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Article contents

Evaluation of psychological interventions in sport and exercise settings.

• Rebecca A. Zakrajsek Rebecca A. Zakrajsek Assistant Professor, Sport Psychology, University of Tennessee
•  and  Jedediah E. Blanton Jedediah E. Blanton Assistant Professor, Sport Psychology, University of Tennessee
• https://doi.org/10.1093/acrefore/9780190236557.013.223
• Published online: 22 August 2017

It is important for sport and exercise psychology (SEP) professionals to demonstrate that the interventions they employ make a difference. Assessing the degree of an intervention’s effectiveness depends first and foremost on the nature and scope of the intervention (i.e., the objective of the intervention) and its targeted group. Traditionally, interventions have been quite varied between the fields of sport psychology and exercise psychology; a common thread however, can be seen as an enhancement of the sport or exercise experience, along with an attempt to help the individual better self-regulate engagement with the targeted behavior or mindset. The central aim of enhancing the experience and increased self-regulation is oriented toward performance enhancement within sport psychology interventions, whereas within exercise psychology interventions the orientation is toward physical-activity adoption and better exercise program adherence. Although the two fields may have different objectives, it can be argued that sport psychology interventions—specifically psychological skills training (PST) interventions—can inform SEP professionals’ research and applied practices with both the sport and exercise populations.

Psychological skills training includes the strategies and techniques used to develop psychological skills, enhance sport performance, and facilitate a positive approach to competition. Since the early 1980s, a growing body of evidence has supported that the PST interventions SEP professionals employ do make a difference. In particular, evidence from research in sport contexts supports the use of a multimodal approach to PST interventions—combining different types of psychological strategies (e.g., goal-setting, self-talk, imagery, relaxation)—because a multimodal approach has demonstrated positive effects on both psychological skills and sport performance. The research investigating the effectiveness of PST interventions in enhancing performance has primarily centered on adult athletes who compete at competitive or elite levels. Elite athletes are certainly important consumers of SEP services; however, SEP professionals have rightfully challenged researchers and practitioners to target other consumers of SEP services who they argue are as deserving of PST as elite athletes. For example, young athletes and coaches are two populations that have traditionally been overlooked in the PST research. PST interventions targeting young athletes can help them to develop (at the start of their sporting careers) the type of psychological skills that facilitate a positive approach to competition and better abilities to self-regulate their emotional responses to stressful competitive situations. Coaches are also performers with unique needs who could benefit from PST interventions. Researchers have begun to target these two populations and the results might be considered the most intriguing aspects of the current PST literature. Future research related to PST interventions should target exercise populations. Exercise professionals often operate as coaches in healthy behavior change (e.g., strength and conditioning coaches, personal trainers, etc.) and as such should also employ, and monitor responses to, PST.

To facilitate further development and growth of PST intervention research in both sport and exercise settings, SEP professionals are encouraged to include a comprehensive evaluation of program effectiveness. In particular, four major areas to consider when evaluating PST programs are (a) the quality of the PST service delivery (e.g., the knowledge, delivery style, and characteristics of the SEP professional); (b) assessment of the sport psychological strategies participants used as a result of the PST program; (c) participants’ perceptions of the influence of the PST program on their psychological skills, performance, and enjoyment; and (d) measurement of participants psychological skills, performance, and enjoyment as a result of the PST program.

• sport psychology
• exercise psychology
• psychological skills training
• psychological technique
• psychological intervention

Introduction

Sport and exercise psychology (SEP) professionals provide services to a range of participants in various domains (e.g., sport, exercise, military, performing arts, and music). It is important for SEP professionals to demonstrate that the interventions they employ make a difference in participants’ performance and well-being because this evidence gives credibility to the field of applied sport psychology (Brown & Fletcher, 2017 ). Assessing the degree of an intervention’s effectiveness depends, first and foremost, on the nature and scope of the intervention (i.e., the objective of the intervention) and its targeted group. Traditionally, the interventions have been quite varied between the sport psychology and exercise psychology; a common thread however, can be seen as an enhancement of the sport or exercise experience, along with an attempt to help the individual better self-regulate engagement with the targeted behavior or mindset. For example, sport psychology interventions have primarily focused on sport performance enhancement (Vealey, 2007 ), and the focus of exercise psychology interventions has been on increasing physical activity and self-regulating exercise habits (Buckworth, Dishman, O’Connor, & Tomporowski, 2013 ). Although the two fields have different objectives, it can be argued that sport psychology interventions—specifically psychological skills training (PST) interventions—can inform SEP professionals’ research and applied practices with both the sport and exercise populations.

“Psychological skills training” is a term that “was coined to describe techniques and strategies designed to teach or enhance mental skills that facilitate performance and a positive approach to sport competition” (Vealey, 1988 , p. 319). When SEP researchers and practitioners are developing PST interventions it is important that they make a clear distinction between psychological qualities, psychological skills, and psychological strategies. “Psychological qualities” are the characteristics or attributes that facilitate optimal performance, and they can be experienced to varying degrees (e.g., high and low self-confidence; Holland, Woodcock, Cumming, & Duda, 2010 ). “Psychological skills” involve the ability to regulate psychological qualities, such as the ability to maintain self-confidence (Holland et al., 2010 ; Vealey, 1988 ). “Psychological strategies” are the interventions or the methods used to purposefully teach those psychological skills and qualities (e.g., thought control; Vealey, 1988 ). PST is of interest to SEP professionals because if sport and exercise participants learn to regulate their psychological using psychological skills and strategies, then their performance, experience, and adherence may be enhanced. Therefore, identifying the psychological qualities that are related to performance success and well-being can serve as a guide in the development of PST interventions in both sport and exercise settings.

In exercise contexts, interventions tend to more closely follow a behavioral theory or combination of theories to help individuals develop a healthier approach and enjoyment of exercise. In line with the description of PST in the preceding paragraph (Vealey, 1988 ), the term PST is used here to refer to various psychological techniques designed to enhance psychological skills and qualities to facilitate optimal sport and exercise performance experiences.

Brief Background on the Development of PST Interventions

In North America, several pioneers in sport psychology began working in the research and practice of PST as early as the 1920s. In 1925 , Coleman Griffith—known as the grandfather of American sport psychology—was the director of the first research laboratory devoted to sport psychology and worked with coaches at the University of Illinois to improve the performance of their athletes (Gould & Pick, 1995 ; Green, 2003 ). He was subsequently hired, in 1938 , by the Chicago Cubs baseball team to improve players’ performance (Green, 2003 ). With the Cubs, Griffith conducted one of his largest sport-psychology research projects (Gould & Pick, 1995 ) and implemented several psychological techniques, such as goal-setting, confidence building, and competitive simulation (Green, 2003 ). Although he was trained in experimental psychology, Griffith also conducted research using systematic observations of and interviews with athletes and coaches (Gould & Pick, 1995 ). Like Griffith, Dorothy Yates ( 1943 ) was a researcher-practitioner who reported positive results in investigations of the effectiveness of PST interventions on performance. Yates is historically known for implementing PST interventions with boxers and aviators that primarily focused on the relaxation set-method and mental preparation, (Kornspan & MacCracken, 2001 ). The relaxation set-method is similar to the psychological techniques used in the 21st century by SEP professionals; it involved a mental set—or positive affirmation (e.g., “keep cool, be alert”; Yates, 1943 )—that helped athletes focus on performance and relaxing. Yates induced relaxation through the use of Jacobsen’s progressive relaxation technique and then instructed the athletes to repeat the mental sets to themselves (Yates, 1943 ). In an experimental study with six pairs of evenly matched boxers, one boxer in each pair received the intervention and the other did not. Five of the six participants who received the relaxation set-method intervention won their matches (Yates, 1943 ).

Unfortunately, after the work of Griffith and Yates, sport psychology remained largely dormant; it wasn’t until the 1980s that the systematic study and practice of PST in sport emerged and became a major focus. It was during this time that the field of sport psychology transitioned from being an academic research discipline to an interdisciplinary profession providing services to various consumers (Vealey, 2007 ). At the time, however, much of the available intervention research involving psychological techniques did not include athletes as research participants and was conducted in highly controlled laboratory studies that used motor performance as the dependent variable. In fact, Greenspan and Feltz ( 1989 ) in their review of PST intervention research identified only four published studies prior to 1980 that employed PST interventions with athletes who competed on a regular and organized basis in actual competitive situations as participants. Richard Suinn ( 1972 ) conducted one of those studies and found that a PST intervention employing relaxation, imagery, and behavioral rehearsal with elite skiers improved their performance during races. This was encouraging, but the very limited PST research available at that time led SEP professionals to question the external validity and generalizability of studies using university students and measuring motor performance in contrived settings to athletes and sport performance in competition settings. For example, Dishman ( 1983 ) argued that it was “not clear to what extent contemporary sport psychology possesses a clearly defined and reliable technology for . . . intervention in applied settings” (p. 127). Similarly, Greenspan and Feltz ( 1989 ) later stated that “practitioners who utilize results from studies conducted in laboratories, or studies employing contrived setting, tasks, or dependent variables, rely on generalizations for which adequate validity has not been established” (p. 219).

Tensions surfaced between SEP researchers and practitioners, partly because professional practice issues appeared to command much of the field’s attention at the expense of research (Wrisberg & Dzikus, 2016 ). Although there was a call in the 1990s for a renewed commitment to the scientist-practitioner model—emphasizing the integration of theory, research, and practice—a gap between researchers and practitioners continued to widen over issues of evidence-based practice (see Wrisberg & Dzikus, 2016 ). Giacobbi ( 2003 ) interviewed Dan Gould about the gap between applied sport-psychology science and practice. Gould “expressed pride in the enormous scientific and practical progress the field has made in the last few decades” evidenced “by the explosion of knowledge in our journals and the number of conferences attended by scholars and practitioners around the world” (p. 29). He also questioned whether the field was recognizing the “delicate balance” between addressing the demands of academia and of those who might benefit from applied research. In other words, “researchers are focusing on issues that are sometimes different from what coaches, athletes, and exercisers experience” (p. 29). Wrisberg and Dzikus ( 2016 ) offer a detailed, critical, and analytical review of the history of PST in the field of sport psychology. In particular, they “examine the persistent tension that has existed between (a) proponents of academic and applied approaches to sport psychology, and (b) professionals trained in departments of kinesiology and psychology” (p. 20). In discussing sport contexts, the focus here is on the research employing an educational approach to PST based on the premise that participants (e.g., athletes, coaches) are basically mentally healthy and have the psychological skills needed to succeed. SEP professionals, therefore, help participants learn and optimize psychological skills and strategies to cope with the various demands of performance (Vealey, 2007 ).

In exercise settings, there is a common thread of utilizing psychological skill building or psychological manipulations in exercise- and physical-activity-focused interventions to help individuals to begin exercising, increase physical activity, or enhance adherence to regular exercise habits (see Berger, Weinberg, & Eklund, 2015 ; Buckworth et al., 2013 ). There has been a long history of interest in the relationship between psychology and exercise (some scholars have linked it to the writings of Heridocus and Hippocrates), but exercise psychology emerged as a focused field of study only in the 1960s (e.g., Layman, 1960 ), and became more fully established in the 1970s and 1980s. Much of the field’s progression has been credited to William P. Morgan, whose body of work focused on various psychological experiences associated with or mitigated by exercise, and his influence in seeing the viability of psychology as field of interest in physical education and exercise science. He is further credited with creating, in 1986 , and serving as the founding president of Division 47: Society for Sport Exercise and Performance Psychology, a division of the American Psychological Association that focuses on the combined interests of exercise and sport psychology (Buckworth et al., 2013 ).

A binding force to overcome within exercise psychology is the prevention and remedy of hypokinetic disease—that is, disease caused by the lack of physical activity and the deleterious psychological and physiological effects that result, health hazards that are comparable to the risks associated with smoking (Berger et al., 2015 ). Exercise psychologists focus on wellness and on psychological enhancements caused by exercise, as well as on the psychological ailments associated with physical inactivity. To promote and encourage physical activity, some of these researchers invoke psychologically based interventions, relying on health-behavior theories and other psychological manipulations to encourage a routine of adequate physical activity. Utilizing some of the same psychological skills and strategies used in sport, exercise interventions in research tend to take on a motivational approach to increase the desire to adopt a physically active lifestyle. Professionals and researchers facilitating future interventions might consdier adopting a strategy of promoting the development of self-regulated psychological skills within individuals, since it is likely they would be able to better assist people in obtaining their optimal experiences, whether performance or enjoyment focused, in sport and exercise settings.

Psychological Interventions in Sport

The catalyst for the development and growth of the practice of sport psychology is the intriguing possibility that PST interventions can create psycho-behavioral changes in athletes (Vealey, 1994 ). Research applications in the area of PST interventions have facilitated the acceptance of SEP professionals into the ranks of other sport-science specialists (e.g., physiologists, biomechanists, athletic trainers, physical therapists, and nutritionists) and their role in enhancing performance and the sport experiences of athletes (Sullivan & Nashman, 1998 ; Vealey, 1994 ). Since the early 1980s, a growing body of evidence has supported that the PST interventions SEP professionals employ do make a difference in sport performance. For example, both qualitative reviews (e.g., Vealey, 2007 ) and quantitative reviews (e.g., Brown & Fletcher, 2017 ; Greenspan & Feltz, 1989 ; Martin, Thompson, & Regehr, 2004 ; Martin, Vause, & Schwartzman, 2005 ; Vealey, 1994 ; Weinberg & Comar, 1994 ) conducted to date indicate that SEP professionals can be optimistic about the efficacy of PST interventions in enhancing athletes’ performance.

In PST research, the intervention process involves “actions initiated by someone other than the athlete that focused on psychological skills [and strategies] in an attempt to improve the athlete’s performance during competition” (Greenspan & Feltz, 1989 , p. 221). PST interventions have been primarily psychological in nature, defined as “any actions or processes that alter functioning and/or performance through changes in an individual’s thought and behavior” (Brown & Fletcher, 2017 , p. 78). The psychological techniques that have been most widely used by sport psychology practitioners, and the focus of most PST intervention research, are imagery, goal-setting, thought management and self-talk, and physical relaxation and arousal regulation (Vealey, 1988 , 2007 ). “Imagery” involves athletes’ use of their “senses to re-create or create an experience in the mind” (Vealey & Forlenza, 2013 , p. 240); it has been argued to be the most widely studied technique in the PST literature, as well as the most popular psychological technique used by athletes (Vealey, 2007 ). Whereas a “goal” is simply a target one strives to attain, “goal-setting” for athletes involves developing a plan that focuses on specific task demands, mobilizes effort, encourages persistence through adversity, and promotes problem-solving and the development of strategies to progress toward achievement of the goal (Locke & Latham, 1990 ). “Thought management” involves athletes’ awareness and management of self-talk—that is, the internal dialogue athletes have with themselves, often in the form of giving reinforcement or instruction, self-evaluation, and interpreting feelings and perceptions (Vealey, 2007 ). Physical relaxation and arousal regulation are techniques used to help athletes’ manage their energy or level of activation in order to match what is needed for optimal performance (Williams, 2010 ). Variations of these four traditional techniques have been used in PST interventions (e.g., centering, cognitive restructuring, behavior modification, breathing techniques, and focusing; Sullivan & Nashman, 1998 ).

Between 1972 and 1993 , a total of 45 studies that employed PST interventions with athletes in competition settings were identified. Greenspan and Feltz ( 1989 ) conducted the first comprehensive review of the PST intervention research that studied athletes who competed on a regular and organized basis and measured their performance in actual competitive situations. A total of 23 interventions across 19 published studies met the inclusion criteria and were categorized into three intervention categories: relaxation techniques (e.g., visuomotor behavior rehearsal and imagery); behavioral techniques (e.g., reinforcement, self-monitoring, feedback); and cognitive restructuring techniques (e.g., systematic desensitization and stress inoculation). Vealey ( 1994 ) has examined the status of the sport-psychology intervention research published since Greenspan and Feltz’s review. Using the same inclusion criteria, Vealey found an additional 11 articles that included 12 interventions and categorized these studies into three areas: cognitive (e.g., developing or restructuring thoughts); cognitive-behavioral (e.g., cognitive development or restructuring and a behavioral routine); and behavioral (systematic feedback). Although the relaxation-based-intervention category in Greenspan and Feltz ( 1989 ) made up a significant portion of the studies they included in their review, it was less common during Vealey’s ( 1994 ) review for PST interventions to employ only a single strategy. Instead, relaxation methods were included as part of a multimodal approach and subsumed within the categories of cognitive and cognitive-behavioral categories. Using the same criteria as the previous reviews, Weinberg and Comar ( 1994 ) identified 10 additional published PST intervention studies categorized into two areas: cognitive and cognitive-behavioral.

Of these 45 studies, 38 (85%) concluded that PST interventions were effective in enhancing performance in competitive situations, and causality (i.e., the intervention caused improvement in performance) could be inferred in 20 (45%) of the studies. Greenspan and Feltz ( 1989 ) noted that positive results were reported in all 11 cognitive-restructuring interventions and in 7 of the 9 relaxation-based interventions, and that 2 of the 3 behavioral studies indicated positive results. In Vealey’s ( 1994 ) review, positive performance results were reported in 5 of the 7 cognitive interventions, 2 of the 3 cognitive-behavioral interventions, and in both of the behavioral interventions. Weinberg and Comar ( 1994 ) reported that positive results were found in three of the four cognitive interventions and in all six cognitive-behavioral interventions. Performance outcome measures included a variety of tasks across the three reviews conducted (e.g., basketball free-throw shooting, batting averages, field-hockey tournament performance, figure-skating scores, football performance, golf performance, gymnastic performance, ski-racing results, sparring performance, swimming seasonal performance, table-tennis forehand attack and technical quality of shot, tennis serve accuracy, and tennis serve reception).

Several trends involving the characteristics of the intervention studies were reported in the reviews by Vealey ( 1994 ) and Weinberg and Comar ( 1994 ). First, a higher percentage of studies employed a control group, which was likely due to the greater use of single-subject designs. Second, more interventions adopted an educational-remedial approach (e.g., intervention was individualized based on athletes’ needs) compared to a general, educational approach. Third, the vast majority of the interventions in all three reviews were multimodal. According to Greenspan and Feltz ( 1989 ), of the five studies that compared the effectiveness of multimodal and single-intervention designs, three demonstrated greater effects using a combination of strategies as opposed to single treatments. For example, various combinations of relaxation plus imagery, or imagery and modeling, were found to be more effective than either relaxation or imagery alone. Fourth, while the majority of participants continued to be collegiate athletes, there were more studies that utilized elite and youth athletes as participants. For example, Greenspan and Feltz ( 1989 ) found that only 13% of interventions used national or elite athletes, and 9% used young athletes (under 18 years of age). Weinberg and Comar ( 1994 ) noted much greater percentages of elite (40%) and youth (40%) athletes as participants in the studies they reviewed. Fifth, a greater percentage of studies included the use of manipulation checks. For example, Weinberg and Comar ( 1994 ) found that 70% of the studies reported using manipulation checks, all of which demonstrated the effectiveness of the intervention. This is encouraging, but most of the procedures were minimal (e.g., interviewing participants about how they felt about the treatment). Sixth, the vast majority of interventions were conducted with athletes in individual sports or on individual skills (e.g., free-throw performance) in team sports. Lastly, interventions included a greater emphasis on cognitive restructuring and the development of cognitive-behavioral routines than was reported in previous PST intervention studies reviewed by Greenspan and Feltz’s ( 1989 ).

