The first session with an athlete–client presents an opportunity to establish the working alliance, acquire useful information to facilitate case conceptualization, and develop an effective treatment plan with appropriate intervention. Although sport psychology professionals have independently discussed how practitioners might go about conducting a first session with an athlete (e.g., Andersen, 2000; Aoyagi et al., 2017; Keegan, 2016; Simons, 2012; Taylor & Schneider, 1992), there is little empirical research in this area. This lack of literature is surprising given the first session sets the stage for subsequent sessions and the consultation process (Andersen, 2000), and allows the practitioner time to appraise whether they can competently provide services to a client (Keegan, 2016). Furthermore, the quality of the first session is one factor that explains premature termination (Swift & Greenberg, 2012), while trainee sport psychology professionals often want supervision about how to conduct appropriate and effective first sessions (Hutter et al., 2015). The purpose of this study, therefore, aimed to advance the science of practice by investigating expert practitioner approaches in conducting a first sport psychology session with an athlete–client.
The initial session with an athlete–client is critically important in sport psychology, and several objectives to achieve and aspects to incorporate have been advanced by various professionals (Andersen, 2000; Herzog & Hays, 2012; Keegan, 2016; Silva et al., 2011; Taylor & Schneider, 1992). The practitioner should aim to understand the presenting issue and relevant history, develop rapport, and begin to establish the working alliance (Andersen, 2000; Herzog & Hays, 2012; Keegan, 2016). As described by Andersen (2000), a primary goal of the initial session is helping the athlete tell his/her story. By the end of the session, the question of whether the practitioner and athlete–client can work together must be answered (Andersen, 2000). Information obtained in the first session facilitates case conceptualization as the practitioner will begin to develop hypotheses regarding the athlete–client’s concerns, a preliminary treatment plan, and potential interventions or between-session exercises to address the presenting problems (Andersen, 2000; Herzog & Hays, 2012; Taylor & Schneider, 1992). For licensed practitioners, the first session is important for determining where the focus of work will be along the psychotherapy-mental skills training continuum (Herzog & Hays, 2012). Regardless of whether the nature of work is mental performance or mental health, there is agreement that limits of confidentiality in a professional relationship should occur before or during the first session (Brown & Cogan, 2006; Watson et al., 2020).
Andersen (2000) recognized the importance of following the athlete in the first session, rather than sticking to a rigid protocol. Much of the sport psychology literature related to client intakes, however, focuses on how to structure this initial session, example areas to address, and types of questions to ask. Perhaps the most recognized article on the initial session with athlete–clients was published by Taylor and Schneider (1992) who described their Sport-Clinical Intake Protocol. The Sport-Clinical Intake Protocol is a clinically focused, comprehensive, semistructured interview designed to help sport psychology professionals gain useful information about an athlete’s sport and life. It is comprised of seven sections: (a) cursory description of presenting problem, (b) athletic history, (c) family and social support, (d) health status, (e) important life events, (f) changes prior to onset of presenting problem, and (g) details of presenting problem. More recently, the Performance Interview Guide (Aoyagi et al., 2017) has been proposed as another method of generating client data in an initial meeting. This semistructured approach is designed for initial performance-focused consultation and is person-centered and strengths based. The Performance Interview Guide has seven components: (a) identifying information, (b) reason for seeking consultation, (c) background of areas for improvement and concern, (d) details of sport/performance, (e) life/identity outside of sport/performance, (f) significant relationships and support system, and (g) self-care. Silva et al. (2011) presented similar questions to include in a structured intake interview while Andersen (2000) suggested asking clients what about sport and competition they enjoy to reinforce aspects of their sport involvement or to better understand their motivation. Nevertheless, Poczwardowski et al. (2004) argued the field lacks guidelines for best practice at different stages of the consulting process, including initial sessions.
Premature discontinuation from psychological services is a widespread problem that limits the effectiveness of interventions. It is defined as occurring when a client decides to discontinue treatment prior to making a meaningful change in the presenting concern that led to seeking help (Hatchett & Park, 2003). The first session represents an important time in consultation to study premature termination, because many clients often decide about whether to return or not after the intake (Andersen, 2000). A meta-analysis of 669 studies including 83,834 clients found about one in every five clients dropout of therapy prematurely, and the rate is even higher (almost 40%) when therapists report this data (Swift & Greenberg, 2012). While dropout rates specific to athlete–clients are unknown, sport psychology practitioners often work with younger clientele, who have been found to be a population at increased risk for premature termination (Swift et al., 2012). Not only does premature termination affect clients, but also it negatively influences practitioners in terms of time, revenue, perceived competence, and well-being (Barrett et al., 2008). Premature termination occurs without mutual agreement, and when clients discontinue services, they typically do so abruptly and unexpectedly. This can lead to a sense of failure, demoralization, and rejection among practitioners (Klein et al., 2003). Experience level of the practitioner affects premature termination with the highest rates occurring among trainees providing services to clients (26.6%; Swift & Greenberg, 2012). Potential strategies to reduce premature termination are based on increasing the perceived benefits and/or decreasing the perceived barriers of engaging in psychological services (Swift et al., 2012). Studying what expert practitioners focus on during first sessions with clients may help to develop best practices with implications for the education and training of supervisees.
