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The purpose of this article is to expand the literature on case formulation as a clinical tool for use within exercise psychology, generally and lifestyle behavior change interventions, specifically. Existing research offers limited support for the efficacy of current physical activity behavior change intervention strategies, particularly in the long-term. The present paper argues that intervention strategies need to pay greater attention to the complex and individualistic nature of exercise and health related behaviors. It has been suggested that existing intervention designs tend to conform to a medical model approach, which can at times potentially neglect the complex array of personal and situational factors that impact on human motivation and behavior. Case formulation is presented as a means of encouraging a dynamic and comprehensive approach to the development and implementation of practical interventions within the health behavior change field. The adoption of these clinical techniques may facilitate the careful consideration of variations in the development, manifestation, and maintaining mechanisms of problematic behaviors (e.g., inactivity). An overview of case formulation in its different forms is presented alongside a justification for its use within exercise psychology.

Providing effective sport psychology services requires practitioners to conceptualize the unique issues and concerns of each individual athlete. However, collecting information on the athlete, understanding the athlete’s issues and needs, and determining how to best assist the athlete can be a complex process. Thus, this article outlines a case formulation approach to help the sport psychology consultant assess the athlete, organize and conceptualize assessment data, classify the athlete’s issues, and choose interventions that directly target those factors that are impeding the athlete’s progress in athletics or other life domains. Two case examples are provided to illustrate the case formulation process.

Psychodynamic concepts have only recently begun to attract serious attention in the sport psychology literature. A dynamically based, interpersonal approach to sport psychology consultation is outlined in this article. Key interpersonal constructs such as important persons and their internalized representations (IPIRs), copy processes, and self-sacrificing gifts of love are described to portray how a case formulation may be developed to explain and guide interventions to overcome some performance problems. Two cases, one involving a performance phobia and the other an enduring slump related to a fear of success, are presented to demonstrate the unique contributions of interpersonal case formulations in performance enhancement consultation.

The present case study illustrates the treatment of a 19-year-old female lacrosse player, classified as experiencing Performance Dysfunction (Pdy) by the Multilevel Classification System for Sport Psychology (MCS-SP). The self-referred collegiate athlete was treated using the manualized Mindfulness-Acceptance-Commitment (MAC) protocol (Gardner & Moore, 2004a, 2007). The intervention consisted of eight individual sessions and several follow-up contacts via e-mail. The majority of the sessions addressed clinically related and sport-related concerns, including difficulties in emotion regulation and problematic interpersonal relationships. Based on self-report, coach report, and one outcome assessment measure, the psychological intervention resulted in enhanced overall behavioral functioning and enhanced athletic performance. This case study suggests that following careful case formulation based on appropriate assessment and interview data, the MAC intervention successfully targeted the clearly defined psychological processes underlying the athlete’s performance concerns and personal obstacles, thus resulting in enhanced well-being and athletic performance improvements.