acpsm the role of psychology in dealing with sport injuries · acpsm the role of psychology in ....
TRANSCRIPT
![Page 1: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/1.jpg)
ACPSMACPSM
The Role Of Psychology in The Role Of Psychology in Dealing with Sport InjuriesDealing with Sport Injuries
AILSA ANDERSONUniversity of Ulster4 November 2003
![Page 2: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/2.jpg)
2 main areas in research on psychology of sport injury
Antecedents to Antecedents to injuryinjury
INJURY
Consequences Consequences of injuryof injury
--adjustmentadjustment
--rehab behaviourrehab behaviour
![Page 3: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/3.jpg)
Aims of Session
Examine responses to injury and why they occurConsider current theoretical modelsIdentify evidence-based strategies to assist athletes in dealing with injury
![Page 4: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/4.jpg)
Three types of responses to injury
1) Cognitive (thoughts) –• ‘That’s it – my season is
over’
2) Affective (emotions)• Anger/ upset/ depressed
3) Behaviour• Effort in rehab/ Give up/
Do other thingsSKIER
(Udry et al., 1997)
![Page 5: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/5.jpg)
Significance of injury
‘I wouldn’t wish injury on anyone, but you don’t really know what the game’s all about until you’ve experienced it’
(Steve Backley)
![Page 6: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/6.jpg)
1) Stage Models
Relates to thought and feeling responses - adapted from models of grief/loss
Key assumption:injury constitutes a loss of an aspect of selfathletes’ responses will be sequential and follow a predictive pattern
Grief Response is most common stage model in SP – based on Kubler-Ross’ (1969) book On Death and Dying
![Page 7: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/7.jpg)
Kubler-Ross Model
Disbelief and Denial
Anger
Bargaining
Depression
Acceptance and Resignation
![Page 8: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/8.jpg)
Problems with this model?
Is it appropriate?- significant differences between terminal illness and injuryResearch suggests very little evidence of denial in athletes (e.g., Udry et al., 1997)Athletes’ don’t respond to injury in such a stereotypic manner (a lot of individual variation/ fluctuations in emotions) (Brewer, 1994)Further research required
![Page 9: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/9.jpg)
2) Cognitive Appraisal Models
Response to injury is dependent on how we think about the injuryBased on stress and coping models (Lazarus & Folkman, 1984)
![Page 10: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/10.jpg)
Brewer’s (1994) Model of Response to Sport Injury
INJURY
Cognitive Appraisal(interpretation of injury)
THINK
Emotional Response(anger, depression etc)
FEEL
Behavioural Response(Coping/ rehab beh etc)
DO
![Page 11: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/11.jpg)
2 components to how we think think about the injury
Primary appraisal:Is the injury a threat to my well-being and goal achievement?
Secondary appraisal:Do I have the resources to cope effectively with the injury?
![Page 12: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/12.jpg)
Lilly
1) I’ve sprained my ankle and it could stop me playing in the final championship game in only 3 weeks
![Page 13: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/13.jpg)
Billy
1) I’ve sprained my ankle and it could stop me playing in the final championship game in only 3 weeks
![Page 14: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/14.jpg)
Lilly
2) My team-mates and coach will help me stay involved, and I can work hard in rehab and get back asap.
![Page 15: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/15.jpg)
Billy
2) That’s it! It’s all over – I know I can’t get back in 3 weeks.
![Page 16: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/16.jpg)
Appraisal leads to…
2) Behavioural response (DODO):
LILLY =Compliance to rehab/ high effort
BILLY =Lack of effort/withdrawal
1) Emotional response (FEELFEEL):
LILLY = Positive attitude/ outlook
BILLY =Frustration/ anger/ depression/ fear
![Page 17: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/17.jpg)
Factors that influence cognitive appraisal
Personal Factorse.g., motivation/ confidence/ injury history/ pain tolerance
Cognitive Appraisal(interpretation of injury)
Emotional Response(anger, depression etc)
Behavioural Response(Coping/ rehab beh etc)
Situational Factorse.g., social support available/
stage of season/ rehab environment/ prognosis
![Page 18: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/18.jpg)
Practical implications
How the athlete THINKS ABOUTTHINKS ABOUT their injury is crucialPossible STRATEGIES:
Ask athlete about their perceptions of their injuryChallenge and question unhelpful thinking
CatastrophisingUnrealisticNegativePersonalisation
Reinforce the role that thoughts play in successful rehabReferral to psych?
![Page 19: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/19.jpg)
Focus on behavioural responses
How an athlete thinks and feels about an injury and/or rehab will influence behaviourFocus on rehabilitation compliance
![Page 20: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/20.jpg)
Defining compliance
Compliance = extent to which athletes follow recommended rehabilitation behaviourOver-compliance and under-compliance
![Page 21: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/21.jpg)
Is compliance an issue?
