-Athlete H & S IssuesAthletics Participation• Banned Drugs and DrugTesting• Injury Prevention andRecovery• Medical Insurance• Risk Minimization• Sports Safety RulesCollege / Student Life/Personal Wellness• Anxiety andDepression• Fitness and Nutrition• Hazing• Life Transitions• Relationships• Sleep• Substance Abuse

2010 NCAA GOALS Survey: My athletics participationis important in preparing me for life after graduation(% Responding Agree or Strongly Agree)BaseballMen’sBasketballDivision IFootballAll OtherMen’sSportsWomen’sBasketballAll OtherWomen’sSportsN 79% 77% 70% 71% 66% 61%Division IIN 69% 74% 69% 65% 64% 52%Division IIIN 66% 66% 69% 60% 60% 50%Note: Endorsement of top two scale points on 6-point scale

Winning is more important to me than goodsportsmanship(% Responding Somewhat Agree or Strongly Agree)BaseballMen’sBasketballDivision IFootballAll OtherMen’sSportsWomen’sBasketballAll OtherWomen’sSportsN 48% 47% 50% 36% 25% 15%Division IIN 46% 44% 43% 33% 21% 15%Division IIIN 46% 44% 42% 31% 18% 10%Note: Endorsement of top two scale points on 5-point scale

Most of Us Don’t . . .Student-Athletes Reporting “Never Used”by Substance:• Anabolic Steroids – 98.6 percent• Ephedrine – 97.7 percent• Amphetamines – 96.3 percent• Cocaine – 95.7 percent• Narcotics – 94.1 percent• Spit Tobacco – 75.1 percent• Cigarettes – 73.8 percent• Marijuana – 62.3 percent• Alcohol – 12.6 percent2009 NCAA Substance Use Survey

Heavy Drinking Trends2009 NCAA – of Those Who Drink2005 2009Overall 5+ drinks in one sitting 59.7% 59%Overall 10+ drinks in one sitting 18.4% 17.4%Women 4+ drinks in onesitting59.2 60.3Men 5+ drinks in one sitting 72.5 68.8Men 10+ drinks in one sitting 28.6% 26.1%

Negative Consequences from Use2009 NCAA – How many times in 12 monthsExperienced as a result of alcohol/druguseNever 1-2 3-5 6+Hangover 33.6% 25.7% 16.1% 24.6%Missed Class 66% 17.8% 9% 7.3%Poor Test or Project Performance 76.1% 15.6% 5.4% 2.8%Missed or Late to Practice 93.8% 4.9% 1% .3%Poor Athletic Performance 79.3% 14% 4.4% 2.2%Driven Under the Influence 76.9% 13% 4.8% 5.3%Memory Loss 70% 17.3% 6.8% 6%Done Something Later Regretted 62.4% 23.6% 10.4% 3.8%

Alcohol on Performance• Causes dehydration which slowshealing• Requires increased conditioningto manage weight• Slows muscle recovery• Inhibits absorption of nutrients• Interferes with ability to sharplyfocus• Hampers memory and retention10

2009 Drug Studies—Comparative DataPercent reported use in last *30 days; in last **12 MonthsNCAACORE[2006]NSDUHcollegeMTF12thgradeMTF19-24Alcohol * 64.8% 71.8% 63.9% 44% 68.1%Cigarettes* 7.9% 26.2% [tobacco] 27.1% 20% 23.5%Spit Tobacco* 12.3% [combined withabove]Marijuana 9.6%*22.6%**Amphetamines**Cocaine 0.5%*1.3%**AnabolicSteroids**16.8%*30.1%**12.7% 8% --20.2%*32%**3.7% 6.2% -- 7.5% --2.2%*5.2%**1.4%*5.3%** 3.5%**0.4% 0.6% -- 1.5% --Banned for use by NCAA student-athletes18.5%*32.1%**1.8%*5.7%**

American College Health Association – National CollegeHealth Assessment 2009-2010 Data -- Overview• Data source: American College Health Association. American CollegeHealth Association – National College Health Assessment, Fall 2009and Fall 2010 (National College Health Assessment II). Baltimore. MD:American College Health Association; (2013-02-15).• Fall 2009 and fall 2010 administrations included 80 institutions andnearly 54,000 unique respondents.• Although the characteristics of the responding institutions are diverse,including public/private, geographic location, student population, etc.,due to the limited institutional participation, this is not considerednationally representative.• At this time, we are unable to match responding institutions with NCAAinstitutional identifiers (e.g., NCAA division). Because of this, it ispossible institutions are included in the following analyses that are notNCAA member institutions.

