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An Exploration of Sports Rehabilitators’ and Athletic Rehabilitation Therapists’ Views on Fear of Reinjury After Anterior Cruciate Ligament Reconstruction

Fiona McVeigh and Stephen M. Pack

Background:

Research involving long-term follow-up of patients after successful anterior cruciate ligament reconstruction (ACLR) has shown that return-to-sport rates are not as good as would be expected despite many patients’ having normal knee-function scores. The psychological component, specifically fear of reinjury, plays a critical role in determining patients’ return to play and is frequently underestimated. Little is known about the recognition and intervention from the therapist’s perspective.

Aim:

To gain a greater understanding of the views of sports rehabilitators and athletic rehabilitation therapists on recognition of fear of reinjury in clients after ACLR.

Method and Design:

A qualitative approach, consisting of semistructured interviews with a purposive sample of 8 participants, sports rehabilitators, or athletic rehabilitation therapists. This population has been largely unexamined in this context in previous research.

Main Findings:

Thematic analysis yielded 2 main themes: communication and education. Participants discussed the importance of communication in the client–therapist relationship and how it is used in addressing misinformation and fear of reinjury. All participants used education in outlining the rehabilitation pathway and dealing with those providing social support around the client. Issues emerged relating to therapists’ recognition of observable signs of fear of reinjury in the clinical setting. Overall, participants thought that fear of reinjury was not a barrier to return to play after ACLR.

Conclusion:

There is a need for more education of therapists on recognizing fear of reinjury and the appropriate use of psychological intervention skills as a method for dealing with this throughout the rehabilitation process.

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The Self-Practice of Sport Psychologists: Do They Practice What They Preach?

Stephen Pack, Brian Hemmings, and Monna Arvinen-Barrow

The maturation processes of applied sport psychologists have received little research attention despite trainees and practitioners having often reported experiencing challenging circumstances when working with clients. Within clinical psychology literature the self-practice of cognitive techniques, alongside self-reflection, has been advocated as a means of addressing such circumstances, and as a significant source of experiential learning. The present study sought to identify the possible types of, and purposes for, self-practice among twelve UK-based sport psychology practitioners. Thematic analysis of semistructured interviews indicated all participants engaged in self-practice for reasons such as managing the self, enhancing understanding of intervention, and legitimising intervention. Some participants also described limitations to self-practice. Subsequently, three overriding themes emerged from analysis: a) the professional practice swamp, b) approaches to, and purposes for, self-practice, and, c) limitations of self-practice. It is concluded that self-practice may provide a means of better understanding self-as-person and self-as-practitioner, and the interplay between both, and is recommended as part of on-going practitioner maturation.

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Transitioning Out of Professional Sport: The Psychosocial Impact of Career-Ending Non-Musculoskeletal Injuries Among Male Cricketers From England and Wales

Monna Arvinen-Barrow, Kelsey DeGrave, Stephen Pack, and Brian Hemmings

The purpose of this study was to document the lived experiences of professional cricketers who had encountered a career-ending non-musculoskeletal injury. Three male cricketers each with over nine years of playing experience in professional cricket representing England and Wales participated in retrospective in-depth semi-structured interviews. The Interpretative Phenomenological Analysis revealed that at the time of the injury, the participants were at the “final stretch” of their professional sporting careers and that despite a range of unpleasant reactions to injury, all participants experienced a healthy career transition out of sport. To best prepare athletes for a life outside of sport, ensuring athletes have sufficient plans in motion early on in their careers can reduce external and internal stressors, which if not addressed, can increase sport injury risk and have a negative effect on athletes’ reactions post-injury.

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Sport Psychology Consultants’ Reflections on the Role of Humor: “It’s Like Having Another Skill in Your Arsenal”

Stephen Pack, Monna Arvinen-Barrow, Stacy Winter, and Brian Hemmings

Previous research demonstrates that sport psychology consultants use humor to facilitate working alliances, reinforce client knowledge, and create healthy learning environments. The current study sought to gain further insights into consultants’ reflections on the role of humor, humor styles, purposes for humor, and experiences of humor use. Forty-eight sport psychology consultants completed an online survey comprising open-ended questions. Thematic analysis revealed four themes: “It’s the way I tell ’em,” “It’s the way I don’t tell ’em,” “This is why I tell ’em,” and learning to use humor in consultancy. Participants used 2 styles of humor (deadpan and self-deprecating), each with the goal of facilitating the working alliance. Although not all participants used humor during consultancy, its incorporation might render the working alliance and real relationship as resources in ways (e.g., a “barometer” that predicts consultancy outcomes) previously not considered in applied sport psychology.