Eleven years later, Martin, Vause, and Schwartzman ( 2005 ) offered the next comprehensive review of PST interventions with athletes in competition. The researchers reanalyzed the 19 studies reviewed by Greenspan and Feltz ( 1989 ) and published experimental studies through 2002 that met the following inclusion criteria: all participants were athletes who competed on a regular and organized basis; athletic performance during actual competition was directly and reliably measured; and all studies were an experimental evaluation of an intervention using either an appropriate single-subject design or an acceptable control-group design. Given the conservative inclusion criteria, only 15 studies from the years 1972 to 2002 were included (Martin et al., 2005 ). Overall, 14 (93%) of the studies reported a positive effect of the PST intervention on performance; 9 reported a substantial positive effect, 5 demonstrated a small to moderate positive effect, and one did not show an effect on performance. Seven studies used single-subject designs (i.e., a multiple-baseline design across participants, multiple-baseline design across behaviors, and modified multielement design), and eight studies used group designs (i.e., AB 1 AB 2 AB 3 within group design, matched-groups factorial design, and simple control-group design). Six (85%) of the seven single-subject design studies reported performance improvements as a result of the PST intervention, and all eight (100%) group-design studies demonstrated higher mean performance in the PST intervention group compared to the control group. The majority of studies used a multimodal approach (80%); studies that included imagery (six of seven studies) and goal-setting (all three studies) as part of the PST intervention were found to be particularly successful.

Martin and colleagues’ ( 2005 ) review also found that studies continued to primarily utilize adult athletes as participants, and the percentage of studies including young athletes (24%) was lower than in Weinberg and Comar’s ( 1994 ) review. The majority of studies in Martin and colleagues’ ( 2005 ) review also continued to focus on individual sports or individual skills within team sports; however, three (20%) focused on team behaviors within team sports (e.g., two or more players were needed for correct execution of behaviors). Twelve (80%) of the studies included at least a partial treatment-integrity check to make sure that an intervention was applied and experienced as intended.

The trend toward the use of PST intervention research employing single-subject designs has continued to increase (Barker, Mellalieu, McCarthy, Jones, & Moran, 2013 ; Martin, Thompson, & Regehr, 2004 ). Single-subject designs offer several advantages for PST intervention research. First, researchers need to locate only a few participants with the same performance problem because it is typical for single-subject designs to include between three and five participants. Second, all the participants in single-subject designs receive the intervention at some point, which may decrease the resistance of some coaches and athletes to participating in a study with a no-treatment control group. Third, single-subject designs are not “hampered by some of the assumptions required of groups designs” (Martin et al., 2005 , p. 636). Fourth, in the context of the individual, single-subject designs can establish causation in the relationship between intervention and performance (APA Presidential Task Force on Evidence-Based Practice, 2006 ; Ivarsson & Andersen, 2016 ).

In their review, Martin and colleagues ( 2004 ) identified 40 single-subject design studies, between the years 1974 and 2003 , that met their inclusion criteria: participants were athletes who competed on a regular and organized basis; the dependent variable was a direct measure of performance during practices or competitions; acceptable interobserver reliability data was reported on the dependent measures (or gave “game statistics” on objective measures); and graphs were presented and included the performance of individual subjects across baseline and treatment sessions. Overall, the reviewed studies demonstrated positive effects of PST interventions on a variety of athletic behaviors (e.g., working harder at practices, decreasing problem behaviors, increasing coaches use of reinforcement and feedback, skill improvements, and performance improvement in competition). The following techniques were part of a multicomponent intervention, all of which reported that the treatment was effective in enhancing performance: goal-setting was a prominent feature in 11 studies; self-talk and imagery were components in seven studies; self-monitoring was used in five studies four studies included behavioral packages (instructions, freeze technique, modeling, feedback); and three studies combined hypnosis with a behavioral “trigger.”

Several aspects of the studies demonstrated advancements in PST research. The ranges in the ages (preteens, teenagers, and adults) and in the ability levels (beginners to international-level competitors) of the athlete participants were quite considerable. A total of 16 sports were included in the studies, representing a wide range of individual and team sports. Of the 40 studies, 25 (63%) included either a procedural-reliability assessment or a treatment-integrity check. Clear evidence of generalization of treatment effects from practice to competition was found in all six studies that intervened at practices, assessed performance at practices, and also measured performance during competitions. Lastly, 26 (65%) studies conducted a formal social-validity evaluation, a much higher percentage and more detailed than had been reported in previous reviews (e.g., Greenspan & Feltz, 1989 ; Martin et al., 2005 ; Vealey, 1994 ; Weinberg & Comar, 1994 ). More specifically, studies reported positive responses to all three of the following questions: (a) What do participants think about the goals of the intervention? (b) What do they think about the procedures applied? and (c) What do they think about the results produced from the procedures applied?

The reviews conducted thus far indicate that, over the years, there has been a higher percentage of studies demonstrating substantial positive effects of PST interventions on athletic performance. This may be partially due to the use of more in-depth, multimodal, inclusive approaches to PST interventions that are individualized (educational/remedial vs. educational/general) and systematic (Martin et al., 2005 ; Weinberg & Comar, 1994 ). Multimodal PST interventions—combining different types of psychological strategies (e.g., goal-setting, self-talk, imagery, relaxation)—are more reflective of the applied work of SEP professionals in which psychological skills and strategies are identified based on the needs of the individual or team and presented simultaneously to participants. The majority of multimodal PST interventions continue to include relaxation, imagery, self-talk, and goal-setting (Greenspan & Feltz, 1989 ; Martin et al., 2004 , 2005 ) with positive effects on performance, and imagery and goal-setting appear to have been particularly successful methods (Martin et al., 2005 ). Methodologies used by more recent researchers appear to be more sophisticated, employing single-subject designs. Although this is promising, the research investigating the effectiveness of PST interventions in enhancing performance has primarily centered on adult athletes who compete at the collegiate level. Collegiate athletes are certainly an important consumer of SEP services; however, SEP professionals have rightfully challenged researchers and practitioners to target other consumers of SEP services who they argue are as deserving of PST as adult athletes (Vealey, 1988 ). For example, young athletes (especially those in mid-childhood and early adolescence) and coaches are two populations that have traditionally been largely overlooked in the PST research. PST interventions targeting young athletes can help them to develop (at the start of their sporting careers) the types of psychological skills that facilitate a positive approach to competition and better abilities to self-regulate their emotional responses to stressful competitive situations. Coaches are also performers with unique needs who could benefit from PST interventions. Researchers have begun to target these two populations and the results might be considered the most intriguing aspects of the current PST literature. The section on current trends in psychological intervention in sport offers some exciting aspects of PST research that has been conducted since these reviews.

Psychological Interventions in Exercise

In the simplest terms, exercise interventions are designed to influence inadequately active, physically inactive, or sedentary individuals to move toward accumulating the World Health Organization’s recommended 150 minutes of moderate-intensity activity of per week (World Health Organization, 2010 ). Interventions focused on a psychological element or theory utilize some sort of interaction aimed at changing individuals’ thoughts or beliefs about their capability to exercise and, ideally, increasing their autonomous choices to be more active. Although they are not directly mentioned as PST in the exercise psychology literature, the tactics and techniques employed in reference studies and reviews of the literature highlighting how interventions that successfully influenced activity in underactive populations were implemented closely mirror what has been published in sport psychology interventions (e.g., behavior modification, enhanced self-regulation, etc.).

Simply educating populations about the benefits of exercise and the detriments of inactivity doesn’t seem to be efficient in promoting changes in physical-activity behavior. Hallal and colleagues ( 2012 ) worked to understand the trends in physical activity around the world, finding that an average of 31% of adults 15 years or older from 122 different countries failed to meet the recommended amount of engagement in physical activity (World Health Organization, 2010 ). The global phenomenon of physical inactivity has caused an increased public-health risk for chronic disease, to which physical inactivity is a primary contributor (see Kohl et al., 2012 ). This marked physical inactivity is despite research indicating that 68% of Americans are aware of exercise guidelines, and 94% are aware of traditional physical activities that provide a health benefit (Morrow, Krzewinski-Malone, Jackson, Bungum, & FitzGerald, 2004 ).

To best serve the population in need of further physical activity, it is imperative that the individual(s) and researchers helping the underactive population be highly attentive to the design and delivery of the messages employed to influence behavior. These interactions, like those in sport, focus on enhancing a psychological skill or skills (i.e., PST) to help the individual enhance their ability to self-regulate their engagement with a healthy level of physical activity. The use of behavioral theories in exercise psychology interventions has been shown to positively influence participants’ engagement in physical activity.

In a meta-analysis of 82 studies following randomized controlled trial methods and utilizing one or more theories to guide physical activity, Gourlan and colleagues ( 2016 ) concluded that no single theory was more efficacious in increasing physical activity than any other, returning an effect size of d = 0.31 overall. However, studies utilizing a single theory (n = 61) to increase physical activity returned a moderate effect of d = 0.35, whereas studies guided by two theories (n = 14) or more (n = 7) returned a smaller effect of d = 0.21. Thirty-one of the single-theory papers utilized the transtheoretical model (TTM); 16 studies utilized social cognitive theory (SCT); 8 utilized the theory of planned behavior (TPB); 5 followed self-determination theory (SDT); and one was based on the protection motivation theory (PMT). These findings underscore the need for individuals working to enhance physical activity to engage with the underactive and inactive populations from a supportive position, showing empathy, working to build competency, and promoting autonomy in choosing exercise activities.

The psychological quality of self-efficacy (Bandura, 1977 ) is present within the SCT, the TTM, the TPB, and the PMT. The construct of self-efficacy speaks to one’s belief, and the strength of that belief, to successfully engage in a behavior. Utilizing PST has a more direct influence on this belief, though research studies in sport and exercise tend to focus on outcome behaviors, such as performance (i.e., in sport) or accumulating more minutes of physical activity (i.e., in exercise). However, few studies report on actual changes in self-efficacy or, for that matter, in the accumulation of the psychological skill the intervention focuses on, rather measuring the targeted outcome. This is not a critique to suggest that the scientific veracity of the studies reported here and published in peer-reviewed journals are not valid; it is instead a strong suggestion to include measures of changes in the psychological skills that were taught or directly disseminated, in addition to outcome changes.

Motivational interviewing (MI) is a technique whereby one person guides another toward a more realistic perspective of goals and success potential by being empathetic and understanding and by positively promoting feasible problem-solving with respect to perceived goal barriers. As already noted, the review of PST research found that the psychological technique of goal-setting is commonly used in both sport and exercise interventions (see Vealey, 1988 , 2007 ). MI focuses on a person’s readiness, willingness, and perceived ability to engage (or cease) a certain behavior. Karnes, Meyer, Berger, and Brondino ( 2015 ) constructed an Internet-based intervention for 23 underactive and inactive adults over a four-week period. Based on self-reported data about each participant’s numbers of steps, the results indicated significant increases in average daily steps and weekly energy expenditures. Additionally, the authors found that the web-based MI protocol also increased several psychological variables including increased physical activity enjoyment and enhanced self-efficacy.

Eight individuals were interviewed after participating in an exercise intervention program for six months (Kerkelä, Jonsson, Lindwall, & Strand, 2015 ). Throughout the program participants had interactions with a coach whose actions and suggestions were guided by the SDT principles of autonomy support, structure, and interpersonal involvement. Additionally, coaches utilized MI interviewing skills, including adopting empathetic stances, helping to clarify realistic goals, and developing problem-solving abilities. Generally, the participants highlighted an increased positive change in their attitudes toward exercise and reported feeling that the study’s intervention was well designed. Interacting with a caring coach was described as a crucial element in participants’ experiences, and the support and affirmation the coach shared helped them in setting goals and by encouraging them to improve their exercise regimen. Individualizing the exercise program helped participants to maintain the motivation to continue exercising. Furthermore, utilizing measurable facets of change in their bodies and psychological state through closely monitored goals and an exercise diary, along with a supportive and motivational coach, were described as the most important aspects of the participants’ ability to remain in the long exercise intervention.

Self-determination theory is a highly regarded and often utilized and cited psychological theory in advocating behavior adoption or change. In a systematic review of 66 SDT-based studies on exercise and physical activity, seven were SDT-based interventions, primarily centered on increasing autonomy support, or encouraging more active choice in pursuing physical activity (Teixeira, Carraça, Markland, Silva, & Ryan, 2012 ). In one such study, an exercise class that was focused on a mix of boxing and step aerobics served as the setting: one session included an SDT manipulation, and the other session was the control; both classes used the same instructor, who only altered her teaching style in the experimental condition (Edmunds, Ntoumanis, & Duda, 2008 ). In the experimental exercise class, the “instructor focused upon promoting autonomy support by taking the perspective of the exercise class participants into account, acknowledging their feelings and providing them with pertinent information and opportunities for choice” (Edmunds et al., 2008 , p. 379). As a result of manipulating the instructor’s teaching style to alter the exercise climate, participants in the experimental condition reported significantly increased scores in autonomy support, structure, interpersonal involvement, relatedness, and competence need satisfaction (Edmunds, et al., 2008 ). Here, the psychological skills or manipulation onto the exercisers were focused on increasing the exercisers’ perceived sense of competency, autonomy, and stronger sense of belonging with the instructor. This is in line with research in sport such as the aforementioned psychological techniques common in thought management (Vealey, 2007 ).

Fortier, Sweet, O’Sullivan, and Williams ( 2007 ) also focused on changing perceptions of autonomy in a 13-week randomized control trial; results indicate that participants in the experimental condition were more successful in changing their autonomous self-regulation to reach their physical activity goals, and predicted increased engagement with physical activity at the end of the 13 weeks.

Although autonomy support was a primary focus in the SDT-based interventions, resulting in positive exercise changes and experiences, across all the studies in this systematic review, among the three needs associated with SDT, competence was the strongest correlate with physical activity behaviors, while relatedness was most often null (Teixeira et al., 2012 ). “In sum, existing interventions are limited in number and highly varied. Longer and more comprehensive longitudinal interventions are needed, especially those which work toward the development of autonomous motivation, allow more time for changes in motivational and behavioral processes to take place, and assess whether those changes (and associations) persist in the long-term” (p. 26). Teixeria and his colleagues encouraged better-designed interventions that will allow enough time to pass, with frequent interactions among researchers and participants, so that, perhaps, a more salient and rewarding exercise experience can be reached. Additionally, collecting data throughout the intervention and for a length of time after the intervention would allow researchers to identify the efficacy of their protocols to create long-lasting, self-regulated, and self-motivated exercisers.

In all the studies that have been mentioned, the participants’ success hinged on how the individuals guiding the intervention protocol interacted with them. For the individuals guiding the exercise-adoption and physical-activity behavior, being cognizant of how they approached the unique characteristics of the underactive participant could have a positive influence on the participant’s current exercise level; as is commonly noted in the exercise psychology literature and textbooks, one size does not fit all (Berger et al., 2015 ; Buckworth et al., 2013 ). Furthermore, including teachable psychological skills can allow exercisers to learn to employ the psychological techniques on their own, much in the way that the psychological skills and techniques employed in PST interventions that enhanced sport performance.

For example, the results of a study tracking exercise and diet indicated that mindfulness training significantly reduced reward-driven eating (characterized by a lack of control over eating, preoccupation with food, lack of satiety, and psychological stress; Mason et al., 2016 ). In comparing a control group and mindfulness group, both of whose participants were enrolled in a diet and exercise program aimed at teaching them to make healthier food and exercise choices to assist in weight loss, the participants in the mindfulness group reported significantly less reward-driven eating after the six-month program ended, and these reductions were also related to weight loss at a 12-month follow-up. Mindfulness training is focused on increased self-awareness and self-regulation. The strategies utilized in Mason and colleagues’ ( 2016 ) intervention mirrored PST by teaching deep breathing and increased self-awareness when the participants engaged in their daily eating routines. The authors advocate for additional focus on changing reward-driven eating through mindfulness training to assist in weight loss interventions, along with exercise.

In another example using newspaper ads, television commercials, radio commercials, and public-education activities at worksites and in community organizations, researchers targeted a small town in West Virginia (Reger et al., 2002 ). The messages used in the campaign were guided by the TPB, particularly the control- beliefs aspects. Messages encouraged the feasibility of control and time to engage in a daily 30-minute walk. Using a similar town in West Virginia with a different media market, data was collected from pre- and postintervention telephone surveys and observational data collected from ten observational sites. Results showed a 23% increase in observed walking compared to the control community. Researchers conducted a three-month follow-up from the media campaign, and found that those individuals in the targeted town who were in communities that were more aesthetically pleasing, had benches for resting, high connectivity, and lots of other walkers reported 87 more minutes of walking per week than those living in less walkable parts of town (Gebel, Bauman, Reger-Nash, & Leydon, 2011 ).

Using carefully designed interventions focused on enhancing the participant’s autonomy, competency, and self-efficacy with respect to their health habits, showed the greatest results in increasing physical activity. The reviews of exercise interventions here highlight how focusing on participant’s psychological skills and regulation have a positive influence on their physical activity choices. As noted in Morrow et al.’s ( 2004 ) findings, a person’s lack of engagement in exercise is not based on a misunderstanding or lack of knowledge about the benefits of exercise, but is more likely due to a lack of motivation or inadequate feelings of efficacy to change one’s physical activity choices. Though the interventions described in the exercise psychology literature have strong research designs (e.g., RCT, longitudinal data collection), exercise researchers should be encouraged to access the strengths from the sport psychology literature and the PST interventions employed therein. Individualizing the approach to enhanced exercise experiences, acquisition of exercise behaviors, and adherence to exercise programming, with more specific and nuanced psychological strategies to improve the psychological skills that manifest in better psychological qualities (e.g., higher self-confidence) could be an exciting endeavor to assist in this important habit. Future researchers and SEP professionals are encouraged to focus on the efficacy of using PST in exercise settings, especially with respect to increasing autonomy, teaching realistic goal-setting, and enhancing efficacy and self-awareness in physical activity.

Psychological Interventions in Injury

Injury is a context relevant to both sport and exercise participants. The integration of PST interventions with injured athletes and performers has seen a recent rise in the literature. Work related to the prevention of injury is largely based on Williams and Andersen’s ( 1998 ) stress-injury model (see also Andersen & Williams, 1988 ), which posits that the stress response may increase the likelihood of injury or, through successful intervention, detour or prevent injury. The stress-injury model suggests that the stress response can be influenced by PST interventions, limiting the likelihood of injury occurrence.

