Athletic Insight - The Online Journal of Sport Psychology

FEATURED ARTICLE:
Establishing a Hierarchy of Psychological Skills:
Coaches’, Athletic Trainers’, and Psychologists’
Uses and Perceptions of Psychological Skills Training

Samuel J. Zizzi
West Virginia University

Lindsey C. Blom
Ball State University

Jack C. Watson II
West Virginia University

V. Paul Downey
West Virginia University

and

John Geer
University of North Carolina-Greensboro

ABSTRACT

Introduction

Methods

Results

Discussion

References

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ABSTRACT

As applied sport psychology continues to grow, a variety of professionals may attempt to teach athletes mental skills; however, there is little research to suggest which skills professionals may be qualified to use with their clients. This research examined sport professionals’ use of psychological skills training (PST) and their previous training, self-efficacy, and perceptions of each skill. After a national survey, the final sample included 54 athletic trainers, 64 coaches, and 50 licensed psychologists (n = 168). Psychologists reported using hypnosis and self-talk more frequently than ATCs and coaches, while coaches reported using team building and time management most often. Participants perceived hypnosis, energy management, imagery, and cognitive restructuring to require the most training out of the nine skills. These results are discussed within the context of developing a hierarchy of psychological skill used to guide professionals in their future work.

Introduction

       Competitive athletes and coaches are continuously looking for methods to enhance their training and performance. Advanced training methods are beginning to include applied areas of sport science, such as exercise physiology and biomechanics, to help athletes achieve an ideal volume and intensity of training (Balague, 2000). Optimal performance also requires the proper application of psychological skills, but these skills have not been systematically adopted and integrated into practice settings like other sport science training methods. Coaches and athletes typically only turn to learning and practicing psychological skills when there is a crisis or a specific problem, even though a preventative approach is considerably more effective (Weinberg & Gould, 1999). By establishing a psychological skills training (PST) program early, it may be possible for athletes to reach their potential more quickly by learning how to perform consistently through increased behavioral control (Balague, 2000).

       Various professionals have attempted to define and categorize psychological skills in their own ways, with a common emphasis on the importance of utilizing them regularly. O’Donohoe and Krasner (1995) explain psychological skills training by breaking down the different terms. Skills are defined as the “ability to perform in a certain manner” (p. 3) not whether the individual actually performs in relevant situations. Performance involves the actual display of a behavior by an individual. Competency refers to the “effects of the performance of skills on the individual’s environment” (p.3). In time, and with successful performances, competence with psychological skills will develop.

Psychological Skills and Sport Performance

       Athletes have been shown to perform best when their psychological skills are developed to a point where consistent performance is displayed across a variety of competitive situations. Mahoney, Gabriel, and Perkins (1987) assessed psychological skills relevant to exceptional athletic performance and found the topics of concentration, anxiety management, self-confidence, mental preparation, and motivation having potential importance in skill-level differentiation. Gould and Dieffenbach (2002) examined the psychological characteristics of 10 United States Olympic champions and how they developed these characteristics. Triangulated results from interviews and psychological assessments indicated that these outstanding performers had strong psychological skills. These Olympians scored high in confidence, goal setting, mental preparation, concentration, readiness for competition, relaxation, emotional control, freedom from worry, and attentional focus. Greenleaf, Gould, and Dieffenbach (2001) discussed Olympians’ perceptions of major positive and negative factors affecting performance. They reported that negative influencing factors included departing from normal routine, distractions, overtraining, injury, and team issues, while positive factors included mental skills and preparation, support services, multifaceted preparation, and coaching.

       Psychological skill training programs have been shown to positively affect performance across various sports and levels of competition. For example psychological skills training programs have been shown to be effective for improving elite athletes’ performances in golf putting (Cohen, Tenenbaum, & English, 2006; Thomas & Fogarty, 1997), tennis (Mamassis & Doganis, 2004), lacrosse (Brewer & Shillinglaw, 1992), cycling (Kress, Schroeder, Potteiger, & Haub, 1999), football (Holm, Beckwith, Ehde, & Tinius, 1996), swimming (Holm et al., 1996; Sheard & Golby, 2006), basketball shooting (Pates, Maynard, & Westbury, 2001; Meyers, Schleser, & Okwumabua, 1982), running (Patrick & Hrycaiko, 1998), equestrian (Blakeslee & Goff, 2007), karate (Seabourne, Weinberg, Jackson, & Suinn, 1985), scuba diving (Terry & Mayer, 1998), and triathlon performance (Thelwell & Greenlees, 2001). Overall, PST programs have evidence of effectiveness across a variety of sport settings for highly-skilled athletes. Elite athletes have also been shown to use psychological skills and strategies in practice and training sessions, not just competition (Taylor, Gould, & Rolo, 2008). However, the benefits of using PST can extend to non-elite populations. As an example, a study by Terry and Mayer (1998) provides evidence that novice divers may benefit from learning skills that can help reduce anxiety, improve attentional control, and increase self-affirmations as part of their pre-dive instruction. In a different study, researchers taught novice golfers psychological skills and found the skills helped improve performance compared to control groups (Beauchamp, Wayne, Fournier, & Koestner, 1996).

