Tag Archives: sports counseling

Life after sport

By Kris Amos November 16, 2021

I will never be the same. I have struggled with reshaping my identity after being separated from sport due to injury. 

As a track and field athlete, where overuse injuries are most common, I did not consider myself to be at significant risk for a career-ending injury. However, athletes can also incur life-changing injuries outside of their sport, as I experienced firsthand when a drunken driver traveling the wrong way down the freeway crashed into my car head-on. 

Personal background

For me, growing up on the west side of Detroit, success meant making it in sports or music. I moved out of Detroit at the beginning of high school and began competing as a track and field athlete. That’s when I discovered my love for the high jump. The thrill of competition was a sensation that brought me life. It provided me a sense of accomplishment, belonging, identity and passion. Competing as a high jumper became a career goal, and when I graduated from high school in 2007 and was offered a scholarship to compete as a track and field athlete at Michigan State University (MSU), I was one step closer to that goal.

My athletic career was promising. I earned a varsity letter my freshman year after finishing sixth in the high jump at the 2008 Big Ten Outdoor Championships with a jump of 2.07 meters. At the time, the competition level in the field events in the Big Ten Conference was very high, and I managed to have the top placement by a freshman at the meet. I barely missed the qualifying standard for the regional championship but was reassured by the fact that I was only a freshman. 

That was until Aug. 20, 2008. At approximately 1:30 a.m., I was driving 75 mph on cruise control heading back to campus when I noticed headlights traveling toward me at very high speed. I was only able to cover my face as my perception of time slowed right before our cars collided. I woke up to a woman knocking on my window, attempting to get my attention. My head was on the steering wheel, the airbags were deployed, and the windshield was crushed in toward my face. I was pulled out of the vehicle through the window and transported to the hospital for surgery. Among the many injuries I sustained were a traumatic brain injury and an extensive injury to my right knee. This was the leg I used to launch myself in the high jump event.

I learned later that the drunken driver had entered the exit ramp and begun traveling in the wrong direction on the highway before colliding with me head-on. After I was struck, a third car hit the side of my vehicle before colliding with the drunken driver. A passenger in the drunken driver’s vehicle died, and the passenger from the third vehicle had a miscarriage. I didn’t really appreciate the extent of my injuries at the time, in part because I was eager to return to competition. Concussion/brain injury protocols were not as established in the NCAA then as they are now, and although I was offered an opportunity to redshirt (to sit out a year without losing any of my collegiate athletic eligibility), I was ultimately allowed to compete. 

I was not the same. I began drinking alcohol daily, including when I woke up, before and after practice, and before I went to sleep. I finished the following semester with a 0.7 GPA, which led to me being declared academically ineligible and dismissed from the team. 

Since then, I have had five surgeries on my knee, several injections and procedures, multiple therapies, and various forms of treatment for my brain injury and chronic pain. I barely graduated from MSU in 2012 with a Bachelor of Arts in psychology and a 2.1 overall undergraduate GPA. My hopes of going to graduate school were crushed when I received a denial letter from the school to which I had applied. After explaining my situation to the program director at the University of Detroit Mercy, I was admitted to the graduate certificate program in addiction studies. After successfully completing the program, I moved to Chicago to attend the Chicago School of Professional Psychology. It was during my clinical internship at Columbia College that I discovered an opportunity to get back into sports. I graduated with a Master of Arts in counseling psychology in 2017 and moved back to Michigan to begin working at MSU.

I am currently a licensed professional counselor at MSU’s Counseling & Psychiatric Services center. I have attempted to reshape my athletic identity by providing mental health services to athletes through advocacy, education and counseling. This has helped me to re-create a sense of purpose that is aligned in sports and consistent with my athletic identity. After learning about existential psychology through my coursework, I began to research its application in sports and have found it to be helpful, both personally and professionally. 

Career-ending injuries

Career-ending sports injuries are representative of an existential crisis. They can have a devastating impact on the individual athlete, the athlete’s team, the athlete’s family and even sports fans. According to Stanley Herring et al. (2016), irritability, sleep/appetite changes, pain, depression and other adverse effects can occur following a sports injury. Not surprisingly, this can be a challenging adjustment for some athletes.

Participation in sports provides athletes with social connection and a sense of identity, meaning and belonging. Athletes are more than the tasks required of them in sports; athletes are also people. We as a species have yet to answer undeniably the big philosophical questions of life, one of which is “Why am I here?” This existential question has barely registered in the field of sports. However, from my perspective, the existential model would seem to be an appropriate fit when treating and supporting athletes who have been separated from their sport due to injury. 

According to the National Safe Kids Campaign and the American Academy of Pediatrics, more than 3.5 million sports injuries are estimated to occur each year among children and teens. A career-ending injury can encompass an unexpected injury, illness or death that prevents an athlete from participating in a sport. An epidemiology study published in 2016 by Jill Tirabassi et al. found that career-ending injuries made up 6% of all injuries captured from 2005-2014 among high school athletes. Studies published in Athletic Insight: The Online Journal of Sport Psychology have suggested that sports career termination should be viewed as a transitional process occurring from the beginning of athletic involvement through post-athletic participation. This transitional process fits well within the existential sport psychology model. 