Ivarsson, Johnson, Andersen, Fallby, and Altemyr ( 2015 ) utilized mindfulness in soccer training as a potential preventive measure for injury. The authors described mindfulness and suggested that

paying attention to what is happening right here, right now has had tremendous survival value. Being mindful is part of our evolutionary heritage, but with our complex and negatively oriented brains we constantly slip out of being present and drift to times and places that actually set us at risk for all sorts of unhappiness, including sport injuries. (p. 322)

The researchers hosted a seven-week mindfulness-based intervention program with 21 Swedish junior elite soccer players compared to 20 similar players assigned to an attentional-focus control group. Injuries for all 41 athletes were monitored over a six-month period. Results showed that 67% (14 of 21) of the mindfulness-based intervention treatment group remained injury free, whereas only 40% (8 of 20) in the control group sustained no injuries.

Tranaeus, Ivarsson, and Johnson ( 2015 ) conducted a meta-analysis of psychological-injury-prevention interventions, albeit small, identifying only seven studies. The inclusion criteria involved the using PST interventions to prevent injuries in athletes. Six of these studies identified a significant reduction in the frequency of injury among participants, with a total Hedges’ g effect size of 0.82. The one study with nonsignificant reduction in injury utilized a single information session as its educational intervention; whereas the other studies were guided by much larger frequency of interaction, up to 16 sessions. The significance in reduction of injury through interventions with multiple PST sessions supports the notion that including well-trained individuals to deliver relatively frequent informational sessions on PST toward injury prevention may reduce the stress response (Andersen & Williams, 1988 ) thus decreasing injuries experienced in a competitive season.

Appaneal and Habif ( 2013 ) report that studies focused on psychological techniques for reducing injury risk were grounded in cognitive-behavioral stress management (see Meichenbaum, 1977 ). These studies demonstrated a reduction in injuries, relaying that when athletes are educated about their cognitive appraisals and stress-response symptoms and then taught strategies to enhance their awareness and coping, they are more likely to avoid injury. Assessing these physiological variables (i.e., total amount or reduction of injuries) is an important step in determining the effectiveness of the interventions; however, as with the interventions in exercise populations (e.g., autonomous self-regulation, sense of relatedness), researchers should also attempt to collect data around the strategy utilized, or the psychological variables the strategy targets, in order to better draw conclusions and make comparisons around the strength of particular psychological modalities.

PST interventions have also been undertaken with injured persons and athlete groups. The focus in these studies has been on examining how a psychological strategy or skill may enhance outcomes related to a better recovery or better mood states while coping with injury. When placing military personnel with nonspecific low-back pain in an experimental group focused on goal-setting, a therapist-led exercise therapy group, or a non-therapist-led therapy exercise group for three weeks, Coppack, Kristensen, and Karageorghis ( 2012 ) found that self-efficacy and adherence was significantly higher with the experimental group, suggesting that goal-setting can enhance the rehabilitation or exercise therapy experience. Similar findings were supported in an earlier study by Evans and Hardy ( 2002 ). After a five-week intervention, injured athletes in a goal-setting experimental group showed increased self-efficacy and adherence.

Schwab Reese, Pittsinger, and Yang ( 2012 ) conducted a systematic review, identifying six studies that targeted reduction of psychological consequences or enhanced psychological coping, or both, through PST-based interventions with samples of injured athletes. Based on their review, the authors suggest that guided imagery coupled with relaxation training had a positive influence on psychological coping and enhanced moods. Furthermore, Schwab Reese and colleagues noted that additional techniques involving acceptance and commitment therapy and microcounseling skills had shown reductions in negative psychological consequences and improvements in psychological coping, which are related to an elevated response to stress, lessening the susceptibility to injury.

When employing PST interventions for injury prevention and recovery, researchers have identified positive results with respect to increased perceived social support (Brown, 2005 ), adherence (Flint, 1998 ), reduced injury susceptibility (Ievleva & Orlick, 1991 ), and prevention of injury (Williams & Andersen, 1998 ); however, health professionals who have had the most frequent interactions with the injured population (beyond research settings), have reported feeling inadequately trained to incorporate and deliver PST (Arvinen-Barrow, Penny, Hemmings, Corr, 2010 ). Alexanders, Anderson, and Henderson ( 2015 ) report that physical therapists (PTs) recognize the importance of psychological well-being, and that recovering from injury and surgery often causes psychological distress. Although PTs training curricula cover psychological concepts, they report feeling inadequately prepared to initiate psychological interventions in their practice with patients (Arvinen-Barrow et al., 2010 ). To better grasp the current perspectives of PTs, Alexanders et al. ( 2015 ) systematically reviewed the research examining how these health professionals perceive and practice psychologically based interventions in their rehabilitation protocols with patients. From 2002 to 2013 , only six papers were found to match the inclusion criteria. The findings of these studies indicated that PTs commonly utilize goal-settings, positive self-talk, and effective communication. Although these studies highlighted that PTs find these psychological tools beneficial, PTs far too often express being inadequately trained to fully utilize PST in practice. This particular finding is highlighted in Arvinen-Barrow et al.’s ( 2010 ) qualitative study, despite Farouk’s ( 2010 ) findings that incorporating the goal-setting PST during rehabilitation shows enhancements in patients’ confidence, self-esteem, and self-efficacy; all beneficial psychological strengths that can strengthen positive regard and adherence to rehabilitation programs.

Current Trends in Psychological Interventions in Sport

Fourteen years’ worth of studies have been conducted since Martin and colleagues’ ( 2005 ) review of PST intervention research on sport performance. A recent comprehensive review by Brown and Fletcher ( 2017 ) offered insight into the current trends in the most rigorous PST intervention research available and addressed “some of the perplexing issues in the sport psychology intervention literature (e.g., do interventions have a lasting effect on sport performance?” (p. 93). A total of 35 studies met the following inclusion criteria: participants were of any age who competed in sport at various competitive standards (i.e., local, regional, national, or international); athletic performance was examined as an outcome measure (i.e., technical task, component of fitness, or overall performance or competition outcome); the effects of a psychological (i.e., any action or process using thoughts and behaviors), social, or psychosocial (i.e., thought and behavior and social factors) intervention on sport performance were evaluated; all studies were an experimental evaluation of an intervention using randomized control trials; and sufficient statistical data was reported to calculate effect sizes. Thus the studies included were those with high internal and external validity. Since no social intervention studies were identified, findings were limited to studies that evaluated the efficacy of either psychological interventions (26 studies) or psychosocial interventions (5 studies). Four studies included intervention types that met the criteria for both psychological and psychosocial classifications.

Overall, psychological and psychosocial interventions were found to have a moderately positive effect on performance. Larger effects were in Brown and Fletcher’s ( 2017 ) review than had been found in previous reviews of PST intervention research, specifically for mental practice, goal-setting, team building, and self-talk. Eight studies (23%) reported follow-up analyses; interventions were found to have large positive effects on performance at least one month following the completion of the intervention. Estimated mean effects also indicated psychosocial interventions to be more effective in enhancing performance than psychological interventions; although, Brown and Fletcher ( 2017 ) noted two outlier studies using psychosocial interventions that may have amplified the effect. Competitive standard intervention components (e.g., single component or multimodal), and type of performance outcome were found to be unrelated to the effects of the intervention. Although reviews mentioned in the section “ Psychological Interventions in Sport ” supported the use of multimodal interventions, Brown and Fletcher’s review found no difference between single-component and multimodal interventions. However, because psychosocial interventions were found to be the most effective and also consist of multiple parts, Brown and Fletcher ( 2017 ) argued that multimodal interventions may be more effective than single-component interventions if they include both psychological techniques (e.g., imagery) and a social agent (e.g., coach). Interestingly, results with type of intervention provider (i.e., coach, equipment, practitioner, researcher, self) found the highest estimated mean effects for interventions delivered by coaches and lowest mean effects for interventions delivered by practitioners. Given the importance of the coach-athlete relationship on athlete performance and well-being (e.g., Mageau & Vallerand, 2003 ), Brown and Fletcher ( 2017 ) also recommend that SEP practitioners involve coaches to gain the greatest effects from PST interventions.

The findings reported in Brown and Fletcher ( 2017 ) offer a strong base of evidence for the use of psychological techniques with athletes, and the PST research has only continued to become more sophisticated. This is likely because SEP researchers and practitioners have continued to identify, and attempted to address, areas of PST intervention research that need attention. These areas appear to be promising steps toward closing the gap between the science and practice of applied sport psychology mentioned in the section “ Brief Background on the Development of PST Interventions .”

Thelwell, Greenlees, and Weston ( 2010 ) identified three important areas that researchers are starting to include in PST program studies. First, what, why, and how skills and strategies are selected and delivered are being discussed in the more recent PST intervention literature with a variety of sports (e.g., Hanton & Jones, 1999 ; Rogerson & Hrycaiko, 2002 ; Thelwell & Greenlees, 2003 ; Thelwell et al., 2010 ; Thelwell & Maynard, 2003 ). And researchers are using evidence-driven models and frameworks to guide and provide a rationale for the development of PST programs. Second, some researchers have started to focus on and provide evidence for the benefits of PST interventions on performance subcomponents, such as shooting performance in soccer (Johnson, Hrycaiko, Johnson, & Halas, 2004 ); goaltender save percentage in ice hockey (Rogerson & Hrycaiko, 2002 ); and success in passing, tackling, and first touches in soccer (Thelwell et al., 2010 ). Third, how psychological skills and strategies impact performance or performance subcomponents throughout competition has started to be included in PST program research (Thelwell et al., 2010 ).

In response to these three important areas, Thelwell and colleagues ( 2010 ) employed a multiple-baseline across individual’s single-subject design and delivered a PST package over a three-day period that included relaxation, imagery, and self-talk with three soccer midfielders who had not previously participated in a structured PST program. The researchers used Taylor’s ( 1995 ) conceptual model for integrating athletes’ needs and sport demands to develop the PST program; the psychological strategies were chosen based on the physical, technical, logistic, and psychological demands of the specific midfielder role. More specifically, relaxation strategies were chosen because they allow for a greater perception of control for physiological and psychological performance demands throughout competition. Soccer midfield participants were introduced to what relaxation is and when it might be beneficial within their role, experienced progressive muscle relaxation to raise awareness of tension and relaxation, were taught a centering strategy to enable quick and effective relaxation, and were encouraged to use the strategy in training sessions when there was a break in play. What, why, and how imagery and self-talk were selected and delivered were also reported. The dependent variables were performance subcomponents (i.e., pass, tackle, and first-touch percentages) measured during two stages (i.e., first- and second-half performance) throughout the competition. Data was collected over eight games. The researchers and a fourth individual who was external to the group (i.e., a qualified soccer coach) individually rated the performance subcomponents during the training sessions and games until a suitable interobserver reliability was achieved (i.e., greater than 80%). Procedural-reliability procedures were also employed in which an independent researcher checked that the intervention elements were applied correctly and consistently. Results indicated that the PST program improved performance at different stages of competition, and participant midfielders improved in at least two subcomponents in second-half performance. Social validation data revealed that participants were satisfied with the PST program and felt that the intervention was of use to them.

Researchers have also advocated for more thorough evaluations of overall PST program effectiveness through the use of qualitative methods (Sharp, Woodcock, Holland, Cumming, & Duda, 2013 ). Back in 1998 , Strean argued that qualitative methodology is particularly well suited to evaluating PST program effectiveness because the interventions take place in the complex world of sports, and “this setting does not lend itself easily to experimental investigation” (p. 340). Given that nearly 20 years have passed since Strean’s call, it is surprising that the qualitative investigations evaluating PST program effectiveness are still limited in number. Nonetheless, the more recent uses of qualitative methods is perhaps one of the most exciting developments in evaluating PST program effectiveness.

Sharp and colleagues ( 2013 ) conducted one of the few studies that employed a qualitative methodology to evaluate the perceived effectiveness of a PST program delivered in an Under-16 Scottish rugby union development program. The researchers developed the PST program based on the psychological demands of youth rugby (see Holland et al., 2010 ; Woodcock, Holland, Duda, & Cumming, 2011 ); needs of the sport; and the perspectives or recommendations of youth athletes, parents, coaches, and administration staff for the delivery of a PST program with Under-16 youth rugby athletes. Sharp and colleagues delivered the content of the PST program (i.e., performance profiling, goal-setting, self-talk, arousal control, imagery, precompetition routines, and precompetition plans) through nine interactive sessions and on-field training support over the course of the program’s rugby season (six months). At the end of the season, they conducted a number of focus groups with the athletes and coaches to assess their perceptions about the effectiveness of the PST program, quality of the service delivery, psychological techniques used by athletes, and perceived influence of the PST program on athlete performance. Sharp and colleagues investigated these areas based on the recommendations made by Anderson, Miles, Mahoney, and Robinson ( 2002 ) on completing a thorough evaluation of sport psychology services. Overall, athletes and coaches viewed the PST program favorably and viewed it as a valuable addition to the rugby development program. Indicators of PST program effectiveness included athletes’ and coaches’ perceptions that the program was interactive and well-planned, the atmosphere was fun and relaxed, athletes developed increased knowledge of psychological techniques and awareness of the importance of the psychological aspect of performance, and the PST program nurtured team cohesion. Instead of a focus on one isolated skill or strategy, the use of the multimodal approach was perceived to be effective, since athletes reported that they were able to select the technique(s) they felt worked best for them and to effectively apply them in their performance. Furthermore, both the athletes and coaches believed the psychological techniques they had chosen to use were effective (e.g., self-talk was effective in helping an athlete calm down) in regulating athletes’ behaviors during rugby performance. Coaches’ knowledge and support of the program was also assessed; participants believed that it was important to increase coaches’ knowledge and understanding of PST so that they would be able to encourage athletes and offer support and on when and how to use the psychological techniques. Lastly, athletes and coaches provided recommendations for future PST program delivery. Both the athletes and coaches felt that teaching and practicing psychological skills and techniques in the competitive environment (e.g., on the field duirng training sessions) would be essential components to add to the PST program and preferred more frequent PST sessions so that athletes would remember what was taught.

Following Vealey’s ( 1988 ) recommendation, SEP professionals have made attempts to expand PST program research participation to youth athletes (Fournier, Calmels, Durand-Bush, & Salmela, 2005 ; Gucciardi, Gordon, & Dimmock, 2009 ; Haddad & Tremayne, 2009 ; Larsen, Henrikse, Alfermann, & Christensen, 2014 ; Sheard & Golby, 2006 ) and to coaches (Olusoga, Maynard, Butt, & Hays, 2014 ). As in the work of Sharp and colleagues ( 2013 ), some of the PST program research has included both youth athletes and coaches as participants in their study (e.g., Gucciardi et al., 2009 ; Larsen et al., 2014 ). Much of the research evaluating PST program effectiveness with coaches has focused on their perceptions of the program (e.g., Gucciardi et al., 2009 ; Larsen et al., 2014 ; Newin, Bloom, & Loughead, 2008 ; Sharp et al., 2013 ). Other PST research with coaches has focused on exploring how they use psychological techniques with their athletes (Hall & Rodgers, 1989 ; Newin et al., 2008 ). While this information has been useful (and more research is needed in this area), more recent literature is starting to explore coaches’ personal use of psychological techniques because coaches are considered performers themselves who must cope with stress and pressure (Olusoga et al., 2014 ; Olusoga, Butt, & Maynard, 2010 ; Olusoga, Maynard, Hays, & Butt, 2012 ; Thelwell, Weston, Greenlees, & Hutchings, 2008 ). Interviews with 13 elite-level coaches revealed that they utilized self-talk, imagery, relaxation, and goal-setting before, during, and after training and competitions (Thelwell et al., 2008 ). Self-talk and imagery were used most frequently and for the purposes of overcoming concerns about athletes’ performance, controlling emotions, developing confidence, helping to plan training sessions, and getting into the appropriate frame of mind. Olusoga et al. ( 2010 ) interviewed 12 world-class coaches and found that they reported only minimal use of psychological skills, and instead avoided stressors as a way of managing stress. It appears that psychological skills and strategies help coaches cope with the demands of coaching, and there is a need for SEP professionals to help coaches identify and develop these skills.

Olusoga and colleagues ( 2014 ) conducted a six-week PST program with five coaches that was aimed at encouraging them to use various psychological skills (e.g., emotional control, communication, confidence). The psychological skills were chosen because they had been found to be essential by highly successful Olympic coaches in previous research (Olusoga et al., 2012 ). An educational approach and cognitive-behavioral framework (e.g., exploring thoughts, emotions, and behaviors related to stress and challenging irrational thinking) was adopted for the delivery of the workshops, while also being client-centered (e.g., discussing and exploring relevant issues significant to the participants; Olusoga et al., 2014 ). Coaches were also taught cognitive and somatic relaxation strategies. The researchers measured coaches’ use of psychological skills, perceptions of precompition state anxiety , and coping abilities before and after the PST program. Results revealed positive changes in coaches’ perceived ability to coach effectively under pressure; the most pronounced changes were in their ability to relax. Coaches’ relaxation skills improved, and they used these skills effectively during competition and rated their somatic anxiety symptoms during competition significantly lower after the PST program. Social validation provided the practical significance of the PST program, in which positive coaching performance changes were reported as a result of the intervention. Coaches also reported being satisfied with the PST program and highlighted building self-confidence and developing the ability to relax as beneficial aspects of the program.

In comparison to traditional PST intervention research in which a single or multimodal intervention involved limited psychological-technique training (e.g., researchers had limited contact with participants, with simple instructions directing participants to apply the technique during a task), the more current research evaluates the effectiveness of the overall PST program. PST programs typically involve several contacts with participants over a sustained period of time (e.g., over an entire sport season), include education about several psychological skills and strategies and their application in a variety of situations, and are partly classroom based (e.g., the teaching takes place away from the location of physical training sessions; Eccles & Riley, 2014 ). Combining psychological skills and strategies in a comprehensive PST program can be advantageous, especially in group settings, because it can influence a greater number of people and facilitate team bonding, while also being flexible enough to accommodate individual differences (Blakeslee & Goff, 2007 ; Sharp et al., 2013 ). The use of team and organizational-level interventions addresses one of the limitations reported by Brown and Fletcher ( 2017 ), in which the studies in their review involved only individual-level interventions.

PST program research has not been designed to determine how much any one skill or strategy included in the program is responsible for the treatment’s effectiveness. This is interesting given that qualitative evaluations of PST programs allow researchers to examine which processes are making the intervention(s) effective (Strean, 1998 ). Although this was not directly assessed by Sharp and colleagues ( 2013 ) in their qualitative evaluation, one participant did report that “self-talk helped me the most” (p. 226), providing some evidence that participants may believe one method to be more useful than others. This also demonstrates that PST programs can equip athletes with a toolbox of psychological techniques and likely provide a solution to individual athlete’s concerns (Patrick & Hrycaiko, 1998 ).

Gardner and Moore ( 2012 ) offered a critique against traditional PST intervention research, which

incorporates therapeutic strategies (i.e., goal-setting, imagery, precompetitive routines, self-talk) focused on developing personal control over one’s cognitions, emotional states, and physiological sensations in the service of the creation and/or maintenance of an assumed ideal performance state (pp. 309–310).