       Examining patterns of use among elite-level consultants provides some insight into the frequency with which specific skills are taught. Gould, Tammen, Murphy, and May (1989) surveyed 44 sport psychology consultants who had worked with more than 25 U.S. Olympic sports during the 1984 and 1988 Olympics. Through group seminars, professionals used arousal regulation skills most frequently with imagery, relaxation training, motivation, goal setting, and concentration close behind. Individual consultations revealed similar results with imagery-visualization and arousal regulation as the first and second most commonly practiced skills, and relaxation, goal setting, concentration also frequently taught. Kirschenbaum, Parham, and Murphy (1993) assessed types of services provided to athletes at the 1991 Olympic Festival and reported that consultations primarily pertained to reducing pre-performance anxiety, improving concentration skills, setting goals, and working on mental plans for competition. Sullivan and Nashman (1998) examined interventions utilized by Olympic sport psychologists who had a history of working with Olympians anywhere from the 1960 to 1994 games. Interventions used by at least 80% of the sport psychologists included breathing techniques, focusing, behavior modification, cognitive restructuring, positive self-talk, imagery, goal setting, and arousal regulation.

Ethical Issues with Psychological Skills Training

       With an increase in research and applied interest in PST (Weinberg & Gould, 1999), professionals have begun to debate the training requirements for individuals teaching psychological skills to athletes. The discussion often stalemates when examining specific skills (e.g. goal setting, hypnosis, relaxation) and who is qualified to teach them to whom, particularly since there are currently no guidelines for practice. Furthermore, individuals and sporting organizations who want to hire consultants to conduct psychological skills training with their athletes often have difficulty determining the competency of available consultants. The United States Olympic Committee (USOC) emphasizes the importance of having objective measures for assessing the qualifications of individuals at least on a minimal competence basis (Gross, 1993). As a positive step forward, the USOC established the Sport Psychology Registry and The Association of Applied Sport Psychology (AASP) certification for consultants continues to grow (Zizzi, Zaichkowsky, & Perna, 2002). In regards to other sport professionals, The Commission on Accreditation of Athletic Training Education (CAATE) requires certified athletic trainers (ATCs) to be educated on the psychological aspects of injury and the use of psychological skills within that setting, while The Commission on Accreditation in Physical Therapy Education (CAPTE) does not specify psychology course work for physical therapists (PTs; Hamson-Utley, Martin, & Walters, 2008).

       The establishment of sport psychology-specific consultant credentials by the USOC and AASP have been steps forward in defining competence for PST, but neither organization provides specific boundaries of practice in this area aside from using the American Psychological Association’s (APA) ethical principles as guidance (APA, 2002). The Canadian Society of Psychomotor Learning and Sport Psychology (CSPLSP) points out that competence is hard to ensure even with specific certifications or titles as those providing sport psychology services may come from diverse backgrounds (Gross, 1993). Furthermore, the accrediting bodies for coaching education, athletic training education, and physical therapy are vague in their description of training requirements regarding psychological skills (National Association for Sport and Physical Education, 2006). These organizations may identify the skills that should be learned (i.e. relaxation, visualization, and desensitization techniques; National Athletic Trainers Association [NATA], 2006) without requiring trained professionals to teach the skills, or an organization may not require any training in psychological skills (CAPTE, 2006). Some argue that only licensed psychology professionals (e.g., counselors, psychologists) can help, but as Danish and Hale (1981) pointed out, there are not nearly enough to help all athletes and teams. This requirement would also eliminate coaches and athletic trainers from providing services (Danish & Hale, 1981), and they are the professionals who are most frequently involved with athletes.

       For example, can Certified Consultants (CCs) from AASP conduct the same interventions with athletes as licensed psychologists (LPs) even though many CCs are not licensed? Can certified athletic trainers ethically teach injured athletes relaxation training and healing imagery even though they have not had formal training? Are coaches qualified to mentally train their athletes by using cognitive restructuring and focusing techniques? While these questions may be currently unanswered, understanding current usage patterns and perceptions of competence across the broad range of psychological skills may begin to provide direction.

