Sports Psychology and Mental Health in Student Athletes

Three Hartford HealthCare physicians join Jada Mirabelle on the CIAC Glory Days Podcast to discuss the critical role of sports psychology and mental health in young athletes. Dr. Peter Lucchio, PsyD, Dr. Ralph Dodd, PsyD, and Dr. Viana Turcios-Cotto, PhD share expert insights on performance, resilience, and supporting student-athletes both on and off the field. A valuable conversation for coaches, parents, educators, and athletes alike.

Transcript

Meet The Team: Sports Psych Experts

SPEAKER_03 0:00

Welcome to CIC's Glory Days Podcast. I'm your host, Jada Mirabel, and today I'm joined by three Hartford Healthcare physicians to discuss sports psychology and mental health in student athletes. I'm pleased to welcome Dr. Ralph Dodd, Dr. Viana Tercios Coto, and Dr. Peter Lucio. Thank you all for joining me here today.

SPEAKER_01 0:16

Thank you for having us. Yeah. Of course.

SPEAKER_03 0:18

So now I'd love to start with each of you maybe briefly introducing yourselves for a few moments and talking about your specialties.

SPEAKER_00 0:25

So you look at me. So I'll start off. I'm P. Lucio. I am one of two psychologists at the Bone and Joint Institute. About half of our work is dedicated to working with kind of general population folks who are candidates for an orthopedic surgery, recovering from an orthopedic surgery, dealing with some type of chronic pain condition, people who have some type of rheumatologic condition, folks recovering from concussion, and then anyone working with like a physical therapist within the rehabilitation network where there's some barrier to their recovery that involves either their mindset or their behaviors or their emotional state. So we serve a lot of different

Roles Across Rehab And Campus Care

SPEAKER_00 1:10

people within that umbrella of kind of rehabilitation medicine. And then the other part of uh Viana and I's work at the Bone and Joint is working with student athletes. Um I'll pass the baton to whoever else would like to go next.

SPEAKER_02 1:26

I'll continue on with that. So, you know, Ralph, you could probably talk a little bit more about this, but through campus care, we have contracts with very specific high schools and colleges throughout the region, and so we do a lot of work with those specific high schools and colleges. And so I end up seeing a lot of teenagers as well for a variety of reasons. Uh, and we see adults uh for us, a lot of them are college students. Um so that's part of the work that we do there.

SPEAKER_01 1:57

And um, my name is Ralph Dodd. I'm a clinical psychologist. I am currently the regional director of collegiate counseling for campus care, which is part of Hartford Healthcare's partnerships with different colleges in the state of Connecticut. And what um we really focus in on is the counseling centers and working with students and student

Benefits Of Youth Sports And Risks

SPEAKER_01 2:17

athletes with a variety of issues that is going on. Um, historically, for me, um I've worked with children and adolescents and that developmental uh period in time, as well as um you know teaching um college-age students.

SPEAKER_03 2:31

Great. Well, it sounds like you all cover a nice span of age groups, which will be great for this conversation. So let's dive right in. So, what mental health challenges are you seeing most commonly in young athletes today?

SPEAKER_00 2:43

Uh I would say it depends on the age. Um I feel compelled to kind of do this sandwiching type of answer where we talk about what's good about doing sport first. Uh sport starting you know very young and throughout development. It teaches athletes to um feel confident about their body and gain confidence in movement regarding whatever level of athleticism they're born with genetically, which I think is is really important. Um helps to build relationships and maintain relationships, helps to build social skills and problem solving, um, helps to feel a sense of accomplishment, which is you know how youths and Ralph and Viana, you can correct me if I'm if I'm off here, how they start to develop a sense of confidence. Um and so it's really very useful to help children throughout their development. I can already see this because my kids are playing sports even though they're young. Uh throughout the past, you know, 10-ish, 15, 20 years, there's been increased pressure on athletes earlier and earlier to specialize. And so where, you know, historically and maybe in different cultures and countries, there's um a lot more diversity

Specialization, Burnout, And Family Pressure

SPEAKER_00 4:06

in what athletes are invited to do. That even though an athlete might be um, you know, comes to mind as like an Olympic weightlifter, they're they're not gonna be Olympic weightlifting throughout the entire year. They're gonna be encouraged to do different things, um, in so that a couple of different things, they're their their body's not going to, well, their body's gonna be able to um, they're gonna learn different things about their body. They're gonna develop other capacities outside of just you know pure explosive strength and pure strength through weightlifting. They'll, you know, they'll have calisthenics and sideways movement and stuff like that. But the real concern, and we see this in certain sports, is uh overuse injury and burnout. Um, things that come to mind are you know young athletes who are uh baseball or softball players with elbow injuries, shoulder injuries. Uh and I know through you know sports like that they try to maintain pitching counts. Um but you know, other uh overuse injuries, sometimes, you know, uh a lot of what I work with personally is ACL tears, um, and some of that can be due to overuse, over uh where other parts of the lower body begin to compensate due to fatigue over time. Um and so that you know, all of that puts a lot of pressure on the young athlete where um for the factors I've already noted, and there's also the impact on the family system, where instead of time spent just hanging out and playing board games or you know, even just relaxing, there's this invitation to be go, go, go, go, go all the time. And that the family starts to just revolve around sport itself. And, you know, there may be benefits to that because it provides structure and time for the family to connect, but there's also these kind of missed opportunities sometimes for the the child just to be a child. Um, and I'll stop talking to give uh Viana and Ralph thoughts.

