THE ROUTLEDGE HANDBOOK OF CLINICAL SPORT PSYCHOLOGY Clinical sport psychology is a rapidly growing field that brings together research and clinical interventions from both clinical psychology and sport and performance psychology. Complementary to sports medicine and clinical sport psychiatry, clinical sport psychology addresses the mental health needs and psychological well-being of athletes, coaches, and other members of the sport community. It offers scientifically informed conceptualizations of psychological distress as it manifests in sport settings, as well as empirically supported clinical interventions tailored to the needs of sport populations. This volume addresses the latest research findings regarding mental health among athletes and other sport professionals, including epidemiological research concerning depression, anxiety, eating disorders, and conduct and interpersonal problems. In addition, it explores the unique etiology of mental health problems among athletes, including psychological sequelae of injury and trauma, as well as concise practice guidelines for conceptualizing and treating psychological distress in sport populations. Strategies for thorough yet efficient psychological assessment of athletes, coaches, and other sport professionals are also provided. A compendium of relevant empirical research and clinical best practices for assessment and treatment, this handbook charts the course that clinical sport psychology has taken since its inception as a distinct clinical specialty and highlights future directions for this rapidly growing practice domain. It offers essential reading for psychologists and other mental health professionals who provide clinical services in sport and performance settings. Donald R. Marks, PsyD, is an associate professor and director of clinical training for Kean University’s Doctor of Psychology program in Combined School and Clinical Psychology. He is emeritus editor of the Journal of Clinical Sport Psychology. Andrew T. Wolanin, PsyD, is a clinical psychologist with a focus on athlete mental health and performance. He has published and presented on the prevalence of depression in athletes. As the president of Wolanin Consulting and Assessment, Inc., he provides evidence-based mental health and performance interventions to collegiate and professional athletes. Kendahl M. Shortway, PsyD, is an assistant professor at Kean University. Her research and clinical interests include athlete mental health, mindfulness and yoga, and response to dis- closure of sexual assault, with attention to social justice. She enjoys practicing therapy with adolescents and adults. THE ROUTLEDGE HANDBOOK OF CLINICAL SPORT PSYCHOLOGY Edited by Donald R. Marks, Andrew T. Wolanin, and Kendahl M. Shortway First published 2022 by Routledge 605 Third Avenue, New York, NY 10017 and by Routledge 2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN Routledge is an imprint of the Taylor & Francis Group, an informa business © 2022 Taylor & Francis The right of Donald R. Marks, Andrew T. Wolanin, and Kendahl M. Shortway to be identified as the authors of the editorial material, and of the authors for their individual chapters, has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data A catalog record for this title has been requested ISBN: 978-0-367-34727-7 (hbk) ISBN: 978-1-032-03859-9 (pbk) ISBN: 978-0-429-33097-1 (ebk) Typeset in Bembo by codeMantra CONTENTS List of Figures ix List of Tables x About the Contributors xi Clinical Sport Psychology: An Overview of the Field 1 1 Introduction: The State of Play in Clinical Sport Psychology 3 Donald R. Marks, Andrew T. Wolanin, and Kendahl M. Shortway 2 Clinical Sport Psychology in Practice: Sport-Specific Roles, Settings, Strategies, and Recommendations for Its Advancement 11 Brad Donohue, Shane Murphy, Simon Rice, and