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Short-term, Cognitive-behavioral-based Treatment in Long-term-injured Athletes

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Most competitive athletes spend an substantial amount of time practicing vigorously to reach peak performance. Although competitive athletes are in great physical condition, the sheer amount of physical vigor most sports require at high levels often results in injuries. Johnson learned through research that athletes sometimes faced prolonged rehabilitation due to psychological factors such as maladaptive coping strategies and lack of goal-setting skills. Although there were recommendations of using short- and long-term psychological interventions during rehabilitation of injuries, there was a lack of empirical support for their use with injured athletes.

Under this realization, Johnson conducted this study with hopes of exploring the effectiveness of psychological interventions using competitive athletes with long-term injuries as samples. To determine the effectiveness 2 groups were established, Johnson used a control group and an experimental group. The experimental group was used to add a psychological intervention to enhance injury recovery functional and/or psychological outcomes. The control group was needed to determine the effectiveness of these psychological interventions by comparing results with the experimental group. There were 58 patients in total (52 men, 6 women), of which 14 were in the experimental group and 44 were in the control group.

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Patients were all competitive-level athletes which suffered injuries that occurred during training or competitions. The patients came from a variety of sport, most commonly soccer. Also, the type of injuries that they sustained varied, but the most common was knee injuries. To ensure that the injury that the athletes sustained was severe enough, they had to be unable to either train or compete for a minimum of 5 weeks due to the injury. Altogether, there was 3 test occasions that occurred. On the first occasion, at the start of rehabilitation. On the second occasion, in the middle of the athlete’s rehabilitation training, which on average lasted 6 to 7 weeks after the first test. On the final occasion, the test occurred when the athletes were supposed to be ready to return to sport again.

During the 3 different occasions of which the intervention occurred, along with traditional sports medicine physiotherapy, the experimental group received 3 different types of training. On the first occasion, the patients learned stress management and cognitive control training. During these training sessions, the patient learned how to cope effectively by using emotion-focused coping. This included seeing the injury more positively by viewing it as a challenge instead of a threat. On the second training session, patients learned how to develop a goal-setting model. This included athletes integrating daily exercise under the belief that they would be able to return to their sport and fulfill their dream. On the final occasion, athletes learned the basic components of relaxation and mental training. This training included breathing and relaxation techniques.

During the 3 test occasions, 7 tests and scales were distributed to measure the effectiveness of the psychological intervention methods. The first 4 test during the first intervention session measured psychosocial risk, 6 bipolar mood dimensions, and physical status, which was measured by the physical therapist. The other tests were done by the patient and the therapist to measure whether the athlete considered themselves physically and mentally ready for training and competition at maximum effort by the end of the treatment.

The results were unanticipated. Depending on the test, there was either little to no differences or quite a significant difference. Results showed that there were no changes on how the patients felt on their attitude towards rehabilitation, but it was noted that the physiotherapist stated that the rehabilitation had worked out well for the patients who were included in the experimental group. Also, in the diagnostic checklist done by the physiotherapist and self rated questionnaire of the patient showed positive progress. A significantly higher ratio of the experimental group felt like they considered themselves fully healed and relaxed with higher initiative to return to physical activity. The results also indicated that a short-term psychological intervention, combined with stress management, goal-setting skills, and relaxation/ guided imagery, seems to have the ability to elevate the patient’s overall mood during and after the rehabilitation period.

Although the results of the study were not astonishing, I believe that the results of the psychological intervention demonstrated that it should be implemented into all rehabilitation in addition to traditional therapy, specifically relaxation/ guided imagery. This technique has shown to be the only one that showed statistical differences between the control and experimental group from responses provided by the patients. Also, the description of the technique itself seems to be effective by combining two individual skills which compliments each other. Although the results of this study were positive, it should be taken into consideration that the increased overall mood could have resulted from the experimental group being specially chosen which contributes to a general sense of satisfaction and recognition. Another possibility is the physiotherapist paying special attention to the experimental group which results in a better overall experience for the patient.

The results of this study provide valuable empirical data which supports the concept of a short-term, cognitive-behavioral-based treatment which has the potential to increase mood levels in long-term-injured athletes. If further research is conducted and the methods is improved, psychological intervention has the capability of making long-term injuries less detrimental on an athlete’s mental state and makes the entire process of rehabilitation more bearable.

Works Cited:

  1. Johnson, U. (2000). Short-Term Psychological Intervention: A Study of Long-Term-injured Competitive Athletes. Journal of Sport Rehabilitation, 9(3), 207-218. doi:10.1123/jsr.9.3.207

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