SPEAKER_02 6:10

I'm gonna follow up on that. Yeah, like Pete, I also have young kids, and I found myself going down that slippery slope of, oh, you're a great soccer player, let's keep pushing you and keep keep pushing you, right? So I think one thing that's really important is checking

Rising Stakes And The Scholarship Chase

SPEAKER_02 6:23

in with your child. Like, are you still interested in this sport? Is this fun for you? And at you know, what level do you want to play at? Uh, because sometimes I think we get caught up in our own excitement as parents and we want to push our kids. But sometimes the child just wants to have fun, right? They just want to do uh something that's not so competitive. I think one piece that I uh that comes to mind also too is the idea of impression management because of this high pressure. So many young athletes, and we've we see it at the professional levels too, they present themselves like everything's perfect, like they have everything together because of that pressure, right? To be confident, to show that you're confident. And so I think sometimes that masks what's really going on underneath, and it's harder to notice perhaps the anxiety or the depression or that burnout because they're working so hard to present themselves as being these perfect little you know, students, athletes. Um, and so I think that's something that's really important to watch out for.

SPEAKER_01 7:25

Yeah, and the only thing I'll add to um what was shared is the just the idea that um there's constant pressure to be good enough, but good enough is never good enough. Like it's constantly moving and changing, and you know, on consequently puts a lot of pressure on um, I'm gonna say, children, adolescents, athletes in general. Um, and that makes it really hard for them to then, I'm gonna say, stay locked in and actually perform to the levels that they're capable of.

SPEAKER_03 7:52

Aaron Powell And do you all find that the pressures over the last 10 to 20 years have grown for student athletes?

SPEAKER_00 7:57

It really seems that way. And some of that is also kind of reinforced by some of the uh things I've chosen to look into, like other podcasts similar to this, where uh there's coaches and professionals talking about what it's like to be working with student athletes and their families. Um and just really lots and lots of pressure to

Red Flags: Behavior, Motivation, Performance

SPEAKER_00 8:20

uh you know piggyback off kind of what Ralph said, it's like to to be the best. And uh I I wonder sometimes if the the mission of youth athletics gets missed and the purpose of it gets missed in trying to be the best out there. Um the reality is is that that's really not going to be for most of us, right? That uh it's really gonna be important about other things. There's nothing wrong with being really athletically gifted. That's that's not what I'm saying at all. But um there's a really interesting article in The New Yorker, maybe like five or six years ago, about the amount of money that families will spend on private coaching to try to get their kids to go D1 in certain sports. And you know, if families have those those resources, that's fine. I just wonder if some of that might be misguided. Um because a lot of it, especially at higher levels, is uh oftentimes much more genetic, you know, that athletes who are going to be getting to those levels that they're it's gonna be really clear right very early on. And a lot of it in certain sports is kind of based on size and and speed. And that's that's largely genetic. Does that mean it can't be trained? No, I I'm really not saying that. I think it's important to go back to what Viana was saying, you know, in terms of interests from the child, right? Instead of trying to kind of push and and get that child to be kind of the starting whatever at the at the D1 school, let the child's interest guide it, let the youth's interest guide it. You know, if we're having to drag the athlete out of bed every morning and it's a fight to get to practice, that's data, right? That lets us know, hey, you know,

Sleep And Nutrition As Performance Pillars

SPEAKER_00 10:18

what where we can reflect as as a family, you know, and whatever the athlete's team, where is the level of interest if we're trying to have to bring you there? Are we forcing something that maybe isn't there? Or how how do we just take a step back and pause and have a conversation about it uh versus just kind of be swept up in the momentum of it?

SPEAKER_02 10:41

That's a great point. Yeah, I was gonna say, you know, I think it has uh increased, those pressures pressures have increased over the last few decades. You know, I can think about my own high school experience. I went to prep school and sports were a huge deal on campus, and even still, you didn't hear about D1 and D three. That wasn't the main focus, right? Student athletes wanted to keep playing sports because they wanted to, uh, but it wasn't the main driver of what college am I going to and why. Whereas I you know, my own perspective, it feels like because college has become so needed for so many professions, right? And it's being pushed as the way forward. And it's also out of reach financially for so many people. It's become the the main way that certain families think that they can get their kids through college, right? Is by going D1 or getting some sort of scholarship um for college. And so they see this as like the meal to get in. So I think that's been from from my perspective, right? From my understanding, that's been a main driver as to why these pressures have increased for families as well.

SPEAKER_03 11:46

It becomes an avenue for scholarships and for money to go and get into college. Absolutely.

SPEAKER_01 11:52

And I'll I'll keep it really brief, but I would just add that the pressures, I think the pressures have increased significantly for a couple of reasons. One, there's just so much more that the athlete has to manage. And there's, you know, if you're not on this AAU team or that um

Injury Psychology And Identity Beyond Sport

SPEAKER_01 12:06

extra team, um, you're not keeping up. And then also, you know, they recognize that their parents want it so badly, right, that it's like I'm going to fail my parents, right? I've worked with a couple of athletes that they're like, you know, kind of to your point about college, like they've invested so much in me going to prep school or private school or, you know, and that costs a lot of money that what I can give back to them is by going to D1, getting a scholarship. And so they're not even necessarily enjoying the sport that much, but they know that that's what they they owe back.

SPEAKER_03 12:38

Yeah, it becomes more of a job almost when you really have to put enjoying it first and finding the real meaning behind sports. Yeah. So what early warning signs should parents, coaches, and teammates look for?