PST interventions have largely been rooted in cognitive-behavioral therapy principles (Whelan, Mahoney, & Meyers, 1991 ), and researchers have questioned the notion that athletes need to control cognitions, emotions, and physiological sensations in order to enhance performance (Gardner & Moore, 2012 ). Based on this critique, interventions using mindfulness and acceptance-based models have gained popularity in the performance-enhancement intervention research (Gardner & Moore, 2012 ; Sappington & Longshore, 2015 ). Gardner and Moore ( 2012 ) state that mindfulness and acceptance-based models are in direct contrast with traditional PST interventions. Instead of changing athlete’s internal experiences (i.e., cognitions, emotions, and physiological sensations), mindfulness and acceptance-based models seek to modify them, with

(a) a nonjudging (i.e., not good, not bad, not right, not wrong) moment-to-moment awareness and acceptance of one’s internal state, whatever that may be; (b) an attentional focus on task-relevant external stimuli, instead of a focus on internal processes that includes judgement and direct efforts to control/modulation; and (c) a consistent and effortful personal values-driven commitment to behavioral actions/choices that support one’s athletic endeavor (Gardner & Moore, 2012 , p. 309).

In their review, Sappington and Longshore ( 2015 ) identified 19 empirical studies (six case studies, two qualitative studies, seven nonrandomized trails, and four randomized trials) that used athletes (at any level) as participants and evaluated the use of mindfulness-based intervention techniques directly or indirectly on performance. Overall, the results of these studies provide preliminary support for the efficacy of mindfulness-based techniques in improved sport performance (e.g., competitive rifle shooting performance). However, based on their review, Sappington and Longshore ( 2015 ) also concluded that “research on mindfulness training for athletes must undergo a dramatic shift toward more methodologically rigorous empirical testing” (p. 256).

Future Directions

To facilitate further development and growth of PST intervention research in both sport and exercise settings, SEP professionals are encouraged to include a comprehensive evaluation of program effectiveness. In particular, four major areas to consider when evaluating PST programs include (a) quality of the PST service delivery; (b) assessment of the psychological strategies participants used as a result of the PST program; (c) participants’ perceptions of the influence of the PST program on their psychological skills, performance, and enjoyment; and (d) measurement of participants psychological skills, performance, and enjoyment as a result of the PST program (see Anderson et al., 2002 ).

Much of the sport-based PST program research to date appears to focus on evaluations of the psychological strategies participants used, of perceptions of the influence of the PST program on performance, and measurements of participants’ performance as a result of the intervention. An area that is often overlooked yet equally important in PST program intervention research involves participants’ perceptions, attitudes, and expectations about sport psychology services and the program. While Sharp and colleagues ( 2013 ) did not assess athletes’ and coaches’ expectations about the PST program until after the season had ended, participants expected athletes to gain a basic understanding of PST techniques and when to apply them, and of how to prepare for and manage their thoughts and emotions during competition. Sharp and colleagues ( 2013 ) reported that their athletes had more positive expectations about the outcomes of the PST program than what has been reported in previous research, perhaps because “youth male rugby athletes indicated no initial negative perceptions associated with the term ‘sport psychology’” (p. 224); however, this was not directly assessed.

Understanding potential sport and exercise participants’ attitudes toward and expectations about sport psychology and PST service use can help researchers and practitioners identify which psychological skills and strategies might be attractive to participants and help to establish initial rapport (Martin, Zakrajsek, & Wrisberg, 2012 ). Zakrajsek and Martin ( 2011 ) developed a multidimensional model of sport psychology service provision using research on perceptions and attitudes toward sport psychology services within several distinct segments of populations found in sport programs, such as coaches, athletes, athletic trainers, and administrators. It provides a framework to illustrate how antecedents, such as the personal characteristics of both the SEP professional and the user of the services, as well as situational factors (e.g., type of sport, competition level, exercise domain) influence attitudes and beliefs about SEP services. Attitudes and beliefs in turn influence the intention to use, actual use of, and satisfaction with SEP services. The model predicts a cyclical pattern in which intended and actual use as well as satisfaction with services influences subsequent attitudes and beliefs. The model lays the foundation from which researchers are encouraged to continue to identify and refine factors that ultimately facilitate or hinder potential or current users’ use of and satisfaction with SEP services.

SEP researchers and practitioners are encouraged to include an assessment of participants’ attitudes toward and expectations about SEP services prior to and after PST program interventions, as another measure of program effectiveness. Four factors have been associated with athletes’ and coaches’ attitudes toward SEP services: stigma tolerance (i.e., belief that athletes and coaches are negatively labeled if they seek assistance from a SEP professional), confidence in the SEP consultation (i.e., a belief that consultation and PST are useful), personal openness (i.e., a willingness to be involved in PST), and cultural preference (i.e., strong identification with a cultural background and preference for working with a SEP professional with a similar background; see Martin, Kellmann, Lavallee, & Page, 2002 ; Zakrajsek, Martin, & Zizzi, 2011 ; Zakrajsek & Zizzi, 2007 , 2008 ). A recent study by Zakrajsek and Zizzi ( 2008 ) involving a sport psychology workshop with coaches found positive changes in their attitudes, intentions, and subsequent sport psychology usage behaviors both immediately after the workshop and at the one-month follow-up.

Perhaps the strongest factor that has been found to impact consumers’ (e.g., athletes, coaches, and athletic trainers) perceptions of the benefits of services, positive attitudes toward services (e.g., higher confidence in and lower stigma toward SEP services), and willingness to use SEP services has been the quality of experiences and interactions with the SEP professionals (Martin, 2005 ; Wrisberg, Loberg, Simpson, Withycombe, & Reed, 2010 ; Wrisberg, Simpson, Loberg, Withycombe, & Reed, 2009 ; Zakrajsek, Martin, & Wrisberg, 2015 , 2016 ; Zakrajsek, Steinfeldt, Bodey, Martin, & Zizzi, 2013 ). It therefore seems imperative that PST program research needs to assess the quality of service delivery by examining what contributed (or detracted from) participants’ experiences and interactions with the SEP professionals delivering the program. SEP professionals who

do good work and build positive relationships with sport [and exercise] participants will not only enhance their own prospects of providing services but will also contribute to the development of positive perceptions about the field of sport psychology so essential to its future (Martin et al., 2012 , p. 23).

The perceived quality of the relationship between the researcher or practitioner and the consumers (e.g., athlete, coach, athletic trainer) is closely tied to consumers’ attitudes toward, expectations about, and willingness to use the services. A trusting relationship between a service provider and a consumer has been emphasized in sport psychology (see Petitpas, Giges, & Danish, 1999 ; Zakrajsek et al., 2013 ) and counseling (see Rogers, 1992 ; Sexton & Whiston, 1994 ) as an essential and highly consistent factor influencing service delivery effectiveness. SEP professionals working to enhance exercise experiences and adherence would also do well to consider consumers’ thoughts and perceptions about exercise leaders (e.g., fitness instructors, personal trainers, health-behavior coaches) and how their actions may shape the exercise context and thus the targeted exercise outcome. Again, exercise psychology interventions framed by behavior-change theories have been successful (see Gourlan et al., 2016 ; Teixeira et al., 2012 ) but these have not collected much data on participants’ perceptions about the individual guiding the manipulation or their perceptions about the benefit of working with an SEP professional. It is important for future researchers to acknowledge and assess the SEP professional–consumer relationship and its impact on the effectiveness of PST interventions.

Research, summarized here in several reviews and in individual studies, has been done on the effectiveness of interventions based on a targeted outcome, that is, on attributing the success of the PST-focused intervention on athletes’ performances, on exercisers’ changed physical-activity behavior, or on the decrease in injuries. But overall, few of such studies have commented on the acquisition of the psychological skill that was utilized toward this outcome change, or on the quality (compared to the quantity of intervention sessions) of the service delivery. To engage in a more programmatic evaluation of a series of PST interventions within a single sport or exercise setting, researchers must be cognizant not only of changes in the targeted outcome, but also of the quality of service delivery, participants’ perceptions of that delivery, and the actual acquisition of the skill or skills utilized to influence the outcome. SEP professionals are strongly encouraged to review the literature on “program evaluation,” which is “the use of social research methods to systematically investigate the effectiveness of social intervention programs in ways that are adapted to their political and organizational environments and are designed to inform social action to improve social conditions” (Rossi, Lipsey, & Freeman, 2004 , p. 16), and to carefully follow evaluation theory to guide this important inquiry (see, e.g., Alkin & Christie, 2004 ). Utilizing the methodological guides of program evaluation will best align the identification of unique programs’ contributions to behavior changes, and the participants’ views of those programs. Such evaluations will help SEP professionals to better identify the mechanisms of change noted in the contemporary research literature and best advance the applied science that is sport and exercise psychology.

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Effects of Psychological Interventions to Enhance Athletic Performance: A Systematic Review and Meta-Analysis

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• Volume 54 , pages 347–373, ( 2024 )

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• Gustaf Reinebo   ORCID: orcid.org/0000-0001-8444-8686 1 ,
• Sven Alfonsson   ORCID: orcid.org/0000-0003-4570-5891 1 ,
• Markus Jansson-Fröjmark   ORCID: orcid.org/0000-0003-2059-1621 1 ,
• Alexander Rozental   ORCID: orcid.org/0000-0002-1019-0245 1 , 2 &
• Tobias Lundgren   ORCID: orcid.org/0000-0002-3872-9660 1  

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Psychological interventions are commonly applied in sports to help athletes enhance their performance, but the effect psychological interventions have on actual performance is unclear despite decades of research.

We conducted a systematic review with meta-analyses to investigate the effects of a wide range of psychological interventions on performance in competitive athletes.

A study protocol was preregistered in PROSPERO, and a literary search was performed in the MEDLINE, PsycINFO, Web of Science, and SPORTDiscus databases. Psychological intervention studies were eligible by using a group design and a quantitative performance outcome with athletes competing at a regional or university level or higher. Included studies were assessed regarding intervention characteristics, research methodology, and risk of bias. A multi-level meta-analysis framework with cluster robust variance estimation was used to quantitatively synthesize the results.

A total of 111 studies met the inclusion criteria, and 25 of these studies (37 effects) could be synthesized into five meta-analyses in which there were similarities in the type of psychological intervention, comparator, and experimental design. Meta-analyses I (multimodal psychological skills training vs control), II (mindfulness- and acceptance-based approaches vs control), and III (imagery vs control) consisted of parallel-group studies, and random-effects models were used to calculate the standardized mean difference. Meta-analyses IV (attentional focus strategies, external vs internal) and V (regulatory focus performance instructions, prevention vs promotion) consisted of counterbalanced crossover design studies, and random-effects models were used to calculate the standardized mean change using change score standardization. Significant results were found in three of the meta-analyses (I, II, and III). Psychological skills training ( g  = 0.83, 95% confidence interval 0.21–1.45), mindfulness- and acceptance-based approaches ( g  = 0.67, 95% confidence interval 0.01–1.32), and imagery ( g  = 0.75, 95% confidence interval 0.14–1.36) outperformed controls with moderate effects. However, when non-randomized trials and subjective performance outcomes were removed in sensitivity analyses, the overall estimates of the effect size were no longer significant in any of the syntheses.

Conclusions

The significant moderate effects for psychological skills training, mindfulness- and acceptance-based approaches, and imagery are not stable, and further trials with robust research methodology, such as randomized controlled trials, are requested for all types of psychological interventions aiming to enhance performance in athletes. Moreover, improved reporting standards and the provision of datasets in open science repositories are important to consider in future trials in sport psychology.

Clinical Trial Registration

PROSPERO CRD42017056677.

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1 Introduction

As sport psychology moved into applied field research during the 1970s [ 1 , 2 ], an interest in evaluating intervention effects naturally followed. Simultaneously, advancements of meta-analytic procedures in psychological sciences enabled ways to investigate aggregated effects [ 3 ]. Feltz and Landers' [ 4 ] meta-analysis of the mental practice of motor skills to enhance skill learning and performance was among the first systematic effect evaluations in applied sport psychology, and several have followed since. Two overviews of reviews were recently conducted. Lochbaum et al. [ 5 ] identified 30 meta-analyses of both correlational and intervention studies related to the sport psychology literature. Lange-Smith et al. [ 6 ] also identified 30 reviews but included various types of review methodologies in addition to meta-analyses (e.g., narrative), only including reviews of intervention studies. Thus, scrutiny of the evidence relating to psychological intervention techniques in sport psychology has proceeded for approximately 40 years. Although evaluation methods have varied over the years focusing on various sport-related outcomes, populations, and interventions, some vital research questions are still unanswered. Specifically, one such research question is whether psychological intervention techniques impact actual sport performance outcomes in clearly defined athlete samples. If this question is true, what are these interventions? To put this research question into context, we need to consider some of the characteristics of prior evaluations. Prior reviews have either focused on a single type of psychological intervention technique [ 4 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ] or several types of psychological interventions but contrasted between intervention types in the analysis [ 17 , 18 , 19 ], or mixed interventions without contrasting between different types of interventions in the synthesis [ 20 ]. Another core characteristic of prior reviews is to either investigate only athlete samples [ 18 , 19 ] or include samples with a wide range of performance levels, including non-athletes [ 7 , 8 , 9 , 10 , 12 , 13 , 14 , 15 , 16 ]. Another characteristic has been to either put the emphasis on actual sport performance outcomes [ 13 , 14 , 17 , 18 , 19 ] or instead include a wide range of outcome types that are not directly related to performance behavior, such as cognitive performance tasks [ 4 , 7 , 8 , 9 ]. When reviews synthesize different types of psychological intervention techniques, samples, and outcome categories without dividing eligibility criteria (depending on the research question at hand) or by conducting proper subgroup analyses, only vague conclusions can be drawn. In general, the prior reviews mentioned above answer many important research questions for some of the intertwined fields of sport science, such as motor learning, performance enhancement, and sport and exercise psychology. However, the research question about whether and which psychological interventions have an effect on actual sport performance in samples verified as athletes still needs to be addressed with further clarity. This systematic review therefore investigates a wide range of psychological interventions with potential effects on performance in athlete samples with a verified competitive level at a regional or university level and higher. Furthermore, we examine the characteristics and quality of this research.

2.1 Data Availability and Transparency Statement

A study protocol [ 21 ] was developed using the guidelines of the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) [ 22 , 23 ] and preregistered in the PROSPERO database. The search strategy (Online resource file 1) and a log of rejected studies (excluded full-text decisions according to PICO [Participants, Interventions, Comparator, and Outcome]; Online resource file 2) are available as supplementary information. Meta-analytic datasets and code are available online in the figshare repository [ 24 ]. We followed the PRISMA reporting guidelines for systematic reviews and meta-analyses for the final report [ 25 , 26 ].

2.2 Literature Search Strategy

A literature search was conducted in February 2017 and replicated twice, in February 2019 and April 2022. The searches were performed in the following databases: MEDLINE (OVID), SPORTDiscus, PsycInfo, and Web of Science. The MeSH terms identified for searching Medline (OVID) were adopted in accordance with corresponding vocabularies in PsycINFO and SPORTDiscus. As SPORTDiscus is a database specialized in sports, it includes controlled terms for several rare sports. Those sports were included in the controlled vocabulary searches because of their exploding functionality. They were not specified in the free-text searches. Each search concept was complemented with relevant free-text terms. The free-text terms were, if appropriate, truncated and/or combined with proximity operators. No language restriction was applied at the search stage. The searches were performed by librarians at the Karolinska Institutet University Library in collaboration with GR. The search strategies are available inOnline resource file 1. Additional hand-search procedures were applied. Reference lists of included studies and references citing included studies (in Web of Science) were screened for eligibility. Furthermore, other reviews and meta-analyses related to sport psychology were also screened for additional studies.

2.3 Eligibility Assessment and Data Extraction Procedures

Through the screening process, two authors conducted all assessments independently. There were three pairs of assessors: GR-SA, GR-MJF, and GR-TL. Disagreements at the title/abstract level were decided by a third assessor in another pair of assessors. Eligibility coding, risk of bias ratings, and data extraction were conducted by two authors independently with two pairs of assessors: GR-SA and GR-MJF. Disagreements over the full-text eligibility coding, data extraction, or risk of bias ratings were solved through discussions with the third assessor in the other pair of assessors (SA or MJF). See Fig.  1 for the PRISMA flow diagram of the eligibility process. A log of rejected studies with decisions on excluded full-text assessments can be found in Online resource file 2.

PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) flow chart of the eligibility process [ 25 ]. a Some reports (publications) included more than one study, therefore the number of studies exceeds the number of reports. PICO Participants, Interventions, Comparator, and Outcome

2.4 Criteria for Inclusion in the Systematic Review

Only studies written in English and published in scientific journals were considered for inclusion. Gray literature, conference papers, and dissertations were not considered. Eligibility criteria were defined using the PICO format [ 27 ] and described below.

2.4.1 Participants

Athletes eligible for inclusion were currently competing at a regional or university level or higher. Sufficient information regarding the performance context had to be stated in the report to verify the current level of performance. All sports were considered. Recreational, novice, junior/youth level athletes, and athletes competing on a local level were excluded. If samples were recruited from a competition (e.g., regional level) in which ineligible participants could take part (e.g., recreational participants in a marathon), additional information regarding the sample had to be described to be considered.

2.4.2 Designs

All group designs, both within-group and between-group (non-randomized and randomized) studies, were eligible for inclusion in the systematic review. For a study to be included in a meta-analysis, additional criteria were used (see Sect.  2.6 ). Single-case research designs were not included.

2.4.3 Psychological Interventions

Several psychological intervention techniques were included. However, for an intervention to be considered psychological, it had to be a method in which the independent variable primarily consisted of a psychological or psychotherapeutic focus. Methods in which the independent variable primarily consists of or directly focuses on technical, instructional, tactical, and biological target factors were not considered. The eligibility criterion was defined in this way to ensure that the investigated intervention effects were not due to, for example, the technical implication of a movement execution instruction. Therefore, interventions such as biofeedback/neurofeedback, attentional strategies and instructional self-talk with a sole technical focus on movement execution, quiet eye training, and the restricted environmental stimulation technique were not considered in this systematic review.

2.4.4 Outcomes

Only studies using a quantitative measure of sport performance were eligible. Both objective performance and subjective ratings of performance were considered. Objective outcomes had to be a result or a direct measure of performance of the studied sport. Indirect performance was not considered. Examples of indirect performance are performance-related measures (e.g., V O 2max for an endurance athlete) and other performance correlated measures (e.g., psychological constructs) that are not the performance itself (which for the endurance athlete could, e.g., be the completion time of an endurance activity). Additionally, for measures to be considered a direct measure of performance, they had to be a primary concern for the studied sport (e.g., endurance could be considered direct performance only in endurance sports). Subjective ratings of performance were either self-rated or by an external person (e.g., coach or expert rated). Subjective ratings had to originate from performances. Ratings of general athletic abilities (e.g., concentration skills, handling of emotions) were not considered. Other outcome measures in the included studies in addition to performance were not extracted to avoid a skewed representation of such measures as studies containing only non-performance or indirect performance outcomes were excluded.