American College Health Association – National CollegeHealth Assessment 2009-2010 Data -- Overview• Survey items address students’ behavior and attitudes on a broadmixture of health and safety issues. Of most interest to the NCAA weretopics including: stress, aggressive behavior, mental health well-beingand outside factors affecting academic performance.• Added for the first time in 2008 was a question regarding whether therespondent was a varsity athlete. The following comparisons are basedon responses to this question. Among the respondents in 2009 and2010, approximately 7.5% self-identified as a varsity student-athlete.

Prescription Medication Use without aprescription --in the Last 12 Months –Males Females OverallSANon-AthSANon-AthSANon-AthAntidepressants 3% 2 % 2% 3% 3% 3%Erectile Dysfunction (menonly)2% 1% NA NA 2% 1%Pain Killers 10% 8% 7% 8% 9% 8%Sedatives 4% 4% 2% 3% 3% 4%Stimulants 6% 6% 4% 5% 5% 5%*highlighted items indicate a statistically significant difference, chi-square, p

Aggressive Behavior in the last 12 months –SAMales Females OverallNon-AthSANon-AthSANon-AthBeen in a physical fight 24% 12% 6% 5% 14% 7%Been physicallyassaulted (excludingsexual assault)Been verballythreatenedIn an emotionallyabusive relationship9% 6% 4% 4% 6% 4%38% 27% 19% 17% 27% 21%8% 7% 10% 11% 9% 10%In a physically abusiverelationship3% 2% 3% 2% 3% 2%*highlighted items indicate a statistically significant difference, chi-square, p

Indicators of Depression –Males Females OverallSA Non-Ath SA Non-Ath SA Non-AthFelt things were hopeless 47% 58% 62% 70% 56% 66%Felt overwhelmed by all youhad to doFelt so depressed that it wasdifficult to function71% 82% 91% 94% 82% 90%36% 46% 45% 55% 41% 52%Felt very sad 59% 70% 76% 83% 68% 78%Felt very lonely 56% 68% 72% 80% 65% 76%Felt exhausted (not fromphysical activity)66% 79% 85% 91% 77% 87%Felt overwhelming anxiety 42% 55% 59% 69% 52% 64%Felt overwhelming anger 49% 55% 53% 61% 51% 59%Intentionally cut, burned,bruised, or otherwise injuredyourself12% 13% 16% 18% 14% 16%Seriously considered suicide 13% 17% 14% 20% 14% 19%Attempted suicide 6% 6% 7% 8% 6% 8%Percents indicate proportion responding event has occurred in their lifetime.*highlighted items indicate a statistically significant difference, chi-square, p

Mental Health Diagnoses in the last 12 months –Males Females OverallSA Non-Ath SA Non-Ath SA Non-AthAnorexia 2% 1% 2% 1% 2% 1%Anxiety 4% 6% 9% 12% 7% 10%ADHD 4% 4% 4% 3% 4% 4%Bipolar Disorder 2% 1% 1% 1% 2% 1%Bulimia 2% 1% 2% 1% 2% 1%Depression 4% 6% 8% 11% 6% 9%OCD 3% 2% 2% 2% 2% 2%Schizophrenia 2%