SPEAKER_01 12:49

So I I'll jump in right away. I think uh to Pete's point, this idea that if you're dragging your kid out of bed, right, and you see that they're doing it not because they really want to, but because they kind of have to, I think that's a a warning sign early on. Also, you know, more from the physical and athletic side of things, when you just start noticing a change in performance, right? Like um, and not in a way that they've peaked uh, you know, and then starting to, you know, go kind of decline, but more that they're just not performing, right? Um I think that speaks to one possible injury, but two, realistically not having that internal drive to you know push that threshold.

SPEAKER_02 13:25

I think also if you see a change in their personality, I think that's the the biggest piece, right? Because people are looking for specifics or concrete thoughts. And it's like, well, some kids are already to themselves, right? Or some kids are um more outgoing. So the idea is are you seeing any changes in their behaviors and the way that they're interacting with their peers and the way that they're handling school? Maybe they don't care about school anymore, or or the opposite. Maybe they've thrown themselves so much into school that now it's hard to pull them into fun activities, you know. So, really for me, that's always a big thing. It's like how are they functioning before? How are they presenting before versus how are they presenting and functioning now?

SPEAKER_00 14:04

This is really

Reducing Stigma And Opening Conversations

SPEAKER_00 14:05

just, I guess, a way to respond to both those. I 100% agree is really looking at what you're seeing out of the athlete as kind of data that you can take a step back and take a look at versus making some type of character judgment about, you know, are are are they just being lazy? Well, you know, if they're playing, you know, two sports each season throughout the year, I'm not sure we can call that laziness. You know, the and and they're also you know, in school. So we really want to invite ourselves to just be curious about what's happening for the athlete versus you know going to this place of, well, you don't want it enough, or well, lots of I when I do talks about recovery, we we try to normalize uh the lived experience of an athlete, which is at some point in the season, you're gonna probably drag, right? It's uh it really is kind of regardless of the sport, you're gonna feel tired. And um, because you're you're a student athlete a lot of times, there's gonna be lots of competing demands, uh, lots of times um suboptimal sleep. And there's gonna be this level of kind of burning the candle at both ends. And so instead of just making judgments about it, can can we be curious together and try to have conversations about it and open up conversations versus let's just push forward, let's just push forward, let's just push forward.

SPEAKER_03 15:30

So now mentioning sleep, what role does sleep and nutrition play in the mental health and

Coach And Staff Playbook For Mental Health

SPEAKER_03 15:36

performance of student athletes?

SPEAKER_00 15:38

The way I'll frame that is uh we could talk about mental performance all day long for years and years, but if you're not sleeping, you're not eating, you're not fueling, uh it really isn't gonna matter. Um that where we recover most as athletes, where you recover most as athletes is through sleep. It's the most anabolic thing you'll do. And what we mean by that is that that's where your muscle tissue and your musculoskeletal system and your hormones are going to respond to the stimulus of training. Um it's where we also recover mentally and cognitively, you know, for for the athletes who are going to be listening that are in school. Um, and so if you're not sleeping, you know, that's that's gonna be a huge problem. And that also alters appetite, metabolism, um, insulin response and signaling to food. Um, it also alters performance. You know, one night of sleep deprivation for most people is going to alter, you know, your neurological functioning and reaction time. Sleep is absolutely 100% critical. Uh, you know, Viana and I work with uh registered dietitians like Chris Barrett at the Bone and Joint Institute, and he could expound on diet. It's kind of the same conversation. If you are, you know, I've met with athletes who are like, you know, I'm not performing the way I want, and I'll ask them, well,

Tools: Mindfulness, Visualization, Self-Talk

SPEAKER_00 17:02

do you eat breakfast? No, I don't eat breakfast. Do you eat lunch? You know, maybe like a soda and some popcorn chicken, and then maybe I'll have, you know, something for dinner. I know that sounds like a lot, a lot of teenagers, you know, and that's kind of a tough habit to break sometimes, but we also have to kind of invite them to understand, like you, you can't really logically expect yourself to be performing in the way that you want if you're not fueling, right? It's it's got to come from somewhere. And especially going back to the last question, like if you're seeing at if you're getting signs that an athlete is dragging or they're not interested, we want to look into these things you're talking about. Are you are you kind of trying to pull from an empty well, so to speak?

SPEAKER_02 17:46

It's a great explanation. Sleep and nutrition are foundational, you know. And um the other piece that people don't understand or recognize is that sleep also impacts your mental health and emotional health, right? So you're more likely to be more anxious, you're more likely to be more depressed, you're gonna have a harder time making decisions, thinking clearly. Uh, as you know, Pete was saying, it affects coordination. So your physical performance, right? All that is going to be affected just by sleep alone. So whether you're a teen or a college student, you should really be getting somewhere between eight to ten hours of sleep, which I think oftentimes people are like, what? Like they most folks know eight hours, right? But even up to ten hours of sleep. Um, and it it really depends on the individual, how much sleep is needed for them to recover and to feel well rested. And then, yeah, that nutritional piece, right? I mean because I meet with teens so much, it's like exactly the same thing that you just said people like, when are you eating? We've got to eat food. And even their parents are like, you have to eat, you know. Um, so we work on different ways. Sometimes I connect them to Chris, or sometimes we talk about do you have a granola bar you could bring with you, a yogurt, cheese stick, right? Quick little snacks, uh almonds, something to keep you fueling

Confidence: Prep, Language, Effort Focus

SPEAKER_02 19:03

throughout the day. Um so yeah, those things are super foundational.

SPEAKER_03 19:08

Yeah, it really does affect each part of your life as an athlete. So, how do you find that injuries impact mental health, especially when it may change a young athlete's path?