       Coaches, ATCs, and other professionals who work with athletes are asked to assist athletes in performing to the best of their ability, and with this job description, they may attempt to teach psychological skills. Without proper training in teaching these skills, these attempts may lead to negative experiences or conclusions that PST does not work. Either of these adverse outcomes may produce frustration with sport psychology and decrease intentions to use performance enhancement services in the future. Potential problems for untrained professionals teaching psychological skills include missing or ignoring important information about an athlete’s experience, lacking the range of intervention skills necessary for the athlete’s concern, not adjusting for individuality and using a “canned” approach, lacking the ability to communicate how to use skills, and lacking the knowledge about how and when to appropriately use skills (Danish, Petitpas, & Hale, 1993). The outcomes of poorly conducted PST programs can include lack of improvement, frustration, and negative stigmatization of sport psychology interventions.

       Another training concern is that given the small number of certified or registered sport psychology consultants (Zizzi et al., 2002) and the growing demand for PST (Weinberg & Gould, 1999), it may be unrealistic to assume that “qualified sport psychology professionals” can provide all the necessary services (Danish & Hale, 1981). With a clarification of the boundaries of practice, other professionals such as coaches and athletic trainers could be involved in teaching psychological skills in limited capacities. Psychological skills training can be used effectively with athletes of all ages and skill levels, but many high school and community programs do not have access to or the finances to fund comprehensive services from a sport psychology consultant. Educating and involving other sport-related professionals in the PST process may help alleviate this problem and grow public awareness of the benefits of applied sport psychology. There is research suggesting athletes have reported coaches often help them with psychological skills (Gould & Dieffenbach, 2002); however there is no research evaluating the effectiveness of coaches’ efforts. Weinberg and Gould (1999) recommend a model where sport psychology professionals would provide advanced training to coaches, with the goal of increasing coaches’ teaching competence. More research is needed in assessing whether instructional techniques may be designed so that positive results can be obtained by non-sport psychology professionals.

       The purpose of this study was threefold. First, we examined sport professionals’ use of psychological skills (e.g., teaching of skills to others) as well as their levels of previous training and self-efficacy for teaching these skills. We hypothesized that licensed psychologists (LPs) would report the highest scores in each of these three areas with coaches and certified athletic trainers (ATCs) reporting lower but similar scores. The second purpose was to examine perceptions of what skills specific professions are qualified to teach. It was hypothesized that LPs would be rated highest overall (averaging across all skills), followed by performance enhancement consultants (PECs) and then the group of non-psychology professionals (i.e., ATCs, physical therapists (PTs), and coaches). Additionally, it was hypothesized that the professionals (i.e., ATCs, coaches, and LPs) surveyed would rate their own professions as more qualified than others would rate them objectively. Finally, the third research question explored boundaries of practice as perceptions of the amount of training needed to teach each psychological skill were assessed. Specific hypotheses were not generated for the order of psychological skills aside from an expectation that hypnosis would be rated as needing the most training by all groups.

Methods

       The survey research project received Institutional Review Board approval and consent was obtained prior to survey administration. Internal grant funds from the School of Physical Education provided partial support for the project.

Survey Development

       During the initial phase of item development for the survey, an extensive literature search was conducted to identify the most common terms used under the umbrella of psychological skills training. This literature review involved consulting commonly used sport psychology texts (VanRaalte & Brewer, 2002; Weinberg & Gould, 1999; Williams, 2001) and included using the terms “mental skills training” and “psychological skills training” in search engines such as PsycInfo and SportDiscus. Based on this search process, the following nine skills were included in the survey instrument: attention/concentration, communication, energy management, goal setting, hypnosis, imagery/visualization, self-talk, team building, and time management. A handout with brief definitions was included in the survey packet to avoid misinterpretation of terminology (see Appendix A). Brief job descriptions of the professions were also provided to familiarize participants with the professional titles.

Measures

       Experiences with PST. Established survey design protocols were followed during initial item development (e.g., Dillman, 2000; Fink & Kosecoff, 1998; Fowler, 1993). The first section of the survey included items on personal experiences with PST such as frequency of use, previous training, self-efficacy, and perceptions of effectiveness for each of the nine selected psychological skills. To prompt them to review the definition sheet, a warm-up question started the survey asking participants to rate their familiarity with the psychological skills listed on the sheet. The next four questions asked participants to rate their current use, previous training, self-efficacy, and perceptions of effectiveness (in improving athletic performance) for each of the nine skills. The following specific questions and seven-point scales were used to collect this data, with each question followed by a list of the nine psychological skills:

  • Frequency of use. How often do you use and demonstrate each of the following skills to your athletes? “Never” (1) to “Always” (7)
  • Previous training. To what extent did your training prepare you with knowledge of each of the following skills? “Not at all” (1) to “A great deal” (7)
  • Self-efficacy. How confident are you that you could effectively use and demonstrate each of the following skills? “Not at all confident” (1) to “Very confident” (7)
  • Effectiveness. How effective do you think the following interventions are for improving an athlete’s performance? “Not at all effective” (1) to “Very effective” (7)

       Qualifications to teach psychological skills. The second section of the survey assessed participant perceptions of qualifications of various professionals in their ability to teach psychological skills. Individual items included asking participants to rate the perceived qualifications of ATCs, PTs, coaches, PECs, and LPs to teach each of the nine skills on a seven-point scale from “Not at all qualified” (1) to “Very qualified” (7). A sample question from this section read “How qualified do you perceive certified athletic trainers to be able to demonstrate each of the following skills?” Other questions were worded identically with the professional title changed in each case.