Existential sport psychology

In a 2015 article, Noora Ronkainen and Mark Nesti discussed existential sport psychology being defined as the process of understanding the subjective reality of sport participation and the meaning assigned to experiences. They described the model as an attempt to understand and embrace the complexities of human life without attempting to “fix” or conquer them. 

Existential psychology is centered on several major concerns: death, meaning, identity, isolation and freedom. Identity and meaning are especially important for elite athletes, given that their identity is generally tied to who they are as athletes. Meaning has sociocultural influences, and the culture of sports is embedded in the value placed on it by society. This would suggest that sports participants also have value and meaning assigned to their participation in sports. 

However, consistent with themes described in 1980 in Irvin Yalom’s Existential Psychotherapy, athletes who experience career-ending injuries may experience a sense of meaninglessness, anxiety and a loss of identity. From this perspective, meaninglessness can be followed by behavioral patterns such as the misuse of alcohol and depression. This is often described as “existential neurosis.” These behaviors appear consistent with the symptomatology athletes can experience following separation from their sport. 

As discussed in Nesti’s book Existential Psychology and Sport: Theory and Application, this model encourages people to accept freedom and responsibility in their lives and to live authentically despite experiences that increase anxiety. For injured athletes, this means beginning to accept the freedom in choosing to confront their injuries, and it provides them with a framework to view themselves as people who also identify as athletes. 

Research published in 2016 by the Scandinavian Journal of Medicine & Science in Sports found that many athletes have been defined by descriptors such as age, gender, level of performance or type of sport. From an existential perspective, these descriptors are very limiting. Athletes are a diverse group of human beings who have dedicated themselves to participating in a sport. Sports participation can be an outlet for developing life skills, building community and social relationships, becoming leaders and much more. 

Furthermore, athletes belong to a culture of competitors and sport participants that is centered on a common identity. This identity is not an athlete’s only identity, but neither does this identity cease to exist following an injury. Therefore, existentialism in sport may present an opportunity for athletes to discover how their athletic identity is expressed outside of competition and sports participation.  

The Application of existential psychology in sport

The application of existential psychology in sport appears to be a model that can empower injured athletes to view themselves as more than athletes separated from their sport. Some may label themselves as “former athletes” who are still elite members of society possessing unique characteristics, talents and skills developed from participation in sports. The years of training, effort and energy expended in the process of becoming elite athletes can be transferred and applied outside of the sports context. 

Although research in this field is limited, existential psychotherapy is a well-documented approach to treatment that is gaining interest in sport psychology. This rehabilitative process involves encouraging athletes to be more authentic in the therapeutic relationship. Encouraging athletes to be more of their authentic selves may help to reveal characteristics about their identity not expressed in the sports environment. 

If an athlete is separated from a sport due to injury, their sense of identity may be lost as they transition. Practitioners can assist in this process by facilitating an environment that encourages athletes to explore their meaning and purpose. The athlete’s beliefs and assumptions regarding the injury and what it means to be separated from their sport can be discussed to continue the existential process. Uncovering beliefs and assumptions associated with being injured may also help the athlete conceptualize thoughts, feelings and attitudes that contribute to maladaptive experiences.

As athletes gain more insight, they begin to identify how their beliefs and assumptions are contributing to the distress they may be experiencing. They can be invited to confront the conflict associated with being injured, the change in their identity, the loss of meaning/purpose, and how it all fits within their role in society. Elite and recreational athletes may have their identities shaped by the daily activities associated with sports participation, the social connections made within their sport community and the cultural expression involved in the sport community. These athletes’ purpose in life was heavily influenced by the interaction of these factors, and their injuries may have completely disrupted how they view themselves in society. 

Strategies organizations can offer

The organizational sports environment influences athletes’ well-being and sense of community. In an ideal world, organizations would assist athletes separated from their sport by providing helpful resources. Offering these tools can help athletes better adjust to and deal with the uncertainty associated with career-ending injuries. Organizations can foster an atmosphere that is supportive of their injured athletes by continuing to celebrate their contributions and achievements once they are no longer participating in sports. 

Further action can be taken by recognizing that injured athletes are still athletes and that their community belonging does not change because they have sustained an injury. This could be demonstrated through messaging in the organization’s mission/vision, by offering roles to injured athletes upon separation from their sport, by providing support groups, and by encouraging the intentional development of life skills. Counselors in this role can facilitate this process by helping athletes and other stakeholders to identify how they relate to society as a whole. Preventive methods can be implemented by maintaining sport participation safety, taking steps to reduce burnout and overtraining, providing psychoeducation, ensuring a safe return to play from previous injuries, and promoting athlete wellness. 