Mistakes or lessons learned pertaining to the first session have been identified. Andersen (2000) noted some general questions to avoid during a first one-on-one session with an athlete–client. For example, asking quiz-like questions that test knowledge in unfamiliar areas may cause clients to become anxious and create a power differential (e.g., “What do you know about sport psychology?”). While structured intakes are suggested, a common mistake that many practitioners make is being too rigid with a prepared list of questions and forcing the pace of the session rather than following the athlete (Andersen, 2000; Silva et al., 2011). Finally, failure to tailor strategies and interventions based on a client’s current motivation level may lead to ineffectiveness and ultimately premature termination (Norcross et al., 2011). Moving too quickly to an intervention in the first session with clients low in motivation may overwhelm them, whereas moving too slowly with clients high in motivation may lead to boredom. Examining mistakes and lessons learned in conducting first sessions with experienced practitioners has implications for educating and training neophyte practitioners.
Over two decades have passed since Andersen (2000) recognized a lack of models, theory, and research to guide the sport psychology practitioner through the first session with an athlete. Despite this, empirical research on first sessions in sport psychology is essentially nonexistent. Aoyagi et al. (2017) recently argued that data-driven research on initial performance consultation is much needed. Thus, this study aimed to advance the science of practice by identifying objectives, characteristics, strategies, and lessons learned that are salient across first sport psychology sessions with athletes. Sport psychology practitioners with significant consulting experience were interviewed, as a useful methodology to identify best practices involves obtaining an “expert” point of view (Fifer et al., 2008). We sought to understand what their approach was and how they were doing it (Martindale & Collins, 2010).
Method
Participants
Purposeful sampling was used to identify and recruit participants with a wealth of knowledge conducting first sport psychology sessions with individual athletes. (Palinkas et al., 2015). Inclusion criteria included (a) at least 10 years of sport psychology consulting experience, (b) significant experience conducting individual sessions with athlete–clients, and (c) a Certified Mental Performance Consultant (CMPC) status through the Association for Applied Sport Psychology. Previous sport psychology literature using expert practitioners has adopted a similar 10-year guideline for defining expertise (e.g., Castillo et al., 2022; Friesen & Orlick, 2010; Gordin, 2012).
Participants were nine (male = 6 and female = 3) CMPCs who had on average 24.22 years (SD = 8.36) of sport psychology consulting experience. Participants reported that 72.7% of their consulting work on average was one-on-one with athlete–clients (as opposed to teams). Four participants were licensed psychologists. A variety of primary employment settings was represented, including private practice (n = 3), academic department (n = 2), athletic department (n = 1), sport academy (n = 1), Olympic training center (n = 1), and sport medicine clinic (n = 1).
Research Philosophy
A qualitative description methodology (Sandelowski, 2000) was used as the aim of this study was to describe what approach expert sport psychology practitioners took when conducting a first sport psychology session and how they went about doing this. This type of qualitative inquiry is useful for developing insight and understanding of a phenomenon (Bradshaw et al., 2017). Qualitative description can be influenced by a variety of research philosophies (Sandelowski, 2010). To ensure the study was methodologically coherent, we approached it using a constructivist perspective by adopting a relativist ontology (e.g., assuming no single universal reality independent of the individual exists) and subjectivist epistemology (e.g., acknowledging that knowledge is created through transactions between the researcher and participant) (Poucher et al., 2020).
In line with our epistemological positioning, we reflected on how our previous experiences within the field of sport psychology may shape the research process, findings, and conclusions drawn from results of this study. At the time of the research, the first and fifth authors held PhDs in sport psychology, were practicing CMPCs, and had published multiple peer-reviewed articles related to professional practice issues in sport and exercise psychology. Furthermore, both had conducted and supervised first sport psychology sessions with individual clients and taught material related to initial intake sessions at the graduate level. The second, third, and fourth authors were students enrolled in a sport psychology graduate program at the time of the research. All three had completed graduate-level university courses related to providing applied services to athletes, were working toward CMPC status, and had experience conducting first sport psychology sessions with individual athlete clients.
