Gymnastik- och idrottshögskolan, GIH

This inspiring text unveils the storms and triumphs of coaching in the form of case studies. It explores coaches’ stories from across the globe through a scientific lens and translates them back into coaching practice, offering essential guidance on how to support both new and experienced coaches in their work and professional development. These stories represent coaches of various ages, genders, ethnic and cultural backgrounds, sexual orientations, religions, and experience levels, presenting readers with a comprehensive and diverse overview of coaching and its varied and complex demands. Each powerful case study helps readers see coaching through a different lens, prompting reflection, thoughtful discussion, and creative problem-solving. Designed to instruct, reveal, and inform, the authors provide key takeaways, highlighting successes and challenges, as they consider what makes (and breaks) a coach as a person and performer, and what contributes to sustainable coaching performance. The cases are organized thematically into six parts, with each chapter including a story, guiding questions, relevant research literature, and practical considerations. This book is essential reading for coaches and those working with them, including educators, coach developers, applied sport psychology practitioners, sport managers, medical staff, embedded sports scientists, and other professionals surrounding the coach. Students in sport psychology, sport coaching, sport management and other sport sciences will also benefit from these inspiring stories, and the lessons that can be taken from them. 

BACKGROUND: The interest in elite athletes' mental health has increased over the past decade. However, there is still a paucity in the literature concerning elite Para athletes' mental health and its association with injuries and illnesses affecting athletes' participation in sports.

OBJECTIVE: To assess the weekly prevalence of mental distress and its association with injury, illness, sleep duration, hours of participation in sports and perceived exertion over a 44-week period in a cohort of Swedish elite Para athletes. A secondary aim was to describe the period prevalence of mental distress.

METHODS: This was a prospective longitudinal study including 59 Swedish elite Para athletes with physical, visual and intellectual impairments. Each week athletes reported mental distress according to 'The four-item Patient Health Questionnaire for Anxiety and Depression' (PHQ-4), sleep duration, hours of sports participation, perceived exertion as well as any new injury or illness. Descriptive statistics and multilevel regression analyses were used to analyse data.

RESULTS: The weekly prevalence was 15% for symptoms of anxiety, and 21% for depressive symptoms. The 44-week period prevalence was 58% for anxiety, and 42% for depressive symptoms. Multilevel logistic regression analyses revealed significant associations between reporting symptoms of mental distress with an ongoing injury, illness, and low sleep duration.

CONCLUSION: Elite Para athletes report a moderate rate of symptoms of anxiety and depression, and there were associations between reporting mental distress and experiencing an injury or illness affecting athletes' participation in sports. The findings highlight the importance of longitudinal mental health monitoring and multidisciplinary support systems targeting those athletes reporting mental distress, injury or illness.

OBJECTIVES: An emerging body of research reveals a heightened risk of gambling problems among elite athletes, particularly among males, but these studies often suffer from small sample sizes and lack diverse representation across sports and groups. This study aimed to investigate gambling problems and their correlates among elite male and female ice hockey players in Sweden's top leagues.

METHODS: During the labor union's on-site visits to Swedish ice hockey clubs in the top two tiers for males and the top tier for females, a web-based survey was conducted. Players were screened for gambling problems using the Problem Gambling Severity Index, and for depression, anxiety, and hazardous drinking using other standardized instruments. Estimated study participation was 75-80%.

RESULTS: Among male athletes, 12% met the criteria for moderate-risk or problem gambling, while none of the females met this threshold. Approximately 24% of male and 2% of female participants reported any degree of at-risk gambling. In males, gambling problems were strongly associated with depressive and anxiety symptoms and with hazardous alcohol consumption.

CONCLUSION: Gambling problems are 3-4 times more prevalent among elite male ice hockey players compared to young men in the general population. The authors discuss the associated mental health consequences, vulnerability to match-fixing-related fraud, and the need for preventive measures and easy access to treatment.

High-performance coaches face complex challenges within their profession, which affect both their performance and their wellbeing. Through a qualitative study design, we aimed to understand how serial-winning high-performance coaches perceive self-compassion practice. Nine Scandinavian participants from various sports (female = 1, male = 8) explored self-compassion through psychoeducation and 1 week of practice followed by interviews. The data were analyzed using reflexive thematic analysis. The three themes are represented via a creative nonfiction story: "We have no fear of self-compassion"; "Realizing why I should be a more compassionate friend to myself, it gives me a performance edge"; and "You have to take the armor off, and that is sometimes hard." This study offers novel insights from serial-winning high-performance coaches-a typically hard-to-reach sample. The findings show how self-compassion was perceived as beneficial based on participants' prolonged experience navigating challenges, and how self-compassion may contribute to psychologically safe high-performance environments.