Practitioner strategies

Athletes are often taught to accept the realization that they are no longer able to participate in sports following injury or health concerns. But life after sport doesn’t always have to be about “letting go” of the athletic identity. Being an athlete is about more than having the ability to compete at the same level experienced prior to injury. It means that one has committed to a lifelong journey of self-improvement while striving to bring out the best in others. Given the tasks required in sports, this is typically focused on the activities necessary for sport performance. 

However, many options can still exist for athletes separated from their primary sport. Practitioners can encourage options such as adaptive sports, which can provide a sense of purpose that aligns with the athlete’s sports identity. This also creates the opportunity to normalize participation in adaptive sports. Not every injury leads to permanent dysfunction, but the existence of adaptive sports challenges the idea that injured athletes are no longer able to participate in competitive sports. 

Clinicians can also continue to implement strategies and techniques that reaffirm the athlete’s identity and purpose. Athletes can be encouraged to take ownership of their freedom to make choices and transform their injury experience into new meaning. This can be accomplished through the therapeutic relationship by fostering an empathic and authentic environment that assists the athlete in confronting the choices associated with their injury. 

An additional strategy clinicians can use involves incorporating concepts of spirituality into the existential sport psychology practice. Athletes can be encouraged to define spirituality, which may provide an opportunity for them to reflect on their relationship with themselves, others and that which is beyond our understanding.

Applying the athlete’s mindset

Life after sport does not have to mean “acceptance” of a life that fails to provide the same level of renown as sports. From personal and professional experience, I can confirm that being an athlete means that you compete against the odds, and as an athlete, you recognize that you cannot allow self-defeating thoughts or negative feedback to dictate your performance. Instead, you must use it as fuel to reach the next level. 

Having an athletic identity means striving to become the best at what you do and doing what needs to be done to get there. It’s about the process. It’s about becoming a better version of yourself by exercising the determination and motivation to become the best. Because as an athlete, you know there is always a chance that you will fail or lose, but you do not let that stop you. That’s why you were able to reach the level of success that you attained — because you did not give up. You continued to be relentless in pursuit of your goal, even with the knowledge that you might have to enlist a backup plan. You may no longer be directly involved in the activity that once gave your life meaning, but the mentality you developed along the way is still a part of you and can be applied in various situations.

Regardless of whether you are still able to participate in your chosen sport, you are, and always will be, an athlete.




Kris Amos is a licensed professional counselor and national certified counselor practicing in Michigan. He works full time as a staff counselor at Michigan State University’s Counseling & Psychiatric Services center and is the founder and owner of Precision Counseling PLLC, a private practice dedicated to providing professional counseling services. Kris provides individual counseling, group counseling, couples counseling, biofeedback, neurofeedback, mental performance training and educational workshops to the Michigan State community. Contact him at amoskris@msu.edu.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Game, set, mental health

By Lindsey Phillips July 13, 2021

Naomi Osaka in 2015. Mai Groves/Shutterstock.com

Tennis superstar Naomi Osaka joined the growing list of athletes who are putting their mental health first when she decided to withdraw from the French Open in May, a few days after being fined for refusing to participate in post-match news conferences with the media. She shared on social media that her decision was made to protect her mental well-being, noting that she has suffered with depression since 2018 and experiences anxiety over speaking with the media.

In a recent New York Times article, Alan Blinder says that Osaka’s decision to withdraw from the French Open was “a potent example of a movement among elite athletes to challenge the age-old notion that they are, and must be, as peerless in mind as they are in body, untroubled by the scourge of mental illness.”

Osaka also decided not to participate in Wimbledon and will instead focus on representing Japan at the Tokyo Olympics later this summer.

Athletes are often held up to unobtainable standards and viewed as superhuman because of their amazing physical talents, says Michele Kerulis, who is a licensed clinical professional counselor with a private practice in Illinois and holds a doctorate in counselor education and supervision. People expect them to be “perfect, excellent, exquisite and all those unbreakable things,” she explains. “But athletes are people who have the same spectrum of feelings that we all have. They feel anxiety, depression, guilt, shame, embarrassment, and so on, and … they are put under a microscope when they have any kind of a feeling that the media or the public doesn’t perceive as fitting within that sport.”

Overcoming the stigma

The stigma attached to depression, anxiety and other psychological conditions often prevents athletes from discussing their mental health needs out of fear they will be seen as weak. And for some college and professional athletes, there’s an added worry that their mental health may cost them their scholarship or contract, points out Kerulis, a professor of counseling at Northwestern University who specializes in sports, exercise and the impact of media on sport psychology.

This fear is not unfounded. Taunya M. Tinsley, a licensed professional counselor and owner of Transitions Counseling Services in Paoli, Pennsylvania, has heard coaches refer to players’ struggles with mental health in a critical or belittling way by making comments such as, “What’s wrong with you? Are you not on your medications?” This attitude further discourages athletes from being open about their mental health.