2.5 Risk of Bias Assessment

A risk of bias instrument adapted to psychological intervention research was developed. The primary aim for the item selection was the assessment of internal validity aspects rather than a full quality of trial assessment. Furthermore, the instrument was composed to enable the assessment of a range of group designs. Initially, other risk of bias or quality assessment tools, both general or traditionally used in medical research [ 28 , 29 , 30 , 31 ] and adapted versions to psychology/psychotherapy research [ 32 , 33 , 34 , 35 ], were screened and served as an item pool. GR compiled and selected items referring to internal validity issues. Additional items were considered and discussed among the study authors. A final selection of 12 items was chosen. The score range is zero to − 13, and a lower value indicates a higher risk of bias. All items of the instrument with the risk of bias assessments of the meta-analysed studies are presented in Table 1 . The risk of bias assessments for the other studies in the systematic review can be found in Online resource file 3.

2.6 Inclusion Criteria in a Meta-analysis

All eligible studies in the systematic review were assessed for inclusion in a meta-analysis. For studies to be included in the same meta-analysis, the following characteristics of studies were considered:

Similarity of psychological interventions and techniques.

Similarity of comparator across studies.

Comparable experimental design across studies (between-group comparisons vs counterbalanced within-group comparisons of two active experimental conditions).

Sufficient study data were available to enable effect size calculation. Attempts were made to contact study authors for additional data if necessary to enable inclusion in a meta-analysis. Estimates of missing standard deviations were calculated when sufficient information was provided [ 36 ].

2.7 Statistical Analysis

Analyses were conducted in the statistical software R (version 4.1.1) using the metafor (version 3.8–1) [ 37 ] and clubSandwich [ 38 ] packages. A multilevel meta-analysis (MLMA) framework [ 39 ] with cluster robust variance estimation (RVE) was used when studies included more than one performance outcome to handle dependency among effects, with an adjustment for small samples [ 40 , 41 ]. Effect sizes were clustered within studies, and there was no information about sampling correlation; therefore, constant sampling correlation was assumed [ 40 ]. r  = 0.5 was used for all MLMA, and sensitivity analyses were conducted with varying levels of r . A meta-analysis either included only parallel-group designs (inter-individual comparisons at post-experiment) or counterbalanced crossover designs (intra-individual comparisons between active experimental conditions that assume no carry-over effects between conditions). In meta-analyses I (psychological skills training [PST] vs control), II (mindfulness- and acceptance-based [MA] approaches vs control), and III (imagery vs control) consisting of parallel-group studies only, random-effects models were used to calculate the standardized mean difference (SMD) [ 42 ]. In meta-analyses IV (attentional strategies, external vs internal) and V (regulatory focus instructions, promotion vs prevention) consisting of counterbalanced crossover designs, random-effects models were used to calculate the standardized mean change (SMC) using change score standardization [ 43 ]. When the repeated-measures correlation was not known in the SMC analyses, r  = 0.5 was used with accompanying sensitivity analyses. All primary studies in meta-analysis IV (attentional strategies, external vs internal) had one performance outcome measure; therefore, a univariate random-effects model was conducted. An MLMA framework was used for all other syntheses (I, II, III, and V). If primary studies included several related experimental conditions (e.g., two variants of external attention conditions) that were eligible for the same synthesis, then conditions were combined [ 36 ].

Statistical heterogeneity was examined with I 2 statistics. In the MLMA models, the variance of both within-study and between-study heterogeneity was calculated. Publication bias was investigated through a test of excess statistical significance (TESS) and the proportion of statistical significance test (PSST). Z scores larger than 1.654 in either the TESS or PSST tests were interpreted as evidence for excess significance bias in the model [ 44 ]. An adapted version of Egger’s regression was also conducted to test for funnel plot asymmetry [ 45 , 46 ]. A modified measure of precision was used as a predictor to remove artifactual correlations between effect sizes and their related standard errors [ 46 , 47 ]. A visual inspection of funnel plots was also conducted.

Cohen’s [ 48 ] rule of thumb for effect-size magnitude categorization was used (small, 0.20–0.50; moderate, 0.50–0.80; large, > 0.80). Moderators were not investigated in any meta-analysis because of the risk of misleading results with fewer than ten studies [ 49 ]. Each sensitivity analysis commenced from the main results of the meta-analysis; studies were never subsequently removed. Datasets and code can be found online in the figshare repository [ 24 ].

First, the overall findings of the systematic review are described. Then, each meta-analysis is presented separately. Thirty-seven effects from 25 studies ( k studies  = 25, j effects  = 37) distributed over five meta-analyses were synthesizable. For the meta-analysed studies, risk of bias ratings are found in Table 1 , and study information is presented in Table 2 .

3.1 Systematic Review Results

A total of 111 studies from 104 reports met the eligibility criteria to be included in the systematic review (see Fig.  1 ). The performance levels of the samples were university athletes (54 of 111, 48.65%), regional athletes (15 of 111, 13.51%), county athletes (4 of 111, 3.6%), state athletes (2 of 91, 2.2%), provincial athletes (1 of 111, 0.9%), national athletes (17 of 111, 15.32%), international athletes (3 of 111, 2.7%), and samples with mixed performance levels (14 of 111, 12.61%). Research designs were uncontrolled trials (12 of 111, 10.81%), within-group time series designs (4 of 111, 3.6%), counterbalanced crossover designs (32 of 111, 28.83%), non-randomized controlled parallel-group designs (25 of 111, 22.52%), and randomized controlled parallel-group designs [RCTs] (37 of 111, 33.33%). Regarding performance outcomes, studies utilized only objective performance (88 of 111, 79.28%), only subjective performance (11 of 111, 9.91%), or a combination of subjective and objective performance outcomes (12 of 111, 10.81%). The mean risk of bias rating score was − 5.69 (range − 2 to − 11). For further details, study information of studies included in the systematic review is presented in Online resource file 4 (except for the meta-analysed studies that are presented in Table 2 ).

3.2 Meta-Analysis I: PST (Multimodal) Versus Control

3.2.1 included primary studies and comparator.

Studies that compared multimodal PST interventions with no-intervention controls were synthesized. Psychological skills training is an umbrella term for psychological techniques that aim to control or change mental states to enhance performance [ 50 ]. Psychological skills training is rooted in the 1950–1970s cognitive and behavioral methods, with interventions such as imagery/visualization, goal setting, attentional/concentration techniques, self-talk, and relaxation, to target mental preparation, arousal, or self-regulation to enhance performance [ 51 ]. In the current meta-analysis, multimodal PST packages consisted of two or more PST techniques, for example, imagery, relaxation, goal setting, self-talk, and attentional strategies. All included studies were parallel-group designs ( k  = 7, j  = 11), and a random-effects MLMA with RVE was conducted.

3.2.2 Results

The estimated overall effect size for PST interventions compared with controls was significant, Hedges’ g  = 0.83 (95% confidence interval [CI] 0.21–1.45, standard error [SE] = 0.25, t  = 3.36, p  = 0.017), in favor of PST. A forest plot is presented in Fig.  2 . Overall heterogeneity was substantial ( I 2  = 70.39%), of which all 70.39% of the variance was estimated to be due to within-study heterogeneity and none due to between-study heterogeneity. No indication of publication bias was found. Both the TESS (− 0.37) and the PSST (0.17) were non-significant. Furthermore, the funnel plot was visually inspected for asymmetry (Fig.  3 ), and the relationship between the effect size estimate and precision was not significant ( t  =  − 0.19, p  = 0.853).

Forest plot for meta-analysis I illustrating the effect of multimodal psychological skills training on sport performance outcomes in athletes in comparison to controls. Effect sizes are the standardized mean difference (SMD [Hedges’ g]) with a 95% confidence interval (CI). Black squares are individual effect sizes and the square size represents the relative weight. Black rhombuses are the summary effect size estimate for the random-effect (RE) model with model-based variance estimates and with robust variance estimates (RVE). a and b are separate performance outcomes in the same study

Funnel plot for meta-analysis I: multimodal psychological skills training versus control. Black dots are individual effect sizes with the standardized mean difference (Hedges’ g ) on the x- axis and the standard error of the effect sizes on the y- axis. The dashed vertical line represents the summary effect size estimate in the meta-analysis model. Positive standardized mean difference values favor psychological skills training and negative standardized mean differences favor controls for the performance outcome. The plot does not account for the fact that some effect sizes are dependent because of being clustered within the same study

3.2.3 Sensitivity Analyses

Removing non-randomized trials: when removing non-randomized trials, the remaining RCTs ( k  = 3, j  = 5) demonstrated an aggregated non-significant effect of g  = 0.51 (95% CI − 1.58 to 2.59, SE = 0.46, t  = 1.09, p  = 0.393), I 2  = 60.64% (34.27% between-study heterogeneity; 26.36% within-study heterogeneity).

Only objective performance: subjective performance outcomes were removed. The remaining studies ( k  = 5, j  = 7) demonstrated an aggregated non-significant effect of g  = 0.56 (95% CI − 0.26 to 1.37, SE = 0.29, t  = 1.95, p  = 0.128), I 2  = 39.99% (36.75% between-study heterogeneity; 3,24% within-study heterogeneity).

Sampling correlation: the average effect size and other model parameters were quite stable when sampling correlations were set to r  = 0.2 and r  = 0.8, respectively.

3.3 Meta-analysis II: MA Approaches Versus Control

3.3.1 included primary studies and comparator.

Mindfulness- and acceptance-based interventions that were compared to no-intervention controls were synthesized. Mindfulness- and acceptance-based interventions are inspired by developments that occurred in clinical psychology during the 1990s and early 2000s. These interventions (sometimes referred to as the “third wave” of cognitive and behavior therapy) target processes such as acceptance, mindfulness, values, metacognition, and attention [ 52 ]. A key theoretical implication of MA approaches was the accumulating evidence of the paradoxical effects in efforts to control, reduce, or suppress distressing thoughts and emotions [ 53 , 54 , 55 , 56 ], which was central to traditional PST to achieve optimal performance states through self-regulatory processes [ 50 , 51 ]. Interventions represented in the current meta-analysis were acceptance and commitment therapy/training [ 57 ], mindfulness-based stress reduction [ 58 ], mindfulness-acceptance-commitment approach [ 59 ], mindfulness sport performance enhancement [ 60 ], meditation, and mindfulness meditation training. All included studies were parallel-group designs ( k  = 6, j  = 9), and a random-effects MLMA with RVE was conducted.

3.3.2 Results

The estimated overall effect size was significant, g  = 0.67 (95% CI 0.01–1.32, SE = 0.25, t  = 2.67, p  = 0.047), in favor of MA over control. A forest plot is presented in Fig.  4 . Overall heterogeneity was substantial ( I 2  = 70.11%), of which 59.39% of the variance was attributed to between-study heterogeneity and 10.72% was attributed to within-study heterogeneity. No indication of publication bias was found. The TESS (− 4.24) and the PSST (− 1.55) were non-significant. The funnel plot was visually inspected for asymmetry (Fig.  5 ), and there was no significant relationship between the effect size estimate and precision ( t  =  − 0.84, p  = 0.430).

Forest plot for meta-analysis II illustrating the effect of mindfulness- and acceptance-based interventions on sport performance outcomes in athletes in comparison to controls. Effect sizes are the standardized mean difference (SMD [Hedges’ g ]) with a 95% confidence interval (CI). Black squares are individual effect sizes and the square size represents the relative weight. Black rhombuses are the summary effect size estimate for the random-effect (RE) model with model-based variance estimates and with robust variance estimates (RVE). a and b are separate performance outcomes in the same study

Funnel plot for meta-analysis II: mindfulness- and acceptance-based interventions versus control. Black dots are individual effect sizes with the standardized mean difference (Hedges’ g ) on the x- axis and the standard error of the effect sizes on the y -axis. The dashed vertical line represents the summary effect size estimate in the meta-analysis model. Positive standardized mean difference values favor mindfulness- and acceptance-based interventions and negative standardized mean differences favor controls for the performance outcome. The plot does not account for the fact that some effects sizes are dependent because of being clustered within the same study

3.3.3 Sensitivity Analyses

Removing potential outliers: John et al. [ 61 ] was removed as a potential statistical outlier. When removing John et al. [ 61 ], the remaining studies ( k  = 5, j  = 8) demonstrated a non-significant aggregated effect, g  = 0.41 (95% CI − 0.04 to 0.85, SE = 0.14, t  = 2.94, p  = 0.062), and heterogeneity was lower, I 2  = 15.51% (0% between-study I 2 ; 15.51% within-study I 2 ). After removing John et al. [ 61 ], there was no indication of further outliers in the context of this model.

Removing non-randomized trials: when removing Ruiz and Luciano [ 62 ] as the only non-randomized trial, the remaining RCTs ( k  = 5, j  = 8) demonstrated a non-significant aggregated effect, g  = 0.66 (95% CI − 0.11 to 1.43, SE = 0.28, t  = 2.4, p  = 0.075), I 2  = 74.92% (65.07% between-study I 2 ; 9.85% within-study I 2 ).

Removing subjective performance outcomes: Glass et al. [ 63 ] and Zadeh et al. [ 64 ] were removed as the only studies using subjective outcomes. The remaining studies ( k  = 4, j  = 5) demonstrated a non-significant aggregated effect, g  = 0.84 (95% CI − 0.36 to 2.03, SE = 0.36, t  = 2.32, p  = 0.109), I 2  = 69.27% (69.27% between-study I 2 ; 0% within-study I 2 ).

3.4 Meta-Analysis III: Imagery Versus Control

3.4.1 included studies and comparator.

Studies that compared unimodal imagery interventions with a no-intervention control condition were synthesized. Imagery comprises mental constructions of athletic scenarios for preparatory and practice purposes. Imagery can be used for motor skill acquisition, cultivation, or to mentally practice/prepare for competitive circumstances (e.g., high-pressure situations) [ 51 ]. If there was more than one imagery condition per study, then the conditions were combined. All included studies were parallel-group designs ( k  = 5, j  = 7), and a random-effects MLMA with RVE was conducted.

3.4.2 Results

The estimated overall effect size was significant, g  = 0.75 (95% CI 0.14–1.36, SE = 0.22, t  = 3.49, p  = 0.027), in favor of imagery over control. A forest plot is presented in Fig.  6 . Overall heterogeneity was moderate ( I 2  = 39.77%), of which all 39.77% of the variance was attributed to between-study heterogeneity and none was due to within-study heterogeneity. No indication of publication bias was found. The TESS (− 0.86) and the PSST (PSST =  − 0.11) were non-significant. The funnel plot was visually inspected for asymmetry (Fig.  7 ), and there was no significant relationship between the effect size estimate and precision ( t  =  − 0.92, p  = 0.398).

Forest plot for meta-analysis III illustrating the effect of imagery on sport performance outcomes in athletes in comparison to controls. Effect sizes are the standardized mean difference (SMD [Hedges’ g ]) with a 95% confidence interval (CI). Black squares are individual effect sizes and the square size represent the relative weight. Black rhombuses are the summary effect size estimate for the random-effect (RE) model with model-based variance estimates and with robust variance estimates (RVE). a and b are separate performance outcomes in the same study

Funnel plot for meta-analysis III: imagery versus control. Black dots are individual effect sizes with the standardized mean difference (Hedges’ g ) on the x- axis and the standard error of the effect sizes on the y- axis. The dashed vertical line represents the summary effect size estimate in the meta-analysis model. Positive standardized mean difference values favor imagery and negative standardized mean differences favor controls for the performance outcome. The plot does not account for the fact that some effects sizes are dependent because of being clustered within the same study

3.4.3 Sensitivity Analyses

Removing non-randomized trials: when removing non-randomized trials [ 65 , 66 ], the remaining three RCTs demonstrated an aggregated non-significant effect of g  = 0.81 (95% CI − 0.136 to 1.75, SE = 0.19, t  = 4.23, p  = 0.065), total I 2  = 0%.

3.5 Meta-Analysis IV: Attentional Focus, External Versus Internal

3.5.1 included primary studies and comparator.

Attentional focus strategies are applied to enhance concentration and optimize performance by intentionally directing focus toward certain stimuli during performance. A common distinction is to either adopt an internal (e.g., focus on body or skill movements) or an external focus (e.g., skill-related external stimuli such as the ball leaving the bat or skill-unrelated stimuli such as sounds in the environment) of attention [ 11 ]. Counterbalanced crossover designs comparing internal and external attentional strategies’ effects on sport performance were synthesized ( k  = 4). If there was more than one internal (or external) condition in a study, conditions were combined [ 36 ]. As no study had more than one performance outcome, a univariate random-effects model was conducted to calculate the SMC. The repeated measure correlation was set to r  = 0.5 except for one study [ 67 ], for which the correlation was known ( r  = 0.651).

3.5.2 Results

The estimated overall effect size was not significant for any of the attentional focuses, SMC =  − 0.74 (95% CI − 1.89 to 0.41, SE = 0.59, z  =  − 1.27, p  = 0.205). A forest plot is presented in Fig.  8 . Heterogeneity was considerable, Q (3) = 22.48, p  < 0.001, I 2  = 90.61% (95% CI 66.22 − 99.44). The TESS and the PSST were non-significant in both directions of the model, for external (TESS = 1.04; PSST = 0.69) and internal attentional strategies (TESS =  − 2.21; PSST =  − 0.97). The funnel plot was visually inspected for asymmetry (Fig.  9 ), and there was no significant relationship between the effect size estimate and precision ( t  =  − 3.36, p  = 0.078).

Forest plot for meta-analysis IV illustrating the effect of applying either an external or internal attentional focus during sport performance in athletes. Effect sizes are the standardized mean change (SMC) using change score standardization with a 95% confidence interval (CI). Positive SMC values favor an internal focus and negative SMCs favor an external focus on the performance outcome. Black squares are individual effect sizes and the square size represent the relative weight. The black rhombus is the summary effect size estimate for the random-effect (RE) model

Funnel plot for meta-analysis IV: attentional focus, external versus internal. Black dots are individual effect sizes with the standardized mean change on the x -axis and the standard error of the effect sizes on the y -axis. The dashed vertical line represents the summary effect size estimate in the meta-analysis model. Positive standardized mean change values favor an internal focus and negative standardized mean changes favor an external focus on the performance outcome

3.5.3 Sensitivity Analyses

Repeated-measure correlation: correlation was set to r  = 0.25 and r  = 0.75, respectively, except for Neumann and Thomas [ 67 ], for which the correlation was known. Neither r  = 0.25 nor r  = 0.75 altered the results in a significant way.

3.6 Meta-Analysis V: Regulatory Focus Instructions, Prevention Versus Promotion

3.6.1 included primary studies and comparator.

Regulatory focus theory was developed by Higgins and proposes two different modes in self-regulation, a focus on accomplishment and aspirations (a promotion focus) or on safety and responsibility (a prevention focus) [ 68 , 69 ]. Regulatory focus moves beyond classic motivational theories that suggest pleasure seeking and pain avoidance as the fundamental guide for behavior. Regulatory focus theory also emphasizes the fit between individual-level orientation (promotion or prevention chronic orientation) and performance instructions (promotion or prevention focus instructions), which may moderate the behavioral effect. Investigations on athletic samples and the regulatory focus instructions’ effect on performance began approximately a decade ago [ 70 ]. Counterbalanced crossover designs comparing the effects of prevention and promotion regulatory focus instructions on sport performance were synthesized ( k  = 3; j  = 6). A random-effects MLMA with RVE was conducted to calculate the SMC. The repeated-measure correlation was not known and set to r  = 0.5 across studies.