       Perceived training requirements and demographics. The final section of the survey assessed perceived training requirements for each specific skill. This question asked “How much training do you feel is required for a person to effectively use and demonstrate each of the following skills?” with each skill rated from “Little or no training” (1) to “Extensive training” (7). Following this question, items were included measuring demographic variables, work-related experience, and previous exposure to sport psychology. The initial draft of the survey included 25 items.

Pilot Testing

       Extensive pilot testing of the survey was conducted prior to the study, as suggested by Fink and Kosecoff (1998). First, a small group of experts (n = 3) in sport psychology provided qualitative feedback on the content and structure of the survey. Second, a group of master’s degree-seeking coaches and athletic trainers (n = 33) participated in pilot testing the survey instrument to provide feedback on the clarity, completeness, and ease of responding to all items. This pilot procedure resulted in a refined format, including the omission of four items and changes to the structure of several questions to improve ease of completion. Pilot testing also revealed that the survey took approximately 10-15 minutes to complete. After adjustments from pilot testing, the final version of the survey included 21 items.

Sampling

       The present study used a stratified-randomized sampling design to generate lists of mailing addresses for 300 ATCs, 300 coaches, and 300 LPs. A randomly generated list of mailing labels for ATCs in clinical settings was obtained from the National Athletic Training Association (NATA). Similar mailing lists for coaches and LPs were obtained from the National Collegiate Athletic Association (NCAA) and the American Psychological Association (APA) respectively. Psychologists were randomly selected from Divisions 17 (Counseling Psychology) and 47 (Sport and Exercise Psychology). As a provision for obtaining these labels, though, none of the three sources allowed follow-up labels to be generated, which is a common strategy for increasing response rate (Dillman, 2000). As a small incentive to complete the survey, free access to a website dedicated to applied sport psychology was provided for a period of three months. This temporary webpage, which was housed within a university department website, provided information describing each of the psychological skills and links to news articles featuring examples of athletes or coaches using sport psychology. The sampling methods resulted in the following response rates per group: 18% for athletic trainers (n = 54); 21.3% for coaches (n = 64); and 17% for psychologists (n = 50).

Results

       The final sample included 54 certified athletic trainers, 64 college coaches, and 50 licensed psychologists (n = 168). The sample was 60% male (range = 59.2-63.5%) with an average age of 42 years (SD = 10.75). Athletic trainers were the youngest group on average (M = 34.6), followed by coaches (M = 40.42), then psychologists (M = 52.4). Average years of work experience for the overall sample was 14.74 years (SD = 8.33), including sub-group scores of 9.5 years of experience for ATCs, 15.3 years for coaches, and 19.6 years for psychologists. Thirty-seven and fifty-eight percent of ATCs and coaches respectively held a master’s degree, while 100% of the psychologists held a doctoral degree. On a seven point scale with anchors of “no training” and “considerable training,” previous training in sport psychology averaged 3.07 (SD = 1.6) with psychologists reporting the lowest average scores (M = 2.67), followed by coaches (M = 3.17), then ATCs (M = 3.3). Means and standard deviations for previous training, frequency of use, and self-efficacy for individual psychological skills are listed in Table 1.

Table 1 Feature

Frequency of Use, Previous Training, and Self-Efficacy for Psychological Skills

       To assess differences across the three professions in their frequency of use, previous training, and self-efficacy for the various psychological skills, three one-way multivariate analyses of variance (MANOVA) were conducted. Each of these MANOVAs used profession as the independent variable (three levels: ATC, Coach, Psychologist) and the nine skills as the multiple dependent variables. Preliminary checks of the assumptions of multivariate and univariate normality were conducted prior to analyses. In cases where assumptions were violated, adjusted F and degree of freedom values are reported. Significant multivariate main effects were followed up with univariate analysis of variance (ANOVA) and Tukey post-hoc testing where appropriate. In the within-subjects models (i.e., repeated measures ANOVAs), appropriate contrast analyses were used to determine pairwise differences. All effect size estimates for MANOVA and ANOVA designs are reported as eta-squared (η 2) which can be interpreted as the proportion of variance in the outcome variable due to the independent factor (George & Mallory, 2001). Eta-squared estimates of less than .09 are considered small, .10-.25 are moderate, and estimates greater than .25 are considered large.