“Just because somebody has strong athletic skills does not mean they’re not going to suffer from mental health challenges, so [counselors] have to help put the humanistic aspect back in,” stresses Tinsley, a member of the American Counseling Association who specializes in sports counseling, multicultural and social justice issues, and spiritual and Christian interventions. Clinicians must help “athletes and those who work with athletes understand that … we can’t separate the mental and emotional wellness from the physical wellness.”

Mental training

Athletes often ask Kerulis, an ACA member and an Association for Applied Sport Psychology fellow, to help them “get in the zone” a few days before a big game or event, and she lets them know that mental training takes time.

Coaches help athletes with the physical and strategic techniques, Kerulis notes, and trainers ensure athletes’ muscles are strong and prepared for the movement required in their sport. “The next piece is practicing those physical techniques [and] developing the muscle memory. When they are learning new skills or techniques, part of it is understanding they’re not going to ace this the first time they try it, and that’s part of what practice is — repetition and trying over and over,” she says. “And it’s the same thing with any psychological skills that athletes are learning. You integrate that into their practice setting.”

Like a strength trainer, Kerulis slowly works with clients using therapeutic approaches such as mindfulness, cognitive behavior therapy, imagery, relaxation and arousal control to help them improve their mental focus.

A basketball player, Kerulis explains, spends most of the game sprinting up and down the court, sweating and elevating their heart rate. But when the player gets fouled, they must quickly transition from this accelerated state to a calm one to successfully hit the free throw. That process requires mindfulness and body awareness, Kerulis notes. She might work with the basketball player for a few weeks to develop a progressive muscle relaxation (PMR) script (slowly tensing and relaxing muscles throughout the body) and help them learn how to scan their body and notice bodily sensations. Then, when they are at the free-throw line, they can do a quick body scan, release any tension and shoot.

“What you might see in a split second could takes weeks of preparation,” she points out.

Anxiety and interpersonal skills 

It’s common for athletes to suffer from performance anxiety. Kerulis, the Association for Multicultural Counseling and Development (AMCD) Midwest Region representative and outgoing chair of the Midwest Region of ACA, once worked with a teenager who was a runner. Before every meet, he felt nauseated and dizzy, and no matter how he did, he felt distraught after it was over. He had already been medically cleared to participate and wanted help overcoming these physiological responses to his anxiety.

In session, they used the cognitive behavior therapy technique of thought stopping to help the client disrupt the negative thoughts he often had a few days before each meet and replace them with positive mantras or statements.

Kerulis’ client was scared to tell his coach about his anxiety because he thought the coach might not let him race. Kerulis asked if the coach had noticed his anxiety and the change in his behavior, and the client said, “Yes, absolutely.” So, they discussed how the coach was probably already wondering why the teenage runner was behaving differently.

This conversation helped the client realize that asking for help was a sign of strength, not weakness, and would show his desire to improve, Kerulis says. With her help, the client prepared talking points to lessen his anxiety around having that conversation with his coach.

The teenager also improved his communication with his parents by explaining that he wanted to have more positive thoughts going into his races. His parents were supportive and checked in with him before each meet, asking, “How are you feeling today? How’s your mantra?”

Identity development

It’s important for counselors to assess where athletes are in terms of their identity development and tailor treatment plans to help them explore identities outside of their sport, says Tinsley, the clinical director of the Mount Ararat Baptist Church Counseling Center in Pittsburgh.

Some individuals may have a foreclosed identity and only see themselves as an athlete without exploring other aspects of their identity, she says. Then a career-ending injury or retirement will cause them to question their identity: Who am I without this sport?

Kerulis finds that if someone’s sole perspective of themselves is being an athlete, they tend to have a more detrimental response when something upsetting happens in the sport. Whereas an athlete with a foreclosed identity may feel extreme disappointment after losing a game, for example, another athlete who has a more open identity would not be as devastated because they have other interests in life and feel more balanced.

In other cases, athletes may have discovered additional interests outside of their sport, but their primary identity as an athlete prevents them from pursuing those interests, says Tinsley, a past president of AMCD. For example, an athlete might want to major in health sciences in college, but their sport schedule hinders them from taking the required classes or putting in the necessary work.

Tinsley begins her sessions by asking questions unrelated to the client’s sport so she can get to know the person, not the athlete. She may ask, “What are your interests when you aren’t playing the sport? Who do you have a good relationship with in your family?”

Kerulis also encourages athletes to maintain diverse interests unrelated to sports. “That’s not to decrease the importance of preparing mentally for [their] sport,” she says. “It’s to help create a more well-rounded individual so if and when they experience difficulties, tough times or roadblocks in their sport, they have this balance … and [can] reset.”


Counselors should focus on the prevention of mental health problems with the athlete population, Tinsley stresses. Part of that involves creating life-skills programs that help athletes plan for retirement before it happens so the transition is not a shocking, traumatic event.