Interview Schedule
The semistructured interview was designed to examine the consulting approaches and practices of conducting a typical first sport psychology session with an athlete and was developed based on conceptual and empirical professional practice literature. As we acknowledge that all first sport psychology sessions are somewhat unique, the present study aimed to identify aspects that were salient across different first sessions the participant had conducted. The first session was defined as a scheduled appointment in which an athlete first comes to seek help from the sport psychology professional. The interview was divided into three sections. In the first section, participants were asked general background questions (e.g., number of years providing sport psychology services, ratio of consulting with individuals and teams, current employment setting). In the second section of the interview, participants were asked to discuss their experiences of conducting a typical first sport psychology session with an athlete, including objectives (“What are your objectives or aims in the first session with an athlete?”), aspects (“What are the important aspects that you typically include in the first session with an athlete? By aspects, I mean things you discuss, disclose, solicit, address, emphasize, or do.”), strategies (“What strategies do you use in the first session with an athlete, if any, to increase the perceived benefits of engaging in sport psychology services or to decrease the perceived barriers?”), and lessons learned (“What missteps or mistakes have you made regarding the first session with an athlete?”). Two saturation probes were posed after each initial question (e.g., “What other objectives or aims do you have for the first session with an athlete?”). Furthermore, we sought to elicit rich information by asking how and what questions for each (e.g., “How do you go about achieving [insert objective] in the first session?” “What was it about [insert misstep/ mistake] that made it a misstep/mistake?”). In the third section, participants were invited to add, clarify, or expand on the comments they made during the interview. Finally, participants were asked to rate how important the first session is in determining whether the athlete continues to attend additional sessions on a scale from 0 (not at all important) to 10 (extremely important).
Procedure
Prior to the interview stage, reflexive bracketing was used to identify the interviewer’s (first author) personal assumptions and ideas regarding how to conduct a first sport psychology session with an athlete (Crotty, 1996). The interviewer was led through the interview guide by the third author responding to each question. Reflexive bracketing is designed to facilitate self-awareness of the interviewer by identifying suppositions and potential bias, as well as to prepare the interviewer for how to react to responses of participants.
Recruitment procedures followed a protocol approved by the Florida State University institutional review board. Expert practitioners meeting the inclusion criteria were emailed a standardized script describing the purpose and procedures of the study and soliciting their voluntary participation. Those who agreed to participate were asked to sign and return the informed consent form and complete a semistructured interview using Skype. Interviews were both audio and video recorded, and transcribed verbatim by three trained research assistants. Member checking was used where participants received copies of their own interview transcripts and were provided the opportunity to review for accuracy. Interviews lasted for an average of 1 hr and 22 min (SD = 18.32).
Analysis
Qualitative content analysis was employed to identify salient themes from participants’ responses (Côté et al., 1993). Following transcription, the second and third authors engaged in a process of in-dwelling by listening to and reading each interview twice prior to coding to make sure they were familiar with the data (Maykut & Morehouse, 2002). These two authors then worked alone to label independent meaning units (complete quotes that were interpretable as a stand-alone unit of data). Meaning units were then categorized to produce broad main themes. These main themes were then analyzed to identify specific subthemes. An abductive approach was taken when analyzing the data. This approach suggests a broad preexisting theoretical knowledge can be relied upon during analysis, therefore, allowing novel insights which reframe existing empirical ideas (Timmermans & Tavoy, 2012).
To enhance the trustworthiness of the data analysis, numerous methods which align with the epistemological positioning of the study were employed. Although the second and third authors worked independently to analyze the data (e.g., identifying meaning units, grouping meaning units to produce themes), they met regularly (e.g., after identifying all meaning units to the first question) to act as critical friends (Sparkes & Smith, 2014) by discussing any differences in interpretations of the data and discrepancies in coding. Peer debriefing (meetings between the first, second, and third authors) was also implemented throughout the analysis (Cresswell & Miller, 2000). The first author was included in these discussions as someone who could provide insight and challenge any researcher assumptions and interpretations of the data.
Results
Participants rated how important the first session is in determining whether the athlete continues to attend additional sessions on a scale from 0 (not at all important) to 10 (extremely important). Perceived importance of the first session reported by participants was 9.42 on average (SD = 0.66, range 8–10). The results that follow offer detailed descriptions of key themes and subthemes related to objectives, aspects, strategies, and lessons learned within a first session. Themes, subthemes, and the number of participants endorsing each, can be found in Table 1.