       With respect to differences in frequency of use across the three professional groups, the multivariate main effect was significant, Wilk’s lambda = .347, F(18, 306) = 10.30, p <.001, η 2 = .41. Univariate follow-up analyses revealed that LPs reported using hypnosis (η 2 = .28) and self-talk (η 2 = .26) more frequently than ATCs and coaches, while coaches reported using team building (η 2 = .35) and time management (η 2 = .11) more often than the other professionals.

       A large multivariate effect for previous training was also found, Wilk’s lambda = .392, F(18, 306) = 10.14, p <.001, η 2 = .37. With respect to univariate results, LPs reported significantly more previous training on the skills of self-talk (η 2 = .23), imagery (η 2 = .07), and hypnosis (η 2 = .14) compared to the other two groups. Coaches reported significantly more previous training related to team building (η 2 = .22) and time management (η 2 = .19) when compared to ATCs and LPs (see Table 1).

       For the third model using self-efficacy scores as the dependent variables, multivariate analyses suggested that LPs had the highest self-efficacy scores overall (5.66), followed by coaches (4.91) then ATCs (4.52); Wilk’s lambda = .375, F (18, 300) = 10.55, p <.001, η 2 = .39. Univariate analyses revealed that coaches were more efficacious than LPs and ATCs in using team building (η 2 = .14). Psychologists reported higher self-efficacy values on attention and concentration (η 2 = .11), imagery (η 2 = .16), self-talk (η 2 = .35), communication skills (η 2 = .16), and hypnosis (η 2 = .28) than coaches and ATCs (see Table 1).

Perceived Qualifications to Practice

       In the second section of the survey, participants rated the perceived competence of ATCs, PTs, coaches, LPs, and PECs to use and demonstrate (i.e., teach) psychological skills with their clients. To help answer the research question “how are the five professional groups ranked in their perceived qualifications to teach psychological skills,” scores across the nine psychological skills were averaged to create a mean qualification score for each professional category. This research question did not target perceived competence to use one particular skill but rather the overall set of skills. A 3x5 repeated measures ANOVA (profession x professional category) using average qualification scores revealed two significant main effects (eta-square values of .54 and .09 respectively) and a significant interaction (η 2 =.19). Post-hoc testing was subsequently used to create a ranked hierarchy of perceived professional competence across the five listed categories, while the interaction effect provided information on where self-perceptions of competence (e.g., coaches rating coaches’ competence) differed from external ratings of competence (e.g., ATC/LP ratings of coaches’ competence). Overall, post-hoc testing suggested a three-tiered pattern among the five professional groups where ATCs and PTs were perceived as least qualified, coaches as moderately qualified, and PECs and LPs as most highly qualified (see Table 2). Notably, there were no significant differences found in the perceived qualifications between ATCs and PTs or between PECs and LPs. Additionally, when interpreting the interaction effect, as hypothesized, ATCs and coaches perceived themselves to be significantly more qualified than other respondents perceived them to be. However, LPs’ self-perceptions of competence were not higher than the independent ratings of other respondents.

Table 2 Feature

Perceived Training Necessary to Use Specific Skills

       To address the third research question related to which skills require the highest levels of training to teach, perceptions of training scores were analyzed using a 3 x 9 (profession x skill) repeated measures ANOVA. On average, skills were rated as needing between moderate and extensive levels of training (M = 5.22; SD = .79), with values ranging from a low of 4.77 (time management) to a high of 6.51 (hypnosis). Contrary to hypotheses, perceptions of training across professions did not differ, F(2, 157) = .82, p > .05, and the interaction effect was very small and not interpretable (η 2 = .03). However, a main effect for skill supported the hypothesis that professionals perceive that some skills do require relatively more or less training, F(5.55, 871.4) = 50.6, p <.001, η 2 = .24. Hypnosis was rated as needing the highest level of training, with the group of attention/concentration, goal setting, and time management rated as needing the lowest level of training out of the nine skills. Repeated measures post-hoc testing was used to establish the groupings displayed in Table 3. The skill groupings within the hierarchy indicate reasonably different groups, as skills in each group were not statistically different from each other but were rated differently from skills in other groups.