Tinsley has worked with the National Football League (NFL) and the Pittsburgh Steelers to provide mental health services to athletes and to train former NFL players to serve as transition coaches between current athletes and mental health professionals. This work introduced her to LaMarr Woodley, a former linebacker for the Steelers who had already started thinking about his transition from the NFL by launching a Sack Attack Program in 2009. Through pledges, every sack Woodley made raised money for youth charities in Pittsburgh and his hometown of Saginaw, Michigan.

Woodley explains in a recent interview with Tinsley how despite some people’s insistence that he focus solely on football, he knew he needed to start preparing for life after his NFL career. He notes how parents and coaches are pushing kids to become professional athletes at younger ages, and this pressure can lead to burnout, stress, anxiety, substance use and other mental health concerns.

Counselors can help prepare athletes for these transitions, Tinsley says. She worked with Woodley to consider his next career options, and eventually, he decided to earn his master’s in sport management studies with a sports counseling concentration and continue to help athletes as they navigate the internal and external pressures that can affect their mental health.

In a Time magazine essay, Osaka stresses the importance of athletes (like other career professionals) being able to take mental health days without scrutiny or explanation, and she reminds us that “it’s OK not to be OK.” Going forward, perhaps more athletes will follow Osaka’s example of putting her well-being above her sport.

Kerulis applauds Osaka’s choice to prioritize her mental health. “It’s so hard for people to admit difficulties,” Kerulis says. “Some people are calling [her decision] a failure, but … it may be one of the biggest successes of an athlete’s career to be able to put themselves first and say, ‘I understand the importance of this competition, and at the same time I know that I need to take care of myself or else I cannot be the outstanding athlete that I know I am.’”



American Counseling Association members: Interested in exploring connections between sports and mental health? Join ACA’s Sports Counseling Interest Network.



Lindsey Phillips is the senior editor for Counseling Today. Contact her at lphillips@counseling.org.


Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Team sports vs. solo exercise: Which is better for your mental health?

By Bethany Bray December 3, 2018

Professional counselors often recommend exercise to clients as a way to improve mood and overall wellness. In addition to boosting serotonin, a neurotransmitter connected to feelings of well-being, exercise offers the chance to unplug from the busyness of daily life and process one’s thoughts.

A recent journal study in The Lancet Psychiatry takes that recommendation one step further, connecting team sports to improved mental health. A cohort of researchers studied four years of recent survey data from more than 1 million American adults.

They found that individuals who exercised experienced 43 percent fewer days of poor mental health in a one-month period than did people who didn’t exercise at all. Individuals who experienced the greatest mental health benefits, however, were those who participated in team sports, followed by those who rode bicycles or did aerobic and gym activities (in durations of 45 minutes, three to five times weekly).

Jude and Julius Austin, American Counseling Association members who played soccer both in college and at the professional level, stress that the study’s correlational findings do not mean causation.

“We think further research needs to be done regarding the lived experience of athletes in team sports who struggle with mental health issues,” said the brothers in a co-written statement to Counseling Today on the Lancet findings.

Although mental health improvements are not caused by exercise, physical activity does, when done appropriately, have biological, cognitive and social benefits — which Jude, an assistant professor in the counseling program at the University of Mary Hardin-Baylor in Texas, and Julius, an assistant professor in the marriage and family therapy and counseling studies program at the University of Louisiana Monroe, say they experienced as soccer players.

“It is exciting to see [researchers] investigating things we believe most athletes can collectively, albeit anecdotally, agree on,” wrote Jude, a licensed professional counselor in residency and Julius, a provisionally licensed professional counselor. “In our experience playing team sports, it feels great to survive a particularly tough practice. Pushing ourselves through seemingly impossible physical tasks with others reinforced that we have everything we need to handle life’s challenges. There is something healing about being swept away by the team’s mentality during a game; pressing or absorbing pressure, counterattacking or keeping possession, the ebb and flow of defense to offense, being in the zone. Even if it’s only for a moment, those sweeping moments were where we received social support, affirmation, genuineness, empathy and unconditional positive regard. These are all therapists’ offered conditions in an effective therapeutic relationship. We could not say this with empirical certainty, but we would imagine that receiving these conditions from a team can cause lessening of mental health issues.”

ACA member Sarah Fichtner, a former Division I women’s soccer player for the University of Maryland (UMD), has mixed feelings about the Lancet study. While there is little doubt that exercise in general benefits both mental and physical health, it can be taken to the extreme when sports are played at a high level, she says.

“I am a firm believer that exercise improves an individual’s mental health, as it produces feel-good endorphins and releases chemicals such as norepinephrine which alleviate stress and anxiety,” Fichtner says. “As an exercise and health enthusiast myself, there is not a doubt in my mind that exercise has many positive implications. However, I am a bit skeptical of the [Lancet] findings pertaining to team sports. I do see the benefits of exercise groups [in] that they provide accountability, comradery and support, but in terms of competitive team sports — particularly at the collegiate level — the environment is extremely different.”