SPEAKER_01 19:17

Yeah, I think it impacts them um significantly. Um, for some, um, it's the first time that you they've actually really been injured. And if you're playing at a high level, you know, the injuries are gonna come. The question is when and how, and how are you going to respond to it? I was working with this one athlete who was a really good soccer player, and um, you know, had one ACL go and then they got back to training and it went again and um just demoralized, right? And wondering, will I, you know, have those other opportunities? And that starts to trickle into motivation. And when I say motivation, it's you know, it's a fine line between motivation and depression, right? Where it's I'm no longer capable of you know doing what I used to and what I envisioned for myself has now changed, right? And that's where the mental health piece kind of kind of weighs in a little bit more. But injuries create a lot of self-doubt, and self-doubt it goes hand in hand with mental health.

SPEAKER_03 20:10

And in those situations, what would you suggest to athletes who are going through those troubling situations?

SPEAKER_01 20:16

Yeah, so what I would normally suggest to them is one, to slow down, take the time to heal, right? But try to do more, you know, tangible things that allows them to build confidence or not, I should say, not diminish the confidence that they had, right? So like you could still, you know, help a teammate, you know, with you know whether it's technique or you know, monitor monitoring them and and supporting them in that way, so that you just try to hold on to what the student in um inherently has as an athlete.

SPEAKER_03 20:46

Yeah, because there's so many ways to be involved in the sport even if you can't physically play at the moment. You can still be involved with your team.

SPEAKER_02 20:51

And I think the other piece that's super important is expounding on your own identity beyond that sport, right? Like you are not just your sport. Uh and so I think that's another piece, particularly

Parents: Support Without Pressure

SPEAKER_02 21:02

when kids are injured and we're working with them, you know, asking them, what else are you interested in? This is the time. If you're not able to go on tournaments or play at the moment, let's think about what are other interests that you might have right now and sort of build your identity around other pieces of life so it's not just sport, right? Because one of the things that I talk about with um my focus is the idea that at some point you're gonna have to be done with your sport. Everybody, right? At some point we have to be done with our sport in some way or another. And so it's at that point we're also gonna be left with like, okay, well, what else about me is you know something that I enjoy that that I look forward to.

SPEAKER_03 21:39

Yeah, who are you outside of that? Yes. Yeah, exactly. That's a great point. So, how do you approach conversations with patients who may be hesitant to talk about their mental health?

SPEAKER_00 21:50

Well, we certainly don't want to force it on them. Um I'll say, you know, mental health is still very stigmatized. And uh you can tell really early on. The way it often happens in the clinic we work in is that you know, an athlete might be going back to Ralph's point, recover, you know, having an ACL injury, it's their first one. Uh maybe they haven't even had surgery yet, and they're just feeling really down and out, which is completely normal. Uh, we want to normalize that. Uh, they might be feeling really angry or misunderstood. And oftentimes athletes will feel misunderstood because the response from their support system is it's gonna be okay. For them, it's really feeling like it's not okay. And you know, we may talk about it later. It it's really representative of how they're feeling of a grief process that you can't, you know, positive self-talk your way through it. You really have to kind of feel your way through it and and be open about it. Um, that's an aside. But uh we try to just kind of um, if possible, uh find a quiet space to to meet with the athlete where maybe it's less around other people. That's not always possible, just kind of introduce ourselves, you know. I'll usually not say Dr. Luci, I'll say, hey, you know, my name's Pete, and um part of my job

Resources: 211 And Access To Care

SPEAKER_00 23:18

is to help athletes in in in the way that they're kind of struggling with, um, and to just kind of watch how they respond to it. And sometimes, you know, if an athlete's not making any eye contact and they're just kind of like, yeah, yeah, that's kind of data for me to just kind of back off and say, you know, um, I'm just gonna share a couple of things, and you know, here's my card if you if you want to make a call. Um, because not we are here to assist, but it it's really not helpful oftentimes to force it. Uh it's um to force someone to be open. That those that almost feels like a paradox. But uh, so there are times where an athlete might not be ready for it and they need time to think about it, and that's completely fine. And then sometimes we'll introduce ourselves to athletes and they'll just be like, Thank goodness you exist. I've been really wanting thinking about this. Um, glad you're here. When can we make an appointment?

SPEAKER_01 24:16

And I would add to that, I think you know, Pete used the word normalizing experiences,

Final Messages And Contact Info

SPEAKER_01 24:20

right? Like I think it's um normalizing to let athletes know that you know mental health is part of life and things that um may arise, and even you know, giving personal examples of you know, injuries that maybe I've had and it's expected that you're kind of down and out and so forth. But I think coaches play a huge role in this, in their their ability to normalize just the mental health component of things. I worked with you know a lacrosse coach, and he you know would bring me in to just do regular series with his team to just say, like these are different topics that you know athletes might go through or athletes might experience. And that opens the door for them to be open when the the time arises, or if they go through something to say, hey coach, you remember when you were talking about this? Like, can you point me in the right direction? Or you know, when we come in and and meet with them, um, it's not something that's so foreign to them.

SPEAKER_00 25:11

I'll piggyback on that. That important I've gotten feedback from athletes about coaches that they really valued when a coach would just check in with them from time to time when there was an when there was an injury happening and they were going to be out. Uh, and athletes felt very affected when the athl when they just felt invisible after the injury, because you know, when there's not communication, uh an athlete might uh make sense of that in a way where they're thinking, feeling like, oh, I'm kind of uh useless to you now. Like I don't really have importance to you, which again goes back to Viana's point of like, well, am I an important person still that I'm that I'm hurt? Right. So we want to help coaches understand, and I know coaches are really, really busy at all levels. Like it, if you just take the time to check in here and there, that that's gonna really mean a lot to an athlete oftentimes.

