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An Interdisciplinary Approach to Improving the Quality of Life in Postural Orthostatic Tachycardia Syndrome: A Case Study

Carl Turner, Jonathan Rhodes, Darren Crocker, Karol Nedza, and Jon May

Postural orthostatic tachycardia syndrome (POTS) is a debilitating condition affecting the autonomic nervous system that causes a series of symptoms, such as blurred vision, brain fog, chest pain, headaches, shortness of breath, fatigue, syncope, and rapid heart rate. These symptoms can lead to diminished daily activity, daytime fatigue, poor sleep quality, and increased suicidal tendencies. Among the physical symptoms, POTS patients present decreased quality of life, increased prevalence of depression, and elevated anxiety. This case study documents an interdisciplinary approach to treating a 39-year-old female POTS patient with an 8-week intervention program and a further 4-week follow-up. The intervention investigated the combined effects of Functional Imagery Training and physical exercise on the patient’s quality of life. Following completion of the program, the subject improved in all four quality-of-life components, and this change was maintained over time when compared with baseline measures. The program demonstrated that high levels of exercise adherence beyond the intervention can be achieved when combining Functional Imagery Training and exercise, regardless of the exercise-intolerant characteristics presented by a POTS patient.

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An Intervention to Support Collegiate Student-Athletes in the Transition to Meaningful Lifetime Physical Activity

Melinda B. Smith, Diane L. Gill, and Erin J. Reifsteck

Former student-athletes (SAs) experience unique barriers to maintaining their physical activity, such as loss of team support, less motivation without specific goals, and identity-related changes. Informed by a self-determination theory framework, the authors developed a 6-week Pilates-based intervention to support the physical and psychological wellness of SAs by fostering self-determined motivation and basic psychological needs satisfaction as they make the transition to physically active alumni. In this case study, the authors outline the development and implementation of the program with final-year SAs (N = 12) at a Division III institution. Feasibility was demonstrated through high adherence and positive participant feedback suggesting they valued their experiences in the program and felt more confident in pursuing new forms of physical activity beyond college sports. To extend this type of programming at other institutions, the authors recommend that sport psychology professionals consider unique institutional barriers and opportunities for supporting SAs in their transition to meaningful lifetime activity.

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Investigating Coaching Behaviors During the COVID-19 Pandemic: A Case Study Within a Case Study

Jonathan Glen, Julie Gordon, and David Lavallee

The purpose of this case study is to offer reflections for both applied researchers and practitioners on our experiences of investigating coaching behaviors during the COVID-19 pandemic. The case is based on the delivery of remote, online tennis coaching sessions to children over a period of 3 weeks. Questionnaire, observation, and focus group data were collected from tennis players, coaches, and parents/guardians. Analyses revealed similarities and differences with previous investigations measuring coaching behaviors, as well as the perceived effectiveness of sports coaching in an online environment. Novel insights and recommendations for applied researchers and practitioners in sport and exercise psychology are highlighted, including the importance of staying connected during the pandemic, keeping players and parents motivated, and creativity. The authors consider the context of conducting a case study into coaching behaviors during the COVID-19 pandemic itself, and conclude by providing reflections on our case study within the case study of COVID-19. These include enhanced communication (as it was easier to connect with each other), the nature of the online delivery improving presession preparation, and the research process being relatively more straightforward to implement, all due to barriers being removed as a direct result of COVID-19 quarantine, stay-at-home restrictions.

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Lessons Learned in Supporting Women With Prediabetes Through Maintaining Diet and Exercise Behavior Changes Beyond a Diabetes-Prevention Counseling Program

Corliss Bean, Tineke Dineen, and Mary Jung

Interventions involving exercise and diet can reduce the progression of Type 2 diabetes, yet they are often short-lived. Progressing toward self-managed maintenance is also challenging. If supports are in place to help individuals with behavior changes beyond immediate programming, they are more likely to maintain these changes. This is particularly the case for women, who often struggle to maintain diet and exercise changes and can benefit from social support. Small Steps for Big Changes is a 3-week counseling program housed in a local YMCA that aims to help people make exercise and diet changes. To understand how to best support women in maintaining these changes beyond program delivery, a knowledge-sharing event was held for 14 women who completed the intervention. The women engaged in a focus group to share challenges they had experienced in making diet and exercise changes and recommendations for continued support. Data were analyzed using a thematic analysis, and three recommendation areas were identified: (a) establishing peer support networks, (b) creating platforms to communicate prediabetes-related information, and (c) providing ongoing trainer support. Several recommendations have been implemented to support these women, and other individuals, postprogram. This case provides insights and recommendations for integration of initiatives beyond delivery of a behavior-change program housed in a community organization.

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Mindfulness in Sport: An Intervention for a Choking-Susceptible Athlete

Jenna Hussey, Robert Weinberg, and Arash Assar

Although antecedents of choking under pressure have been studied, prevention efforts have been somewhat inconsistent. Current choking-susceptibility criteria include trait anxiety (TA), self-consciousness (SC), and coping style. In the present case study, a college track-and-field athlete was self-identified as choking susceptible (CS), and a sport-specific mindfulness intervention to reduce levels of TA, SC, and alter coping to reduce choking susceptibility was implemented. The athlete identified as CS completed the 6-wk Mindful Sport Performance Enhancement (MSPE) program. Trait and state mindfulness were assessed throughout the program, with a follow-up 6 wk postintervention to gain further insight into the continuing effects of the mindfulness training. Visual analysis and quantitative and qualitative data demonstrated increases in mindfulness levels and changes in TA, SC, and coping, resulting in the participant’s failing to meet the choking-susceptibility criteria postintervention, indicating a reduced likelihood of choking in future performances. Enhanced mindfulness levels promoted greater awareness and acceptance, which may help counter the negative effects of stressful sport performances.