Within the last 12 months, have you found thefollowing traumatic or difficult to handle –SAMales Females OverallNon-AthSANon-AthSANon-AthAcademic 33% 38% 44% 47% 39% 44%Career-related issue 15% 21% 15% 24% 15% 23%Family problems 20% 19% 29% 32% 25% 28%Intimate relationships 26% 26% 32% 33% 29% 30%Other socialrelationships17% 19% 26% 26% 22% 24%Finances 24% 30% 29% 38% 27% 35%Personal appearance 11% 14% 21% 25% 17% 21%Personal health issue 8% 12% 16% 20% 13% 17%Sleep difficulties 17% 21% 21% 26% 19% 24%*highlighted items indicate a statistically significant difference, chi-square, p

Within the last 12 months, have any of the followingnegatively affected your academic performance –Males Females OverallSA Non-Ath SA Non-Ath SA Non-AthAlcohol Use 6% 5% 4% 3% 5% 4%Chronic Pain 3% 2% 3% 3% 3% 3%Drug Use 4% 3% 1% 1% 2% 1%Finances 5% 7% 3% 7% 4% 7%ExtracurricularActivities19% 8% 23% 8% 21% 8%Eating Disorder 2% 1% 1% 1% 2% 1%Stress 16% 22% 26% 30% 22% 27%Gambling 2% 1%

Summary• Prescription Medication• There are very few differences between student-athletes and non-athletes in regards totaking prescription medication without a prescription. Male student-athletes were slightlymore likely than male non-athletes to have taken pain killers and erectile dysfunctionmedication without a prescription.• Aggressive Behavior• Both male and female student-athletes were more likely to report they had been in a physicalfight in the last 12 months when compared with their non-athlete peers. Among the females,however, this difference was very small. Male student-athletes, on the other hand, were twiceas likely to report having been in a physical fight when compared with male non-athletes.• Male student-athletes also were significantly more likely to report having been verballythreatened.• Indicators of Depression• There were several significant differences between student-athletes and non-athletes in theirreports of experiencing an indicator of depression at some point during their lifetime (e.g.,feelings of hopelessness, loneliness, overwhelming anxiety).• In each instance, student-athletes were less likely to report having experienced theseindicators.• A few findings are of particular interest…student-athletes were significantly less likely toreport feeling overwhelmed by responsibilities, feelings of loneliness and feelings ofdepression and anxiety (these last finding are repeated elsewhere in the data).

Summary• Mental Health Diagnoses• Student-athletes not only were less likely to report having experienced indicatorsof depression and anxiety in their lifetime, they also were less likely to reporthaving a depression or anxiety diagnosis in the last 12 months.• Student-athletes, however, were slightly more likely than their non-athlete peersto report an eating disorder diagnosis, including both anorexia and bulimia.• Daily Life Challenges• Respondents were given a number of daily life occurrences (e.g., academics,family problems, sleeping) and asked if each had been traumatic or difficult tohandle in the last 12 months.• Differences of particular interest include student-athletes being less likely to reportthat academics, finances and personal health issues have presented significantchallenges in the last 12 months.• Effects on Academics• Student-athletes were significantly more likely to report that extracurricularactivities have negatively affected their academic performance while non-athleteswere more likely to report that stress had a negative effect on their academics.• As previously mentioned, non-athletes were more likely to report concernsregarding finances. Among females, we see that non-athletes are more likely toreport that financial concerns also have had a negative effect on their academics.

NCAA Programs/Resourceswww.ncaa.org/health-safety• APPLE Conferences – Promoting Student-AthleteWellness and Substance Abuse Preventionwww.virginia.edu/case/apple• Coaches Assist – to deter AOD Abuse (on the APPLE site)• NCAA CHOICES Alcohol Education Grants, EngagingAthletics with the Campus Prevention Effortwww.ncaa.org.choices• Step UP! Bystander Intervention Programwww.stepupprogram.org• NCAA Drug Testing www.ncaa.org/drugtesting

NCAA Mental Health Emphasis• 2005 Summit with Clinical Psychologists• NCAA News Focus• Sports Medicine Guidelines• Mental Health Handbook• Membership Education at Convention, Equity Forum, etc.• CSMAS Engagement with Big Sky Group• Sport Science Institute

NCAA Sports Medicine HandbookProviding Guidance to Sports Medicine Staffthrough new and expanded guideline:• Considerations in identifying and referringstudent-athlete with potential mental healthissues.• Fostering relationships with mental healthresources on campus or within the localcommunity to facilitate effective treatment.

