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Intervention 1: Self-Talk
Prior to Tom’s injury, he was a dominant, aggressive basketball player. However, his performance seems to be suffering, even after he was given the green light to continue playing. The expectations for Tom to perform well for his team may lower his confidence and cause him to be anxious, leading to poor self-confidence.
State anxiety, specifically anxiety that arises from after recovering from an injury, can significantly impact performance. Reducing anxiety can lead to an increase in self-confidence which further increases performance (Raglin & Hanin, 2000). The study by Hatzigeorgiadis, Zourbanos, Mpoumpaki, and Theodorakis (2008) examined the effects of motivational self-talk in self-confidence, anxiety and task performance in athletes. The results of the study showed that self-talk significantly enhances self-confidence and reduce anxiety.
Adopting some of the techniques from Hatzigeorgiadis et al. (2008), we suggest the use of a facilitative ‘Goal-directed’ self-talk intervention, to increase Tom’s self-confidence and reduce anxiety. First, Tom would be asked to reflect on experiences before and during a game. The aim of this is to encourage self-reflection through the recollection of negative and undesirable experiences. Second, employing this negative experiences, Tom would be encouraged to consider self-talk solutions. With help from us, Tom would come out with self-talk solutions for problematic situations he found himself struggling to overcome (e.g., disengaging thoughts, negative emotions or negative physical sensations). Third, for each problematic situation, Tom will be asked to elaborate as many as three possible goal-directed statements he could adopt to make himself feel better or solve the situations. To further help Tom identify the usefulness of each statement, each statement will be rated by Tom on a 5-point Likert scale, ranging from 1 (Extremely useless) to 5 (Extremely useful). Finally, he will be asked to think about potential alternative situations that may arise for himself in the future and self-talk solutions to overcome them. For future basketball games, Tom would be able to use the statements that he derived from this intervention to increase his self-confidence, decrease anxiety, encourage and motivate him to perform better.
The self-talk intervention focuses on facilitative self-talk to guide the participant. This intervention was further supported by the study from Cumming, Nordin, Horton, and Reynolds (2006), where the results show that facilitative self-talk significantly enhances performance whereas debilitative self-talk may worsen a participant performance. Hence, facilitative self-talk would be a reasonable solution for Tom. The effectiveness of goal-directed self-talk intervention was also concluded by Latinjaks, Font-Llado, Zourbanos and Hatzigeorgiadis (2016), that goal-directed self-talk interventions might be efficient by enhancing performance in the way athletes think and feel by empowering their own guiding voice in their heads.
Intervention 2: Imagery
After coming back from a severe injury, Tom did not seem to be 100% fit even though the doctors gave him the okay to go back into training. Mentally, Tom might not be ready, specifically after his team losing the grand finals, negative feelings like “letting his teammates down” could cause Tom to lose focus on the game and decrease his self-confidence. This could also leave to poorer performance and the fear of re-injury if he plays too aggressively.
Psychological impacts of injury may have detrimental effects on athletes’ performance, specifically on the return to sport or re-entry phase. The fear of re-injury and loss of self-confidence was often associated with return to sport (Johnston & Carroll, 2000). The study by Hamson (2006) examined the use of imagery and relaxation techniques in injury rehabilitation, including re-entry to a particular sport. The study reported that negative images, including mentally replaying the image of the injury and negative past performance can hinder an athlete re-entry to the sport. The aim of the re-entry to a sport was to reduce the fear of re-injury and improving an athlete self-confidence.
Adopting some of the techniques used in the study by Hamson (2006), we suggest the use of a guided individualised script, focusing on re-entry to sport relaxation imagery and relaxation techniques to improve psychological coping and reduce re-injury anxiety. First, we will help Tom design a script, the mental imagery will include verbal guidance and visual images of successful prior performance. It will also aim to improve confidence in the recovering ankle that it can perform without any limitations. The imagery script will also help Tom to organise his goals and provide motivation to achieve those goals. Second, we will advise Tom to practice imagery regularly and use some relaxation techniques which include but not limited to, slow deep breathing and meditation. This is because imagery, like any other skill, has to be practiced regularly to be effective. He will also be encouraged to incorporate this intervention in training, before a game and time outside of training, typically, 10 to 15 minutes a day. Finally, we will have Tom’s opinion on the script and make changes as we see fit. For future basketball games, Tom will be able to use imagery to help overcome poor performances and increase his self-confidence.
