Context: Athletic trainers have traditionally conceptualized rehabilitation programs in terms of 3 distinct physiologic phases; however, these phases appear to neglect athletes' psychosocial responses to their injuries. Objective: To document injured athletes' psychosocial responses during the different phases of injury rehabilitation. Design: Qualitative study. Setting: National Collegiate Athletic Association Division II university in the mid-Atlantic region of the United States. Patients or Other Participants: A total of 8 previously injured athletes (4 men and 4 women) participated in the study. Data Collection and Analysis: We collected participant data by using semistructured interviews, transcribed verbatim and analyzed by directed content analysis. Established themes were triangulated to determine trustworthiness. Results: Initially, athletes' cognitive appraisals were predominately negative in nature, leading to negative emotions. These appraisals changed after diagnosis and when moving to the reaction-to-rehabilitation phase and the reaction-to-sport phase. During the reaction-to-rehabilitation phase, athletes reported mixed cognitive appraisals and identified frustration as the main emotional response. When returning to sport, athletes reflected on the lessons learned, yet they expressed some doubts related to their ability to return to play. These cognitive appraisals served as a precursor to the resulting emotional responses of nervousness and reinjury anxiety, as well as excitement. Throughout the various phases of rehabilitation, athletes reported seeking out social support: initially from significant others and then from their athletic trainers during the reaction-to-rehabilitation phase. Conclusions: The results appear to support the use of the integrated model of psychological response to sport injury and the rehabilitation process and the 3 phases of rehabilitation as a framework for understanding how physical and psychosocial factors may interact during sport-injury rehabilitation. Understanding this interaction may help athletic trainers provide better care to their injured athletes.
Context: Despite the Psychosocial Strategies and Referral content area, athletic trainers (ATs) generally lack confidence in their ability to use this information. Objective: The current study's primary purpose was to determine (a) perceived psychological responses and coping behaviors athletes may present to ATs, (b) psychosocial strategies ATs currently use with their athletes, (c) psychosocial strategies ATs deem important to learn more about, and (d) ATs' current practices in referring athletes to counseling or sport psychology services. Design: Mixed-methods study. Setting: Online survey containing both quantitative and qualitative items. Patients or Other Participants: A total of 215 ATs (86 male, 129 female), representing a response rate of 22.50%. Main Outcome Measure(s): The Athletic Training and Sport Psychology Questionnaire. Results: Stress/anxiety (4.24 ± 0.82), anger (3.70 ± 0.96), and treatment adherence problems (3.62 ± 0.94) were rated as the primary psychological responses athletes may present upon injury. Adherence and having a positive attitude were identified as key determinants in defining athletes' successful coping with their injuries. The top 3 selected psychosocial strategies were keeping the athlete involved with the team (4.57 ± 0.73), using short-term goals (4.45 ± 0.67), and creating variety in rehabilitation exercises (4.32 ± 0.75). The top 3 rated psychosocial strategies ATs deem important to learn more about were understanding motivation (4.29 ± 0.89), using effective communication (4.24 ± 0.91), and setting realistic goals (4.22 ± 0.97). Of the sample, only 59 (27.44%) ATs reported referring an athlete for counseling services, and 37 (84.09%) of those who had access to a sport psychologist (n = 44) reported referring for sport psychology services. Conclusions: These results not only highlight ATs' current use of psychosocial strategies but also their desires to increase their current knowledge and understanding of these strategies while caring for injured athletes.
Injury, an unavoidable part of sport, is often accompanied by negative psychological reactions. This reaction may have a negative influence on an athlete's experience of injury and rehabilitation. Findings suggest that perceptions of social support provided by ATCs have the greatest influence on injured athletes' rehabilitation and well-being.
In a prospective study of collegiate athletes (N = 117), the application of self-compassion within the context of sport injury was explored. Previous literature indicated that self-compassion enhances adaptive coping and well-being and reduces anxiety in stress-provoking situations. This research suggested that it could potentially reduce the stress response and subsequent injury risk. Findings indicated that self-compassion may buffer the experience of somatic anxiety (rs = −.436, p < .01) and worry (rs = −.351, p < .01), and reduce the engagement of avoidance-focused coping strategies (rs = −.362, p < .01). There were no significant findings related to self-compassion and injury reduction. A challenge with this research is distinguishing the impact of resistance to self-compassion from the potential benefits that it may have on coping and appraisal of stress in sport. This research was a preliminary exploration of self-compassion within the context of responses to stress and subsequent injury risk. Results suggest that further investigation across different athletic populations, sports, and injury situations is warranted.
The current study’s primary purpose was to determine the impact of a sport psychology workshop on athletic training students’ sport psychology behaviors. Using a quasi-experimental research design, partial randomization was used to assign athletic training students (n = 160) to a treatment group or control group. A 2 × 2 repeated measures MANOVA revealed a significant multivariate effect for Group x Time interaction [Wilks’s Λ = .22, F (5, 154) = 1, p < .001, η2 = .77]. Follow up ANOVAs revealed significant interactions for all sport psychology behaviors (allp < .01) except referring an injured athlete to a sport psychologist. Results from the current study revealed that members of the experimental group reported a significant increase in their use of total sport psychology behaviors at the six week follow-up when compared with those in the control group. Such increases highlight the need for increased exposure of athletic training students to sport psychology. Given the potential benefits that could be derived from the incorporation of sport psychology skills and techniques into injury rehabilitation by athletic training students’, the assertion that injured athletes’ physical rehabilitation could be enhanced with the incorporation of psychological skills and techniques appears to be supported.
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