3.6.2 Results

There was no significant difference in effect between prevention and promotion focus performance instructions, SMC = 0.07 (95% CI − 0.42 to 0.55, SE = 0.11, t  = 0.65, p  = 0.588). A forest plot is presented in Fig.  10 . Heterogeneity was low, I 2  = 20.64%, of which 18.6% was due to between-study heterogeneity and 2.04% was due to within-study heterogeneity. The test of excess statistical significance and the proportion of statistical significance test were non-significant in both directions of the model, for prevention (TESS =  − 1.42; PSST =  − 0.70) and promotion performance instructions (TESS =  − 0.79; PSST =  − 0.35). A visual inspection for funnel plot asymmetry was conducted (Fig.  11 ), and there was no significant relationship between the effect size estimate and precision ( t  = 0.58, p  = 0.594).

Forest plot for meta-analysis V illustrating the effect of applying either a prevention- or promotion-oriented regulatory focus instruction on sport performance in athletes. Effect sizes are the standardized mean change (SMC) using change score standardization with a 95% confidence interval (CI). Positive SMC values favor a prevention instruction and negative SMCs favor a promotion instruction on the performance outcome. Black squares are individual effect sizes and the square size represent the relative weight. Black rhombuses are the summary effect size estimate for the random-effect (RE) model with model-based variance estimates and with robust variance estimates (RVE). a and b are separate performance outcomes in the same study

Funnel plot for meta-analysis V: regulatory focus instructions, prevention vs promotion. Black dots are individual effect sizes with the standardized mean change on the x -axis and the standard error of the effect sizes on the y -axis. The dashed vertical line represents the summary effect size estimate in the meta-analysis model. Positive standardized mean change values favor a prevention instruction and negative standardized mean changes favor a promotion instruction on the performance outcome. The plot does not account for the fact that some effect sizes are dependent because of being clustered within the same study

3.6.3 Sensitivity Analysis

Repeated-measure correlation: varying repeated-measure correlations were tested ( r  = 0.75; r  = 0.25) but did not alter the main results in a significant way.

4 Discussion

4.1 meta-analysis i: pst (multimodal) versus control.

Multimodal PST interventions significantly outperformed the no-intervention control on sport performance outcomes in athlete samples with moderate effects. However, sensitivity analyses showed a decline in effects and a non-significant result when non-randomized studies were removed from the synthesis [ 71 , 72 , 73 , 74 ]. Additionally, when removing subjective performance outcomes [ 72 , 73 ], the effect estimate declined and was non-significant. Taken together, the sensitivity analyses cast doubt on the robustness of the effect estimate, emphasizing the importance of interpreting the results cautiously.

The mean risk of bias rating score was − 5.71 (range − 4 to − 8); see Table 1 . The consistent weaknesses in research design across studies were that no single study had a preregistered study protocol, and did not prespecify a primary outcome or adjust for multiple testing. Only Thelwell and Maynard [ 74 ] conducted an intention-to-treat analysis, and only Blakeslee and Goff [ 75 ] investigated deterioration or side effects.

In future research, several concerns should be addressed to further strengthen the scientific robustness of PST research. Seven studies met the eligibility criteria to be included in the synthesis, and only three of these were RCTs. This suggests that additional trials are needed in general and randomized studies in particular. Furthermore, the sports included were soccer [ 71 ], equestrian sports [ 75 ], biathlon [ 76 ], cycling [ 77 ], cricket [ 74 ], and two studies with athletes from various sports [ 72 , 73 ]. This implies a variation of sports represented in the synthesis, although the total number of sports is still limited. Future research would also benefit from comparing PST with other active psychological interventions. Direct comparisons would provide better insight into what type of intervention may be most beneficial in certain sports or performance contexts.

4.2 Meta-Analysis II: MA Approaches Versus Control

Mindfulness- and acceptance-based approaches significantly outperformed no-intervention control on sport performance outcomes in athlete samples with moderate effects. However, the significant effect did not remain through the sensitivity analyses. The removal of a potential statistical outlier [ 61 ], the only non-randomized trial [ 62 ], and the use of subjective performance outcomes [ 63 , 64 ] altered the average effect into a non-significant result in all sensitivity analyses. This calls for cautious interpretation of the robustness of the results. The limited number of studies ( k  = 6, j  = 9) is another reason to make cautious interpretations.

The mean risk of bias rating was − 4.67 (range − 3 to − 7); see Table 1 . Consistent weaknesses in research design were the lack of a prespecified study protocol and not investigating side effects. Except for Ruiz and Luciano [ 62 ], studies did not clearly predefine a primary outcome or adjust for multiple testing. Studies were randomized except for Ruiz and Luciano [ 62 ] and investigated intervention adherence except for John et al. [ 61 ] and Zadeh et al. [ 64 ].

Sports represented in the synthesis were shooting [ 61 , 78 ], chess [ 62 ], rowing [ 79 ], soccer [ 64 ], and a sample with various sports (cross-country/track; swimming; tennis; lacrosse; field hockey; soccer; baseball; American Football; volleyball) in Glass et al. [ 63 ].

The limited number of studies ( k  = 6, j  = 9) in this meta-analysis precluded extensive conclusions; however, MA interventions showed significant moderate effects to enhance performance in athlete samples. Additional trials investigating the effect of MA interventions on athlete performance are needed, preferably with robust research methodology designs such as RCTs.

4.3 Meta-Analysis III: Imagery Versus Control

Imagery significantly outperformed control with an overall moderate effect. However, the effect was no longer significant when the non-randomized trials were removed in a sensitivity analysis, which also improved heterogeneity. This suggests that the results should be interpreted cautiously and that additional trials with robust methodologies, such as RCTs, are needed to further establish imagery intervention effects on the performance of athletes. Additional trials would also enable investigations of moderating effects.

The mean risk of bias rating was − 4.6 (range − 2 to − 8); see Table 1 . A consistent weakness in research design was the lack of a preregistered study protocol. Only Lu et al. [ 66 ] investigated side effects. Another common weakness was the lack of investigating intervention adherence/manipulation checks, except for Lu et al. [ 66 ] and Seif-Barghi et al. [ 80 ]. Additionally, only Lu et al. [ 66 ] and Robin et al. [ 81 ] conducted intention-to-treat analyses. Of the total five studies, three were randomized [ 80 , 81 , 82 ], and the other two were non-randomized [ 65 , 66 ].

Sports represented in the analysis were karate [ 65 ], soccer [ 80 , 82 ], and basketball [ 66 , 81 ], making team ball sports the main context of study. Additionally, only one study included female athletes [ 66 ]. This is a limitation for the generalizability of the results.

4.4 Meta-Analysis IV: Attentional Focus, External Versus Internal

There was no significant difference associated with applying an external or internal attentional focus on sport performance in athlete samples. The number of studies in the analysis was limited ( k  = 4), which resulted in a poor basis for funnel plot inspection. Additionally, the statistical heterogeneity was considerable. It cannot be ruled out that the obtained non-significant results were due to low power, which is affected by the number of studies, sample size, and heterogeneity in the analysis [ 83 , 84 ].

The risk of bias score was − 5 across all studies with the exact same item ratings (Table 1 ). Consistent design weaknesses were the lack of a preregistered study protocol, no randomization of order of experimental conditions, dropouts were not reported, and no side effects were investigated.

Sports and outcomes included were baseball batting performance [ 85 , 86 ], table tennis forehand performance [ 87 ], and golf putting performance [ 67 ]. Although there are many differences between these sports, there are some similarities regarding the motor skill of hitting a ball in all performance outcomes. The internal focus conditions were skill-focused across studies. However, the external focus conditions varied across studies with both skill-irrelevant/extraneous external focus [ 85 , 86 , 87 ] and skill-relevant external focus [ 67 , 85 ]. Hence, stimuli foci can differ between two external focus conditions, although both are still considered external focus strategies. This can also be the case for different types of internal focus strategies. However, this meta-analysis can only draw conclusions based on the broad distinction between internal and external attentional focus strategies, which is another limitation of the current synthesis.

Prior reviews have concluded that an external focus is preferred over an internal focus for sport and motor performance [ 11 , 88 ]. Such conclusions could not be drawn based on the current synthesis. However, the results of the current synthesis should be interpreted with caution. In future research, further studies with robust research designs comparing internal and external focus strategies in athlete performance are warranted for further evaluation of potential effects. If sufficient experiments are conducted across different sports and motor skills in athletes, more nuanced conclusions can be made regarding the most effective strategy for a given skill in a specific sport. Counterbalanced crossover designs such as the studies in the current meta-analysis are a feasible research design alternative, especially if carryover effects are assessed and controlled for with manipulation checks. This also has the potential to increase sample sizes. However, randomized parallel-group studies are another useful option if the prerequisites are sufficient.

4.5 Meta-Analysis V: Regulatory Focus Instructions, Prevention Versus Promotion

There was no significant difference in the effect of applying prevention- or promotion-oriented regulatory focus instructions in athletes on sport performance outcomes. The limited number of studies in the synthesis ( k  = 3; j  = 6) suggests that the results should be interpreted cautiously.

The mean risk of bias rating score was − 6 (range − 4 to − 7); see Table 1 . Consistent weaknesses in research design were the lack of a prespecified study protocol and not investigating intervention adherence with, for example, manipulation checks. No forms of side effects were investigated. Randomization of order for the experimental manipulations was only utilized in Wegner et al. [ 89 ]. Sports represented in the synthesis were table tennis [ 90 ], soccer [ 91 ], and volleyball [ 89 ].

The non-significant results were expected and in line with the core hypothesis of the regulatory focus literature, namely, that the regulatory focus instruction effect is moderated by the fit of the chronic regulatory focus orientation to the individual [ 89 , 90 , 91 ]. The current meta-analysis showed no significant differences in effect and was limited to regulatory focus instructions only and does not contain data on chronic regulatory focus orientation. In future research, an individual participant data meta-analysis that considers chronic regulatory focus orientation may further elucidate the effect of regulatory focus instructions on athlete performance.

4.6 General Discussion

Scrutiny of the evidence relating to psychological interventions’ effect in sport has proceeded over four decades investigating different types of interventions, sport populations, and performance outcomes [ 6 ]. This systematic review investigated a wide range of intervention types in studies focusing on only athlete samples and direct performance outcomes to bring further clarity to the understanding of psychological intervention effects in competitive athletes. Furthermore, the characteristics of such research were examined. In total, 111 studies met eligibility for the systematic review, and 25 ( j  = 37) of these were quantitatively synthesized in five separate meta-analyses (I, PST multimodal vs control; II, MA vs control; III, imagery vs control; IV, attentional, external vs internal; V, regulatory focus instructions, prevention vs promotion). Moderate significant effects were found in meta-analyses I, II, and III, in which multimodal PST, MA interventions, and imagery outperformed no-intervention controls for sport performance outcomes in athletes. However, when non-randomized trials were removed in sensitivity analyses (in meta-analyses I, II, and III), the effects were non-significant. Additionally, when subjective performance outcomes were removed in sensitivity analyses (in meta-analyses I and II), the effects were no longer significant. Therefore, the moderate effects in meta-analyses I, II, and III cannot be considered stable and should be interpreted with caution. Meta-analyses IV and V differ from I, II, and III as active experimental conditions (psychological techniques) were compared in counterbalanced crossover design studies. Such experimental designs (a.k.a. Latin-square designs) are based on paired data and assume no carry-over effects between conditions. Furthermore, the purpose of the counterbalancing procedure is to remove bias due to order and periodic effects [ 92 ]. In meta-analysis IV, no significant differences were found when comparing an external or internal focus of attention on athlete performance, although the results should be interpreted with caution owing to the limited number of studies in the synthesis. Finally, in meta-analysis V, there were no significant differences in applying prevention- or promotion-oriented regulatory focus performance instructions. Taken together, additional trials with robust research methodology, such as RCTs, are required for all types of psychological interventions to further investigate their effect on athlete performance.

The considered outcomes in this systematic review had to be a direct measure of sport performance, and similar criteria have been used in prior meta-analyses in sport psychology [ 93 , 94 ]. For a meaningful understanding of whether the effect is relevant or not, its real-world meaning should be contextualized when possible [ 95 ], and effect size interpretation in sport psychology is more straightforward when studies use outcomes that incorporate performance-relevant behavior [ 96 ]. As the meta-analyses in this systematic review included a variety of sports and performance outcomes, a nuanced interpretation of the real-world meaning of the performance change is difficult to make and not suggestible based on the overall effect estimates. Furthermore, the starting point of an effect size interpretation is preferably its CI [ 97 ]. This should be considered for the significant results in meta-analyses I (Fig.  2 ), II (Fig.  4 ), and III (Fig.  6 ). All CIs are comparatively wide, which is another reason for interpreting the results carefully.

An advantage of including a wide range of psychological interventions is to enable comparisons across interventions. Prior reviews have commonly focused on one type of psychological intervention [ 4 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ], with some exceptions [ 17 , 19 ], including the current review. Unfortunately, only two studies in the systematic review directly compared PST and an MA intervention [ 98 , 99 ], which was not enough to conduct a meta-analysis. However, further direct comparisons of PST and MA may provide better insight into what type of psychological intervention may be beneficial in various sport contexts.

Many risk of bias assessment tools assess only one type of study design, for example, RCTs, such as the Cochrane Collaboration’s tool for assessing risk of bias [ 30 ]. As this systematic review contains a wide range of group designs, an instrument was developed to enable assessments across varying designs (uncontrolled, non-randomized, randomized, and with either parallel-group or counterbalanced crossover designs) but with criteria relevant to the risk of bias in experimental trials of psychological interventions in general. This was the reason for the deviation from the study protocol for which the initial plan was to use CONSORT items in full [ 21 ]. Because group designs varied, an item could formally assess different design features, although it pertained to an adequate rating of bias for that type of study design. For instance, Item 2 assesses whether randomization is conducted. For parallel-group designs, this refers to traditional randomization procedures. However, for counterbalanced crossover designs, the item assesses whether the order of experimental conditions was randomized to account for bias due to periodic effects [ 92 ]. Therefore, comparisons of risk of bias ratings should only be performed between studies with comparable experimental designs, as in meta-analyses I (PST, mean risk of bias score =  − 5.71, range − 4 to − 8), II (MA, mean =  − 4.67, range − 3 to − 7), and III (imagery, mean =  − 4.6, range − 2 to − 8) which contained only parallel-group studies (see Table 1 ).

4.7 Limitations

The results of a systematic review and meta-analysis may be influenced by study reporting (reporting bias), as some excluded studies may in fact be eligible, although underreporting makes this difficult to verify [ 100 ]. The use of performance levels as an eligibility criterion was to enable answers to the research question regarding the performance context of competitive athletes and not recreational, novice, or junior participants. Nor were local level athletes considered in this systematic review. Similar approaches for defining and assessing sample eligibility criteria have been used in prior reviews, for example, [ 93 ]. This can distinguish between competitive athletes and samples that, for example, may still learn/acquire basic skills in sports, which was not the focus of this review. It may also account for other differences in the performance contexts for competitive and non-competitive athletes that the psychological intervention targets to a larger extent as a function of competitive level (e.g., handling high-pressure situations). The log of rejected studies (Online resource file 2) shows that among the 603 excluded reports in the full-text assessments, 417 experiments/studies were excluded on the participant criterion. We naturally do not know how many were excluded because of underreporting. However, there may be a problematic low consensus of how/which sample characteristics should be reported in sport psychology [ 101 ]. Therefore, we will extend our reasoning and declare our decision process regarding this criterion and the use of regional- and university-level athletes as the minimum of performance expertise. University athletes had to be on a university team and/or compete in intercollegiate competitions. University “sports clubs” and intramural participation were thus excluded. High school athletes were considered equal to junior level participants and were therefore excluded. When sample ages were reasonably young but not explicitly reported as competing on a junior or senior level, age standards of senior level participation of international sport federations were used when such guidelines existed (e.g., gymnasts under 15 years of age do not compete in senior level competitions according to the International Gymnastics Federation). The comparison of performance level between sports and countries is not clear-cut. This is aggravated by the available levels of expertise in different sports within a country, further complicated by international differences owing to the type of sport. However, performance level, referring to the geographical level of competition standards (e.g., local, regional, county, state, provincial, national, and international), has been used as a central criterion in taxonomy classification systems of athletic expertise [ 101 , 102 ] and therefore was used as a key criterion in this study. Other reviews in sport psychology have used similar criteria [ 20 ]. As geographical definitions vary between countries, terms such as county, provincial, sectional, and state were considered comparable. Eligibility assessments were based on available sample information to verify the current performance level. However, it did not solely rely on terms such as “elite” because such terms have been shown to represent immense variation and inconsistency of actual performance level [ 101 ] and therefore are not possible to verify without additional information. For the same reason, the sole use of related terms, such as “semiprofessional” or “professional” was not considered without additional information (e.g., type of league or competitions that the athletes participated in) that could verify the competitive level. This also implies that “amateur” athletes could be included when competitive level was reported and eligible. The verification of performance level is necessary for feasible comparisons of study samples with athletes from different sports and countries and crucial in making valid conclusions about existing evidence. Hence, this is important for future research to consider as part of the methodological reporting of trials. Underreporting of study sample characteristics cannot be ruled out as a potential source of lost data for the current review.

This review emphasizes that eligible psychological interventions primarily consist of a psychological or psychotherapeutic focus. Psychologically related methods in which the independent variable primarily consisted of or directly focused on technical, instructional, tactical, and biological target factors were not considered. Naturally, psychological interventions and techniques commonly target sport behaviors as the very purpose of a sport psychology intervention may be to aid such behaviors. However, some techniques are so technically oriented around how to execute a certain motor behavior (e.g., “lift your knees high”) that it becomes unclear whether the technique is still to be defined as a psychological or technical/instructional technique per se. There are, for instance, both self-talk techniques and attentional focus techniques that primarily focus on the technical execution of behavior. However, as the aim of the current article was to review the effect of psychological interventions and techniques, clarity of independent variables becomes a crucial issue to ensure that investigated effects are not due to, for example, the technical implication of a movement execution instruction. Although self-talk and attentional techniques that focus on technical execution may have a logical place in aiding certain sport behaviors, they did not meet the criteria for psychological intervention techniques in this review. As such, the current review does not contain full account of attentional and self-talk techniques. There are other reviews that use a wider framework for the inclusion of samples and interventions with both psychological and technically oriented independent variables for attentional focus interventions [ 11 , 88 ] and self-talk interventions [ 103 ].