SPEAKER_03 26:09

Are there any other suggestions that you would say to athletic staff and coaches to help promote that mental well-being on teams, besides those check-ins and those making sure the door is open for conversations? Is

Closing Thanks

SPEAKER_03 26:20

there anything else specific that comes to mind?

SPEAKER_02 26:22

I mean, I think one thing is being supportive and talking about the resources available. Like, hey, if you ever want to talk to uh a sport psychologist or you know, a sport performance provider, uh, we know some folks, we can connect you to to some support. And it doesn't have to be just when folks are people are injured, right? Or when people are like suffering. It's just making that as part of this is what we do, and this is well, these are the resources that are available to us no matter what. Um, but being a positive person uh in the life of um the youth, I think that's super important so that they feel like they can come to you as a coach or as as an athletic trainer and talk to you and uh let you know what's going on with them.

SPEAKER_03 27:10

It just creating that positive environment makes a big difference for athletes.

SPEAKER_01 27:14

Yeah, and I would just add too, um we as people in general should always be observant, but coaches specifically should be observant of their players, their athletes, and you know what Viana had mentioned earlier about just changes in personality, right? Like you if you're observing your your team and you notice something is off, you know, to be able to be proactive and pull an athlete aside and you know have a you know a private conversation, I think is key.

SPEAKER_03 27:38

Absolutely, because they're seeing these athletes every day. Yeah. They can sense the change in behavior.

SPEAKER_00 27:43

Open-ended questions, right? You know, and as I alluded to earlier, if you get a sense an athlete is struggling, pull, you know, getting some privacy before you ask the question, how are you doing really? Right? How are you really doing? Uh open-ended questions are just giving the opportunity for an athlete to share. And to the honest point, you know, coaches can start to talk about the um the overlap, the interaction of your general mental health and your athletic performance. That they overlap for everybody, you know, that uh if an athlete has a significant loss or a death or struggles in their inner personal life, that can oftentimes trickle if they're not being coped with or managed into their level of focus or level of motivation uh on the field. And it just takes kind of what Ralph Dodd Ralph said, you know, that having that curious conversation versus, you know, get your head in the game, you're checked out, more of like a punitive style.

SPEAKER_02 28:48

Yeah. Getting to know the player outside of the sport, right? Yeah. Knowing who are your parents, what are you interested in, the what's going on with you outside of just your sport. And then again, that feeling of like I'm important outside of just the sport. You actually care about me. This is what we talk to parents about, this is what we talk to teachers about. You know, and I'll I'll say one more thing. I think sometimes people don't realize that everything that we're talking about here, it's happening at the professional levels, right? We have sports psychologists at the professional levels. These conversations happen there too, and coaches are also trained in exactly what we're talking about at the professional level, right? So that when they're working with professional athletes, they're looking for these sort of red flags and then sending them off to sports psychologists and mental health providers. So this isn't it's not just about a teen or a college athlete, right? This is what's happening in sports uh all around. And so it's I think hopefully that stigma that we were talking about earlier can start to you know dissipate a little bit more as we realize this is part of that work. This is part of the sports world.

SPEAKER_03 29:57

And I find now that a lot of professional athletes and college athletes even are using their platforms to speak out about mental health. Do you think that that helps break that stigma to help kids feel comfortable?

SPEAKER_01 30:06

Yeah, I think it helps significantly. Um because you know, a lot of times people, I'm gonna say, struggle in isolation, right? They're like, oh well, I'm going through this, but I'm clearly the only one going through this, so I might as well keep quiet. And in the last few years, you've had a lot more athletes come out and say, like, yeah, I'm not functioning where I'm um supposed to be because I have X, Y, and Z going on, and that's okay. And I think um a lot of the, whether it's professional organizations, college organizations, and you know, into the high school organizations are really trying to offer the resources and support when an athlete is is struggling and saying, like, yes, we understand that this is this is part of life now.

SPEAKER_03 30:46

So can you walk us through the collaborative care model between medical doctors and sports psychologists? How does that work?

SPEAKER_00 30:53

Oftentimes what will happen is, you know, going back to an athlete who's well, it can be a concussion, it could be an orthopedic injury, what they'll often ha what will often happen is they will meet with their specialists. Uh if it's a let's say an orthopedic injury, knee, shoulder, elbow, hand, um, they'll be screened for um levels of emotional distress. And or uh the provider, the the orthopedic surgeon will ask them you know questions like, well, how are you? Or they'll just look at how they're presenting nonverbally. And based on that, you know, Fiona or I will receive a referral from the orthopedic provider, or a lot of our work is with um people, athletes who are recovering from concussions. And so part of those evaluations with the neurologist is usually uh like a mood and anxiety screening measure. And so they're gonna be asking questions about that, and if it's kind of high enough, or you know, the athlete says, you know, I'm I'm really struggling with this, that usually keys them to make the referral to us.

SPEAKER_03 32:07

And are there any specific sports psychology techniques that you find effective for stress management and performance anxiety?

SPEAKER_02 32:14

We talk a lot about meditation and mindfulness. Um I think that might that's those are some big ones. Um and you know, I think like we mentioned earlier, the sleep and nutrition foundationally starting there. Well, I'll let uh did you call and chime in?

