Cognitive Behavioral Approaches in the Training Room

Although sports medicine physicians, physical therapists, and certified athletic trainers indicate that they encounter psychological issues that are both injury-related (e.g., fears of re-injury, lack of patience; Mann et al., 2007) and non-injury-related (e.g., stress, anxiety, and burnout; Mann et al., 2007) and also report that the role of psychological skills are valuable and effective in the rehabilitation process (Hamson-Utley et al., 2008), the majority of individuals associated with the physical recovery of an injury indicate that there is a lack of training regarding application of psychological skills that could be used in a sports medicine setting (Arvinen-Barrow et al., 2010). Both pre-injury models (e.g., Williams & Andersen, 1998) and post-injury models (e.g., Wiese-Bjornstal et al., 1998) suggest that cognitive processes are key factors that influence both the risk for a sport-related injury and the outcome or recovery from a sport-related injury. Therefore, given the reports of psychological issues reported in various sports medicine settings, teaching individuals associated with the physical recovery of injuries basic skills that address cognitive processes could be an effective way to enhance both physical and psychological outcomes of injuries.

For example, teaching individuals involved in the physical recovery process basic tenants of cognitive therapy (Beck, 1995) could help individuals challenge maladaptive automatic thinking patterns that may be influencing the recovery process. An individual practicing a new rehabilitation exercise may have the automatic thought that, “this is too hard and I’ll never be able to do it.” According to cognitive therapy, this thinking pattern may influence one’s emotions as well as behaviors. An injured athlete with this thought may experience feelings of sadness and, as a result, stop rehabilitation exercises. Teaching an individual associated with the recovery process basics skills and techniques to challenge maladaptive thoughts like these could not only increase the likelihood that an athlete has a positive psychological response to the injury, but also adheres to rehabilitation processes throughout the treatment leading to a positive and successful physical outcome. Although application of all the intricate details of cognitive therapy would be beyond the job-scope of an individual working in a sports medicine setting, learning basic components of this therapy could lead to better treatment outcomes, both physically and psychologically. Is it asking too much to encourage sports medicine physicians, physical therapists, and certified athletic trainers to attend seminars to learn basic components of various cognitive behavioral approaches?

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