Main Themes and Subthemes Including the Number of Participant Endorsements
| Area | Themes | Participants |
|---|---|---|
| Objectives and aspects | Establishing the relationship | 1 2 3 4 5 6 8 9 |
| Building rapport | 1 2 3 4 5 6 8 9 | |
| Setting guidelines and expectations | 1 2 4 5 6 7 8 | |
| Establishing expectations for the consulting relationship | 1 2 3 4 5 6 7 8 9 | |
| Guidelines of confidentiality | 1 2 3 4 5 6 7 | |
| Understanding the client’s background | 1 2 3 4 5 6 7 8 9 | |
| Gaining a holistic understanding of the client | 1 2 3 4 5 6 7 8 | |
| Understand clients definition of success | 1 2 3 4 7 9 | |
| Discussed sport psychology based on client experience | 2 3 6 7 | |
| Identifying presenting concerns | 1 2 3 4 5 6 7 8 9 | |
| Exploring the presenting problem | 1 3 4 5 6 7 9 | |
| Using assessments and inventories | 1 4 7 | |
| Formulating the treatment plan and building skills | 1 2 4 5 6 7 8 9 | |
| Taking a skill or insight | 2 4 5 6 7 8 9 | |
| Strategies | Conveying consulting approach and philosophy | 1 3 4 5 6 7 9 |
| Clarifying parameters for client change | 1 2 3 4 7 8 9 | |
| Emphasizing the value of sport psychology | 1 2 3 4 | |
| Destigmatizing sport psychology help-seeking | 1 5 6 8 | |
| Creating and individual path to success | 2 3 4 | |
| Targeting the presenting concern | 3 6 9 | |
| Lessons learned/mistakes made | Doing too much | 1 2 3 4 5 6 7 8 9 |
| Appreciating individual differences | 2 3 4 5 8 9 | |
| Preplanning | 1 2 3 5 7 9 | |
| Significant others | 2 3 5 6 8 | |
| Active collaboration | 3 4 5 7 |
The What, Why, and How: Important Objectives and Aspects of the First Session
Establishing the Relationship
Try to keep it fairly casual. And it’s more of a conversation; it’s not me sitting across from them with a pad of paper taking notes on what they say. It’s really just a conversation. And if they want to lead it, I allow that. If they don’t quite know what it is, I do, then I have a certain series of questions that I’ll go through in terms of understanding. So it’s a very flexible type of interaction. (E6)
I’ll make sure that we talk about something where I can get, um, or I’ll frame something where I can help you to smile, help you to laugh. You know, joke around, be sarcastic. Something where the experience as a whole is enjoyable for you. (E4)
Other ways in which practitioners aimed to build rapport were by establishing trust (E1), speaking the client’s language (E6), reading body language (E9), being friendly and warm (E2 and E8), and asking questions about both sport and life (E1, E2, and E4).
Setting Guidelines and Expectations
Another main aim of the initial session was setting guidelines and expectations related to the consulting process. Nine experts indicated that athlete–clients should leave the first session understanding what the consultation relationship will look like in addition to the boundaries of confidentiality (e.g., knowing what information will be shared and with whom). Practitioners reported establishing expectations for the consulting relationship in multiple ways. All nine experts highlighted establishing expectations early in the consulting relationship through collaborative discussions regarding the logistics and guidelines underlying consultation. These discussions included establishing consultation goals. It was also important for expert practitioners to establish expectations by clearly delineating the boundaries of competence at the onset of the consulting relationship. This helps to ensure athlete–clients understand the direction of consultation and receive the most appropriate services. “I disclose who I am and who I am not, what I’m here to do and what I’m not here to do” (E1). Explaining the role of a mental coach more generally was also mentioned (E6: “I’m here to help you learn strategies that can help you perform the best from a mental training standpoint”). This included outlining the roles and responsibilities of the athlete–client. Expert 2 explained, “[Clients] are the ones who are really driving this vehicle, so I’m helping them develop better awareness to understand that just like physical conditioning, they’re the ones that have to do the work.”
What’s very, very important at that initial onset is that this person understands that this is a relationship with an individual who will maintain confidentiality, they understand the basic tenants of the counseling process, any information that’s going to be released needs to be informed and signed. (E7)
You have to understand there’s a wide variety of confidentiality and it’s case specific, and it depends on who that client is you are seeing. Yet at the same time, you have to be very, very clear that the one-on-one relationship and the content within that relationship is confidential information. (E7)
Several experts (E1, E3, E5, E6, and E7) mentioned requesting written permission from the athlete to disclose session attendance with coach/parent, while not discussing the topic or content of sessions. Some other important guidelines covered by consultants included normalizing the process of engaging in sport psychology support (E8) and discussing appropriate places to meet for sessions (E4).
Understanding the Client’s Background
I typically try not to just start right off the bat with what’s going wrong, or what’s not working, or why did you see me? It’s tell me a little bit about what you are doing? If you’re a junior athlete, what’s your favorite class at school or do you play other sports? (E1)
Six experts attempted to gain insight into the client’s background by understanding the client’s definition of success. This theme involved exploring the athlete–client’s performance philosophy, objective/subjective goals and understanding of success, and self-awareness. To get a deeper understanding of an athlete’s mindset, one expert asked a series of questions, including “What’s your philosophy of great performance? What’s your philosophy of excellence? And try to understand what they think leads to greatness. What are the characteristics that lead to what they’re trying to achieve?” (E1). Another stressed the importance of helping clients become more aware of their sport motives and sources of enjoyment: “I want to get into first and foremost why do they do what they do, why do they play their sport, what’s their passion for it, what’s their love for it. And we spend some time talking about that” (E9).