A power analysis is an important part of planning a meta-analysis [ 84 ] but was not conducted prior to this systematic review. Power refers to the ability of an analysis to correctly reject the null hypothesis of no effect when a true effect exists. For random-effects meta-analyses, power can be affected by factors such as the number of included studies, sample size and the statistical heterogeneity of included effects [ 83 , 84 ]. Power is a likely issue for the interpretation of the results found in this study for a few reasons. The significant effects found in meta-analyses I–III were accompanied by sensitivity analyses to investigate whether the removal of studies with certain characteristics, such as using an inferior study design (non-randomized trials) or subjective performance measures, affected the results. As studies were removed in the sensitivity analysis, power was probably reduced compared with the full meta-analyses that could be considered small to begin with. This weakens the interpretations of whether the non-significant results in the sensitivity analyses suggest a non-significant overall effect when considering only superior research designs (RCTs) or if it reflects a loss of power that fails to detect a true intervention effect that exists. Additionally, meta-analysis IV that compared attentional strategies (external vs internal focus) only had four effect sizes. Thus, the non-significant trend of favoring an external focus could be a result of low power. The number of studies in the meta-analyses is a limitation to the interpretation of the results for other reasons in addition to the issue of power. All five meta-analyses had too few studies (PST, k  = 7, j  = 11; MA, k  = 6, j  = 9; imagery, k  = 5, j  = 7; attentional, k  = 4; regulatory focus instructions, k  = 3, j  = 6) to conduct meta-regression analyses to investigate moderating effects because of the risk of misleading results with fewer than ten studies [ 49 ]. This makes it difficult to conclude to what extent certain study design features, risk of bias implications, or other experimental differences influence intervention effects. Furthermore, meta-analyses I (PST) and II (MA) consist of psychological intervention packages considered similar enough to synthesize as they share many common intervention procedures; however, there are still differences in the interventions between studies. Both PST and MA meta-analyses have different combinations of intervention procedures and protocols (see Table 2 ). Ideally, with additional trials, subgroups of intervention protocols could have been investigated or to what extent different intervention protocols moderated the average effect. Another limitation associated with small-numbered meta-analyses is that the basis for inspection of funnel plot asymmetry is rather poor, which weakens the interpretation of potential publication bias [ 104 ].

Another related limitation is that only 25 studies ( j  = 37) from the systematic review were quantitatively synthesized, which means that 86 studies (77.48%) were not. To be included in a meta-analysis, primary studies had to be similar across psychological intervention techniques, comparators, and experimental designs and present sufficient data to enable effect size calculations (and attempts to contact study authors were made when needed). These factors are the reasons why no further studies in the systematic review were included in a meta-analysis. However, some potentially useful data remain in the systematic review that together with a few additional studies could be included in further separate meta-analyses in the future for interventions such as hypnosis or some of the remaining PST single modal interventions (e.g., relaxation, self-talk, or goal setting), or for active comparisons between interventions (e.g., PST vs MA). The full list of studies in the systematic review not included in any of the meta-analyses can be found in Online resource file 4.

5 Conclusions

Significant moderate effects on athlete performance were found for PST, MA, and imagery interventions compared with controls. However, the results were no longer significant when non-randomized studies and subjective performance outcomes were removed from the syntheses. This suggests that the effects were not stable and that conclusions should be drawn with caution. Another two meta-analyses were also conducted. Attentional interventions comparing external and internal focus strategies showed no significant differences in athlete performance. Finally, prevention- and promotion-oriented regulatory focus performance instructions were compared and showed no significant differences. In general, improved research methodology, reporting standards, and the provision of datasets in open science repositories are important to consider in future trials investigating the effect of psychological interventions on performance in athletes. Because of the limited number of studies in all five current meta-analyses, additional trials with robust methodology are needed for all types of psychological interventions with the aim of enhancing performance in athletes to further establish the effects found in this review and to enable additional investigations of moderating effects.

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We thank Magdalena Svanberg, Susanne Gustafsson, and Narcisa Hannerz at the Karolinska Institutet University Library for help with the literary search.

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Reinebo, G., Alfonsson, S., Jansson-Fröjmark, M. et al. Effects of Psychological Interventions to Enhance Athletic Performance: A Systematic Review and Meta-Analysis. Sports Med 54 , 347–373 (2024). https://doi.org/10.1007/s40279-023-01931-z

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Sport Psychology Intervention: A Case Study

2021, Sport Psychology Intervention: A Case Study

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ORIGINAL RESEARCH article

Psychological intervention program to control stress in youth soccer players.

• 1 Department of Personality, Evaluation and Psychological Treatment, Sports Activities Service, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain
• 2 Department of Basic, Evolutionary and Educational Psychology, Autonomous University of Barcelona, Barcelona, Spain
• 3 Department of Psychology, Real Murcia C.F., Murcia, Spain
• 4 Department of Physical Activity and Sport, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain
• 5 Department of Computing and Systems, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain

The influence on the psychological well-being of the players and their sports performance seems to be one of the keys to the current sports practice. The purpose of this study was to determine the effectiveness of a psychological intervention program for stress control in youth soccer players. A total sample of 19 male youth soccer players (age: 16.3 ± 0.99 years; years playing soccer: 10.89 ± 1.56 years) completed the current research. The Psychological Characteristics Questionnaire related to Sports Performance (CPRD) was used to assess stress factors related to sports competition. A program based on Cognitive-Behavioral Therapy was implemented during eight sessions of approximately 50 min each. A pre-post design was used and statistical differences between pre- and post-measures were checked through dependent sample t -tests. The results indicated that the post-test scores were higher than the pre-tests in “Influence of the Evaluation of Performance” and “Mental Skills” factors, which supposes a significant improvement of the stress management related to performance evaluation, as well as the use of psychological resources and techniques. In addition, the post-test scores were also higher in the “Stress Control” factor, although in this case the differences were not statistically significant. Practical indications deriving from the findings of this study can help youth soccer players to manage the stress of competition using a psychological training program.

Introduction

Currently, psychological interventions are usually utilized in sport, thanks to their positive influence on the psychological well-being ( Golby and Wood, 2016 ; Breslin et al., 2017 ) and sport performance ( Brown and Fletcher, 2017 ; Gross et al., 2018 ). Psychological training can help several psychological variables such as motivation, concentration, self-confidence, or activation level ( Beckmann and Elbe, 2015 ; Olmedilla and Domínguez-Igual, 2016 ), as well as the acquisition of psychological skills as techniques and resources to manage the sport practice ( Simonsmeier and Buecker, 2017 ; McCormick et al., 2018 ).

In sports with changeable demands where it is necessary to make complex decisions continuously (team sports), cognitive skills have equal or even more relevance than technical or tactical executions ( Escolano-Pérez et al., 2014 ; Larkin et al., 2018 ; Olmedilla et al., 2018a ). Although psychological skills do not provide an increment of the athlete’s sport performance on their own, they can assist athletes (in conjunction with the physical, technical, and tactical training) with the achievement of higher level of performance ( Abdullah et al., 2016 ). For instance, the knowledge of the psychological influence might help an individual to apply appropriated interventions for neutralizing some factors that could obstruct the sport performance ( Gimeno et al., 2007 ). Thus, variables such as motivation, concentration, stress control, or self-regulation of mood have been proposed as key to explain differences in athletes’ sport performance ( Cerasoli et al., 2014 ; Mercado et al., 2017 ; Swann et al., 2017 ).

Psychological training is not only important in professional or elite sport, but also in grassroots sports. Young athletes sometimes need a certain amount of motivation to obtain a good level of adherence to sport practice (matches and trainings), and require efficacy resources to manage the stress derived from competitions. A suitable psychological development in young athletes will increase their achievement of goals and satisfaction in sport ( Navarrón et al., 2017 ; Simonsmeier and Buecker, 2017 ; Brière et al., 2018 ), and will make easier the process of socialization through sport practice, managing better the requirement and pressure habitually supplied by coaches and/or parents ( Tjomsland et al., 2016 ; Gómez-Espejo et al., 2017 ; Lorenzo et al., 2018 ).

Several stress sources exist at within youth sport practice, and their consequences may be really negative for the young athlete: less sport performance ( Romero et al., 2010 ), absence of satisfaction, mental disorders ( Schinke et al., 2018 ), dysfunctional attitudes ( Fenoy and Campoy, 2012 ), sport dropout ( Gimeno et al., 2007 ), or sport injuries ( Ivarsson et al., 2017 ), among others. Likewise, stressful conditions during competitions provoke psychological disorders, such as loss of attentional focus or anxiety increase, that may negatively affect the athlete’s sport participation ( Bennett and Maynard, 2017 ; Brown and Fletcher, 2017 ). Something we perceive as a threat is stressful and, therefore, produces significant changes in physiological, psychological, and behavioral responses; in a competitive sport context, this causes the athlete to think and act differently in stressful situations ( Márquez, 2006 ). However, stress can also have positive connotations, helping the athlete to be prepared for the competition and favoring motivation, attention, and, consequently, the subsequent athlete’s sport performance ( Ferreira et al., 2002 ; McCormick et al., 2018 ).

Properly managing stress is very important for any athlete since it entails directing the stressors in order to avoid the incorrect development of the sport activity ( Kerdijk et al., 2016 ; Randall et al., 2018 ). Thus, this ability to control stress is one of the main requirements to achieve sport success, and athletes use different coping styles according to their individual characteristics ( Fletcher and Sarkar, 2012 ; Kerdijk et al., 2016 ; McCormick et al., 2018 ). Coping might be defined generally as the cognitive and behavioral effort that is carried out by the athletes with the aim of controlling some demands (internal or external) that are really difficult to deal with using their own resources ( Pinto and Vásquez, 2013 ; Nicholls et al., 2016 ; Arnold et al., 2017 ). Coping styles have been divided in two types, principally: problem-focused coping and emotion-focused coping, depending on whether the individual typically exerts cognitive and behavioral efforts to change a situation or typically adopts strategies to regulate any emotional distress, respectively ( Urra, 2014 ; Nicholls et al., 2016 ). Scientific literature highlight the importance of stress control for an athlete’s sport performance and mental health ( Gimeno et al., 2007 ; Schinke et al., 2018 ); so, stress management training programs seem to be an essential approach to sportspeople in both youth and professional levels.

Some authors defend the need to know the psychological profile of the athlete ( Pazo et al., 2012 ) as a starting point to design specific psychological training programs that favor the optimal development of a sports career. Psychological training is another way of sports training that directly affects athletic development; this training must be based, on the one hand, on the learning of psychological skills and strategies that allow the most appropriate coping of different sports situations ( Reyes et al., 2012 ; Portenga et al., 2017 ; Gross et al., 2018 ) and, on the other hand, on the promotion of the psychological well-being of the athlete that allows him/her to grow and mature as a person ( Romero et al., 2010 ; Golby and Wood, 2016 ; Breslin et al., 2017 ; Olmedilla et al., 2018b ). In any case, the psychologist must pursue that the athlete has a better expertise of his skills and psychological strategies, as well as the processes of reflection and decision-making in the different situations of sport and extra-sport ( Olmedilla et al., 2018b ).

The evaluation of psychological skills can allow working hypotheses about the most appropriate psychological intervention to favor sports performance ( Olmedilla et al., 2010 ; Abenza et al., 2014 ). The knowledge of the psychological profile of an athlete allows to understand him/her better, improve communication processes with him/her, and increase the effectiveness of training ( McCormick et al., 2017 ; Olmedilla et al., 2018a ). Although it is not possible to find two equal athletes, there are certain common characteristics that lead to sport success. The weight of psychological factors in the definition of the successful athlete is high, so nowadays in sport, mental preparation and psychological skills can distinguish the successful athlete from the rest ( Bahrololoum et al., 2012 ).

Therefore, the main purpose of the present study was to determine the efficacy of an intervention program for the acquisition of psychological skills to control stress in male youth soccer players.

Materials and Methods

Participants.

A total of 19 male youth soccer players completed the current study (age: 16.3 ± 0.99 years; years playing soccer: 10.89 ± 1.56 years). All of them belonged to the same Spanish soccer club that was engaged in a Regional Amateur Soccer League of the Spanish Soccer Federation, and participated in four training sessions and one competitive match per week.

Psychological variables were assessed using the Psychological Characteristics Related to Sport Performance Questionnaire (CPRD, Gimeno et al., 2001 ), based on the Psychological Skills Inventory for Sports (PSIS, Mahoney et al., 1987 ; Mahoney, 1989 ). The questionnaire consists of 55 items graded in a 5-option Likert scale (from totally disagree to totally agree) and grouped into five subscales: Stress Control (SC), Influence of Performance Evaluation (IPE), Motivation (M), Mental Skills (MSK), and Team Cohesion (TCOH), showing acceptable values of internal consistency for the total scale ( α = 0.85) and for most of the subscales (αSC = 0.88; αIPE = 0.72; αM = 0.67; αTCOH = 0.78; αMSK = 0.34). According to the authors, the low internal consistency of MSK is probably related to it tapping a wide range of different skills but authors still keep the subscale due to the factorial loads shown by the items of this factor.

SC consists of 20 items and refers to athlete’s responses to potentially stressful situations and other training and competition demands. Higher scores denote the athlete has management skills to cope with sport-related stress. IPE consists of 12 items and refers to athlete’s responses to situations in which he/she or people close to him/her judge his/her performance. It also includes an assessment about antecedents of athlete’s performance judgment. Higher scores mean the athlete can control the impact of performance judgment. M consists of eight items referring to basic motivation to sport performance and achievement, as well as to the regular training and competition activities. Higher scores indicate strong motivation and commitment to competitive sport practice. MSK consists of nine items and assesses the use of different mental skills that are related to sport performance. Higher scores express better psychological resources to improve his/her performance. TCOH includes six items and assesses the extent to which the athlete feels attracted to and identified with the sport group. This scale has not been used in this study due to the nature of the target sports.

After the authors’ institution IRB approval (UM1551/2017), athletes were contacted through the psychological staff belonging to the club, who collaborated with the researchers to explain to coaches, parents, and athletes about the aims of the study and use of the information. Those who voluntarily agreed to participate in the current research signed an informed consent form (parents and athletes).

Subsequently, a psychological intervention program was implemented, whose theoretical framework was based on Cognitive-Behavioral Therapy and its four key principles ( McArdle and Moore, 2012 ). This psychological training program was carried out in eight sessions of approximately 50 min each. All psychological intervention sessions were developed in small groups and before the regular soccer training practices, aiming to avoid the fatigue effect. The structure of the psychological session was based on previous therapy programs used in similar cohorts of athletes ( Beswick, 2001 ; Dosil, 2006 ; Olmedilla and Domínguez-Igual, 2016 ). Table 1 shows the structure of the program with the number and content of the different intervention sessions.

Table 1 . Chronogram and general contents of the program.

Data Analysis

Prior to statistical analysis, the normal distribution ( p > 0.05) of raw data set was checked using the Kolmogorov-Smirnov test. Descriptive statistics including means and standard deviations were calculated. Dependent sample t -tests were carried out to assess differences between the pre-intervention and post-intervention measures. Finally, effect sizes were calculated using the method previously described by Cohen (1988) . All the analyses were completed using the statistical software SPSS version 21 (SPSS Inc., Chicago, IL, USA). Statistical significance was set at p < 0.05.

Table 2 shows the data obtained from the dependent sample t -test and the statistical significance in each of the CPRD subscales.

Table 2 . Differences between pre- and post-intervention scores in each of the CPRD subscales.

Figure 1 presents the pre- and post-scores for each of the CPRD scales (SC, IPE, M, MSK, and TCOH). Statistically significant differences are found in two of the five factors: Influence of the Performance Evaluation ( p = 0.030; d = −0.389) and Mental Skills ( p = 0.030; d = −0.788); and there is a marginal significance in Stress Control ( p = 0.083; d = −0.234). The results are complemented by a calculation of the effect size in order to evaluate the degree of change observed in the sample.

Figure 1 . Graphical comparison of the total means pre-test and post-test.

The aim of this study was to determine the effectiveness of a psychological intervention program (Cognitive-Behavioral Therapy) in a cohort of male youth soccer players for the acquisition of psychological skills to control and manage stress. The results indicated a general improvement in the scores of the players after the intervention program; thus, differences in the IPE and the MSK factors appeared statistically significant, which suppose an enhancement to stress management related to the evaluation of performance, as well as to the use of resources and psychological techniques. Likewise, scores after the program were also better in the SC factor, although in this case the differences were not statistically significant.

The results of the present study are similar to those obtained in recently published research ( Aoyagi et al., 2017 ; Brown and Fletcher, 2017 ) and show the efficacy of psychological intervention programs both for the acquisition and learning of psychological techniques, and for the application of these improving skills for managing the stress of competition and sports practice, which could improve the psychological disposition of players favoring the increment of sport performance ( McCormick et al., 2017 ). This psychological disposition, focused on variables such as motivation, concentration, or self-efficacy, will be optimized through the use of visualization, goal setting, or relaxation through breathing techniques, among others.

In addition, stress control has proven its usefulness and effectiveness in the field of athlete’s health, both physical and psychological. In terms of physical rehabilitation or prevention of sport injuries ( Mankad and Gordon, 2010 ; Gagnon et al., 2015 ; Wesch et al., 2016 ; Olmedilla et al., 2017 ), there are numerous studies that correlate stress to the increase in the incidence of injury in sport. Ivarsson et al. (2017) found strong associations between responses to stress and the history of stressors with injury rates, results that agree with many other investigations ( Johnson and Ivarsson, 2011 ; Edvardsson et al., 2012 ). Otherwise, and regarding psychological well-being, mental health has been considered a very important resource for athletes in relation to their performance and professional development. Recent studies ( Gouttebarge et al., 2015 ) show that more than one-third (38%) of active professional soccer players suffer from depression or a similar disorder, as well as 35% of retired players. Similarly, the probability of a professional suffering depression increases by up to four points when the player has suffered at least three serious injuries, the pressure exerts before the expectations of a large signing and/or an unfulfilled self-demand occurs. In general, athletes experience situations (high training loads, highly relevant competitions, stressful lifestyle) that are real risk factors for their mental health ( Schinke et al., 2018 ). In this regard, the International Society of Sports Psychology (ISSP) has presented six proposals and recommendations to address the mental health of athletes from an intervention and research perspective ( Henriksen et al., 2019 ).

On the other hand, although psychological programs focused on Cognitive-Behavioral Therapy have shown their effectiveness ( McArdle and Moore, 2012 ; Brown and Fletcher, 2017 ), other types of programs that could be effective in sports have also been proposed in recent years. For instance, in the study by Gross et al. (2018) , university athletes who participated in a mindfulness program (Mindfulness-Acceptance-Commitment, MAC) reported reduced anxiety, eating problems, and other psychological disorders; increased psychological flexibility; and had better sport performance than the group of university athletes who participated in a conventional program of psychological skills. As indicated by Bühlmayer et al. (2017) , mindfulness as a form of mental training oriented to the present affects cognitive processes and is considered increasingly significant for sport psychological training approaches. In any case, these results, rather than invalidating the Cognitive-Behavioral Therapy programs, present other options for psychological preparation that led by expert psychologists ( Aoyagi et al., 2017 ; Portenga et al., 2017 ) can complement what already exists.

However, far from affecting only the sports context, the application of these programs can also represent an extraordinary learning for daily life. Learning skills in the sports field can be closely related to learning life skills; for this, it must be transferred and applied successfully beyond sport. As Pierce et al. (2017) stated recently, the transfer of life skills is an essential process that has not yet been sufficiently described in the scientific literature of sports psychology. Therefore, stress control could be a very important application tool from the sports context to the vital (daily life) context of the athlete.