NCAA Mental Health HandbookEmphasizing that:• Treatment works.• Coaches and administrators can provideencouragement and support.• Addressing mental health issues is importantfor both performance and health, anddemonstrates to student-athletes that you careabout them as a person.

NCAA Sport Science InstituteTo promote and develop safety, excellence, andwellness in college student-athletes, and to foster lifelongphysical and mental development through• Research• Education• Collaboration• Policy Development• Best Practice Guidelines

Applied Sport SciencesPhysiologyBiomechanicsPsychologyStudent-AthleteNutritionMotorControlSportsMedicine

NCAA Sport Science InstituteGoal: 3 year• Develop a mental health epidemiologicalstudy of student-athletes• Develop a pro-active lifestyle educationalvehicle for student-athletes

NCAA Sport Science Institute• Engage in active communications regardingstudent-athlete wellness issues with keyathletics department staff, coaches, sportsmedicine staff, campus health and wellnessstaff, faculty and students.• Provide ongoing educational resources andoutreach to member institutions to addresscampus concerns.

Working Within an Athletics DepartmentBarb Hansen• Collegiate Athletics (Div. II): Basketball, volleyball andfield hockey• Professional Athletics: Women’s Professional BasketballLeague (WBL)• Clinical Administrator in substance abuse program forteens and young adults (3 yrs)• EAP and private practice clinician (20 yrs and currently)

Working within AthleticsUniversity of Michigan Athletic Program StructureInternal Staffing ModelReferral ProcessConfidentialityReferrals and Community ResourcesRole and ResponsibilityHealth and Wellness

Working within AthleticsTop Reasons Student Athletes Seek Counseling Services1. Anxiety – generalized, social, academic, performance2. Performance Issues – athletic and academic3. Relationships4. Depression5. AOD6. Disordered Eating/Eating Disorders7. Injury Recovery and Team Related Concerns

Working within AthleticsChallenges‣ “So much to do and so little time.”‣ Pressure to succeed – internal/external‣ Keeping it all in perspective/having balance‣ Athlete identity – whole person identity‣ Asking for help

Working within Athletics‣ Determination‣ Resilient‣ Goal-driven‣ Resourceful‣ Open to new ideas‣ CreativeStrengths

Learning To Play With Others:Building a collaborative relationshipbetween Athletics and Student CounselingL. Kenneth Chew, Jr., Psy.D., HSPP• Started at Indiana State University in 2002• Director since 2007• Started working with student-athletes in 1996• Facilitate the Student Affairs Behavioral Assessment Team(SABAT)• Review all medical withdrawals for the university• Primary University liaison for the outsourced Student HealthCenter• Rookie Success Program instructor for the Indianapolis Coltssince Fall of 2012

Common Characteristics ofToday’s Students• Greater pressures but lessexperience taking on adultresponsibility than earliergenerations• “Helicopter parents”• Less defined personal andcareer identities• Greater sense of entitlement• Sense of being forced to pursuea college degree• Report feeling homesickness orisolated from campus life athigher levels than students inthe past• Greater connection toinformation and means ofcommunication but not aswell developedcommunication skills.• More connected electronically• Less direct communication• Difficulty with assertingthemselves• Because of social media andaccess to information; they do“grown up” things at an earlierage, but exhibit much greaterimmaturity than students from10-20 years ago

How Common Characteristics of Today’sStudents impact Student- Athletes• Student-athletes display many of the same traits as their peergroup, which often puts them at conflict with traditionalathletics culture.• Some student-athletes are coming to college withmisconceptions of what “competition” really means.• More likely to put themselves in precarious situations due tosocial media.• Many are more sensitive to criticism or perceived harshcommunication.• Many tend to have more perfectionistic tendencies than in thepast.