Start to talk about what sport psychologists do, break down some of those stigmas they have. An initially very unmotivated individual by the end of the session may be semimotivated to take some things and start understanding how to use it. (E7)
Other areas to explore included what was worked on and what did and did not work (E3).
Identifying Presenting Concerns
I want to understand them, have some sense by the end of the first session of both what this person is like and what they are looking for, what we are going to be able to work on, and approximately how complex it is. (E8)
Seven experts indicated that identifying presenting concerns could be achieved through exploring the presenting problem. Experts mentioned gaining a better understanding of what the athlete–client is aiming to accomplish and efforts they have made to address the problem in the past. This involved exploring how the athlete–client experiences different elements of performance, what has worked and has not worked in the past and motivates to pursue sport psychology services. Experts also mentioned exploring presenting concerns by asking questions about greatness and the path toward it (E1), understanding the athlete’s priorities in and out of sport (E2 and E6), discussing their abilities to reflect, and explaining the intrinsic and extrinsic facets of their sport (E8), and asking the miracle question (E3).
Using assessments and inventories was a structured way in which experts explored any initial presenting client problems. Results from these helped to establish a baseline from which to begin consultation, as well as to evaluate and communicate progress. Three experts reported administering sport-specific inventories (e.g., TOPS, TAIS, ACSI-28, Attributional Styles Questionnaire) in the first session. Expert 1 explained that using inventories “gives us a starting point to discuss different mental skills and how they play in practice versus perform on game day.” Experts used inventories to confirm/disconfirm athlete’s experience (E4), help understand motivation to change (E7), and as a “conversation starter” (E1).
Formulating the Treatment Plan and Building Skills
Developing a consultation plan provides the athlete–client with an understanding of expected improvements of the presenting concern. Formulating the treatment plan and building skills was mentioned by seven experts. Practitioners discussed working with the athlete to establish specific consultation goals to set a clear direction for subsequent sessions. As indicated by Expert 7, formulating a treatment plan provides a basis for future sessions and strengthens the therapeutic relationship: “A first session is really geared towards establishing goals; assessing the client’s capacity, abilities, mindset, emotions; and assessing where they’re at.” Formulating a preliminary treatment plan was achieved by asking goal-related questions (E1 and E9), what resonated with the client during the debrief (E5), and presenting practical ideas for immediate use/impact, such as a skill, audio file, meditation, relaxation, or imagery (E6, E7, and E8).
I’ve taken them through some exercises and I’ve given them concepts, and I put those concepts into exercises. Now they come alive when they start to see that this is not just talk, but there are things that you do. One of the keys to what I try to do, is they’ve got to integrate the things I’m talking about, and we’re talking about, into task relevant performance keys. (E9)
Another expert acknowledged that while the techniques introduced in the first session are unlikely to resolve the athlete–client’s presenting concerns, it provides a foundation to build upon in future sessions. “We need to give them skills they can work on. And to try things out. Maybe this didn’t work, or maybe it did work, and you know it’s about skill development.” (E5)
Strategies to Increase Benefits and/or Reduce Barriers of Seeking Services
Conveying Consulting Approach and Philosophy
Another expert shared what this looks like in terms of their behavior:Get them to understand that it’s not about something that’s wrong with you, right. It’s about, you know, all of these people are at a pretty good point in their lives or in their career and they’re still trying to get better, you know, it’s about going from good to great. (E1)
I’m spending time trying just to be a real person and be someone that they can come to when they need resources and they’re going to feel comfortable doing that. So, I’m really just trying to be myself and I’m not trying to be really clinical. (E6)
In addition to being authentic and present, accepting the athlete–client during the first session was important: “So, listening, attending, and having somewhat of a structured interview process. I like to establish in the initial session that you’re not wrong no matter what you think or feel when you’re here” (E7).
