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Psychotherapy for mental health symptoms and disorders in elite athletes: a narrative review
  1. Mark A Stillman1,
  2. Ira D Glick2,
  3. David McDuff3,
  4. Claudia L Reardon4,
  5. Mary E Hitchcock5,
  6. Vincent M Fitch1,
  7. Brian Hainline6
  1. 1 Clinical Psychology, Mercer University – Atlanta Campus, Atlanta, Georgia, USA
  2. 2 Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
  3. 3 Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
  4. 4 Department of Psychiatry, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
  5. 5 Ebling Library for the Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
  6. 6 National Collegiate Athletic Association (NCAA), Indianapolis, Indiana, USA
  1. Correspondence to Dr Mark A Stillman, Clinical Psychology, Mercer University – Atlanta Campus, Atlanta, GA 30341, USA; stillman_ma{at}mercer.edu

Abstract

Background Athletes, like non-athletes, suffer from mental health symptoms and disorders that affect their lives and their performance. Psychotherapy, either as the sole treatment or combined with other non-pharmacological and pharmacological strategies, is a pivotal component of management of mental health symptoms and disorders in elite athletes. Psychotherapy takes the form of individual, couples/family or group therapy and should address athlete-specific issues while being embraced as normative by athletes and their core stakeholders.

Main findings This narrative review summarises controlled and non-controlled research on psychotherapy for elite athletes with mental health symptoms and disorders. In summary, treatment is similar to that of non-athletes—although with attention to issues that are athlete-specific. Challenges associated with psychotherapy with elite athletes are discussed, including diagnostic issues, deterrents to help-seeking and expectations about services. We describe certain personality characteristics sometimes associated with elite athletes, including narcissism and aggression, which could make psychotherapy with this population more challenging. The literature regarding psychotherapeutic interventions in elite athletes is sparse and largely anecdotal.

  • elite performance
  • mental
  • psychiatry
  • psychology
  • sport psychology

https://doi.org/10.1136/bjsports-2019-100654

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    Footnotes

    • Contributors MAS, IDG, DM, CLR, MEH, VMF and BH all contributed to the writing of the manuscript. All authors helped perform the literature search and write the article. MAS and IDG had the idea for the article and MAS is the guarantor. Each author’s contribution to the paper is listed and described below. All authors are in agreement with the content of this manuscript. MAS: conception, design, construction and interpretation of the study; revising the article; final approval. IDG: review of the literature; construction of the article; revising the article; final approval. DM: review of the literature; interpretation; constructing and revising the article; final approval. CLR: conception and design of the study; construction of the article; revising the article; final approval. MEH: construction of the article; revising the article; final approval. VMF: review of the literature; constructing and revising the article; final approval. BH: construction of the article, revising the article; final approval.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.