Aims:
To assess your ability to apply knowledge of common mental health disorders and intervention approaches to the case formulation of an
athlete, including predisposing, precipitating, maintaining, and protective factors.
To assess your ability to relate psychological theory and evidence to propose a basic intervention plan for improving the mental health of the athlete.
Instructions: Based on the case description below, formulate the case by drawing on psychological theory and research, and develop a basic intervention plan.
Elements to include:
Formulation:
Integrate the case history into a particular theoretical framework to convey your understanding of the nature of the athlete’s presenting issue, how it developed, how it is being perpetuated/maintained, and what personal strengths/protective factors are available to help the athlete to move forward (e.g., by reducing the chances of the presenting issue continuing).
Consider the athletes’ perspectives of their current situation, their expressed needs and hopes as well as any key events and contextual influences in their life that are relevant to the issue(s) to be addressed.
Combine your ideas into a concise, integrated formulation statement that will underpin your working hypothesis(es) for the intervention plan.
Intervention plan and evaluation:
A basic intervention plan and a rationale for choosing this evidence-based approach. Explain how the formulation informed your intervention plan and briefly describe the key components of the intervention.
The intervention should have a clear beginning, middle, and ending but a session by session account of what the intervention will include is not needed.
A plan for quantitatively and/or qualitatively evaluating the success of the intervention and your predictions for how the intervention might progress. Consider what issues or problems might arise during the intervention based on the athlete’s case history and your understanding of the intervention approach? For example, are there barriers or enablers that you will need to consider for this athlete to more fully engage with the intervention?
Reference list: Include all (and only) sources cited in the text.
Appendix: You may include up to a maximum of 2 tables/figures (e.g., to illustrate your case formulation, present a timeline of key events in the athlete’s life that are relevant to the formulation, give an overview of the intervention plan). Please note that the appendices will not be considered when marking the formulation and intervention & evaluation elements of the marking rubric so should not be used to extend the word limit. All essential information should therefore be included in the main body of the report.
Style and Formatting: Using appropriate sub-headings, your case formulation should be a maximum of 1500 words (not including reference list and appendices), double-spaced, and in 12-point font. A consistent formatting style should be applied throughout the report (e.g. Harvard, APA 7th edition), and you should ensure that the sources cited in the text also appear in the reference list.
Case Description:
Corbett* is a 21 year old elite male rower who has been selected for the U23 GB squad. Despite coming from a working class background, he fell into the sport while at school and trained at the local club. He started to take rowing seriously at 16, winning medals at the national champions as a junior and competed at the world championships. Despite his gritty determination and inner strength to train hard, Corbett’s performances started to decline in the next two seasons and a loss of confidence in his ability to race soon followed. But just as his dream of competing at the Olympics seemed dashed, Corbett’s then coach suggested that he make a switch to competing as a lightweight.
Although this change meant having to lose about 14-15 kg to compete, Corbett believed this was a small sacrifice to achieve his goals. He also didn’t have much of a back up plan if rowing didn’t work out. Sport was everything to him and where he felt he belonged. Being the best helped him to feel accepted and wanted. In contrast, Corbett always had struggled in School and had a poor relationship with his dad who was often away on work trips. Although his mom was supportive of his rowing, she was also kept busy by his 4 younger siblings. Instead, his youth coach became a surrogate parent to Corbett and the club was his family.
As a lightweight, Corbett’s performances soon earned him a place on the U23 GB squad. But he struggled to make the weight requirements and would regularly be told off by the high performance coaching team if he put any weight on. Rowing has very strict rules for how much a light weight rower must weight in order to compete, and Corbett lived in fear of letting the squad down. He was willing to try just about anything, including working with the squad’s nutritionist. Unfortunately, the diet plan given to him to follow just didn’t work and he became increasingly frustrated with himself.
Things came to ahead when returning from the Christmas holidays. Corbett had been told to lose 5 kg over the break, but instead put on 2 kg. The threat of being kicked off the squad hung heavily over him, and he started to weigh himself 5-6 times per day. Keeping to a very low calorie diet was very hard but he found eating a large breakfast and making himself sick and sweating down by doing several hours of cardiovascular work each day (while wearing several heavy layers) helped to keep the weight down. Other weight control measures soon followed including a rigid diet and using laxatives. Despite this, Corbett never felt like he had an illness but was just doing what was needed.
Although the coaches were happier with his weight, they were not aware that Corbett was undertaking such dangerous and unhealthy eating behaviours. He kept it a secret and felt ashamed of what he was doing to stay competitive. He started to feel miserable and depressed and was encouraged to see the sport psychologist. But Corbett gave up on this support after several sessions because he felt that the sport psychologist was trying to get him to think about too many things. He instead preferred to bottle things up and block out his problems.
It was only when routine physical tests revealed several indicators in his blood of poor nutrition and laxative use that his coaches began to suspect that something more serious was going on. When coupled with his training diary reporting weakness and fatigue and high scores on the Eating Disorders Screen for Athletes (EDSA), the extent of Corbett’s problems became much more. Through British Rowing, Corbett was referred for more extensive screening and specialist support and he was found to meet the clinical criteria for bulimia nervosa.
References to use
Eichstadt, M., Luzier, J., Cho, D., & Weisenmuller, C. (2020). Eating disorders in male athletes. Sports Health, 12, 327-333. https://doi.org/10.1177/1941738120928991 (Links to an external site.)
Gapin, J. I., & Kearns, B. (2013). Assessing prevalence of eating disorders and eating disorder symptoms among lightweight and open weight collegiate rowers. Journal of Clinical Sport Psychology, 7, 198-214. https://doi.org/10.1123/jcsp.7.3.198 (Links to an external site.)
Hazzard, V. M., Schaefer, L. M., Mankowski, A., Carson, T. L., Lipson, S. M., Fendrick, C., … & Sonneville, K. R. (2020). Development and validation of the eating disorders screen for athletes (EDSA): A brief screening tool for male and female athletes. Psychology of Sport and Exercise, 50, 101745. https://doi.org/10.1016/j.psychsport.2020.101745 (Links to an external site.)
Karrer, Y., Halioua, R., Mötteli, S., Iff, S., Seifritz, E., Jäger, M., & Claussen, M. C. (2020). Disordered eating and eating disorders in male elite athletes: a scoping review. BMJ Open Sport & Exercise Medicine, 6, e000801. http://dx.doi.org/10.1136/bmjsem-2020-000801 (Links to an external site.)
Limbers, C. A., Cohen, L. A., & Gray, B. A. (2018). Eating disorders in adolescent and young adult males: prevalence, diagnosis, and treatment strategies. Adolescent Health, Medicine and Therapeutics, 9, 111-116. https://doi.org/10.2147/AHMT.S147480 (Links to an external site.)
Quatromoni, P. A. (2017). A tale of two runners: A case report of athletes’ experiences with eating disorders in college. Journal of the Academy of Nutrition and Dietetics, 117, 21-31. https://doi.org/10.1016/j.jand.2016.09.032 (Links to an external site.)
Stoyel, H., Delderfield, R., Shanmuganathan-Felton, V., Stoyel, A., & Serpell, L. (2021). A qualitative exploration of sport and social pressures on elite athletes in relation to disordered eating. Frontiers in Psychology, https://doi.org/12. 10.3389/fpsyg.2021.633490