SPEAKER_01 32:34

Yeah, I was I started uh to chuckle a little bit when you asked that question because it you know there's this silly thing that I have started doing with some athletes now, and I think it's more appropriate for like you know high school athletes is just creating a vision board, right, of you know, what are my goals, my goals, not my parents' goals, not my coach's goals, but what are my goals and what are the things that can motivate me when I am struggling, right? And just to kind of put it up there. And you know, I had one athlete just put it above their bed, right? So before they go to bed, they walk in and they see it up there and they just kind of start visualizing and mentalizing, you know, the experiences that they want to have or the goals that they have. And you know, there's a I know Viana just mentioned about you know meditation and so forth. There is a big piece that visualization also plays in performance, right? Can you see yourself doing an action? What does that action look like, right? So that when you physically go out to try to um duplicate it, you can have that success, right? So just trying to push a little bit of that.

SPEAKER_03 33:30

Yeah, that's a great tip. Give you something positive to look forward to and work towards.

SPEAKER_00 33:35

Visualization not only helps with skill practice, but what I'll often invite athletes to use visualization for is what's called stimulus response, which is how do you prepare for the hard time? How do you how do you want to respond to that hard time? And how do you visualize yourself responding when that happens? And so it really gives athletes a framework to not be blindsided by experiences or sensations in the body that they've already practiced in their mind what they're gonna do. They've rehearsed, okay, so when I'm feeling these things, I go to this place. I remind myself of my goals and values. Um, to piggyback off. But Ralph's story, I was working with an athlete. They ended up going D1 in their sport, very happy about it. And they said, you know, Pete, I'm I'm finding that in the middle of competition, I just have no energy. I just kind of like quit on myself. And so we're talking through it, and I said, Well, what well, what are your goals? And they said, Well, my goal was to go D1. And I said, Well, do you have any goals now? No. And kind of what with the turning point from our work with them was like you you you didn't have any goals, and that's kind of why you're deep feeling flat, demotivated. And so let's find some new goals based on where you're at now versus you've already accomplished it.

SPEAKER_02 34:58

I'll just add to a piece that comes from cognitive behavioral therapy that I end up using a lot is the idea of like self-talk and thought stopping, right? It's amazing how oftentimes people either aren't aware or don't actually have a voice in their head. And it's one tool that we can all use within sport or outside of sport, right? That idea of talking to yourself, talking yourself through it, just like with this idea of visualization, right? Like helping yourself get to that place of calm. Uh, and I always say it could just be a neutral thought. Like we don't have to be the best. We don't have to, you know, I'm not gonna go out there and necessarily be the top person, but just I can do this. I've been practicing for this, I know I got this, I can do this. Um, but sometimes, again, we have a lot of negative chatter in our head, so trying to turn that into either a neutral voice or a little bit more of a positive voice without putting on that extra pressure, but using that self-talk for your your internally is super helpful.

SPEAKER_03 36:00

Yeah, and those are just simple things that athletes can start implementing to their daily routines.

SPEAKER_00 36:04

I heard a um a sports psychologist say once, uh, your job as an athlete is not to be positive, it's to manage negativity. And when we talk about confidence, you know, I I'll usually frame it as like pillars of confidence. Uh if you want to build and maintain confidence, uh, that's usually based on three things your preparation. Uh you can positive self-talk or your your way forever. But if you are not preparing through the things that we mentioned and all the X's and O's and getting into the gym, it's not going to matter, right? So preparation is critical. Uh, your self-talk, like Viana said, and then orienting your mind to your effort versus the outcome. You know, bringing the conversation back to earlier, you know, all these concerns about going D1. I was meeting with an athlete, and they would say, you know, I'm doing really well in the beginning of a competition, but then like some way through, I just lose steam, and you know, I'm losing to people who I feel like I should be beating. And I said, Well, well, where's the mind? You know, where's the mind? The mind is, well, if I lose this point, I might not be able to go to that college I want to. That is a mind that is not in the here and now, going back to mindfulness and being in the moment. That is a mind that is off into something that's completely out of our control. And so we want to invite the athlete and their staff, you know. This goes back to kind of the culture of a team and coaching. You can cue athletes to be doing this in terms of how you start to have conversations, even in the beginning of your season. You know, we're we're really focused on being the best we can. You hear coaches, professional coaches all the time. I've heard Nick Saban say this all the time. It's about doing your job the best that you can, right? It's not about everyone else and this and that. It's just about that. And they say that for a reason. Um the mindfulness stuff is critical, you know, it's it's one of those things that's it's for everybody, but not for some people. Uh some it just some people just rubs in the wrong way. But the reason we use that um is because all psychological skills begin with the capacity to pause and be aware. If you can't pause and just check in and be aware of what the mind is doing and be aware of kind of, well, am I are is my decision making consistent with my goals, right? You're it's just gonna feel like it's you know, you're you're stuck in the momentum of the the problem. And so we invite athletes to practice something through either you know, actual form formal mindfulness training or breath work to practice pausing and just checking in. Because if we don't check in, it's hard to make a make a difference.

SPEAKER_03 38:54

It's a great way to break it down. And Nick Saban also did another talk where he was saying about a 24-hour rule. So if you have a bad moment on the field or a bad moment on the court, you not have to dwell on it for more than 24 hours, that was the rule for his team. So it kind of goes back to that, but just being in the moment and taking it point by point and not dwelling on maybe a mistake that you made out there.