Fichtner is a counselor intern at Hackensack Meridian Behavioral Health and is working on completing a master’s degree in clinical mental health counseling at Kean University in New Jersey. After her experience as a DI athlete, she calls for balance when it comes to competition and team sports.

“During my time as a student-athlete and captain at the University of Maryland, I saw firsthand the detrimental consequences of the collegiate world. When a player is recruited to play at the DI level, he or she is expected to perform. Coaches have one goal in mind, and that is to win,” she explains. “Practices are intense, to say the least, and the idea of healthy competition goes out the window. A player is competing against his or her teammates every day to secure a starting position. They are competing to be the fastest, fittest, slimmest and most technical or tactical player. And every day, their coaches are telling them, ‘You are not good enough,’ ‘You need to lose five more pounds to be in the running for a starting position,’ ‘Your teammates are working harder than you’ and ‘Ask your teammate so-and-so for help. She is outperforming you. She has great skills.’ This high-intensity environment can lead to many mental health challenges such as eating disorders, anxiety, depression and low self-esteem, which I witnessed during my four years at UMD. Thus, when I think about team sports, specifically at the collegiate level, the word balance comes to mind.”

“Aside from the intense environment, there were many positives takeaways from my time as a student-athlete,” Fichtner adds. “I made lifelong friendships, competed at the highest level of collegiate sports, was privileged to visit many states, had top-notch gear, learned important life lessons and would do it all over again in a heartbeat. Nevertheless, now as a mental health counselor, I see the collegiate world through a different lens. Many of the challenges we athletes faced on a daily basis seemed both normal and absolute. But now as I grow both personally and professionally, I realize that colleges need to establish a balance between a healthy competitive environment, where athletes are pushed and held accountable, and a debilitating, harmful environment, in which athletes are placed in harm’s way [of] mental health challenges. Balance is key to any exercise regimen, especially in the collegiate world.”




Read the Lancet study in full: thelancet.com/journals/lanpsy/article/PIIS2215-0366(18)30227-X/fulltext#seccestitle10




ACA members: Interested in exploring connections between sports and mental health? Join ACA’s Sports Counseling Interest Network.




Bethany Bray is a staff writer and social media coordinator for Counseling Today. Contact her at bbray@counseling.org.


Follow Counseling Today on Twitter @ACA_CTonline and on Facebook at facebook.com/CounselingToday.




Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

A counselor looks at football

By Kevin Doyle January 29, 2018

I have been a lifelong football fan. I remember playing outside in the snow, emulating the National Football League (NFL) stars of the 1960s and then going inside to watch some of the fabled rivalries of the time, like the Kansas City Chiefs versus the Oakland Raiders. I grew up on Joe Namath’s Super Bowl guarantee, Franco Harris’s “Immaculate Reception,” and the undefeated Miami Dolphins team of 1972. My beloved Washington football franchise (yes, that name is a problem — but that is for another story) owned the 1980s (along with the San Francisco 49ers), and my brother and I sported Charley Taylor (42) and Larry Brown (43) jerseys in the previous decade. My two sons played the game at the high school level, both excelling and taking much from the experience. In short, I was raised on football in many ways.

All of these things will stay with me, but recent events have conspired to lead me to question of whether the sport in its current form is morally defensible. Recently, coverage of the death by suicide of former New England Patriots player, and convicted murderer, Aaron Hernandez, noted that his brain had advanced chronic traumatic encephalopathy (CTE), and a study published in 2017 in JAMA found evidence of CTE in 110 of 111 former NFL players.

Former NFL player Antwaan Randle El, a nine-year NFL veteran who is now in his late 30s, recently spoke out about his memory problems. He became the latest in a series of both high- and low-profile professional players known or alleged to have had serious brain issues possibly due to their football careers. This includes well-known players such as Junior Seau, Dave Duerson, Mike Webster and Frank Gifford.

The national discourse has been stirred by Steve Almond’s searing Against Football: One Fan’s Reluctant Manifesto; the film Concussion, based on the work of forensic pathologist Bennet Omalu and the work of Jeanne Marie Laskas in her article for GQ titled Game Brain; as well as pro football works such as Gregg Easterbrook’s The Game’s Not Over: In Defense of Football and Mark Edmundson’s Why Football Matters: My Education in the Game.

What, then, is the role of the professional counselor in this debate — or is there one? I submit that counselors in a variety of settings have a responsibility to be aware of this issue that is currently facing our culture, and there are several reasons why.

First, this appears to be a significant safety issue for a segment of our population, namely those individuals who have either played football in the past or are currently playing. No less an authority than the Mayo Clinic has reported that symptoms such as aggression, motor impairment, tremor, memory loss, irritability and focusing problems are associated with CTE.