The imagery intervention uses guided individualised script. This intervention was further supported by Koehn & Díaz-Ocejo, (2016), where it was concluded that individualised script with verbal and visual guidance would be most beneficial during the re-entry phase of rehabilitation. Relaxation techniques have also been shown to aid injury rehabilitation and increase the effectiveness of imagery (Dridiger, Hall, & Callow, 2006; Evans, Hare, & Mullen, 2006). The study by Schwab-Reese, Pittsinger, and Yang (2012) examined the effectiveness of psychological intervention techniques, specifically imagery to increase self-confidence and reduce re-injury anxiety. It concluded that guided imagery and relaxation was demonstrated to be correlated with improved psychological coping and lower anxiety of re-injury, which may lead to an increase in performance.
Intervention 3: Goal Setting
Many sources believe that the team would have won the grand finals if Tom was playing, probably his teammates as well. The constant external pressure to perform well may hinder Tom’s performance. The expectation for Tom to perform at pre-injury levels may have led Tom to lose self-confidence and become so nervous in games that he could no longer concentrate. The execution of his movements was impaired which may lead to a loss of creativity, “touch for the ball” and spatial orientation.
Many Elite athletes face external pressures to perform at pre-injury levels from their coaches, teammates, media or even sports doctors. Such pressure derived from competitions and the importance of attaining desired team outcomes places unnecessary pressure on an individual athlete, which may lead to decrease in performance, inability to execute a particular sports move or distress of “falling behind” (Padlog & Eklun, 2010). Goal setting has been shown to increase one’s behaviour change through increasing motivation. The benefits of setting goals have been explored extensively (Locke & Latham, 2002; Wikman, Stelter, Melzer, Trier Hauge, & Elbe, 2014). Both studies argued that positive goal setting is essential to improve an athlete performance. The study by Wade (2009) examined the effectiveness of goal setting and the goal-setting process. It concluded that goal setting was a central feature in rehabilitation and may lead to regaining confidence and improving performance.
The five key elements in SMART goals are defined as Specific, Measurable, Attainable, Realistic and Time-based goals. Adopting the techniques in the SMART goal setting process by Wade (2009), we suggest the use of SMART goal setting that aims to: (1) motivate Tom, increase mental toughness and increase performance, (2) ensure Tom goals are in line with the team goals, (3) ensure that important actions are not overlooked and (4) allow monitoring of change for ineffective activities.
First, in specific, Tom will be advised to list out specific goals that could be worked towards, whether it is pressuring the defence, nailing five straight three-point shots in a row or driving successfully to the basket and scoring points, the goal has to be as specific as the results he is trying to achieve. Second, in measurable, goals that were set out should be able to be measured in terms of being successful or unsuccessful. This ensures that Tom may evaluate his goals and improve upon them if needed. Third, in attainable, Tom’s goals should be set to be difficult but achievable with focus and effort. Fourth, in realistic, goals that Tom define are not only realistic but relevant to the larger goal (increasing performance). Finally, in time-based, Tom’s goals need to have a time limit and the effectiveness of his goal setting is in place. For example, Tom may take two weeks to commit to his goals and then evaluate the effectiveness of his goals if he has achieved success he desired or if he has to work on his goals longer or if he needs to modify his goal. Prior to every future basketball game, Tom may look upon his goals to improve performance in his games.
The intervention aims to improve Tom’s performance and attain his form prior to his injury. This intervention is further support by Evans and Hardy (2002), where it examined the effectiveness of a goal setting intervention on athletes’ rehabilitation. It argued that goal setting as a means to enhance performance can lead to increasing self-efficacy. Positive goal setting can lead to an improvement in performance and increasing one’s self-confidence (Filby, Maynard, & Graydon, 1999). The success of goal setting and attaining one’s goals depends on the formulation of goals (Bovend’Eerdt, Botell, Wade, 2009). This study further supports the intervention which concluded that with proper consideration when setting goals, it can lead to an increase in proficiency of a particular skill, performance, and self-confidence.