SPEAKER_00 39:11

Yeah, yeah. You you want that, you know, most of the people know now because it's so popular, a growth mindset versus a fixed mindset. A growth mindset can take that loss and spend that 24 hours like, okay, so that didn't feel good. Uh what do I need to learn from that? Right? That is a growth mindset versus a fixed mindset, is kind of like, you know, I'm the worst, we're the worst, and like really unable to kind of take from it because going back to identity, when an athlete's struggling with a fixed mindset, their mind interprets loss as a threat to their identity and what's important to them. And so that's why all of these this kind of all of these things we're talking about, they all build on each other.

SPEAKER_03 39:56

Absolutely. So, how can parents encourage progress without applying? Too much pressure on the athlete.

SPEAKER_01 40:03

That's a good one. Parents are ch a challenge. Because, you know, of two reasons. One, their own wants and what they want for their children, right? What they want for their children is to be successful, to um not fail, right? Um and what they might want for themselves is um, you know, whether it's their kid is the best or their kid doesn't have to experience the failure, their kid doesn't have to experience a disappointment, so that's good for them. Um but I think it's important for you know parents, and you know, if I do talks with parents to, you know, remind them to gut check themselves, right? Like what is what is your driving force for why you have your child in a sport, right? And what are we hoping that your child gets out of it and hopefully they're getting things out of it like you know, improved self-esteem, improve confidence, and improved um problem solving, critical thinking skills, all those kind of aspects. But when it's more about um, you know, a goal, like you're gonna go to college, or a goal, you're gonna have friends, or which is not a bad goal necessarily, but when it's more about their goals, that's where I think it's hard for them to just be positive. Right. I think um you we work with parents to be positive about the things that the kid has identified as this is what I'm working towards, this is what I'm working for, right? But at the same time not being more positive than their child is, right? And what I mean by that is like if I want this so bad, right, I'm actually robbing my child of that experience. Right. And so that's almost the the threshold line of how positive can they be so that their child can be still have their thing and be successful.

SPEAKER_02 41:49

Yeah, there has to be that balance. Like they're more invested than their own child is in that situation.

SPEAKER_01 41:54

And it happens, you know. I know I've been at a few sporting events myself where I could see I'm more invested than you know the people playing um on the field, and that's where I have to do that gut check and be like, yeah, I know, tone it down.

SPEAKER_02 42:07

And I think you know, I do this with my kid, I have a nine-year-old boy who plays a lot of different sports, and I try to check in with him, right? Do you want me shouting on the sidelines or not really? Like, what feels good to you? What do you want from me as a parent supporting you? Um, do you want me to talk to the coach about that? Do you want to talk to you? How do you want to handle this? Or do you want to just leave it alone, you know? Uh so really if we can have a strong relationship with our kids, again, outside of sports, right? I I know I keep going back to this idea, but it's so important because if we don't have strong relationships outside of sports, then within the sport, it's not gonna really matter, right? They're not gonna really listen to you or take you sort of seriously, um, or it's gonna be too much pressure on them because oh, you only love me because of my sport. Exactly. Yes. Yeah. So so the idea being let's try to have a strong relationship outside of the sport to begin with, but then within the sport, checking in with our kids again, are you enjoying this? How can I support you? You know, how can we move forward together in this?

SPEAKER_03 43:11

Yeah, they have to know that you care outside of just then being an athlete.

SPEAKER_00 43:15

I I think of it as like your job as a parent is to be their fan. It is not if you are coaching your child on the sideline, that is a time to pause and self-reflect. Um because you know, you're welcome to disagree with me. That's that's not your job. There's there's coaches on the sideline who are there to do that, and it may potentially disrupt what's happening. So, you know, your job is to is to really support them. And uh, I really appreciate Viana's point and um to try to kind of be brief about it, it's a real art on how and when to have conversations, especially when things get more intense, like in high school or even some sports younger than that, when the athlete starts to really get invested and they feel like the outcomes are really important, um, on how and when to just talk about it. You know, um I've heard a lot of professional athletes talk about, you know, the dreading the car ride home. Because instead of it being, you know, when I'll coach parents about it, instead of it being like, okay, so what do you want to eat? What do you want to get some? How about some ice cream? You know, what about um instead of that, it's all the things that could have, you know, woulda, woulda, shoulda, coulda. And that is um very understandable going back to Ralph's points and Viana's points, because we want, we sometimes want our kids to succeed. Um, but that's oftentimes really not what the athlete needs. The athlete needs some time to to sit with it. And I think if you know, going back to my point of like coaching your child on the sideline, we have to let our kids fail. Right? That's you see this in other cultures that are much more that where this is part of their education, that it's letting your kid just make the mistake, right? Because of why sport is really useful is because they learn how to practice self-awareness and get feedback and not take it to heart, right? We don't want to deprive them of that because those are those are developmentally critical skill sets for if they want to continue in sport at a higher level where it's gonna get, you know, people are not gonna be as gentle, right? Or just going into the workplace.

SPEAKER_03 45:33

And those are such critical life skills that they can take into the adult world that they learn in sports. So are there specific resources that families should know about locally or within healthcare systems?

SPEAKER_02 45:46

No, no, go ahead. One that comes to mind for me, right, statewide is 211. If we're ever having any sort of emergency where we're feeling like we I don't know how to manage this situation and uh my child is in a crisis sort of situation, 211 is a great resource immediately that comes to mind.