Current estimates of compliance:range from 40 – 91% (Brewer, 1998)↓ Length of rehab program↓ Home-based
In survey of UK physiotherapists good compliance was associated with coping well with injury (Hemmings & Povey, 2002)
![Page 22: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/22.jpg)
How do we measure compliance?
AttendanceSelf-report of completion of home-based activities (diary)Practitioners’ observation or estimate of home/hospital adherence
![Page 23: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/23.jpg)
What factors effect compliance?
Situational factorsBelief in efficacy of treatmentPerceived support during rehabConvenience of rehab scheduling
Personal factors:Self-motivationPain toleranceToughmindedness (assertive/independent/ self-assured)Trait anxiety (-vely)
![Page 24: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/24.jpg)
But need a theoretical framework
Current study based on Theory of Planned Behaviour (Ajzen, 1985, 1991)
With Musgrave Park – ACL rehab behaviourWith SINI – range of injuries (min 6-week rehab period)
Identify what factors are most influential in predicting rehab behaviour and then target these to increase compliance
![Page 25: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/25.jpg)
Adherence Behaviour
Over 8 WeeksIntention
![Page 26: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/26.jpg)
Intention immediate determinant of behaviour
‘I intend to follow the recommended rehab programme in next 8 weeks’
![Page 27: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/27.jpg)
Adherence Behaviour
Over 8 WeeksIntention
AttitudeTowards Following
Rehab Prog
![Page 28: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/28.jpg)
Attitude
Person’s overall evaluation of performing the behaviour in question‘For me to follow the recommended rehabilitation programme in the following 8 weeks would be’
unimportant-importantuseless-usefulharmful-beneficial enjoyable-unenjoyable
![Page 29: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/29.jpg)
Influencing attitudes –Practical strategies
SOURCE:
(physio & coach) credible/ trustworthy/
attractive
MESSAGE:
unambiguous/ supported with evidence/ fear-
inducing?
Persuasive communication:
Highlight importance of compliance
![Page 30: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/30.jpg)
Influencing attitudes –Practical strategies
MODELLING - We form attitudes by observing the consequences of other’s behaviourUse role models who have successfully completed rehab–
e.g.:BeckhamTeam-matesSupport groups
![Page 31: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/31.jpg)
Perceived control
Adherence Behaviour
Over 8 WeeksIntention
AttitudeTowards Following
Rehab Prog
![Page 32: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/32.jpg)
Perceived control
Is it under my control whether I carry out the rehab programme or not?
‘It is mostly up to me whether I follow the prescribed rehabilitation programme for the next 8 weeks’
What factors could influence control?Practical implications/ strategies?
![Page 33: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/33.jpg)
Influencing PC - Practical strategies
Assist in removing barriers to successful completion of rehabilitationE.G.,
Scheduling times/ places etc??
![Page 34: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/34.jpg)
Adherence Behaviour
Over 8 Weeks
Perceived control
Self-confidence
Intention Attitude
Towards Following Rehab Prog
![Page 35: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/35.jpg)
Self-confidence
Behaviour may be under athletes control but how confident is the athlete that they have the ability to complete the rehab programme
‘I believe I have the ability to complete the recommended rehabilitation programme for the next 8 weeks’
Factors that could influence self-confidence?
![Page 36: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/36.jpg)
Influencing self-confidence -Practical strategies
Build upon previous success
goal setting diary
ModellingPersuasive communication
From others and self
![Page 37: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/37.jpg)
Adherence Behaviour
Over 8 Weeks
Perceived control
Self-confidence
Intention Attitude
Towards Following Rehab Prog
Social Pressures
![Page 38: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/38.jpg)
Social pressures
Social pressures relates to an individual's perception of the pressures put on him/her by important others to perform or notperform the behaviour
‘People who are important to me, want me to follow the recommended rehabilitation programme for the next 8 weeks’
![Page 39: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/39.jpg)
Influencing subjective norm -Practical strategies
Incorporate significant others into consultation process?
??
![Page 40: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/40.jpg)
Call for volunteers
Additional aspect of the TPB study
Interview physios on what you think influences compliance behaviour
Approx 1 hour interview at place of your convenience
Please fill in form and leave your details
![Page 41: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/41.jpg)
Summary
Athletes’ responses to injury include cognitive, affective and behavioural responsesStage models and cognitive appraisal models help make sense of cognitive and affectiveresponsesTPB could be a useful framework for investigating and increasing compliance behaviour
![Page 42: ACPSM The Role Of Psychology in Dealing with Sport Injuries · ACPSM The Role Of Psychology in . Dealing with Sport Injuries. AILSA ANDERSON. University of Ulster 4 November 2003](https://reader030.vdocuments.us/reader030/viewer/2022041122/5f385bde499fcb33813abb59/html5/thumbnails/42.jpg)
Game over