If an adult male were to report symptoms such as these in counseling, it could be prudent to check to see if the client was once a football player. Referral for additional medical assessment could be an appropriate course of action, although currently, no effective treatments for CTE-related symptoms seem to be available. In fact, a definitive diagnosis cannot be made until tests of the brain can be conducted after an individual’s death.

For players currently involved in football, repeated concussions could be placing those individuals at increased risk and should be monitored. Most levels of play, including the NFL and NCAA, have put so-called “concussion protocols” in place to prevent players from continuing to play until they have received medical clearance. Although counselors would likely not play a leading role in these determinations, it would be advisable for counselors working on college campuses, with professional football players or even at lower levels (high school, middle school, youth football) to be aware of them and to support efforts to protect player safety.

Second, the question of whether to allow children to play football has become an emotional and sometimes conflict-ridden debate within families. Participation rates in both high school and youth football have widely been reported to be declining and show no signs of changing in the near future, according to numerous sources.

Counselors routinely work with children and families, and reaching a decision about whether a child should play football can be difficult. An informed decision must balance the potential safety concerns associated with the sport and the potential benefits of playing the sport, including physical activity and learning about teamwork and discipline. In some families, football is seen as a rite of passage — something that adolescent males (and, in some cases, females) engage in as part of the maturation process. In some cases, it may be the child who desperately wants to play, while the parents are warier. In other cases, parental pressure on a child to participate may be the driving issue. In either instance, a counselor, whether school-based or community-based, may be in a position to help the family make this decision. Knowledge of some of the relevant issues is essential to any effort to be of assistance.

Third is the reality that any societal issue can make its way into a counseling session. This is not to imply that we as counselors need to be experts on any and all social and societal issues. However, we do have a responsibility to be aware of burgeoning issues facing our culture and to be ready to discuss or address them —or at least to listen to our clients do so.

Many of us no doubt had clients with opinions about the most recent presidential election. Their thoughts naturally made their way into counseling sessions. Our own personal feelings aside, we had a responsibility as counselors to listen, to consider our clients feelings and opinions, and to ponder what role, if any, these thoughts contributed to the stressors they were facing. Likewise, we must strive as counselors to stay informed about myriad issues of relevance to our clients. Societal question such as same-sex marriage, health care, immigration and employment barriers for those with criminal convictions, to name a few, play out in our clients’ lives on a daily basis.

Granted, the issue of football may pale in comparison to some of these, but we have a responsibility nonetheless to pay attention, to inform ourselves and to monitor the debate, because it may well come up in a counseling session with an individual or family. If we are unaware of this issue (or another one), we may need to do further research in between sessions or, in extreme cases, even consider referring our client to another provider with more knowledge of the issue he or she is facing.

Finally, there are social justice issues to be considered, consistent with the counseling profession’s recent emphasis in this area. One would have to have been living under the proverbial rock not to have noticed the emotional national dialogue around NFL players sitting or kneeling during the playing of the national anthem. Started by former San Francisco 49er quarterback Colin Kaepernick in 2016, this protest has spread to other players and teams and led to an increasingly hostile “conversation” about the form of the protest itself, overshadowing the issue of police brutality that Kaepernick sought to highlight.

The various authors I noted earlier identified numerous concerns more specifically related to football that are of a social justice nature. Approximately 68 percent of NFL players are African American, and the treatment of players has been criticized by some as evoking memories of slavery by the so-called “owners” of the franchises. Anyone who has ever watched the “meat market” known as the NFL Combine, which consists partly of athletes’ bodies being examined by prospective employers (owners), and which is now nationally televised, cannot help but notice this parallel. With the average NFL career lasting less than four years and contracts, even when lucrative, not being guaranteed in case of injury, discerning individuals can easily raise legitimate social justice questions.

In summary, a growing national conversation about football, its viability, its safety and its future is becoming difficult to ignore. Counselors at various levels and in various settings have a responsibility not only to be aware of this conversation, but also to consider its significance in relation to the clients with whom we work. Engaging in this conversation is consistent with current calls within the profession for social justice.





Kevin Doyle is a licensed professional counselor in Virginia and an associate professor in the counselor education program at Longwood University. He has also coached youth, high school and adult sports for the past 30 years. Contact him at doyleks@longwood.edu.




Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.


Counseling, football, recovery and triumph

By Bethany Bray September 28, 2015

In a life of ups and downs, football has been a constant for Chris Harris, a 34-year old limited licensed professional counselor (LLPC).

Among the struggles Harris has faced was a battle with severe depression that threatened to derail his life at a young age. Football served as a saving grace for him during some of his darkest periods — times when life didn’t seem worth living.

Chris Harris, LLPC

Chris Harris, LLPC

Harris’ example of how football can change lives for the better was featured in the National Football League’s “Together We Make Football” campaign in 2013. He was one of 10 finalists from across the United States featured in nationally televised video clips on Thanksgiving Day.

In the NFL’s three-minute video, Harris explained how football had been a lifesaver for him, in addition to providing him with an opportunity to become a leader and peer counselor on a newly established club team at Oakland University in Michigan.