SPEAKER_01 46:06

Yeah, and while you're saying that, this was not where my initial response is going to be, but I will say that you know Hartford Healthcare is one of the, you know, largest, has one of the largest behavioral health uh networks in the nation, right? And pretty much Harford Healthcare is everywhere. And so within grasp of every school system, there should be, I'm gonna say, a local Hartford Healthcare behavioral health network close by, and that's always a touch point whether you reach out to the Access Center and say, hey, I don't even know where to begin. That's a starting point. But then also if we were to scale it down, and this was my initial uh response was gonna be every school has, you know, a guidance counselor, a department, a social worker who is skilled and trained in resources for behavioral health support for athletes and all their other students. So that's where I would Yeah.

SPEAKER_03 46:57

There's always someone to reach out to for help and someone who cares. So is there one last message that you would share to young athletes about mental wellness and what would it be?

SPEAKER_00 47:09

I'm gonna spoil something. You gave us some of these questions beforehand to prepare, and this was the one that kind of stumped me because I I'm reflecting on kind of my experience as an athlete, and I'm not sure I could condense it to one statement because there would I would want to sit down and have a conversation with young Pete and say, listen, you know, um sport is great. It's really important, um, but that's not the most important thing about you. And just because maybe people haven't said that out loud to you doesn't mean it's not true. Right. So we want them to understand that, yes, hey, sport is great, and being connected to a team is great, and you are a person that regardless of whether you win or of your stats or whatever, you have value, right? And and that's kind of that in and of itself is a skill where now we don't feel like our confidence is teetering on performance. And you know, I made the choice to to do kind of tough sports growing up. I played football and rugby and you know, stuff like that. And uh, and I'm not sure if I could have heard it, but someone saying, listen, you know, maybe balance some of that tough stuff out with some gentleness towards yourself, right? And uh I'm not sure he could have heard that, that young Pete back then, but um, and it might have been like simple stuff like, you know, take care of yourself and you know, watch how you talk to yourself in your mind, you know, going back to what Fion had said. And um it goes back to some of that basic stuff too, you know, eat and sleep, and you know that that yeah. I I I guess I'm uh I'm showing how non-eloquently I respond to that question, but because I'd want to pack in a whole bunch of different points to really give them something to deal with any situation, right? That and when I'm working with athletes, the way I'll kind of frame things is that we want you to feel like you can perform through anything rain, sleet, panic, whatever, right? That you can perform through it. And that's what I would want them to understand by giving them a really strong base.

SPEAKER_02 49:23

That was a good answer.

SPEAKER_00 49:24

Thank you.

SPEAKER_02 49:25

I mean, and I think that speaks to that idea of like you are more than just your sport, right? Like you are a whole person, a whole human being, uh, and taking really good care of yourself in that way. And I think one of the things that also brought to my mind is the idea of when I've worked with high school students and college students, and so much of them are driven by my parents say I should be a lawyer, my parents should say I should be a doctor, or you know, go to D1 or whatever it might be, right? That idea of is this what you want? Yeah, right? Like, is is this this is your life? You're the one that's gonna have to step out on that field, that court, go to that bio exam, right? This is you and your life, and sometimes, and again, this is work that we do, you might have to advocate for yourself and go against what your parents want. That's really hard. That's really hard as a young person, especially if you're depending on your parents financially and you know, shelter and all that sort of stuff. But sometimes advocating for ourselves and taking care of ourselves outside of sports and outside of what our parents want is the most important thing that we need to do for ourselves.

SPEAKER_01 50:36

And mine is very simple. Um, and Pete stole it a little bit, but one, be kind to yourself. Yeah. Right? Just be kind to yourself. And the second part is don't let anyone steal your joy. Right. Um, having played sports and done it, I remember a time when I no longer enjoyed the sport that I was doing. And I was still going and competing, competing at a high level, but it I made the decision. I'm like, yeah, I'm not gonna do this anymore because I was I that joy was gone, and it was because of decisions that other people make, whether it's the and I'll be honest, it was coaches, right? Yeah, um, because coaches are often where can it was track as a sport? Um, where can we get up points? Where can we do this? Instead of what does my athlete want to do and where's my athlete excelling? So, you know, be kind to yourself, don't let anyone steal your joy and hold your own.

SPEAKER_03 51:24

So great sentiments. And I liked how each of you mentioned as well that you know you're greater than the game. There's a purpose outside of sports. We all have a purpose here on earth, and it all goes beyond sports. So that's a I really appreciate you all mentioned that. So before we wrap up, is there a way for viewers to get in contact with each of you in your offices and use Hartford Healthcare's resources?

SPEAKER_00 51:44

Yeah. Our our uh usually the way it works is um and for a student athlete or athlete to connect with us, they probably have to be kind of connected to one of the schools within um who in who we have contracts with. Uh but sometimes we can we can definitely um make make exceptions to that and and see athletes who who need some help. So um you can contact us. Our our front desk is uh 860-972-5945. I don't have our fax number memorized. I apologize for that, uh, even though I've been there for you know since 2018. But um yeah, you can call us and or I think there's a there's a way I uh I'm not sure exactly on the like the bone and joiner support medicine page to kind of send an email to the system that we'll receive. Um so there's phone numbers and you know that you can call to reach out.

SPEAKER_03 52:43

We can put specific information in the description. That would be great. Yes, yeah.

SPEAKER_01 52:46

Yeah, and I was gonna say, as I mentioned earlier about Hartford Healthcare and the Access Center, if you call the Access Center and say this is where I'm trying to go, they'll figure it out. Yeah, yeah. They'll direct you.

SPEAKER_03 52:55

Yes. Well, Hartford Healthcare has always been such a great supporter of CIC student athletes. So I thank you all for joining me today on this podcast. It was such an important conversation that we were all able to have today. So thank you.