Table 3 Feature

Discussion

       This project sought to add clarity to the literature base by describing the self-reported uses and perceptions of psychological skills of coaches, ATCs and LPs. We initially hypothesized that LPs would report the highest levels of previous training, current use, and self-efficacy of the three groups sampled; however this hypothesis was only partially supported. LPs did report higher previous training and use of self-talk, imagery, and hypnosis, but coaches reported higher previous training and use of team building and communication skills. The patterns of use reported by LPs in the present study were similar to those of elite level consultants in the Gould et al. (1989) and Sullivan and Nashman (1998) studies, suggesting commonalities may exist in the use of PST across athletic and clinical populations. One caveat, though, is that LPs did not commonly report using attentional focusing or energy management techniques suggesting they may not use these skills as frequently in their clinical work as some of the other skills. The coaching data on previous training and frequency of use supports the assertion by Ravizza (1988) that coaches may play a key role in teaching some psychological skills to their athletes, particularly those related to team processes that have been shown to impact performance (Carron, Spink, & Prapavessis, 1997).

       The self-efficacy findings supported our hypotheses more closely in that LPs reported the highest self-efficacy on all skills with the exception of team building. When comparing self-efficacy scores within professions, ATCs were most confident with goal setting, while coaches were most confident in using team building and goal setting, and LPs reported the highest self-efficacy for communication skills and cognitive restructuring (self-talk). These efficacy perceptions corresponded directly with skills that were used most frequently by each group (see Table 1).

       Psychologists may have been conservative when reporting their own previous training and competence given the emphasis placed on ethics in their professional training and licensure (APA, 2002). At the same time, ATCs and coaches may have over-reported competence in some areas with less of a focus on ethical practice. However, both of the accrediting bodies for athletic training education and coaching education do require minimal course work in psychology, with specific mention of psychological skills. Psychologists, however, consistently reported high self-efficacy values on skills where they also reported low to moderate training and frequency of use. Thus, the self-reported values may not be entirely accurate, and each professional group may be over-estimating their confidence in teaching psychological skills.

Perceived Qualifications to Teach Psychological Skills

       In support of our hypotheses, coaches and ATCs rated their qualifications to teach psychological techniques significantly higher than they were rated by the other groups. Psychologists, however, rated themselves similarly to their objective ratings. This data may suggest that coaches and ATCs perceive themselves to have a potential role in the application of PST within their respective work environments while other professionals may fail to recognize this possibility. It may be that coaches and trainers feel they are qualified to use psychological skills because they have had informal experience “counseling” athletes or because they see this as an area where they could expand their professional skills. However, the data may simply reflect over-confidence on the part of ATCs and coaches in their ability to teach these skills to athletes. Research has already shown that both of these populations value the importance of psychological skills in performance and injury rehabilitation (Larson, Starkey, & Zaichkowsky, 1996; Partington & Orlick, 1987; Sullivan & Hodge, 1991; Thelwell, Weston, Greenless, & Hutchings, 2008). Coaches and ATCs may be open to taking part in PST programs conducted by other more qualified professionals, or they could continue teaching psychological skills without further training. ATCs with formal training in teaching psychological skills have been shown to be more confident in the effectiveness of the skills and express a more positive attitude regarding use of the skills than those without formal training (Thelwell et al., 2008).

       The qualification data provided more interesting insight into the perceptions of coaches and ATCs in that both LPs and PECs were rated as equally qualified to apply PST programs. This result may demonstrate recognition by coaches and ATCs of the unique role of PECs or a higher degree of familiarity with sport psychology than expected. Conversely, this similarity in ratings could suggest that participants read the definition sheet included with the survey and were impacted by the descriptions. Additionally, this result may provide some evidence that sport psychology specific credentialing such as Certified Consultant status from AASP is worthwhile and recognized. Psychologists’ perceptions of professional qualifications directly supported our hypothesis as they rated LPs and PECs first and second respectively with the group of non-psychology professionals rated equally lower. Those LPs who are unfamiliar with the sporting environment or the roles of coaches and ATCs may have disregarded the potential for these groups to be involved with PST due to ethical concerns over lack of competence to use psychological interventions. Finally, physical therapists and athletic trainers were rated similarly and the lowest of the five professional groups offered despite the fact that athletic trainers are likely to have significantly more experience with athletes. Thus, coaches and LPs may not have accurate understanding of differences in the training paths of these two professionals or they regard them as equally lacking in training in psychology.

Moving Towards a Hierarchy of Training for Psychological Skills

       There was very little deviation in the hierarchy of training for the psychological skills as rated by coaches, ATCs and LPs. This pattern may suggest that those ATCs and coaches that chose to respond were more familiar with sport psychology than the overall population, which could be an artifact of the lower than desired response rate. Despite this, those who did respond may have had a strong interest in sport psychology, thus leading their perceptions to be similar to those from psychology backgrounds. All skills were rated as needing more than a moderate level of training, which could suggest that participants felt a reasonable amount of training is needed to gain competence in each of the individual skills. Despite this finding, it is unclear why introductory skills such as time management and goal setting were rated above the scale’s midpoint, even though they were the lowest rated of the nine skills listed. This lack of variability in ratings may suggest that some professionals had difficulty differentiating the training requirements across the skills.