When he was younger, “I couldn’t see myself living to even be 20 [years old],” Harris says, citing his struggles with alcohol addiction, depression and fitting in with peers. “Anytime I got really down, football would come knocking. That’s why I love football.”

Harris says football will always be a central part of his life, even though his playing days may be behind him. He graduated from Oakland University this year with a master’s degree in counseling.

Harris wants to build a platform from which he can reach people who are wrestling with some of the issues he has struggled with, including depression, anger, alcoholism, bullying and finding focus and direction in life.

He has established a private practice and hopes to eventually specialize in sports counseling and youth development and mentoring. He would also like to become a public speaker.

“I’ve always had a natural passion for helping people,” he says. “With my personal experience with mental illness and trauma, I know how that impacts people. … I have a passion to be a bridge builder.”

When Harris speaks about the potential for recovery and triumph, it’s personal. Counselors should never underestimate the power of growth and development to change a person’s life, he says.

“Even if a client doesn’t see it in that moment, have the vision of them yourself growing and developing to achieve the life that they want for themselves,” he says. “As a counselor, make sure you maintain that vision of them getting healthy, recovering and achieving the triumph that they would like, because it is possible.”


‘I would have never imagined myself being here’

The 6-foot-5-inch Harris played football as a youngster growing up in Detroit. At age 19, he made the roster of the Motor City Cougars and played semi-professionally for four years.

ChrisHarris_1Playing with the Motor City Cougars pulled him out of a downward spiral he fell into after high school, including a bout of depression, alcohol dependency and grief over the death of his grandfather.

He fell into another dark depression in 2009 when he was six months shy of earning an undergraduate degree in social work at Wayne State University in Detroit.

Although his 2009 mental health crisis was as a breakdown, it also marked a breakthrough for him, Harris says. Since that time, he has been able to rise above his struggles and make a 180-degree turn, he says.

He has completed bachelor’s and master’s degrees at Oakland University, where he also was a leader on the school’s club-level football team.

“At my darkest time, I would have never imagined myself being here,” says Harris, a national certified counselor (NCC). “But guess what? I did the work, I sacrificed, I made the decisions, and it happened. I know it sounds cliché, but if I can do it, anybody can do it.”

Harris is starting a yearlong internship this fall with Michigan College Access Network, an organization that works to boost the percentage of Michigan residents who go to college. The organization places particular focus on students from families with low incomes and students who would be the first in their families to seek postsecondary education. Harris will be working in a local high school, where he will advise students on everything from choosing a college or academic major to applying for financial aid.

James Hansen, a professor and coordinator of the mental health specialization within Oakland University’s counseling department, describes Harris as a bright, warm, accepting and curious person.

“He glows with those qualities, and his clients will certainly benefit from that, as [will] the others in the counseling profession he encounters,” says Hansen, who is a member of the American Counseling Association.

“I admire his courage,” Hansen says of his former student. “His own journey informs his empathy and his ability to be an excellent helper. … He has a sincere desire to help others. I admire what he’s gone through.”


Trust and team building, on and off the field

Much like football, counseling is based on building relationships and trust with those you work with, says Harris. The relational aspect of counseling is what ultimately drew him to the profession, he says.

“[Counseling] has techniques and theories. However, it’s all about the relationship, the therapeutic alliance,” he says. “I feel in my heart that it’s the truth – relational health is central.”

As a counselor, Harris would like to work with athletes – a natural fit with his personal experience and with the profession’s relational approach.

“I understand the mentality of an athlete,” he says. “The same things that make them successful on the field of play can get them in trouble off the field – aggression, being strong, being a leader. It’s difficult for athletes to channel that in the right way. You can’t get rid of it (anger, competitiveness, etc.). It’s what you do when you’re angry that gets these people in trouble. I’d like to use my experience as a platform.”

Athletes are hard-wired to understand the give-and-take, trust and relationships that are part of being a tight-knit team, Harris explains. Counselors can leverage these skills when working with clients who are athletes, he adds.

Athletes will especially understand and respond when given a finite task or job to do, Harris says, because that’s what they’re used to in team sports. For example, athletes are used to having to go home and learn their playbook, he says. In counseling, this could translate to the “homework” assignments that counselors often give to clients, such as journaling or communication exercises.

“In sports, you’re used to a script [or playbook], following directions and doing your job,” Harris says. “If [a counselor] can sit down with an athlete, or anyone, and lay the foundation for the relationship to gain and earn their trust – after that, your counseling skills, the ability to sense patterns, read body language, etc., will benefit.”

“Counselors should listen first. Listen to your client speak about what inspires them, what drives them and what they desire,” he says. “Once you’re comfortable and know the client well enough, then you can begin to engage them from that perspective. Bring their struggle back to their strengths.”





Bethany Bray is a staff writer for Counseling Today. Contact her at bbray@counseling.org


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