Clarifying Parameters for Client Change
We’ve got to go through what’s your routine look like, how do you prepare for practice, what are the distractions you have to deal with, how do you focus, what things work for you? Then, we’ve got to talk about it, and talk about it in terms of, they’ve gotta know themselves, and that’s part of what my job is facilitating their self-knowledge, so that they’re starting to learn how to reflect and learn from their experiences. (E9)
Emphasizing the Value of Sport Psychology
I think the idea of normalizing. You’re not the only one with this particular concern, you’re not the only one who’s walking into this particular type of situation, and you’re not the only one that’s suffering these particular types of issues. (E4)
Destigmatizing Sport Psychology Help-Seeking
Support and validation of seeking services was also emphasized:If they’ve had a bad experience and they described it to me I will acknowledge that oh yeah you know, I see how that wasn’t helpful for you. Um and then, then again I try to express how, what I would do with them would be different or you know, if they’re saying I really need somebody who helps me in this way and if I can do that, I say yes I can do that. (E6)
Supporting their decision to come in and meet with me and the value of it may be by something I say but it also, as much as anything, may be by what I invite them to tell me about why they decided to do this and then really emphasize the value of that. (E8)
Creating an Individual Path to Success
One of the, the things that I’ve used consistently is a, is a variation on the performance profile, or performance profiling. Mapping out outcome goals with performance and process goals, and sometimes it’s very . . . superficial, as far as just simply kind of explaining the relationship between those three things. But helping them start to develop a blueprint, which I think essentially maybe goes in to that game plan concept. (E2)
Targeting the Presenting Concern
I think that if I give them something to take away and they find that useful, then they are gonna come back. And usually we have some sort of a plan, try this, you’re gonna come back in a week, we’re gonna evaluate how that went, and then we’re gonna see if we need to change it. (E6)
Lessons Learned From and Mistakes Made in the First Session
Doing Too Much
If in my past, you sit back and listen too much in that initial session, that increases the anxiety of the client. [They begin to think] I gotta say something and they’re already anxious about being there, and I don’t want to increase their anxiety—I want to decrease their anxiety. And I think if you give them too many tools up front, you’re not giving them much accountability for the change. (E7)
Expert consultants urged letting the session flow by not addressing issues too quickly.
Appreciating Individual Differences
not spending enough time understanding the story of . . . , whether it’s past experiences of sport psychology. Or . . . , not understanding parent or coaching dynamics, and how whether that’s how they got into the session, and understanding their level of resistance or real intent . . . . Just falling guilty of um, making assumptions. (E2)
Furthermore, they believed it was important to use an athlete centered approach that is applicable to the client’s sport, be sensitive to cultural norms, and accept that every relationship may not work. Individual differences included recognizing the client’s expertise, speaking their language, and understanding their culture. For example, Expert 8 indicated that a mistake was “not being clear enough [that] their expertise is in their sport and my expertise is in helping their approach to their sport.” Expert 9 expressed that “If I couldn’t speak their language and we can’t get the connection, then it is irrelevant to them, they’re done.”
Preplanning
Sharing their, their perceptions and thoughts and the more you lead, the more, um, the easier it is to end up on your own agenda or following your assumptions, um, and the key is to empower them with understanding themselves and understanding them where the opportunities are for us to help impact them. (E2)
Lessons learned related to preplanning included handling paperwork before the session, understanding your own motives and biases, and leaving sufficient time for the first session.
Significant Others
Five experts described lessons learned regarding when and how to include important significant others (e.g., person from the athlete–client’s social network). Experts addressed previous mistakes by involving the client’s support network, sharing client information with their coach, and understanding protocols for dealing with self-referral versus coach-referrals. Experts had mixed views regarding the extent to which they involved significant others in the first session. For example, one expert explained that they meet only with the athlete during the first session: “typically I will request a first session just with the client and then allow the coaches in after that. I want the player to drive it and I want them to be okay with how that session is used” (E2). On the other hand, other experts noted that not involving the parents in the initial consultation was a mistake: “if I didn’t engage the parent enough, that was a short sight on my part and being involved with me, without having the relationship, will almost put the kid in a triangle” (E3).
Active Collaboration
The single biggest thing is to really be able to develop that level of empathy for where a client is right now. What is the client’s experience? And if I’m moving ahead or trying to fix, I’m going to be missing a whole lot of different cues. Verbal or non-verbal, I’ll be missing something I need to key in on. (E4)
Discussion
Findings from the current study provide a better understanding of the approaches and techniques employed by expert sport psychology practitioners during a first sport psychology session. These have implications for the training and development of beginning and emerging sport psychology consultants. The results related to the objectives of the first session both corroborate and expand upon the existing literature. Several objectives align with Andersen’s (2000) assertion that the first session functions primarily as a vehicle through which the practitioner helps the athlete–client tell their story and determine whether it is appropriate to move forward with the consulting relationship. The results show that primary objectives include establishing the relationship and outlining expectations of the consultation process. Establishing and creating a collaborative alliance between practitioner and client has been identified as an important factor at the start of any consultation process (Poczwardowski & Sherman, 2011). Indeed, a positive relationship created between these two parties can be viewed as a reflection of consultant effectiveness (Sharp et al., 2014). The aims of understanding the presenting issues and relevant athlete–client history have also been emphasized in previous literature (Andersen, 2000; Herzog & Hays, 2012). Creating this initial alliance, as well as attempting to understand any pressing concerns would therefore appear paramount to address within a first session meeting with a client. Although experts focused on achieving numerous objectives throughout the initial session (e.g., building the relationship, establishing expectations, etc.), they appeared to do this in an unstructured manner. Authors have proposed semistructured guidelines for practitioners to follow in first sessions (Aoyagi et al., 2017; Taylor & Schneider, 1992), yet it would seem participants in this study adopted a uniquely individual approach. More rigid guidelines could still provide structure and comfort to novice practitioners as they transition from a “practitioner-led” to “client-led” approach (Keegan, 2010), but experts may achieve the same outcomes (e.g., gathering information on a client’s background) through their own line of questioning.