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Navigating Subclinical Sport Psychology as a Trainee: A Case Study of Acceptance and Commitment Therapy in Elite Youth Athletics

Chris Hartley

The current case reports the service delivery experiences of a trainee practitioner working within elite youth athletics, discussing the experiences and challenges associated with encountering clinical issues and appropriate referrals for the first time. Alongside ongoing clinical support, this case warranted ongoing sport psychology service delivery, during which the trainee adopted an acceptance and commitment therapy approach. Interventions were focused toward the promotion of openness to experience and the identification of value-driven behaviors for sport. Service effectiveness was evaluated via a multimodal method including other professionals in a multidisciplinary support team. Reflections on the service delivery highlight the potentially beneficial or detrimental impacts that practitioner beliefs and values may have, as well as issues regarding role clarity, education, and preparedness for sport psychology trainees encountering clinical issues for the first time.

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One-to-One Support With a Professional Rugby League Player: A Case for Referral?

Nick Wadsworth, Ben Paszkowec, and Martin Eubank

This article presents a reflective case study of an applied consultancy experience with a 22-year-old professional rugby league player. The primary aim of the intervention was to provide the client a confidential space where he could discuss his experiences in and outside of a sporting context while also exploring and challenging his core values and beliefs. The consultancy process lasted for 12 mo, leading to the development of a strong relationship. During this time, the client experienced multiple critical moments such as deselection from the first-team squad and contract negotiations, which at times led to reductions in his well-being and forced the trainee sport and exercise psychologist to consider his scope of practice in relation to mental health and depression. Reflections are provided that explore the possibility of referral during these moments. The case study also provides insight into the trainee sport and exercise psychologist’s philosophy of practice and how influential this can be when considering referral of a client. The importance of supervisor support during uncertain moments is highlighted, and the case study concludes with reflections from the client, trainee practitioner, and peer supervisor regarding the efficacy of the intervention and the decision not to refer.

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An Online Intervention to Support Student-Athlete Mental Health: Implementation, Evaluation, and Critical Reflection

Ben Laslett and Mark Uphill

This study examined the influence of two interventions (therapeutic letter to self; values targeting) on student-athletes’ mental health using two variants of a single-subject design: a multiple-baseline single-subject design and a probe design. Four high-ability student-athletes (two males and two females) who competed in various sports (e.g., soccer and cycling) completed two preintervention measures (Mental Health Continuum Short Form; Clinical Outcomes Routine Evaluation 10) at baseline. These measures were then readministered after Intervention 1, Intervention 2, and at a 2-week follow-up using a probe design. Mental well-being (Short Warwick-Edinburgh Mental Well-Being Scale) was assessed every 2 days from start to finish using a multiple-baseline across-participants design. Data were analyzed via visual inspection methods, specifically, immediacy of effect, mean change, effect sizes, and percentage of overlapping data. Results indicated that two participants who completed the study (Nina and Tim) showed an increase in total mental health and a decrease in psychological distress from baseline to follow-up. Findings are discussed with respect to prior research and study limitations.

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An “Organizational Triangle” to Coordinate Talent Development: A Case Study in Danish Swimming

Ole Winthereik Mathorne, Kristoffer Henriksen, and Natalia Stambulova

This case study in Danish swimming was informed by a holistic ecological approach in talent development and aimed to explore (a) collaborative relationships between the Danish swimming federation, a municipality, and a local swimming club, termed “an organizational triangle,” and (b) factors influencing the success of their collaboration at the local level. Data collection and analysis were guided by the athletic-talent-development-environment (working) model and a newly developed collaboration-success-factors (CSF) model. Methods included interviews with talent-development coordinators representing the organizations and analysis of documents. Results allowed the authors to transform the CSF (working) model into an empirical model containing the collaboration preconditions (e.g., power to make decisions), processes (e.g., strategic planning), and initiatives (e.g., efficient use of the swimming pool) and shared assumptions of the talent-development philosophy (e.g., long-term focus). The success of this organizational triangle was visible in the way the organizations increased the quality of talent development in the local swimming club.

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Preshot Routines to Improve Competition Performance: A Case Study of a Group of Elite Pistol Shooters

Peter Gröpel, Christopher Mesagno, and Jürgen Beckmann

Evidence shows that using a preshot routine (PSR) improves performance in self-paced, closed-skill tasks. A PSR is a set of cognitive and behavioral elements an athlete systematically engages in prior to performance execution. The present study describes the implementation and evaluation of a PSR intervention with elite pistol shooters in the 10-m air-pistol discipline. Individualized PSRs were developed with the shooters in individual psychological sessions, and the PSRs were then practiced in subsequent training sessions. Intervention effectiveness was evaluated by analyzing the shooters’ competition performance. Overall, the shooters improved on average by 2.5 points from before to after the intervention. This improvement was unlikely due to seasonal effect, as the league average (scores of league shooters not included in the intervention sample) remained stable during the study time. These results indicate that using a PSR before a shooting series has benefits for subsequent shooting performance.