ACHA/NCHA 2011 survey• 86 out of 100 students reported feeling overwhelmed by allthey had to do.• 30 out of 100 have felt so depressed it was difficult to function.• 11 out of a 100 reported being formally diagnosed with havinga depressive disorder in the past year.• About 30% reported feeling so depressed at least once in thepast year that it was hard to function.• 12 out of 100 had a formally diagnosed anxiety disorder.• About 50% of students report overwhelming anxiety during thepast year.

ACHA/NCHA 2011 survey - cont.• 6.6 percent of students seriously considered suicidewithin the past year.• 5.2 percent reported intentional self-harm.• Approximately 45% of students reported feeling as ifthings were hopeless.• 36.2% of students reported experiencing overwhelminganger within the past year.

Additional Statistics• In the past 10 years, most centers have reported a 10%-25%increase in usage, with some reporting spikes ofapproximately 40% during the busiest times of year.• Students coming to college with increased pathology andsymptom severity.• 13% of clients coming in with extensive treatment histories.• 25%-30% of students at Counseling Centers are on psychotropicmedications.• 25%-30% of students at Counseling Centers are onpsychotropic medications.• Approximately 1 in 5 students are referred for medication.

Most Common Concerns ofTraditional Students• Depression• Anxiety/panic• Relationship issues• Thoughts of harming self or others• Drug/alcohol concerns• Adjustment to college/Homesickness• Eating Disorders• Stress management• Death or loss• Referral for behavioral concerns• Roommate issues• Bipolar Disorder• Anger issues• Test anxiety• Family concerns• Sexual/physical assault• PTSD• Developmental concerns of earlyadulthood

Most Common Concerns ofStudent-athletes• Depression• Anxiety• Academic• Performance• Generalized• Substance abuse referral• Relationship concerns• Suicidal thoughts or ideation• Stress• Performance concerns• Disordered Eating andEating disorders• Issues related to injury• Transitions• Adjustment to college• New demands of collegiateathletics• End of career• Sexuality/coming out

Benefits to Counseling Services• Students who attend counseling often have higher GPAsand graduate at higher levels.• If intervention is received early, students are less likely tohave significant drops in grades or other areas ofperformance.• Proper assessment may assist getting proper academicaccommodations if needed.• Takes pressure off of administrators, coaches, and SportMedicine staff to address issues they are not trained inand may be uncomfortable with.

PhysicalCuluralSocialVocationalWellnessSpiritualIntellectualEnvironmentalEmotionalAn often overlooked benefit of college counseling: focus on overall wellness

Creating Services for Student-Athletes Within CounselingCenters

Collaboration BetweenCounseling and Athletics is Key!

Why Collaboration is Important• Athletics and Sport Medicine:• Serve as gatekeepers for student-athlete referral.• Are first to notice changes in functioning or other red flags thatsuggest referral.• Help establish the norm that it’s okay to get help.• Are in stronger position to get student-athletes help than mostother parts of any university.Decreased need to bring in outside professionals for otherservices such as leadership training, team building, performanceenhancement, etc.In some cases, it allows for shared resources to address campusand community problems or concerns.Reduces program and campus liability.

Barriers to Collaboration• Uncertainty about what each other does.• Culture of athletics versus culture of counseling• Getting a “foot in the door”• Trust• Misperception about how counseling services can benefit athletics• Range of services• Confusion about confidentiality and privacy.• Doubt about what these terms even mean.• Flow of information• Control?• Stigma associated with counseling and mental health.• Perception of being “mentally weak” if you need help• Counseling is for “crazy” people

Barriers to Collaboration- cont.• Availability and hiring of qualified professionals• There is a small but growing number of qualified professionals.• Centers don’t generally look for this specialty, despite the number of studentathletesbeing served.• Professional Training versus Professional Self-Promoters.• Though growing, there are not a lot of mental health professionals trained in SportPsychology or counseling of athletes as a specific population.• The Psychology versus Physical Education debate.• Not everyone who has seen an athlete in the past is trained in working with athletes, despitewhat they say or how they try to sell themselves.• Referral• Identifying student-athletes who may need to be referred.• How and when to refer.• When a referral is made, who is the client?• Time• Counseling is NOT a quick fix.• Certain services take time to show benefits, especially with teams and performanceenhancement.