Although sport psychology practitioners and researchers acknowledge the importance of continued professional development (CPD) for professional effectiveness and excellence, few studies have explored the influence of CPD activities on the practitioners' practice and thinking. This study examined qualified Swedish sport psychology practitioners' experiences of engaging in a CPD program and how it impacted their professional development. The Swedish Sports Confederation offers a CPD program that targets performance enhancement services and psychotherapy for sport psychology practitioners. We explored the influence of this CPD program on the professional development of 13 graduates (five females; age in years: M = 41.2, SD = 8.3) via semi-structured interviews. Our stance involved a realist ontology and constructionist epistemology. We followed the six-step Reflexive Thematic Analysis procedures to analyze data. We identified four themes of CPD: (1) Critique (participants decided to do the CPD program because of perceived gaps in their knowledge and skills), (2) Change (participants discussed several changes as a result of the CPD program), (3) Context (participants discussed the aspects of the CPD program that promoted change), and (4) Challenge (participants mentioned issues related to having completed the program). The study provides insights into the value of CPD activities for sport psychology practitioners, advances current knowledge on practitioner maturation, and illustrates how CPD fits within a practitioner's lifelong learning. Future research could investigate the professional development of mid-career sport psychology practitioners engaging in other CPD programs to confirm or extend this work.

Eating disorders are highly prevalent in elite athletes but the lived experience of these has not been investigated extensively. In this article, we draw on life story data generated from four hours of interviews with a young (20 years plus), Swedish, elite, female athlete in an individual sport, named Lisa (a pseudonym) to explore her experiences of living with, seeking treatment, and attempting to recover from a diagnosed eating disorder. This exploration is accomplished by the use of poetic representations. Having made the methodological case for their use we then present the poems for consideration by the reader. The three poems are entitled All the little pointers, The voice inside my head, and Turning it around. Following this, we offer some reflections on how each poem might act as a pedagogical resource to assist those involved with elite athletes to better understand the nature of eating disorders, how the sporting environment can play a role in initiating and sustaining them, and how athletes might be supported and guided on the road to recovery.

Most studies to-date have used mean difference analyses to explore group differences in depressive symptoms among athletes. However, these traditional group mean analyses may mask important information concerning symptom profiles such as the severity, type, and number of symptoms. In this study, we examined idiographic depressive symptom profiles in nine Icelandic team sport athletes with recurrent clinically significant depressive symptoms (clinical symptoms at baseline and six-month follow-up) and those with depressive symptoms only at one time point. The aim was to explore depressive symptom patterns in these two groups and their relationship with daily functioning and changes in sport-specific factors. Among those with recurrent clinical symptoms, depressive symptom profiles were stable, both in terms of type and severity of symptoms, while those with clinically significant symptoms observed only at one time point showed generally fewer symptoms, symptom profiles were more variable, and total symptom scores were less severe. Interestingly, no clear associations were observed between sport-specific variables, such as satisfaction with the head coach or subjective evaluation of athletic performance, and depressive symptoms, as several cases reported satisfaction in these areas despite significant depressive symptoms. This idiographic approach highlights the need for targeted and continuous assessment to better understand depressive symptoms in athletes.

This study explores the reasons given by five elite athletes for choosing to seek psychiatric support and treatment outside, rather than inside, their own sport environments. Life story interviews were conducted with these athletes, who were recruited from an open psychiatric clinic in Stockholm, Sweden. The interviews were then subjected to a structural and a thematic narrative analysis. The former revealed the power of the performance narrative to frame the lives of the athletes by producing a single-minded focus on performance outcomes that justifies, and even demands, the exclusion of any form of psychological weakness or vulnerability. The latter revealed the relationship between the performance narrative and the process of stigmatization associated with psychiatric disorders in elite sport and how this pressures athletes to adopt specific Goffmanesque impression management strategies to protect themselves within their own sport environments. These strategies were as follows: wearing a mask (to hide their psychological suffering), adhering to a vow of silence (making stories of psychological suffering untellable in elite sport), and finding an alibi (a way of portraying suffering in an “acceptable” form). Finally, we reflect on implications for practice, including the potential of narrative care, to help elite athletes explore alternative narratives that might be supportive rather than dangerous companions when suffering from psychiatric disorders.

Lay summary: Five elite athletes were interviewed about their experiences of living with psychiatric disorders, focusing on their choice to seek psychiatric treatment outside, rather than inside, their own sport environments. Stigma and adhering to a single-minded focus on performance forced the athletes to adopt different strategies to hide their psychological suffering.

IMPLICATIONS FOR PRACTICE

• The performance narrative, characterized by a single-minded focus on performance that demands the exclusion of any form of psychological weakness, stigmatizes elite athletes with psychiatric disorders, making their stories untellable within elite sport.
• To protect themselves from stigma, these athletes developed impression management strategies to hide their psychological suffering within elite sport.
• Knowledge of these impression management strategies among different mental health providers working to support athletes, and the use of narrative care to explore alternative narratives, may facilitate elite athletes in seeking support, help, and understanding for their psychiatric disorders.