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Ask the expert: Anxiety and athletes – what can we do?

By: Emily Kroshus, ScD, MPH Post-Doctoral Research Fellow, Harvard School of Public Health & NCAA Sport Science Institute

Anxiety disorders can affect a student athlete’s ability function effectively – academically, athletically or socially. Symptoms of anxiety disorders often worsen under stress.  A student-athlete may be experiencing stress because of the transition of being away from home and adjusting to a new living situation, or worrying about achieving academically, or meeting performance expectations in his or her sport.  Leading sports psychology expert Dr. Scott Goldman, the Director of Athletic Counseling for the University of Michigan’s athletic department, provides concrete suggestions for how to coaches and clinicians can work together to address problematic anxiety among student-athletes.

Q: Athletes often get anxious before competitions.  How can you tell if this anxiety is “appropriate” or if it suggests the athlete may have an anxiety disorder and should seek the care of a mental health professional?

Rather than trying to differentiate between performance anxiety and an anxiety disorder, I think it’s beneficial to determine whether the anxiety is functional or dysfunctional for the student-athlete in their context. Basically, you look at the student-athlete’s “productivity” – academically, athletically, socially, and so forth and compare it to their baseline.  You can also look at the student-athlete’s subjective sense of wellness and general happiness.  The best questions to ask include: “Is the emotion helping with day-to-day functioning?  Is it helping with performance?” If the answers suggest that the student-athlete’s functioning is being impeded, then an intervention can be developed that takes into consideration the severity of their anxiety, their unique individual characteristics and needs, and their context.  Coaches, athletic trainers, academic counselors, and other athletic department personnel have the benefit of seeing student-athletes across multiple contexts: on the court, on road trips, and in team meetings.  Consequently, they are well positioned to get a sense of how the student-athlete is doing.  While some individuals might appear to only get anxious in certain situations—for example on the court or field of play – emotions are rarely isolated to one situation and this individual may be having difficulties elsewhere.

Q: What should coaches do if they are concerned that a student-athlete may be experiencing problematic anxiety?

The simplest solution is to ask the student-athlete directly in an empathic and supportive manner “Are you ok? And, how can I help?” Ideally, the coach has access to a licensed mental health care provider, like a psychologist or counselor. If they have this competitive advantage, I would recommend the coach discuss the concerns they have about the student-athlete with the licensed provider so they can develop a “game plan” as well as create an ideal environment to increase the likelihood of the student-athlete’s success and growth. The most important thing, however, is for the coach to express genuine compassion when communicating with the student-athlete and be supportive of the therapeutic process. It is recommended that the coach focus on encouraging the student-athlete to seek treatment from a licensed mental health care provider rather than themselves attempting to help the student-athlete manage their emotional issues.  

Q: What are the best things that coaches can do to help prevent or reduce the negative effects of anxiety?

It’s important to remember that there are many reasons why some student-athletes experience problematic anxiety. Individual differences such as their cognitions and personal history play a large role in whether specific situations – like some coaching behaviors – influence their anxiety.  That being said, for some student-athletes, the coach can be an activating event.  If you think of coaches as teachers, then you can use basic learning theories to understand how athletes develop and master sport.  This means considering things like positive reinforcement, negative reinforcement and punishment.  When a coach uses punishment to teach (for example, yelling), it can be very effective in producing compliance in the short term. However, when used incorrectly or excessively, punishment also yields a long-term side effect, namely anxiety and fear.  Most coaches say they want their team members to be fearless, but if the coach is being overly punitive when a student-athlete makes a mistake (which is a part of sport as no one is perfect) then the punishment can induce performance anxiety. If such a system is established, the student-athlete is less likely to own their mistakes and, more importantly, less likely to approach the coach. Coaches want to teach and student-athletes want to learn. When punishment is incorrectly used, the relationship is disrupted. Specifically, student-athletes stop seeking to learn and avoid the coach and/or situation. This is exemplified when the student-athlete begins to look over to the bench to see the coach’s reaction after the making a mistake on the playing field. To be clear, punishment has its benefits. It should just be noted that it is best when it is high in intensity, short in duration, and used infrequently.  No one coaching style is universal, and what works for one team might not work for another team. Seeking out alternative ways to teach and reinforce understanding may increase overall success. This does not mean a coach should coddle the student-athlete. Rather, it means a coach should hold the student-athlete accountable without being excessively punitive. Fundamentally, coaches and student-athletes have a shared desire of attaining sport mastery and overall success. Thus, finding ways to educate without induction of fear generally increases the likelihood of successful performance and makes the experience more enjoyable for everyone.

To learn more, read Dr. Goldman’s chapter on anxiety disorders in the recent NCAA mental health publication “Mind, Body, and Sport.”

About Scott Goldman, PhD
As the Director of Athletic Counseling for the University of Michigan’s athletic department, Scott Goldman, Ph.D. provides direct patient care to the student-athletes as well as consulting services for the coaches and staff. Dr. Goldman has provided mental health care in a variety of settings for amateur, collegiate, semi-professional, and professional athletes.  Starting in 1994, Dr. Goldman’s clinical experience includes working in university counseling centers, rehabilitation centers, private and government funded psychiatric children’s hospitals, school counseling centers, and outpatient therapy institutes. Dr. Goldman is a member of the NCAA Mental Health Task Force and the NFL/NCAA Mental Health Think Tank.