Oxford Research Encyclopedia of Psychology: Evaluation of Psychological Interventions in Sport and Exercise Settings

Evaluation of Psychological Interventions in Sport and Exercise Settings
Oxford Research Encyclopedia of Psychology

Evaluation of Psychological Interventions in Sport and
Exercise Settings
Rebecca A. Zakrajsek and Jedediah E. Blanton
Subject: Methods and Approaches in Psychology, Sport Psychology
Online Publication Date: Aug 2017 DOI: 10.1093/acrefore/9780190236557.013.223
Summary and Keywords
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.
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date: 12 September 2018

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.
Keywords: sport psychology, exercise psychology, psychological skills training, psychological technique,
psychological intervention
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
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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
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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
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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
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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.
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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).
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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,
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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., AB1AB2AB3 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-
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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.”
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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
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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
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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
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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
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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
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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
Page 16 of 35

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
Page 17 of 35

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
Page 18 of 35

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-
Page 19 of 35

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
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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
Page 21 of 35

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
Page 22 of 35

(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).
Page 23 of 35

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
Page 24 of 35

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.
Page 25 of 35

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
Page 26 of 35

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.
Conclusion
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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Rebecca A. Zakrajsek
Assistant Professor, Sport Psychology, University of Tennessee
Jedediah E. Blanton
Assistant Professor, Sport Psychology, University of Tennessee
Page 35 of 35

Oxford Research Encyclopedia of Psychology: Evaluation of Psychological Interventions in Sport and Exercise Settings

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Oxford Research Encyclopedia of Psychology: Evaluation of Psychological Interventions in Sport and Exercise Settings

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Evaluation of Psychological Interventions in Sport and Exercise Settings

Oxford Research Encyclopedia of Psychology

Summary and Keywords

date: 12 September 2018

Sport and exercise psychology (SEP) professionals provide services to a range of

date: 12 September 2018

In exercise contexts, interventions tend to more closely follow a behavioral theory or

Brief Background on the Development of PST

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Tensions surfaced between SEP researchers and practitioners, partly because

In exercise settings, there is a common thread of utilizing psychological skill building or

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Psychology, a division of the American Psychological Association that focuses on the

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Psychological Interventions in Sport

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Of these 45 studies, 38 (85%) concluded that PST interventions were effective in

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Psychological Interventions in Exercise

In a meta-analysis of 82 studies following randomized controlled trial methods and

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Eight individuals were interviewed after participating in an exercise intervention

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Using carefully designed interventions focused on enhancing the participant’s autonomy,

Psychological Interventions in Injury

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The researchers hosted a seven-week mindfulness-based intervention program with 21

Tranaeus, Ivarsson, and Johnson (2015) conducted a meta-analysis of psychological-

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Current Trends in Psychological Interventions

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Overall, psychological and psychosocial interventions were found to have a moderately

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Following Vealey’s (1988) recommendation, SEP professionals have made attempts to

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(Olusoga et al., 2012). An educational approach and cognitive-behavioral framework (e.g.,

In comparison to traditional PST intervention research in which a single or multimodal

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incorporates therapeutic strategies (i.e., goal-setting, imagery, precompetitive

PST interventions have largely been rooted in cognitive-behavioral therapy principles

(Gardner & Moore, 2012, p. 309).

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Understanding potential sport and exercise participants’ attitudes toward and

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SEP researchers and practitioners are encouraged to include an assessment of

(Martin et al., 2012, p. 23).

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APA Presidential Task Force on Evidence-Based Practice. (2006). Evidence-based practice

Appaneal, R. N., & Habif, S. (2013). Psychological antecedents to sport injury. In M.

Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavior change.

Brown, D. J., & Fletcher, D. (2017). Effects of psychological and psychosocial

Dishman, R. K. (1983). Identity crisis in North American sport psychology: Academics in

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