       Developing a hierarchy of psychological skills indicating what training level is required for each skill may clarify some of these issues and act as a first step towards establishing boundaries of practice. With an increased understanding of the professional issues related to the application of PST, many parties may benefit. Sport psychology professionals would be able to increase awareness of the use of psychological skills and train other sport-related professionals to properly administer PST programs. These benefits may also lead to increased employment opportunities in training and direct service within coaching and sports medicine environments. Increased training among coaches and ATCs may also serve to reduce the stigma of sport psychology services, which often prevents service use and referral (Maniar, Curry, Sommers-Flanagan, & Walsh, 2001). Coaches and athletes have been found to more favorably respond to psychological skills training programs when they have an understanding of psychological skills and have input in the development and management of the training program (Hardy & Parfitt, 1994). Ultimately, by training more professionals to properly teach psychological skills, a greater number of athletes could be reached with more effective programming to promote life skills and consistent performance.

       A hierarchy of skills was established based on the empirical data generated from the survey (see Table 3). Four reasonably independent groups emerged with goal setting, time management, and attention/concentration in the first group (e.g., lowest level of training needed). This first group of skills would seem useful to both coaches and ATCs in their work with athletes, and have been shown to be the most frequently utilized skills by Olympic athletes during practice sessions (Taylor et al., 2008). Additionally, none of these skills currently require a credential to legally practice, so with proper guidance, ATCs and coaches may already be prepared to teach the first group of skills to athletes. In support, Cramer-Roh and Perna (2000) suggest that ATCs can be trained to effectively use systematic goal setting and pain management techniques, the latter of which could include the use of association and dissociation strategies. The only exception among these skills that may require additional training is the attention and concentration area. Some researchers have argued that these focusing skills are often misunderstood, and comprehensive training programs are necessary to achieve mastery (Nideffer, 1978).

       The second group of skills, which our data showed that coaches frequently use, included team building and communication skills. These skills are common components of coaching education programs (Martens, 1987) and are considered critical to team success (Cox, 2002; Ebbeck & Gibson, 1998). Coaches seem the most appropriate audience for using these skills, and some coaches may have already received training in this area. ATCs, however, may rarely need to conduct team building interventions but many of their individual interactions with clients could be improved with increased communication skills.

       The next group of skills included imagery, cognitive restructuring (self-talk), and energy management. In previous research, these skills were all reported by coaches and athletes as key components of sport psychology interventions (Gould et al., 1989; Kirschenbaum et al., 1993), but were the least frequently used by athletes in competitive situations (Tayler et al., 2008). Olympic athletes may not be using imagery and relaxation techniques frequently because the individuals who are working with them do not have the competency to teach these skills (Tayler et al., 2008). Furthermore, these findings were to a study of professional coaching in the United Kingdom that reported coaches used self-talk and imagery more often than relaxation and goal setting because of the perceived usefulness and familiarity of the skills (Thelwell et al., 2008).

       Applied psychology graduate programs typically offer specialized training in cognitive restructuring, relaxation and imagery, thus most LPs and PECs would have this training. It is unlikely that many ATCs and coaches would have formal training in these areas, but some may seek out additional training to gain competence in these skills. Without additional educational degrees and proper training, it would not seem appropriate that ATCs or coaches use these skills with athletes due to the possibility of adverse reactions to poorly designed interventions (Cramer-Roh & Perna, 2000). As hypothesized, hypnosis was considered to require the most training of all the skills listed. This result suggests that hypnosis requires even more specialized training than imagery, cognitive restructuring, and energy management. In support, the American Society for Clinical Hypnosis (ASCH, 2003) offers voluntary certification programs in hypnosis for psychology professionals. ASCH certification is available only to those professionals who are already registered (Canada) or licensed (US) to practice psychology in their home province or state. Other organizations do offer training programs in hypnosis but many are not recognized by the American Psychological Association. Thus, ATCs and coaches would not have access, and many PECs without counseling degrees would not be appropriate audiences for this type of training either.

Limitations and Future Directions

       Although the responding group sizes were reasonably equal and provided more than enough power for the statistical analyses, the overall response rate of 19% is considered lower than desired for this type of research and limits generalizability of the results. This limitation in response rate may have increased the bias due to voluntary participation in survey research as the respondents may have been more familiar with sport psychology than non-responders. Also, the wording of some items (“use and demonstrate with your clients”) may have led to participants to think of their personal use instead of their ability to teach the skills to others. However, pilot testing did not result in any negative feedback on these items so initial wording was kept. Finally, the survey did not focus on the application of psychological skills to injury rehabilitation but instead took a general approach to “working with clients” across a variety of professional settings. This omission of specific scenarios or descriptions of how PST could be applied in injury rehabilitation may have made the survey less applicable or interpretable by ATCs in the sample.

