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Is Sport Psychology a New Clinical Direction For You?

There are plenty of similarities between my clinical and sport psychology work. Like any group, however, athletes have their own lingo, culture, rituals, and lifestyle. Understanding the ins and outs of them can give you a leg up on establishing rapport, trust, and mutual understanding.

Q: After being in private practice for many years, I’m considering a new clinical specialty in sport psychology. Do you have any tips?
A: When I contemplated making a similar change, my wife wondered if I’d lost my marbles. “Why would you want to become a sport psychologist when you’re finally busy and making money! Why stop now?”
But as I thought about the next several years of my life, I realized that two things mattered most to me. First, I was interested in finding a niche that would take me out of my comfort zone and get my juices flowing. Otherwise, why bother? Second, I wanted to distinguish my practice from what everyone else in my office—and most of the therapy community—was doing.
As a lifelong athlete who enjoys doing 12-hour team endurance challenges and running marathons, it made sense to move toward a specialty area that applies what the field of psychology has learned about motivation, cognition, visualization, emotion, and behavior to help athletes. Today’s sport psychologists counsel players at all levels, including pros. These “mental coaches” might get to sit at the end of their basketball team’s bench during games or wear their football team’s official logo, and it still excites me that my work brings me so close to live sports action.
There are plenty of similarities between my clinical and sport clients in terms of the work we do. In fact, my training in cognitive behavioral therapy (CBT), mindfulness, and acceptance and commitment therapy (ACT) is just as applicable to my work with athletic competitors as with clinical clients, whether it’s a student athlete who’s showing signs of depression and contemplating quitting her sport, or a parent of a star tennis player who gets so mad at his son for not trying harder in matches that all they do is scream at each other.
Like any group, however, athletes have their own lingo, culture, rituals, and lifestyle, and understanding the ins and outs of them can give you a leg up on establishing rapport, trust, and mutual understanding. For instance, when the game becomes more obligation than recreation for athlete-clients, it’s helpful to appreciate that quitting may be the first thing they think of but the last thing they’d ever want to do. Clients who take their sports seriously will prefer seeing someone who appreciates how significant the game is to them.
The bulk of what I do as a sport psychologist is to teach high-performing athletes how to compete when the competition gets rough, using techniques drawn from a range of approaches, including ACT’s concept of willingness, DBT’s distress-tolerance skills, and mindfulness teachings on how not to be sabotaged by “mind chatter.” Young kids, high-school and college players, even elite and professional athletes, will tell you the game is different when a crowd fills the stands, when your opponent’s skills are just as good as yours, and when you’re playing with something big at stake, causing many athletes to focus on avoiding embarrassment, rather than playing the game. In other words, they get anxious, and can’t talk freely to their coaches or parents about feeling intimidated, scared, unstable, and depressed. That’s where I come in.
Therapists often ask me if they need to have specific sport knowledge to work with these athletes. The answer is yes and no. It’s not essential to know the exact rules of every sport, though my clients who compete in lesser-known sports, such as fencing, curling, Irish dancing, and dragon-boat racing, are always eager to explain how theirs works. It’s more important to be aware that the “just get out there and have fun” philosophy you might espouse with your other clients won’t work with ultra-competitors, who are often in the serious business of earning a scholarship, landing a big contract, or finishing on the podium.
To compete, these athletes make huge sacrifices—financial, physical, and personal—and they’d find it hard to justify their time and energy commitments if they didn’t regard the payoffs as important and substantial. So they’ll expect you to help them embrace the challenges of their sport, rather than discount its value.
Getting Started
My first sport psychology job was an unpaid position at an elite basketball academy. I got to watch talented future college and NBA players do their thing on the court, but the academy had never worked with a sport psychologist before, and I had little idea as to what I was supposed to be doing there. Yet I knew enough to explain that punishing an underperforming player by having him shoot 100 extra shots after every practice was making matters worse. Before our conversation, the coaches hadn’t taken seriously that this player’s fears about being benched, not getting a college scholarship (which was his ticket to afford college), and losing the trust of his teammates might be affecting his performance. Luckily, given my clinical experience with helping teenagers gain focus and reach their goals, I was able to help him find his groove again.
Still, it took me a while to understand some of the bigger differences between clinical work and sport psychology. Unlike most therapy clients, athlete-clients generally seek guidance when preparing for an event but may quickly lose interest once the event is over. So if you’re a fan of short-term, solution-focused therapy, this niche may have great appeal for you.
Also, many athlete-clients may ask to schedule a second session three or four weeks after an initial meeting. At first, I figured this was a sign that our connection wasn’t as strong as I’d hoped, or that the individual wasn’t as motivated as I’d thought. But eventually I realized that a single session with an athlete often provides enough material for him or her to chew on for several weeks. For example, after I impart advice to a golfer on pre-shot routines, she may not be able to evaluate the value of my recommendations until a month later, when she plays in her next tournament. If she feels that she found her swing again, I wouldn’t necessarily expect her to return anytime soon.
As you can imagine, this kind of sporadic scheduling can affect your bottom line, so to make sure your calendar is full, you’ll need twice as many sport clients as clinical clients. That’s why it’s better to gradually shift your practice in the direction of sport psychology than to attempt an all-at-once transition. Once I realized this, I felt relief knowing that I could keep my income flowing from my clinical caseload while opening up key slots in my schedule for athletes. Additionally, being a licensed clinical psychologist (with an existing practice and a background in child development) has given me an advantage over those with just a sport psychology background. Because I’m a licensed clinician, some clients I see can receive a diagnosis and get reimbursed by insurance for my services. So if you’re already licensed, the expansion of your private practice to include sport clients will be easier and, frankly, more lucrative.
Often, growing your athletic caseload requires a departure from traditional therapy norms, such as taking on a consultant role to athletes, coaches, and athletic departments. Though I don’t have formal sessions as a consultant, I enjoy the variety of work this affords me. One day I might be chatting with a basketball player in the bleachers after his practice about how to set small, achievable goals. Another day I might be discussing mental toughness with a client between intervals on a track, meeting with athletic directors about their new policy for dealing with overinvolved parents, or facilitating a discussion with lacrosse team captains about leadership skills. Do I get paid for every one of these consultations? No. But you can bet that these freebies pay off in referrals.
If you’re uncomfortable with these sorts of loose boundaries, sport psychologist might not be the right role for you. After all, consulting with athletes can involve being available to your clients beyond the parameters of actual sessions. Games are often played in the evenings or on weekends, when you may be called on to provide last-minute reminders, perhaps concerning a visualization technique that you and an athlete recently devised. My phone buzzes practically every weekend because someone’s checking between in matches on the tennis court, on the way to a race, or after a tough loss. Rather than seeing this as a burden, I relish having athletes feel comfortable enough to reach out for help before or after a game.
Shifting my career was risky and not without its hazards, but I find it enormously rewarding to combine my clinical training with my knowledge of and deep respect for competitive sports. In many ways, forging this new career path took the same kind of steely determination, mental strength, and daily work that I put into my training for marathons and endurance events. Should you decide to pursue a similar path, I’ll certainly be rooting for you.

This blog is excerpted from "Got Game?" by Mitchell Greene. The full version is available in the September/October 2017 issue, The Future of Couplehood: Esther Perel is Expanding the Conversation.
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