Gymnastik- och idrottshögskolan, GIH

The aim of the present study was to investigate the effects of a sport-specific acceptance and commitment therapy (ACT) group intervention on mental well-being and stress symptoms in athletes. In this randomized controlled superiority trial (RCT), national level athletes (n = 95; 55% female, 45% male; mean age 19.9 years) were pair-matched and randomly assigned to either an ACT intervention group (INT, n = 49) or a waitlist control group (WLC, n = 46). All the measures were administered pre- and post-intervention, which comprised of six face-to-face group sessions supplemented by home exercises over a 6-week period. Primary outcomes were mental well-being and stress. Other outcomes were experienced recovery, self-esteem, depression symptoms, and psychological flexibility skills. The results show improved mental well-being (d = 0.33, small difference) and reduced stress symptoms (d = 1.13, large difference) in the ACT group compared to the WLC condition between pre- and post-measurement. Also, the ACT group reported increased psychological flexibility (d = 0.31 - 0.53, small to medium difference). Evidence was found that athletes' mental well-being and psychological flexibility skills improved after the brief 6-week ACT group intervention. Our findings indicate that a sport-specific ACT group intervention model might be an effective option for promoting the mental well-being of athletes.

Although high-performance coaching can be rewarding, it can also cause considerable performance, organizational, and personal stress, which over time, can diminish coaches' mental health. There is a growing recognition that collective and community-based interventions that extend beyond the individual level are needed to support mental health, such as a social learning space. Therefore, the purpose of this study was to understand university coaches' experiences participating in a season-long social learning space on topics related to and impacting coach mental health. Specifically, 10 Canadian University coaches engaged in six monthly sessions throughout one competitive season on topics related to mental health. Data collection consisted of pre- and postseason individual, semistructured interviews. Data were analyzed abductively using a reflexive thematic analysis. Results revealed that coaches reported positive experiences from participating in the social learning space, including the sense of community it created and the quality of the knowledge provided by the invited speakers. The environment encouraged sharing and provided insights into mental health, leadership, and the coach-athlete relationship. Coaches also acquired new resources, improved personal well-being, and enhanced coaching effectiveness. Overall, this initiative empowered coaches to become advocates for mental health-both for themselves and for their athletes and networks.

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. 

Five coaches working at the highest level of their respective sport in Denmark participated in a five-session compassion-based intervention. The intervention aimed to enhance the high-performance coaches (HPCs) understanding of compassion principles, develop their ability to act compassionately, and strengthen their role as compassionate role models. Utilizing a single-case mixed methods design with a dominant qualitative analysis, we explored the HPCs experiences with the intervention and its perceived effects. Semi-structured interviews were conducted pre- and post-intervention, and quantitative measures of compassion were used to examine potential changes in compassion levels. Thematic analysis of interview data generated two higher-order themes. The first focused on the HPCs experiences with the intervention's format, content, and delivery. The second addressed perceived outcomes, including changes in how they understand, relate to, and apply the three flows of compassion. Findings suggest that a compassion-based intervention, when embedded within HPCs elite sport environment and facilitated by a sport psychology professional is both feasable and impactful. The coaches' responses indicate that compassion training may contribute to improved coaching practices, personal well-being, and long-term professional sustainability in high-performance sport settings.

The purpose of this study was to explore interpretations and implications of head coaches ' use of humour in three national Paralympic teams from the perspective of athletes and integrated support staff. We conducted six focus groups with 19 Paralympic athletes and individual interviews with 10 support staff members across the teams. Our reflexive thematic analysis resulted in two overarching themes that helped us understand how humour influenced feelings of psychological safety in the team environment, as well as considerations or challenges with using humour as a coaching strategy, including miscommunication or misunderstanding. Relational awareness, emotional intelligence, and effective communication were identified as important coaching competencies to consider when implementing humour as a leadership behaviour, particularly in an environment where power differentials of status and disability were present. The study was among the first to explore interpretations and implications of humour as a coaching strategy from athletes and staff in the high-performance parasport context. Coaches who implement humour within their environments are encouraged to reflect on the receivers of the interaction and how to maximise the facilitative rather than debilitative functions of humour as a "double-edged sword" to ultimately promote team satisfaction, well-being, and success.

Objective To qualitatively explore the perceptions of Para athletes, coaches and stakeholders of the implementation, use and effects of the health promotion intervention 'Safe and Healthy Para sport' (SHAPE). A secondary aim was to explore participants' perceptions of how safety and health in Para sport could be further developed.Methods As part of a process evaluation, this qualitative, descriptive study applied a thematic analysis approach. In total, 18 participants (athletes, coaches and staff) from Sweden and South Africa participated in three focus groups.Results Three themes were generated from the focus groups: 'how to reach every Para athlete in implementation and use', 'proactive athlete growth and support', and 'opportunities for sustainable Para sport'. Participants perceived that the SHAPE intervention was end-user friendly and that it was difficult to find health promotion material for Para athletes elsewhere. Athletes had used the health information to recover from injuries, and their awareness of mental health conditions had increased. Athletes also identified a need for more individualised content, but some athletes were not aware of the health platform. It was suggested that health promotion in Para sport could be better facilitated by peer support. The weekly athlete health monitoring fostered a sense of accountability both among athletes and within the sports organisation, but participants still perceived that medical evaluations are mostly neglected in Para sport and voiced a need to strengthen medical and economic support structures.Conclusion Health promotion can be used to improve health and well-being among Para athletes. However, it was challenging to reach out to the individual athlete, suggesting that health promotion should be implemented in each layer of the socioecological model within Para sport.

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.

In elite sport, athletes and staff may face unique personal- and sports-related stressors that can both bolster and undermine their mental health. Meanwhile, toughness, perfectionism, stigma, and unwanted attention can serve as exacerbating factors and help-seeking deterrents. Two outpatient psychiatric clinics specializing in elite sport and health have been established in Sweden, including one in Malmö, to provide tailored-clinical care, narrow the patient-clinician gap, and foster greater acceptance for mental health care in sport. This population's full journey from first developing symptoms to seeking and receiving treatment in this unique context has not been previously described. This study aimed to characterize this population through a retrospective medical record review (n = 96, Study 1) and explore patient experiences with mental health, help-seeking, and the quality of care at the Malmö clinic through semi-structured interviews (n = 15 athletes and staff, Study 2). The majority of Study 1's sample were female (71 %) and identified as actively competing athletes at admission (87 %). Stress-related and somatoform disorders (53 %) were most common, followed by affective (18 %) and behavioral disorders (16 %). Participants described how their mental health was shaped and expressed through internal, external, and sport-culture-specific causes, factors, and outcomes, while barriers and facilitators to seeking treatment included perceptions of mental health, logistical aspects, and the role of support networks. Overall, participants were satisfied with the care they received, identifying strengths and limitations related to treatment approach, access, and availability. Implications and future directions are discussed.