During last summer’s Olympics, athlete mental health made the medal stand as top athletes opened up about the immense pressure they experience and how they cope. With the Winter Olympics beginning soon, Richard Ginsburg, PhD, co-founder of the Sport Psychology Program within the Department of Psychiatry at Massachusetts General Hospital, explains what sport psychology is, the importance of mental health in athletics and how working with a sport psychologist can impact an athlete’s performance.

What is sport psychology?

The American Psychological Association defines sport psychology as a proficiency that uses psychological knowledge and skills to address optimal performance and well-being of athletes, developmental and social aspects of sports participation, and systemic issues associated with sports settings and organizations.

The mission of the Sport Psychology Program at Mass General is to promote healthy psychological functioning, character and optimal athletic performance for athletes of all ages. Our program also provides guidance to parents, coaches and administrators who support them. We work with athletes on both performance enhancement and clinical mental health needs.

We found that because sports are accessible and playful, they are a non-threatening entry point to reaching people who might not otherwise seek treatment for mental health issues that may or may not be related to their athletic performance like anxiety. We’ve developed a niche in seeing athletes who have performance challenges and other issues that need to be addressed, and we do so in a proactive and non-pathologizing way.

How did you find your way to this specialty?

There are two avenues for this profession: some sport psychology professionals have a master’s or PhD in the discipline and focus specifically on performance enhancement using strategies like goal setting, visualizing and self-talk. Others have a license in clinical psychology who, in addition to counselling on performance enhancement, can provide clinical interventions as well.

I played college sports, and then became a teacher and coach, and from that experience, I became interested in the clinical psychology side of athletics. I attended graduate school to study psychology broadly. After earning my PhD, I was able to blend my psychology expertise with my own passion for sports into a sport psychology career.

Stephen Durant, EDD and I founded the Sport Psychology program within the Department of Psychiatry at Mass General in 2000. Our practice is a hybrid of clinical and sport psychology services. Because we’re embedded within the wide Psychiatry department, we can offer specialized treatment and comprehensive care, and refer out to our colleagues when needed.

Who benefits from sport psychology services? Is sport psychology only for elite or professional athletes?

A wide range of athletes and people participating in sports can benefit from sport psychology services. At the beginning of our practice, we focused on children participating in youth and high school sports, then expanded the practice to include collegiate athletes and eventually professional athletes and teams as well.

Children and high school student athletes can experience a range of sports-related mental health issues, including overzealous parents, extreme training and the exploitation of young athletes. Our practice includes working with parents and schools since the people around student athletes is so central to their mental health, and how they develop (or don’t) the tools for overcoming challenges and practicing good habits. Our work with them is steeped in healthy development and evidence-based treatment.

After a terribly tragic incident in 2001 involving parental rage at a youth hockey practice game, Dr. Durant and I felt compelled to more broadly share our expertise and wrote a comprehensive guide that helps parents ensure a positive sports experience for their children, Whose Game Is It, Anyway?. It’s necessary for parents and coaches—for all the adults involved in youth sports—to critically think about what’s appropriate for student athletes and what culture they’re helping to create for the kids. Youth sports can be a tremendous value add to a child’s life—they build resilience, create character and provide opportunities to practice discipline. Those are the tenets we have to nurture in youth sports.

How is your practice different when you’re working with children and parents vs. professional athletes and teams?

There are some similarities—just like when working with student athletes, the people around them have a significant influence on their mental health.

In the context of professional and elite athletes that means coaches, team managers and administrators who can provide insight and collaboration. When we work with just the athlete, it remains important for us to be aware of the culture of the team.

How can working with a sport psychologist impact an athlete’s performance?

As an athlete’s career advances into professional sports, we most often work with them on their performance and performing under pressure using strategies like goal setting, visualizing and self-talk.

The fundamental skill an elite performer needs to perfect is their ability to manage distractions and stay in the moment. Distractions will happen and we teach them techniques on how to tolerate the distraction and quickly reset their focus so they can perform in the moment. That skill differentiates the good from the great.

Why do you think athlete mental health was so widely discussed during last summer’s Olympic Games?

First off, I think it’s important that mental health, athlete or otherwise, is becoming more openly discussed. Too often, stigma is attached to those seeking mental health care, when, they should be praised for taking care of their emotional and mental well-being.  

Elite athletes, and that certainly includes Olympians, can be under an immense amount of pressure to perform and that can also impact their mental health beyond athletics. When those in the spotlight discuss their struggles and demonstrate how they invest in their mental health, that helps destigmatize it for everyone else. You don’t have to be an Olympic athlete to experience personal or professional stress; taking care of your mental health is open to everyone.  

What does your work look like?

Our program sees patients referred to us by hospital departments like pediatrics, sports medicine, primary care and rehabilitation, including collaboration with Mass General Brigham Sports Medicine. We also work with professional sports teams like the Red Sox, Bruins and Patriots and some of us have a private practice as well.

Our hospital-based work includes working with people recovering from an injury—and the fears and delays that can come with that process—and those navigating the loss of sports due to an injury or some other experience or condition. I also spend time working with patients in the Sports Concussion Clinic at MassGeneral for Children.

My colleagues and I also give talks to schools and communities on sports as a mechanism for character development and healthy physical and emotional development in children.

In addition to our book, we conduct research in the areas of sports specialization among professional baseball players and collaborated with other colleagues to write content-driven articles on topics such as the female athlete triad, establishing youth sport guidelines for US Lacrosse, and generating white papers on the integration of sport psychology in professional baseball. It is our hope to expand our research capacities as our program continues to grow.