- Bovend’Eerdt, T., Botell, R., & Wade, D. (2009). Writing SMART rehabilitation goals and achieving goal attainment scaling: a practical guide. Clinical Rehabilitation, 23(4), 352-361. doi: 10.1177/0269215508101741
- Cumming, J., Nordin, S., Horton, R., & Reynolds, S. (2006). Examining the Direction of Imagery and Self-Talk on Dart-Throwing Performance and Self Efficacy. The Sport Psychologist, 20(3), 257-274. doi: 10.1123/tsp.20.3.257
- Driediger, M., Hall, C., & Callow, N. (2006). Imagery use by injured athletes: A qualitative analysis. Journal Of Sports Sciences, 24(3), 261-272. doi: 10.1080/02640410500128221
- Evans, L., & Hardy, L. (2002). Injury Rehabilitation: A Goal-Setting Intervention Study. Research Quarterly for Exercise And Sport, 73(3), 310-319. doi: 10.1080/02701367.2002.10609025
- Evans, L., Hare, R., & Mullen, R. (2006). Imagery Use During Rehabilitation from Injury. Journal of Imagery Research In Sport And Physical Activity, 1(1). doi: 10.2202/1932-0191.1000
- Filby, W., Maynard, I., & Graydon, J. (1999). The effect of multiple-goal strategies on performance outcomes in training and competition. Journal of Applied Sport Psychology, 11(2), 230-246. doi: 10.1080/10413209908404202
- Hamson, J. (2006). The Effects of Mental Imagery on Recovery Time and Adherence to Sport-injury Rehabilitation Programs of College Athletes. American Alliance for Health, Physical Education, Recreation and Dance, Salt Lake City, Utah, April 2006. Retrieved from https://www.researchgate.net/publication/292275886_Imagery_use_in_rehabilitation_after_the_knee_joint_arthroscopy
- Hatzigeorgiadis, A., Zourbanos, N., Mpoumpaki, S., & Theodorakis, Y. (2009). Mechanisms underlying the self-talk–performance relationship: The effects of motivational self-talk on self-confidence and anxiety. Psychology of Sport and Exercise, 10(1), 186-192. doi: 10.1016/j.psychsport.2008.07.009
- Johnston, L., & Carroll, D. (2000). The psychological impact of injury: effects of prior sport and exercise involvement. British Journal of Sports Medicine, 34(6), 436-439. doi: 10.1136/bjsm.34.6.436
- Koehn, S., & Díaz-Ocejo, J. (2016). Imagery intervention to increase flow state: A single-case study with middle-distance runners in the state of Qatar. International Journal of Sport and Exercise Psychology, 1-14. doi: 10.1080/1612197x.2016.1187653
- Latinjak, A., Font-Lladó, R., Zourbanos, N., & Hatzigeorgiadis, A. (2016). Goal-Directed Self-Talk Interventions: A Single-Case Study with an Elite Athlete. The Sport Psychologist, 30(2), 189-194. doi: 10.1123/tsp.2015-0120
- Locke, E., & Latham, G. (2002). Building a practically useful theory of goal setting and task motivation: A 35-year odyssey. American Psychologist, 57(9), 705-717. doi: 10.1037//0003-066x.57.9.705
- Podlog, L., & Eklund, R. (2010). Returning to competition after a serious injury: The role of self-determination. Journal of Sports Sciences, 28(8), 819-831. doi: 10.1080/02640411003792729
- Raglin J. & Hanin, Y. (2000) Competitive anxiety and athletic performance. In: Hanin, Y. L. (Ed.). Emotions in Sport. (pp. 93-112). Champaign, Illinois: Human Kinetics. Retrieved from https://books.google.com.au/books?hl=en&lr=&id=KaGZ1KS07SYC&oi=fnd&pg=PA93&dq=Raglin,+J.,+%26+Hanin,+Y.+(2000).+Competitive+anxiety+and+athletic+performance&ots=htFvW002vL&sig=Vps4qbfbCElKKOpqUhyFWSLQy1U
- Schwab Reese, L., Pittsinger, R., & Yang, J. (2012). Effectiveness of psychological intervention following sport injury. Journal of Sport and Health Science, 1(2), 71-79. doi: 10.1016/j.jshs.2012.06.003
- Wade, D. (2009). Goal setting in rehabilitation: an overview of what, why and how. Clinical Rehabilitation, 23(4), 291-295. doi: 10.1177/0269215509103551
- Wikman, J., Stelter, R., Melzer, M., Hauge, M., & Elbe, A. (2014). Effects of goal setting on fear of failure in young elite athletes. International Journal of Sport And Exercise Psychology, 12(3), 185-205. doi: 10.1080/1612197x.2014.881070
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