       In conclusion, many types of professionals may be “qualified” to teach psychological skills with athletes given the proper training and circumstances. From the current study, it appears that ATCs, coaches, and LPs perceive hypnosis, energy management, imagery, and cognitive restructuring to require the most training out of these skills. The next step appears to be surveying sport psychology professionals on the same issues and comparing their hierarchy of skills to those of coaches, ATCs, and LPs. This continued line of research is warranted to establish firm standards of practice and help accrediting bodies determine what psychological skills are appropriate for their group of sport professionals. Furthermore, it is hopeful that the current data provide a step in the right direction in clarifying issues of competence with PST, while helping spread the positive effects of sport psychology techniques to a wider audience.

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Appendix A: Handout on PST Definitions

       Attention and Concentration Control (focusing) - commonly used to help individuals identify their current situation and the relevant stimuli within that situation. These skills help them maintain their mental intensity within a situation. Common techniques include: 1) attention control training and 2) techniques to expand awareness (e.g., focused breathing, attending to sounds and bodily sensations).

       Communication - used to help improve group cohesion and individual interactions in a sport setting (e.g., athlete-athlete, athlete-coach, coach-parent). Techniques used with this skill include: 1) teaching active listening and communicating skills (reflecting, clarifying, encouraging, paraphrasing), 2) helping individuals create a free and open environment, and 3) assertiveness training.

       Energy Management - most commonly used to help individuals who experience arousal at a level that is not effective (i.e., too high or too low) for optimal performance. These techniques have also been used for anxiety, stress, and anger management. Common treatments include: 1) breathing exercises (e.g., diaphragmatic breathing, sighing with exhalation, and rhythmic breathing), 2) progressive relaxation, 3) meditation, 4) visualization, 5) autogenic training, and 6) cognitive techniques (e.g., thought stopping and cognitive restructuring).

       Goal Setting - commonly used for enhancing motivation and for focusing attention upon the aspects of performance that are most in need of improvement. The establishment of a goal setting program often includes several common components, including identifying target dates for attaining goals, identifying goal achievement strategies, and providing regular goal evaluation.

       Hypnosis – used to help individuals achieve a state of deep relaxation, altered consciousness or focused attention and heightened suggestibility. Participants typically experience changes in sensations, perceptions, thoughts, or behavior. Used most commonly in the treatment of anxiety, attentional problems, and phobias.

       Imagery, Visualization, Mental Practice - using all of the mind’s senses to re-create or create an experience in the mind. Uses include: 1) mental preparation, 2) arousal control, 3) attention, 4) building self-confidence, 5) learning new skills, and 6) injury recovery. Common components include the evaluation of imagery ability, the establishment of the proper physical and mental setting (i.e., relaxed and quiet), and practice creating vivid and controllable images.

       Self-talk - what you say or think to yourself. Self-talk patterns are related to how people feel and act. Changing self-talk is commonly used for 1) prompting a specific behavior, 2) improving self-confidence, 3) attention control, 4) motivation, and 5) arousal control. Common components include the identification of negative or irrelevant thoughts, challenging these thoughts, the creation of positive thoughts, and the substitution of positive thoughts for the negative thoughts.

       Team Building - the process of helping the members of a group enhance their ability to work cohesively through the improvement of communication, group objectives, trust, and respect. Team building strategies are often used at the beginning of a season to help group members become more familiar and trusting of each other. Common techniques include group introductions of each other, ropes courses, and individual and team goal setting.

       Time management/Organization - the ability to plan and maintain one’s regular schedule in a way that avoids confusion, conflict and undue stress. Common techniques in this area include: 1) teaching how to use a planner, 2) learning about the demands of a task, 3) setting legitimate goals for tasks, 4) understanding the demands of one’s life, and 4) developing pre-performance routines.

Professional Role Definitions

Athletic Trainer – typically works with a specific sports team to provide acute and long-term care for athletic injuries. Designs and monitors rehabilitation programs.

Physical Therapist – typically works in a sports medicine or hospital clinic to provide acute and long-term care for a variety of sport and work-related injuries. Designs and monitors rehabilitation programs.

Coach – the organizational leader of a specific sports team. Often manages team affairs (travel, recruiting, scheduling) in addition to having a primary role as a teacher of sport-specific skills and strategy.

Psychologist – trained in clinical or counseling psychology to provide individual or group therapy relative to a broad range of behavioral and emotional issues. Typically work in a public clinic or private practice.

Performance Enhancement Consultants – professionals trained in sport psychology but are not licensed psychologists or counselors. Also known as sport psychology consultants or mental coaches. Provide individual or group consultations geared towards performance-related issues.

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