Psychology

John Smith is a 23 year old American Professional swimmer who has been infamous for his speed and teamwork. Over the years their team had won various international swimming events in 4x 100 medley races. John Smith excels in backstroke leg and he currently holds the record of 53.85 sec. His team relies on his short relapse time for a particular distance. His speed is a one of the factors that brought their American Swimming team to glory. However after the teams success for 1-2 Olympic seasons, his coach has noticed that his performance level has significantly decreased over their current competitions. The athlete and team player they knew, has began to drag the team down.  His speed has slowed and consequently affected the whole team. He particularly underperformed under highly important swimming events.

John Smith has sought my assistance on February 13, 2010, Friday. He has called in my office and booked for an appointment. We both agreed to meet on the following week February 9 2010, Monday at nine in the morning. I gave him my office address.

This is what transpired when John showed up for our appointment
Tara Well you must be John, welcome to my office Im glad weve finally meet
John Same here, nice to meet you as well.  I must say Im impressed with the design of your office
Tara thank you, John. A lot of my clients half expected to stumble upon a Freudian- influenced coach (manage to elicit a smile from John). You have a very keen observation. And that shirt looks good on you

John thank you and Im very glad to finally work on the issues that concerns me right now
After our initial conversation which functions to entrenched rapport, I proceed with the formalities. I stated my degree in sport psychology at Yale University, and that I am well versed in the issues that he is facing right now, since I am also an athlete during my prime. I told him that my 5 years experience in mental training has made me legible in providing assistance to athletes who are undergoing different dilemmas. We also tackled for the fees of every session.

I asked John what he wanted out of these sessions, as a framework for the following weeks. John stated that he wanted to regain the speed and performance that he been known for. I asked him to specify his objectives for our next meeting.  At the end of the first session, both of us agreed to meet every Monday at 9 in the morning.

Second session   John came in the next session with specific goals in mind. First, upon finishing the sessions he wanted to regain his speed. Second, he wanted to recover his confidence in his skill, and regain the trust of his team. Lastly, rebuild his image as highly performing swimmer and a team player.  I specifically asked him to identify the current elements that hinder the realization of these goals. He mentioned that he couldnt perform well because he experiences uneasiness, stiffness in muscle groups and extreme discomfort. He even recalled an event where he felt extremely conscious on the movements of his arms and legs and breathing, when he was doing his backstroke. I explained that he is experiencing arousal associated with anxiety. I saw the need to focus on the elimination of his anxiety, since addressing such problem could be the key in accomplishing the goals that he specified.
 
I let John took two self report measures, namely Competitive State Anxiety Inventory-2 (CSAI-2) and Sport Competition Trait Anxiety Test (UCAT) to asses his trait and anxiety levels. The result indicated that John has a high state anxiety and a low trait anxiety. This would help me in identifying appropriate cognitive and behavioral techniques to apply in his case.

I explained how anxiety has affected his performance and asked him to identify its sources.   He mentioned that he feels pressured by his coach and teammates, he oftentimes feel that he carries the weight of the teams victory on his shoulders. I assured him that we would work together to address these sources of anxiety.

In this session I have accomplished 2 goals assess the nature of Johns current concern and its corresponding sources.  I give him the homework of identifying ways to alleviate the disastrous effect of arousal in his performance. This functions to prepare him for the next session.
Third session   The first goal of this session is to present strategies in coping with his negative perception of arousal. I explained that his conception that arousal causes a decrease in performance is manifested into actions behavior.  However this could work in his advantage. I suggested that he begin to treat arousal as a component that could elicit increase performance. I advised utilizing positive self-talk. For instance he could say that I can use this level of arousal in my advantage, or I am a record breaking athlete who thrives with this level of arousal. It should be noted that John is simply correcting his faulty assumption about how arousal affects his performance. Adhering to the inverted-U shape, arousal becomes detrimental when it has passed its maximum point.   An athlete only requires an average level of arousal to preform well.

I introduced two types of anxiety, namely somatic and cognitive. The former, refers to the physiological tension felt by a person such as sweating, muscle tension, and irregular breathing. On the other hand cognitive anxiety is manifested through extreme fear and worry, doubts, and  negative thoughts. John mentions that that he experienced both types of anxiety. This occurs simultaneously, he usually feels the tension of muscle groups and other bodily discomfort followed by extreme worry that he would not be able to performed well. I suggested mental imagery, where he would be asked to imagine an anxiety-provoking situation. He could visualize that their swimming team is closely tied with another team. This technique would reduce his anxiety since he would likely devised actions that would be applicable in real life situation.