Approaches to Collaboration• There is no “one-size” fits allapproach to making thiswork.• Each institution has adifferent culture, policies,and demands; and thereforewould be advised to assesstheir needs prior to forcing acollaboration.• Before recreating the wheel,it helps to consult withinstitutions similar to yoursto see what they’ve done.• Below are 5 tips for bothAthletics and Counseling tomake collaboration moresuccessful.

5 Points to Consider: The Athletics Side• Athletic Director and Athletics Administration buy-in.• Collaboration will never work without this.• Determining the structure that best fits your institution.• Services housed in Counseling and Psychological Services.• Counselors housed in Athletics as part of Sport Medicine.• Shared position between Counseling and Athletics.• Outsourcing services or having part-time consultants.• What is the chain of communication and referral?• Handling the release of information.• Is there a primary referral source, such as the Head Athletic Trainer?• to whom will the majority of follow up be directed?• Regular meetings with an identified administrator or Sport Med.

5 Points to Consider: The Athletics Sidecont.• What services are you wanting provided?• Counseling and consultation• Drug and alcohol referral• Performance enhancement• Coaching concerns• Team building and leadership• Life skills and wellness education• Athletics liaison• Identifying or training qualified professionals.• For best results, consult with professionals already doing this work .• Work with counseling to make sure providers are appropriatelytrained.

5 Points to Consider: The Counseling Side• Willingness to do the leg work to get in the door.• Meeting with administration, sport medicine, and coaches.• May have to educate about what we do and other issues such asconfidentiality and privacy.• Competence.• Training in Sport Psych or counseling of athletes.• Recognition that student-athletes and the athletics culture is not likeother populations.• Having a degree or a prior client who was an athlete does not meanyou are qualified to do this work.• Become aware of NCAA and departmental rules pertaining tostudent-athletes.• Be mindful of team dynamics and pressures of issues such as time ofseason, injury, and career transition.

5 Points to Consider: The Counseling Sidecont.• Boundaries.• Don’t ask for tickets, jerseys, t-shirts, or any other items fromteams or athletes.• Confidentiality and privacy concerns related to individuals andteams.• Once again – awareness of team dynamics when working withteams and individuals on those teams.• Consistent communication.• Flexibility with regard to scheduling and where we meetstudents.• May need to attend practices and games.• After-hours calls or consultations.

Trends in Providing PsychologicalCare to College AthletesChris Carr• Collegiate football (DIII) player: GA FB Coach• Sport Psychologist @ Washington State University, ArizonaState University, The Ohio State University, Purdue University,& Indiana University (current consulting role)• US Ski Team (10 yrs); USA Diving (4 yrs); 2 Olympic Games(2002, 2008); USOC Sport Psych Registry since 1992• Professional: Arizona Cardinals (1994-95); Kansas City Royals(1999-2005); Columbus Crew (1996-2000); Indiana Fever(2001 to present); Oklahoma City Thunder (2009 to 2011);Indiana Pacers (2011 to present)• President – APA Division 47 (Sport Psych), 2007-09

Trends in Providing PsychologicalCare to College Athletes• Overview of Sport Psychology Services within collegiateathletics• Development of “Psychologist for Athletics” positionssince 1992• Program models• Professional identity and development• Collaboration and resources – Big Sky Retreat

Relevant Issues for Psychology in Sport• Pre-participation exams may or may not addressprevious/current psychological issues (assessingpresenting symptoms)• Once a mental health issue identified, resources may belimited or difficult to access (follow-up care challenges)• Issue of “sport” vs. “clinical/counseling” psychology• Competency of providers to understand the unique“nature” of clients (athletes and culture of sport)

