conducting assessment and intervention Flashcards
What is the heart of the assessment?
the personal interview
- establishes trust and confidence which is more important than getting info
What are some things to consider during the assessment?
- receptivity of the athlete to skills training
- the severity of the psychological impact
- Degree of time urgency
What are the differences between athletes and non-athletes in rehab?
Advantages of athletes:
- goal orientation over outcome orientation
- proclivity for physical activity
- strong motivation to return to optimal functioning
- good pain tolerance
Disadvantages of athletes:
- return to daily functions is usually not good enough (need to return to play)
- longer recovery to meet the demands of the sport
- potentially greater loss due to investment of time, energy, and emotion in sport
Why do we have reluctant athletes?
- competitive sport discourages athletes from displaying vulnerability and encourages self-reliance
- injury challenges this mindset
- due to this, and the anxiety inherent with any new action with a trainer, it is understandable that athletes will be reluctant to psychological intervention
What are the fundamentals of psychological assessment?
- identify the subjective costs of the injury
- identify coping resources that the athlete can engage in
Characteristics of subjective costs?
- Severity of injury
- the likelihood of enduring performance deficits
- length of downtime
- timelines of injury
- influence these factors collectively have on the athlete’s future performance
Factors od diagnostic overview?
- factors preceding injury
- factors associated with injury
- factors following injury
What are some factors preceding injury?
-Medical history
*Psychological history
*Somatization
*Life stress and change
*Sport stress and change
*Approach of major competition
*Marginal player status
*Overtraining
*Sport-related health risk factors
What is somatization?
*Inability to differentiate somatic sensations arising from physical illness and those that typically accompany emotional distress (i.e., choking, butterflies in the stomach)
- overinterpretation and mislabeling of sensations
- conversations will be directed more toward pain than the psychological aspects
- common in youth athletes but not limited to
What are some factors associated with injury?
*Emotional distress
*Injury site
*Pain
*Timeliness
*Unexpectedness
What is emotional distress?
*Extreme fear, anxiety, agitation, or hopelessness observed or reported at the time of injury
- catastrophizing thoughts occurring at the time of injury
- incomplete memory of circumstances of injury (retrograde/posttraumatic amnesia)
Injury site effect on an athlete:
*Injury to a part of the body that is highly prized or for which there is special fear has greater psychological impact than other injuries.
- some parts of the body are more important to your sport than other parts (ex. ACL tear v. broken arm for soccer player)
What is the effect of pain on the athletes psychological aspects?
*Reflects severity of the tissue damage but also anxiety/expectations regarding the impact of injury on performance
- pain that appears outside of the norm based on the severity may signify a breakdown in coping mechanisms
Timeliness and unexpectedness affect on an athlete?
- Even minor injuries at key point in the athlete’s competitive season can be of tremendous consequence.
- injury/illness is more likely on the anniversary of a significant prior trauma
- compensation for injury and stress factor for illness
- can be conscious or unconscious decisions about it
- For an athlete who eludes the dangers inherent in sport it may be particularly distressing to lose playing time to an accident outside of sport
-An auto racer being injured in a MVA while out for a drive with friends
What are the factors following injury?
*Culpability
*Compliance with treatment
*Perceived effectiveness
*Treatment complications
*Pain
*Medication use
*Psychological status
*Social support
*Personality conflicts
*Fans and the media
*Litigation
Why check on physical injury in psychological assessment?
- SEP should routinely check the objective evaluation of injury provided by the sports medicine specialist
- Because they ate linked and as physical rehab increases, we should see improved psychological assessments. However, if this does not line up we can see if there is a coping problem
What is culpability?
*Responsibility for a fault or wrong
*Athlete’s may feel that they let their team, coaches, and family down
*Athlete may blame others (i.e., coach) for their injury. Anger and resentment can influence interpersonal relationships
How are fans and the media important?
*As the treatment provider, it is important to know when and how the injured athlete is presented in the media
- important for professional athletes
Criteria for acute injury assessment:
*Rehabilitation process
*Pain
*Psychological status
*Life circumstances
*Coping resources
What do you need to be aware of in the rehabilitation process?
Compliance
- attendance and effort levels
Knowledge
- nature of the injury treatment and specific rehab goals
perceived effectiveness
What do you need to be aware of related to pain?
If there is pain in:
- rehabilitation
- Day-to-day activity
- sports performance
Criteria for assessing psychological status?
- mood (in general)
- fear/anxiety (in specific situations)
- psychophysiological problems
- nausea, headache, fatigue, sleep issues, appetite change, etc. related to the injury and anxiety surrounding stress
Catagories for life circumstances in assessment?
- sports-related stress/change
- general life stress/change
- look out for because stress may not be related to sport or shows their support system dynamic
- overtraining prior to injury
Coping resources
Driving through
- By striving for high levels of personal motivation, setting goals, and focusing on rehab
Self-distraction
- Keeping busy and participating in variety of activities
Managing emotions and thoughts
- Using mental imagery, keeping positive focus, sharing emotions, taking it slow in rehab
Social resource
- Seeking support from others as role models and sources of motivation
Patient-reported outcome measures:
- Provide info about the status of the patient directly from the patient
- objective and measurable
- can be used for function, quality of life, and psychological assessment