The second goal is to identify his physical and psychological state between his worst and best performance with the aid of Checklist of performance states that I gave him. This is the first step towards greater awareness of how anxiety has affected his performance. He stated that his worst performance is associated with uneasiness, self-doubt, lack of concentration, and fatigue, while his best performance is characterized by the absence of those elements. John admitted that he wasnt even aware of this discrepancy, and this checklist has given him significant insights.

As homework, I asked him to employ catching-oneself or detect and stop thoughts that lead to dysfunctional behaviors.  I encourage him to continually adhere to the techniques that I taught, and evaluate his current performance during practices.

Fourth session   I assess the effects of the techniques being used, and suggested that he work further on changing both his behavior and cognitions to reduce the anxiety. I introduced Progressive relaxation technique which facilitates relaxation of muscular tension.  I asked John to sit or lye in a comfortable position, close his eyes and alternately tensed and relaxed muscle groups.  With the eyes closed I let him focused on the sensation of tension and relaxation. It provides relaxation and anxiety reduction.  Through this method he would be used in differentiating the sensation of tension and relaxation. He could employ breathing control to ease the detected tension. This method is characterized by shallow and calm inhalation and exhalation

I told him to close his eyes, and focus on his breathing. I presented a scenario where their team is competing for a gold medal and his performance would make a difference between a win and a defeat.  He must completely immerse himself to such situation, and then employ this controlled breathing. I instructed him to inhale and exhale in a rhythmic way. I asked him for a cue that would instantly trigger this relaxation technique. He preferred to use the memory of the blue-colored wall of my office.
At the end of the session, he agreed to master the techniques that I taught him, and observe its effects. I want to assess the improvement that John is making, and suggested that we conduct our next meeting in venue of their swimming competition.

Fifth session   I headed to the venue where Johns team is playing. Prior to the game I asked him to answer CSAI-2 to measure his state anxiety. The result indicated that the techniques that I been employing are working. As the game is about to begin I asked him to apply the techniques that he learned, namely positive self-talk, mental imagery, breathing, catching oneself  and various anxiety reduction techniques.

I talk to Johns coach regarding the overwhelming pressure John felt in winning. This is due in part to the outcome goal orientation that he has adopted, rather than a task goal orientation. I suggested that his coach begins to recognize and prioritize Johns effort rather the outcome. Since this is already affecting Johns performance.  I advised that giving intangible rewards like praise for a faster speed is a good way to resolve Johns confidence issues, and additionally emphasize that his efforts are credited. In the game I noticed that John has used the techniques efficiently as he aces other competitors. He has controlled breathing and confidence. His level of anxiety has significantly reduced based on my assessment on his performance.

After the game I asked him how he thought the competition went, and he is apparently satisfied with his performance. He stated that he feels he has performed to his optimum level. I set our next meeting back to my office, and ask him to evaluate his current performance.   I also inform that we will proceed with the assessment of the techniques, and decide if his goals have been accomplished.
Sixth  session   My goal in this phase, is to identify if John has accomplished  the objectives that he set during the first session. I intend to utilize his evaluation to identify if his objectives have been accomplished. John stated that he has regained his speed, recovered trust among his teammates and rebuilt his image as a highly performing swimmer. This is a good manifestation that the techniques employed are effective.  However he felt that he further needs my assistance in mastering techniques. He also feared the possibility of spiraling down or relapsing to old ways. We both agreed to extend 3 more sessions to master the techniques and increase his confidence.

To utilize the remaining psychological training I suggested that he specifically state personal new goals. In addition I encourage him to set process goals where he could focus on the actions for desired outcome. I challenged him to take moderate to difficult yet feasible goals, for instance beating his time record by 2 sec. for each competition.  His goal should be classified as a long term or a short term goal. The long term goals are at top of the staircase while short term goals connect the top to bottom stairs. This staircase technique provides an insight into his progression.      

The succeeding session provides an opportunity where I could stress the need for him to be independent. He should be able to manage his current and future concerns without my assistance. Additionally he stated that he would definitely master the techniques with the time given.