Finally, it is necessary to point out that this work provides evidence on the effectiveness of a cognitive behavioral intervention in youth soccer players, using conventional psychological techniques of confirmed validity, such as visualization ( Wesch et al., 2016 ; Simonsmeier and Buecker, 2017 ). Epidemiological studies have indicated that sports practice in the youth represents a protective factor against psychological imbalances ( Brière et al., 2018 ); so if psychological work is also available, this protection could be increased. The work of a sport psychologist in these adolescent ages is really relevant for a good sport and social development of the youth athletes, both in the work with the athletes themselves and with coaches and parents ( Tjomsland et al., 2016 ; Lorenzo et al., 2018 ). These ages constitute a fundamental stage for the acquisition of good practices and habits for a future professional sports career or, simply, a healthy vital relationship with sports.

Limitations and Future Research Directions

The main limitation of the current research is the small sample size of soccer players ( N = 19) who received the psychological intervention, which makes it difficult to extrapolate the present results to other cohorts of soccer players. In addition, the participation of the coaches in the study was unequal, showing, sometimes, a lack of involvement in the planning of the program. The increased involvement by these coaches could favor a greater participation of the players in the intervention program, making possible at the same time the application of parallel programs to coaches that could improve the results obtained in the current study. Also, the timing in which the psychological program was carried out (mid-season) hindered its development and made it impossible to compare the effects of the intervention in different sections of the season. Therefore, future investigations should study the possible differences derived from the implementation of this type of psychological program in several competitive phases of the season, using a larger sample size of soccer players and checking the effect of parallel interventions with coaches.

Conclusions

The findings of this study show that the implementation of a psychological training program of duration 50 min (per session) for eight sessions can be effective to provide psychological skills to youth players that will help them to better manage the stress of sports practice, both in competition and training sessions.

Data Availability Statement

The datasets generated for this study are available on request to the corresponding author.

Ethics Statement

This study was carried out in accordance with the recommendations of the Declaration of Helsinki. The studies involving human participants were reviewed and approved by the Comité de Ética de la Universidad de Murcia (ID: UM 1551/2017). Written informed consent to participate in this study was provided by the participants’ legal guardian/next of kin.

Author Contributions

AO and IM-F contributed to the conception and design of the study. AO and EO organized the database. EO and IV performed the statistical analysis. AO wrote the first draft of the manuscript. IM-F, VG-E, and FR-P wrote the sections of the manuscript. FR-P was in charge of the formal aspects of the work. All authors contributed to the revision of the manuscript and read and approved the presented version.

This research was supported in part by the Murcia (Spain) Regional Football Association’s, Football Project (Grant FFRMUMU-040092 321B 64502 14704) and by Counseling Contract Real Murcia CF-Foundation (RM-UMU-8141-19256). FR-P was supported by the Program of Human Resources Formation for Science and Technology (Grant 20326/FPI/2017) from the Seneca Foundation-Agency for Science and Technology in the Region of Murcia (Spain).

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Keywords: psychological training, adolescent, football, stress, psychological skills

Citation: Olmedilla A, Moreno-Fernández IM, Gómez-Espejo V, Robles-Palazón FJ, Verdú I and Ortega E (2019) Psychological Intervention Program to Control Stress in Youth Soccer Players. Front. Psychol . 10:2260. doi: 10.3389/fpsyg.2019.02260

Received: 07 June 2019; Accepted: 20 September 2019; Published: 16 October 2019.

Reviewed by:

Copyright © 2019 Olmedilla, Moreno-Fernández, Gómez-Espejo, Robles-Palazón, Verdú and Ortega. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Enrique Ortega, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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Members may access CSSEP online in the Member Area under Publications.

Case Studies in Sport and Exercise Psychology ( CSSEP ), jointly published by the Association for Applied Sport Psychology (AASP) and Human Kinetics, is an online, peer-reviewed journal and searchable library focused on providing practitioners, students, and instructors with case studies showing different approaches (strategies) and methods (tactics) relevant to sport and exercise psychology applied research and consultation, covering a wide variety of issues and topics that arise in the profession from around the world.

CSSEP is a forum for scientifically driven case studies, broadly defined. The journal is open to the use of diverse practical and methodological approaches, derived from the international community. Manuscripts considered for publication in CSSEP will present approaches and results from high quality empirical research and/ or systematic interventions. Each case study must demonstrate practical and academic rigour that goes beyond description of processes to interpretive qualities and relevance outside of a single context.

This unique collection of case studies is continually updated online and covers important emerging and established areas of sport and exercise psychology. Case studies will begin with reflections on the context and the key agents involved, with special attention paid to the author(s), their approach to practice, their philosophy, and a brief outline of the experiences that have helped to shape and evolve their particular approach (strategies). Then, once explaining, in detail, the case itself and the focal interventions (tactics) and outcomes, there will be a strong focus on reflection. The authors will be required to reflect on their experience, the effectiveness of their approach, things they would do differently, and major lessons learnt.

MANUSCRIPT SUBMISSIONS Visit https://journals.humankinetics.com/page/authors/cssep for more information.

EDITOR Richard Thelwell University of Portsmouth, UK [email protected] (term ends December 31, 2024)

JOURNAL AWARDS FOR CSSEP For both the Paper of the Year Award and Reviewer of the Year Award, the Associate Editor (AE) of the Case Studies in Sport and Exercise Psychology  ( CSSEP ) will propose two papers/reviewers.

Available awards include:

• Paper of the Year Award
• Reviewer of the Year Award

Learn More About CSSEP  Awards

Watch the video "Getting Published in JASP, JSPA, and CSSEP."

Latest Case Studies

Volume 8 (2024): Issue 1 (Jan 2024)

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A Case Study of a Senior High-Performance Leader Managing Psychological Effects During the COVID-19 Pandemic

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Nichola Kentzer in Conversation With Göran Kenttä: Recipient of the 2022 Association for Applied Sport Psychology Distinguished Professional Practice Award

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Using Acceptance and Commitment Therapy to Develop Self-Confidence in a Neurodivergent Athlete

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Case Studies in Sport and Exercise Psychology

An Official Journal of the Association for Applied Sport Psychology

Indexed in: ProQuest, EBSCOhost, EBSCO A-to-Z, Google Scholar

Online ISSN: 2470-4857

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Volume 8 (2024): Issue 1 (Jan 2024)

About cssep.

Case Studies in Sport and Exercise Psychology ( CSSEP ) is a journal focused on providing practitioners, scholars, students, and instructors with case studies demonstrating different approaches and methods relevant to applied sport and exercise psychology. CSSEP is jointly published by the Association for Applied Sport Psychology (AASP) and Human Kinetics as an online, peer-reviewed journal. It publishes continuously in one regular issue; case studies in special issues are also published continuously. CSSEP is searchable in libraries and databases. Since its inception in 2017, CSSEP has covered a wide variety of issues and topics that arise in the profession, from diverse sport-and-exercise contexts all around the world. Our unique collection of case studies is continually being updated and extended to ensure that the approaches and methods of psychological practice in diverse settings are showcased, unpacked, and understood by practitioners and user groups worldwide.

CSSEP is a forum for scientifically driven case studies, broadly defined to include both research and reports on practice. The journal is open to the use of diverse practical and methodological approaches derived from the international community. Manuscripts considered for publication in CSSEP will present approaches and results from high-quality systematic interventions, with each case study demonstrating practical and academic rigor that goes beyond description of processes to consider interpretive qualities and relevance outside of a single context. Case studies focusing on the implementation of empirical research are encouraged, but authors should note that manuscripts with a primary focus on original empirical research, even if in applied settings, are likely to be more suitable to other journals.

To assist authors considering a submission to CSSEP , it is suggested that case studies will begin with reflections on the context and the key agents involved, with special attention paid to the authors, their approach to practice, their philosophy, and a brief outline of the experiences that have helped shape and evolve their particular approach (strategies). Then, after a detailed explanation of the case itself and the focal interventions and outcomes, there will be a strong focus on reflection. Authors are required to reflect on their experience, the effectiveness of their approach, things they would do differently, and major lessons learned. In addition to more traditional case studies, the editorial team welcome submissions that may address the following:

• How empirical research has been used to develop systematic interventions in sport and/or exercise psychology practice
• For case work to move beyond an ‘individual’ lens to work that may be at more of a group/organizational level and/or to include key stakeholders (e.g., parents, support staff, caregivers, clinicians)
• Professional practice processes that practitioners work through (e.g., confidentiality, systemic/culture issues, barriers to entry, media and management of social media, working to contract)

The editorial team are acutely aware that many practitioners may not be able to disseminate their wealth of knowledge given that they are situated in applied practice where time is precious, rather than in academic environments where dissemination/publication is often a requirement of tenure. To support the development of manuscripts from a wider network of authors we propose two approaches:

• For practitioners to work with another individual (possibly) from an academic background to co-author a manuscript. Specifically, the manuscript could be generated via an interview with the practitioner who would be detailing their approach to practice.
• For individuals who are considering a submission but may lack the confidence and/or time to curate the work, we encourage them to liaise with one of the editorial board members to facilitate any necessary (re)shaping of the work so it conforms to CSSEP ’s requirements. If there is uncertainty regarding whom to contact, please liaise with the Editor in the first instance.

The online journal serves as a searchable library of cases. Cases can be purchased individually, or users can access all cases with an individual or institutional subscription. Subscriptions provide subscribers full access to the journal’s content, as well as to digital archives of back volumes.

If you wish to contact the Editor for any reason (e.g., becoming a reviewer, interest in joining the editorial board, issue about journal policy), please e-mail Richard Thelwell at [email protected] .

Special Issues

The editorial team are keen to receive expressions of interest for special issues (SIs). In the first instance, individuals are required to submit a short document (no more than 2 pages) to the Editor. The document should include the rationale for the SI (how it fits with CSSEP ’s mission), suggested guest co-editors (with associated short CVs—additional 2 pages each), structure of the SI (intended number of manuscripts), and intended time periods for submissions, reviews, and completion. The documentation will then be reviewed by at least one of the Associate Editors and a further member of the editorial board prior to a final decision being made by the Editor.

Once a special issue has been announced and a call for papers issued, the Editor will meet with the Guest Editors to outline the expectations for the manuscript-handling and -review process. Specifically, this will include training on the ScholarOne Manuscripts™ review system and a meeting with the Editor regarding the preferred number, quality, and timeliness of reviews. Although the process will be led by the Guest Editors, it will be overseen by the Editor, who will also conduct a final review of manuscripts prior to final acceptance. All peer reviews are blind to all reviewers as per the normal process for CSSEP .

• Ethics Policy

Please visit the Ethics Policy page for information about the policies followed by CSSEP.

Richard Thelwell University of Portsmouth, UK

Editors Emeriti

Stewart Cotterill (2016–2019) AECC University College, UK

Robert Schinke (2020–2021) Laurentian University, Canada

Associate Editors

Svenja Wachsmuth Eberhard Karls University Tübingen, Germany

Rebecca Zakrajsek University of Tennessee, Knoxville, USA

Editorial Board

Rebecca Busanich, Saint Catherine University, USA

Megan Byrd, Georgia Southern University, USA

Gillian Cook, Liverpool John Moores University, UK

Muhammad Deen, MD Performance, Malaysia

Jana Fogaça, California State University, Long Beach, USA

Adam Gledhill, Leeds Beckett University, UK

San-Fu Kao, National Tsing Hua University, Taiwan

Nichola Kentzer, The Open University, UK

Gretchen Kerr, University of Toronto, Canada

Carsten Hvid Larsen, University of Southern Denmark, Denmark

Charlie Maher, Cleveland Indians/Rutgers University, USA

Neha Malhotra, National Youth Sports Institute, Singapore

Alister McCormick, Plymouth Marjon University, UK

Thierry Middleton, University of Portsmouth, UK

Alessandro Quartiroli, University of Wisconsin–La Crosse, USA

Fernanda Serra de Queiroz, Innera Wellbeing & Performance, Australia

Duncan Simpson, IMG Academy, USA

Kelley Strohacker, University of Tennessee, Knoxville, USA

Tshepang Tshube, University of Botswana, Botswana

Paula Watson, Made Up to Move Ltd., UK

Stacy Winter, St Mary’s University, Twickenham, UK

Human Kinetics Staff Julia Glahn, Senior Journals Managing Editor

Prior to submission, please carefully read and follow the submission guidelines detailed below. Authors must submit their manuscripts through the journal’s ScholarOne online submission system. To submit, click the button below:

Page Content

Authorship guidelines, manuscript guidelines, preparation of figures and tables, open access, desk rejection policy, additional resources.

• Open Access Resource Center
• Figure Guideline Examples
• Copyright and Permissions for Authors
• Editor and Reviewer Guidelines

The Journals Division at Human Kinetics adheres to the criteria for authorship as outlined by the International Committee of Medical Journal Editors ( http://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html ). Each author should have participated sufficiently in the work to take public responsibility for the content. Authorship credit should be based only on substantial contributions to all of the following:

a. Substantial contributions to the conception or design of the work or the acquisition, analysis, or interpretation of data for the work b. Drafting the work or revising it critically for important intellectual content c. Final approval of the version to be published d. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved

All conditions must be met. Individuals who do not meet the above criteria may be listed in the acknowledgments section of the manuscript.

Authors who use artificial intelligence (AI)-assisted technologies (such as Large Language Models [LLMs], chatbots, or image creators) in their work must indicate how they were used in the cover letter and the work itself. These technologies cannot be listed as authors as they are unable to meet all the conditions above, particularly agreeing to be accountable for all aspects of the work.

All Human Kinetics journals require that authors follow our manuscript guidelines in regards to use of copyrighted material, human and animal rights, and conflicts of interest as specified in the following link: https://journals.humankinetics.com/page/author/authors

Before writing and submitting a case, please see " Writing Manuscripts for Case Studies in Sport and Exercise Psychology " and " Conducting and Publishing Case Study Research in Sport and Exercise Psychology " for guidelines. In addition, review the sample case study " One-to-One Support With a Professional Rugby League Player: A Case for Referral? "

Cases must be submitted electronically in Microsoft Word format (.docx) at the CSSEP submission site on ScholarOne ( https://mc.manuscriptcentral.com/hk_cssep ). Cases should follow the style guidelines set forth in the latest (7th) edition of the Publication Manual of the American Psychological Association , be double-spaced, use a standard 12-point Times New Roman font, and use 1-in. margins on all sides throughout. Submitted manuscripts must include an abstract of no more than 150 words. Subheadings should be used throughout the manuscript to help organize the content and guide the reader. The manuscript itself should include the following sections:

Context: A reflection on the context and the key agents underpinning the case study. In particular, the paper should be clearly focused on the authors, their practice approach and philosophy, and briefly outline experiences that have helped shape and evolve their particular case-study approach. The Case: Explaining, in detail, the case itself and the focal interventions (tactics) and outcomes. Reflections: Authors will be required to reflect on personal experience, personal approach, things that could have been done differently to enhance the case, and recommendations for future practice.

All manuscripts should be presented as concisely as possible, and preference is to receive manuscript submissions to CSSEP that are 15–25 pages in length (4,000–6,000 words), exclusive of supplementary materials. If submitting authors have concerns with the space limitations, they are encouraged to contact the Editor in the first instance.

The writing style should be clear and engaging. Authors can achieve this by presenting their ideas in an orderly manner and by expressing them smoothly and precisely. The authors should establish a tone that conveys the essential points of the work in an interesting and systematic manner while engaging readers in their idiosyncratic approach.

Continuous line numbering should be included throughout the manuscript. Any identifying information on the title page or in the content of the manuscript must be removed or concealed prior to submission, as the journal uses a blind review process.

Submitting a case for review indicates that the authors (a) have not previously or concurrently submitted their manuscript to another journal, (b) agree to transfer copyright to Human Kinetics on acceptance, and (c) acknowledge that where appropriate, they have followed proper institutional review-board procedures at their respective institutions. Authors are also responsible for obtaining permissions for any copyrighted work such as figures or tables included in their paper.

Authors whose cases require supplementary materials such as additional documents, files, or video not contained in the case itself should seek preliminary approval from the Editor before submission.

Case submissions meeting these criteria will be subject to blind review. Reviews will be returned to authors within approximately 60 days.

Resolution of digital images should be 300 dpi at full size for photos and 600 dpi for line art. Figures or photos should be submitted as .jpg or .tif files. Although our online articles support color figures, bear in mind that the journal prints in black and white, and most color files will be printed in black and white. Make sure that any color figures submitted will be interpretable in grayscale/black and white. Format tables using the Table Layout function in Word rather than aligning columns in text with tabs and spaces or using text boxes. See additional figure guidelines here .

Human Kinetics is pleased to allow our authors the option of having their articles published Open Access. In order for an article to be published Open Access, authors must complete and return the Request for Open Access form and provide payment for this option. To learn more and request Open Access, click here .

Before full review, submissions are examined at the editorial level. The manuscript will be sent out for full blind review if either the Editor or the Associate Editors believe that the case warrants full review. If the Editor or Associate Editor assigned to the manuscript believes that the submission has extensive flaws or is inconsistent with the mission and focus of the journal, the submission will receive a desk rejection.

Individuals

Online subscriptions.

Individuals may purchase online-only subscriptions directly from this website. To order, click on an article and select the subscription option you desire for the journal of interest (individual or student, 1-year or 2-year), and then click Buy. Those purchasing student subscriptions must be prepared to provide proof of student status as a degree-seeking candidate at an accredited institution. Online-only subscriptions purchased via this website provide immediate access to all the journal's content, including all archives and Ahead of Print. Note that a subscription does not allow access to all the articles on this website, but only to those articles published in the journal you subscribe to. For step-by-step instructions to purchase online, click here .

Please note that this journal will be online only as of 2024.

Institutions

Institution subscriptions must be placed directly with our customer service team. To review format options and pricing, visit our Librarian Resource Center . To place your order, contact us . 

Peer reviewing is a collaborative process that provides both scrutiny and feedback on manuscripts submitted to CSSEP by independent experts within the field of applied sport and exercise psychology. Click here to read more about serving as a reviewer for CSSEP . 

Please visit the Ethics Policy for more information.

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Emotions and golf performance: An IZOF-based applied sport psychology case study

Affiliation.

• 1 Florida State University, USA.
• PMID: 16574814
• DOI: 10.1177/0145445503261174

A multiple case study investigation is reported in which emotions and performance were assessed within the probabilistic individual zone of optimal functioning (IZOF) model (Kamata, Tenenbaum,& Hanin, 2002) to develop idiosyncratic emotion-performance profiles. These profiles were incorporated into a psychological skills training (PST) intervention, with a focus on three emotional dimensions, that is, arousal, pleasantness, and functionality, and several psychological strategies employed during practice and competition. Two female varsity golfers at a major Division I university in the Southeast participated in the case study during the Spring 2002 season. The PST intervention resulted in enhanced emotional self-regulation skills and improved golf performance. Directions for future research into the IZOF model and implications for practical application of the model are discussed.

• Achievement*
• Golf / psychology*
• Individuality*
• Internal-External Control
• Models, Psychological*
• Models, Statistical*
• Practice, Psychological
• Psychology, Applied
• Referral and Consultation
• Self Efficacy