Important aspects to include in a first session with an athlete–client were intuitive extensions of the objectives. Given the primary objectives of establishing the relationship and understanding the athlete–client, aspects were more specific in nature such as building rapport and exploring the presenting problem. Researchers have identified the importance of the consultant demonstrating trust, honesty, knowledge and expertise, and ethical behavior when attempting to establish a relationship (Sharp et al., 2015). Although many of these factors were identified in the current study, building rapport through being authentic was something specifically mentioned by participants. These findings complement research looking at preferential characteristics of sport psychology consultants. It has been shown how clients prefer practitioners who exhibit high interpersonal skills that may be crucial to building rapport, such as empathy, and being approachable and caring (Woolway & Harwood, 2020). Experts in the current study also mentioned attempting to speak the client’s language. This has been acknowledged as a cultural competency necessary for effective consulting (Ravizza, 1988) and has been shown as an important way to establish trust (Fortin-Guichard et al., 2018). Although not specifically mentioned in the current study, enhancing cultural competencies has recently been highlighted as a priority for those providing sport psychology services to athletes (e.g., McGannon et al., 2014; Quartiroli et al., 2020). In addition to speaking the client’s language, practitioners should become more aware of themselves as cultural beings by reflecting on their own and their clients’ cultural background, traditions, customs, values, and beliefs (Quartiroli et al., 2021).
During the initial session, expert practitioners gathered data on their client’s background to understand the presenting concern and create an approach to treatment. Intake sessions have been identified as ways to gain useful information about the client which helps facilitate case conceptualization and the formulation of a plan to help (Andersen, 2000; Herzog & Hays, 2012). Taylor and Schneider (1992) suggested it is common for a client to feel comfortable initially seeking help for a sport-specific problem even though the underlying cause is unclear. For this reason, they encourage consultants to explore interpersonal history and dynamics, major life events, and seemingly “trivial” events that led up to changes in performance. A recent review of the literature focusing on sport psychology consultants has shown how adopting a holistic approach, that is one which considers the athlete as a whole and not only focuses on performance, but also could be considered an asset (Fortin-Guichard et al., 2018). Gaining a holistic view of client was one shared by most participants in the current study. Results indicated that some practitioners use inventories in the first session as a form of assessment. Such practitioners regarded it as a useful tool for establishing baselines and initiating conversation on the athlete–client’s status. Silva et al. (2011) notes that inventories can be useful in validating information obtained from interviewing and for gathering new information. Although using inventories was mentioned by a third of the sample, recent researchers have shown mental performance consultants only spend around 10% of their time using this method of assessment compared with interviews/discussions (65%) and observations (22%) (Vealey et al., 2019). Data from the present study also support the idea that information should flow both ways during a first session (Herzog & Hays, 2012). Practitioners should obtain as much information as possible from the athlete–client, while also clearly outlining expectations about the consulting process and discussing logistics such as limits of confidentiality.
Results from this study highlight strategies used to increase perceived benefits and/or decrease perceived barriers of sport psychology consultation to prevent premature termination. Strategies most reported were conveying the consulting approach and philosophy and clarifying the parameters of change. Premature discontinuation rates decrease when a client understands what the consultation process will look like and how long it will last (Swift et al., 2011). Discussing what positive change might look like can help the athlete–client recognize the benefits of consultation. In addition, explaining how sport psychology consultation is not a quick fix helps to create realistic expectations. Other strategies reported included targeting the presenting concern and creating an individualized path to success unique to the athlete–client. To achieve this, collaboration with the athlete–client is essential. Clinical and counseling research indicates that the therapeutic alliance, client expectations and preferences, and collaboration impact dropout rates by increasing the perceived benefits of services (Tryon & Winograd, 2011). Interestingly, none of the practitioners discussed allowing the athlete–client to select the preferred intervention, which has been shown to be an effective strategy for reducing the likelihood of premature termination (Swift et al., 2011).