Chris Carr 3 Foundational Competencies of a Clinical Sport Psychologist 25 Jessyca N. Arthur-Cameselle SECTION I Psychological Distress in Sport Populations 39 4 The Athlete with Depression: Risk Factors and Effects 41 Andrew T. Wolanin and Dan Cohn 5 Understanding Anxiety and Its Impact in Sport Contexts 53 Lonnie Sarnell and Lori Schwanhausser Freeman 6 Athletes, Trauma, and Posttraumatic Stress 64 Kendahl M. Shortway and Jared Brooks Hammond v Contents 7 Body Image and Disordered Eating among Athletes 77 Justine J. Reel, Jenny H. Conviser, and Amanda S. Tierney 8 Emotion Regulation and Dysregulation in Athletes: Intrapersonal and Interpersonal Dimensions 95 David Brandwein, Daniel Watson, and Yael Osman 9 Substance Use in Athlete Populations: Prevalence and Theories 107 Michael O’Kane and Benjamin Foote SECTION II Social and Situational Stressors in Sport and Performance Settings 119 10 Sports and the COVID-19 Pandemic 121 Kendahl M. Shortway and Andrew T. Wolanin 11 Psychological Issues and Interventions in Sport Injury Rehabilitation 126 Annamari Maaranen and Britton W. Brewer 12 The Challenges of Sport Success for Professional Athletes 139 Brennan Petersen, Cole E. Giffin, Thierry R. F. Middleton, and Robert J. Schinke 13 It’s a Contact Sport: The Psychological Impact of Social Media in Sport 153 Jeffrey B. Ruser and Jesse A. Steinfeldt 14 Gender Discrimination in Sport 165 Lindsey Miossi and Tanya Prewitt-White 15 Cultural Discrimination and Marginalization in Sport Contexts 178 Ritvik Dutta, Keryn Kleiman, and Donald R. Marks SECTION III Assessment, Conceptualization, and Treatment 199 16 Looking Good: Understanding Impression Management in Assessment of Athletes 201 Andrew T. Wolanin and Christina Galese 17 Psychological and Developmental Concerns in Child and Adolescent Athletes 209 Samuel J. Nayman, Maurice J. Elias, Mark E. Louie, and Gabriella Guzman vi Contents 18 Mindfulness- and Acceptance-Based Approaches to the Treatment of Athletes and Coaches 223 Kat Longshore and Michelle M. McAlarnen 19 Utilizing Systems Theory to Frame Interventions with Athletes across the Developmental Spectrum 243 Travis E. Dorsch, Chris Carr, Matthew Vierimaa, and C. Ryan Dunn 20 Organizational Models of Implementing Mental Health Services for Athletes 258 Andrew T. Wolanin, Eric Laudano, and Donald R. Marks 21 Pharmacotherapy in the Treatment of Athletes 270 Claudia L. Reardon and Vuong Vu SECTION IV Best Practices in Clinical Sport Psychology 281 22 Best Practices in Assessment and Treatment of Mood Disorders in Sport and Performance Contexts 283 Andrew T. Wolanin and Dan Cohn 23 Best Practices for the Assessment and Treatment of Anxiety Disorders in Sport Populations 294 Lori Schwanhausser Freeman and Lonnie Sarnell 24 Best Practices for Diagnosis and Management of Trauma-Related Disorders in Athletes 306 Cynthia Miller-Aron and Sydney Marie LeFay 25 Best Practices for Assessment and Treatment of Eating Disorders in Sport and Performance Contexts 321 Jessyca N. Arthur-Cameselle and Paula A. Quatromoni 26 Best Practices for Substance Use Treatment in Student-Athletes 338 Benjamin Foote and Michael O’Kane 27 Best Practices in Cognitive-Behavioral Therapy with Suicidal Athletes 347 Cory F. Newman 28 Best Practices for the Assessment and Treatment of Interpersonal Problems in Sport and Performance Contexts 360 David Brandwein, Simone M. Cooper, and Yael Osman vii Contents 29 Best Practices for Pharmacotherapy in Sport and Performance Contexts 373 Vuong Vu and Claudia L. Reardon Conclusion 395 30 Looking Downfield: Future Directions for Clinical Sport Psychology 397 Donald R. Marks, Andrew T. Wolanin, and Kendahl M. Shortway Index 405 viii FIGURES 3.1 The cube model of competency development (Rodolfa et al., 2005, p. 350) 28 3.2 The competence constellation (Johnson et al., 2013, p. 349) 34 ix