Sport Psychology Services withinCollegiate Athletics• Mental health issues (e.g. substance abuse)• Development of “performance” psychology field• “Models” of care within athletics (e.g. sports medicine &academic counseling)• Understanding a continuum of care model (Moore)• Education of athletic department personnel• Fads, snake oil, “motivational speakers”

Continuum of Psychological Issues & Treatment OptionsDebilitatingor dangerouspsychologicaldisturbancePsychiatrist(medicallytrained)ClinicalPsychologistSeveresymptomsresulting inimpairedrelationships,judgment,thinking,mood andfunctioningSerioussymptoms,moderatedifficultyin social,occupational,or schoolfunctioningCounselingPsychologistModerateto Mildsymptoms,somedifficulty innormal dailyactivities &relationshipsNormalpsychologicalfunctioning: alittle stressed,unbalanced,and occasionaldips infunctioningVery fewsymptoms,involved in awide rangeof activities,effectivesocially &vocationally.Desires toimprovefurther inspecificareas of life.May still behindered bycertain lifeproblems.Goodfunctioningin daily life–problemsapproachedwith relativeease. Desiresto becomemoreeffective, orto experiencemore joy orsatisfaction.SportPsychologyConsultantHigh-levelfunctioning.Life isapproachinga balanced,satisfactorystate. Seeksto improveperformancein multipleareas oflife. Seekingenhancedsatisfactionand success.Balanced living& excellentpsychologicalfunctioning…findingsignificance,meaning,and successin many lifedomains.Seekingoptimalperformance.Adapted from Moore, S. N. (2010, April). Using our heads by making a move: Creating an action plan to enhance student-athlete mental health andperformance. Presentation at the NCAA Gender Equity & Issues Forum, Chicago, IL. 1

“Barriers”(From NCAA News, 2004)• Limited comfort within sports medicine to address mental healthissues• Coaches hesitancy to address issues• History and tradition (stigmatizing mental health)• Athletic department desire to disassociate mental illness withathletic participation• Mental “wellness” not always perceived as necessary for athleticperformance• High profile of athletes/teams may magnify unwanted attentionwhen help is sought• Funding for services

Addressing the Issue• Development of “Psychologist for Athletics”positions within Athletic Department• Increased “Awareness” of campus resources• Educational programming on “psychological health”issues for student-athletes, coaches, support staff,and admin.• Consultation with Sports Medicine, AcademicCounseling, and “Life Skills” Staff• Development of policy and procedures in addressingstudent-athlete mental health issues• Breaking the “stigma” of psychological issues

Models of Service• Full-time/Multi-personnel: University of Oklahoma,University of Virginia, University of Washington,University of Southern California• Full-time/Single provider: Virginia Tech, KansasUniversity, Louisiana State University, Kansas StateUniversity, University of New Mexico, Brigham YoungUniversity, University of Arizona, University of Iowa• Consultant/Specific Counseling Sport Psych: IndianaUniversity, Purdue University, University of NorthCarolina-Chapel Hill, Providence College, UCLA,University of Wisconsin, USNA

Professional Identity andDevelopment• PhD (Counseling or Clinical Psychology) vs. PhD(Physical Education)• Multi-disciplinary training (competency)• Advantages of licensure as psychologist (liability)• Pitfalls of “non-athletic” mental health providers• Knowledge of collegiate athletics culture• Consultant, teacher, and therapist….multiple roles• “Everything is about PERFORMANCE” (McCann)

Collaboration• Defining “sport” psychology as a unique competencywithin field of psychology• Education of clinicians on issues related to studentathletedevelopment, identity, and psychological issues• Working with Sport Science-trained professionals todevelop knowledge related to sport psychology• Contributions to the academic literature and researchcollaboration• Big Sky Retreat – unique training for qualifiedprofessionals

Questions and Thanks!• Chris Carr -- cmcarr@stvincent.org• Ken Chew -- Kenneth.Chew@indstate.edu• Barb Hansen -- barbhan@umich.edu• Mary Wilfert – mwilfert@ncaa.org