Understanding the lessons learned and mistakes of experienced practitioners has important implications for the education and training of neophyte practitioners. Doing too much during the first session was reported by all nine participants. This is consistent with previous literature, which has suggested it is unnecessary to delve into any significant mental training in the initial session (Andersen, 2000), and comparable to those who recommended thorough exploration and case conceptualization is needed prior to moving forward with any intervention (Fifer et al., 2008; Hatcher & Lassiter, 2007). However, the results show that a balance between restraining from doing too much and providing a useful skill, tool, or strategy may be optimal. Other lessons learned included recognizing and appreciating the uniqueness of each athlete–client (e.g., active collaboration and preplanning). While preparing for a first session is important, it is equally central to avoid assumptions and biases about the athlete–client and being overly restrictive with the agenda or set of questions. Authors have previously recommended that practitioners avoid being overly mechanical in the first session (Silva et al., 2011) as well as suggesting that consultants should follow the athlete in their line of questioning (Andersen, 2000).
Limitations and Future Directions
While the current study sheds new light on the objectives, aspects, strategies, and lessons learned/mistakes associated with a first sport psychology session, there are some limitations. Findings from this study may not generalize to non-CMPC practitioners or represent the approaches used by trainees working toward CMPC status. Nevertheless, using purposeful sampling highlights how experienced practitioners conduct a first session which could be useful for educating and training novice practitioners. Future research could examine differences between how expert and novice practitioners typically conduct a first session or analyze how first sessions change with experience. Another limitation may be related to contact between the practitioner and potential client that often occurs before the first session. Because we defined the first session as a scheduled appointment in which an athlete first comes to seek help from the sport psychology professional, important discussions between the first contact and first session were likely not fully captured in the data. A final limitation related to the study design was how difficult it became to obtain data about all the objectives and aspects expert practitioners focus on within a first session. While we clarified at the onset of the interview that the aim was to identify salient approaches across different first sessions, there may be nuances or contextual considerations that provide further insight on the topic. Sport psychology practitioners often conduct first sessions with teams, coaches, and nonathlete performers. Thus, investigating best practices for conducting a first session with these populations is warranted. Other avenues for future research should focus on studies which incorporate quantitative methods to examine the efficacy of different approaches to first sessions on outcomes such as attitudes toward sport psychology consultation, readiness to engage in psychological services, utilization of services, retention or premature termination, and therapeutic alliance.
Clinical Implications
Understanding the important objectives, aspects, strategies, and lessons learned based on the findings of the current study are essential for enhancing competency of practitioners and perhaps preventing premature termination. The results suggest sport psychology consultants strive to achieve five key objectives when conducting a first sport psychology session. Throughout the first session, consultants should aim to establish the relationship by focusing on building rapport and connection with clients. Practitioners can achieve this objective by acting in a genuine manner and making the client feel comfortable. During the first session it is also important to set guidelines and expectations related to the consulting relationship. Clients should exit the first session with an understanding of what consultation with a sport psychology practitioner might entail. To achieve this objective, practitioners could provide insight into how they practice including what the client can expect from the consultant and what the consultant can expect from the client. Furthermore, outlining ethical concerns like confidentiality (e.g., who has the responsibility for upholding this) also helps to set expectations at this stage of the relationship. Gathering information related to a general understanding of the client’s background is another important objective of the first session. Accomplishing this aim by viewing the client holistically, that is seeing them both as a person and athlete, can also be a way to aid rapport and connection. More specific information which helps to identify any presenting concerns, including causes, underlying reasons, and consequences, should also be gained in the initial session. Achieving this objective can be done in ways unique to the philosophy of the consultant (e.g., by asking questions, exploring areas of strengths and weakness, using psychometric inventories). Agreeing on an initial treatment plan mapping out the course for subsequent sessions and treatment goals, based on information given by the client, is a final objective to be achieved by the end of this session. This initial consultation also provides an opportunity for the practitioner to provide the client with knowledge or a mental skill to take away from the first session which they can immediately implement in their sport or performance area.
Although sport psychology practitioners should aim to achieve these important objectives using some of the strategies highlighted by participants in the current study, there are several best practice points to be considered based on the experiences of expert consultants. Finding a balance between understanding the client, including their background and mechanisms underpinning any presenting concerns, and moving too quickly to a treatment plan or mental skill is the key to an effective first session. Trying to do too much in the initial meeting by moving too quickly to an intervention, or being overly directive, may overwhelm the client. Furthermore, sticking too rigidly to a session plan could create a perception that the session goals of the practitioner are more important to achieve than any concerns a client wishes to discuss during this first contact. Sport psychology practitioners are therefore encouraged to be flexible based on the needs of their client. Finally, consultants should approach initial sessions appreciating the individual differences of each client and refrain from forming any preconceived assumptions regarding the client or their experiences. Overall, findings from this study provide an initial understanding of best practices of conducting a first sport psychology session with an athlete–client and have implications for the education and training of sport psychology practitioners across developmental levels.
Acknowledgments
This research was supported by a First Year Assistant Professor award from the Council on Research and Creativity at Florida State University. The authors would like to acknowledge Carly Block for her assistance with transcribing the interviews.
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