Psychological Preparation of athletes with disabilities and challenges we face 5. 4. 3

Author: Jasna Vešligaj Damiš

Keywords: psychological preparation, relaxation, motivation, goal setting, communication, self-esteem

In modern sports, appropriate psychological preparation has become more and more important in order to achieve good, excellent results. The purpose of this preparation is improvement of results, which the individual is able to achieve only if he/she is well psychologically prepared for all the distress he faces in sports.

Good psychological preparation of the athlete means strong motivation, high concentration, high self-esteem and good emotion management. An athlete who has received good psychological preparation works better, reaches ones potential and top results.

However, in order to become a successful athlete, you do not need to be a professional athlete or an Olympic champion. You do not need to have many trophies or cups, you do not need to win at the national championship or be on the cover of a sports magazine.

It is essential for an athlete that the sport he/she chooses is important to him/her and he/she is dedicated to it, regardless of the fact if he/she is a top athlete or a recreational player, an athlete with disability or no disability, a Paralympic or an Olympic athlete who uses sports as a means of rehabilitation.

It is important that an athlete develops desired realistic goals that are sufficiently high and realistic according to his/her own abilities. It is important for the goals to be in accordance with ones limitations such as, daily life obligations, finances, time, disability, etc. Consequently sport participation enriches the life of an athlete, and if he/she values what he/she receives, it is worth the resources he/she has invested in sports.

At the same time, psychological work for an athlete can be of much broader significance since the same mental abilities that athletes use to achieve success in sport can also be used to achieve success in other areas of life.

Sports psychologists thus help athletes improve their motivation, increase self-confidence, increase team cohesion, and concentration (Kajtna and Jeromen, 2013). If a sports psychologist cooperates with a disabled athlete, it is important to focus on the individual’s abilities rather than on his disabilities (Hanrahan, 2007).

The goal of professional psychological preparation

Through psychological characteristics for an athlete with a disability, we encourage the improvement of the performance of the activity, the achieving of better results and significant success in competition. Therefore, we discover the causes of:

  • fluctuations in implementation, motivation for sports activities, etc.,
  • managing crisis, stress,
  • setting limits (how much he/she is able to perform, where is his/her limit, or limits can be improved);
  • differences in performance, when he/she works better or worse,
  • slow progress - the athlete progresses steadily, but much slower than he/she wants or imagines he/she could.

Practical aspects of mental preparations for work with athletes with disabilities

In general, psychological skills programs for athletes with disabilities are not very different from those for athletes without disabilities. Nevertheless, there are some adaptations to be taken into account (Hanrahan, 2014).

The main adaptations that are normally required in the work of people with disabilities are most often related to communication issues and other specific adjustments resulting from disability. Working with individuals with disabilities requires appropriate assistance, communication adaptation and creativity. (Hanrahan, 2015).

The mental preparation of an athlete with disabilities, like an athlete without disabilities, helps him/her to focus, to be self-confident and to have a positive mindset. General mental preparation consists of:

  • creating a positive philosophical, moral and ethical attitude towards the world,
  • creating a positive attitude towards sport,
  • Creating a high level of motivation, self-motivation (internal motivation),
  • creating appropriate, realistic goals,
  • managing effectively anxiety, emotions and stress,
  • maintaining good and focused concentration,
  • creating a stimulating social environment where appropriate atmosphere and support must be established,
  • learning effective patterns of behaviour towards self, situations and others,
  • learning and using different psychological techniques.

Psychological preparation involves learning psychological techniques that allow an athlete to recognize his or her abilities. This process requires of him/her many hours of training and persistence. Among the most popular and most frequently used techniques are (Tušak, Misja and Vičič, 2003):

  • Relaxation techniques,
  • Visualization, sensory,
  • Concentration techniques,
  • Self-speech techniques,
  • Breathing techniques,
  • And techniques of positive thinking and hypnosis.

All these techniques can also be used for athletes with disabilities, if necessary, modified according to their abilities or skills and specific limitations.

Relaxation training

Progressive muscle relaxation (PMR) may be problematic for some individuals with physical disorders. For example, clinical observation shows that individuals with cerebral palsy who have higher level of spasticity may skip the phase of tension of PMR and focus only on relaxation, as the tension phase may increase spasticity (Hanrahan, 2015).

Alternatively, these athletes may want to consider alternative ways of relaxation, such as autogenic training.

Athletes with amputated limbs or those in wheelchairs are given the option of selecting the PMR script: the relaxation is performed on individual parts of the body, where the muscles are in place and leave the amputated limbs or body parts that are affected by the spinal cord lesion. Hanrahan (1995) found that the athletes with physical difficulties decided about 50:50 with regards to the mentioned relaxation scripts.

It should be noted that abdominal breathing as a relaxing exercise can enhance relaxation and concentration in athletes who do not use abdominal muscles (Hanrahan, 1995).

Visualization and sensory training

The technique of visualization, which is a form of mental representation, is very often used in sports. It helps to learn new motoric functions and movement elements, eliminates negative thoughts and feelings and improves concentration.

Visualization technique or presentation of motoric images can be an extremely useful technique for athletes with physical disabilities, and can be used as mental preparation for training physical skills. Because athletes with disabilities often have limited opportunities and certain training problems that are difficult to overcome compared to their healthy colleagues (due to problems such as transport, accessibility, poor equipment etc.), mental exercise can become extremely important. In addition, exercise for visual motoric behaviour is helpful for athletes with cerebral palsy, because the relaxation component can reduce spasticity (Martin, 2013).

It also assists with preparation for stressful events and sports performance, as with mental imaging the automation and optimization of the performance is increased.

The visualization technique can be effective for athletes with physical disabilities. It is important that athletes see themselves as they are and how they do sports (Hanrahan, 1995). For example: swimmers with one foot do not swim with prosthetic devices, so prosthesis is not part of the image they represent.

It is important to ensure that images of visualization are precise in terms of what is or what is not included and physically match the real situation (for example, if a sportsman uses prosthesis in sport, this prosthesis should also be part of the visualization image).

The clarity of the motoric images (visualization) of affected limbs after complete damage to the spinal cord is maintained, but is weaker after loss of the limb (Malouin & Richards, 2010).

Short-term physical disorders, such as broken legs, can lead to reduced clarity of motoric images, for example those that include the leg. Immobilisation of the ankle in only 2-4 weeks leads to a significant reduction in the clarity of motoric images in movement of the foot (Malouin et al., 2009).

Of course in athletes who have acquired physical disorders (as opposed to those who have genetic disorders), the use of visualization techniques can lead to frustrations that originates mainly from the relationship between the image itself and image before the injury. For example: a swimmer who has an amputated hand, swims with only one hand, and visualizing themselves in the picture with both hands as before the injury. This can lead to anger, frustration, split image of oneself, etc. This is why we must be very careful when we guide such an athlete through a visualisation technique. It is important that we build on the clarity of the imagined image of himself, the image control (swim with one hand) and in this way we form an effective strategy for improving his technique, preparing for competition and strengthening his own confidence (Hanrahan, 2014).

Similar to visualization is sensory technique in which athlete imagines ones sport performance but it also contains kinesthesia, voices and other sensory performances that occur during the sport performance (Tušak & Tušak, 2003).

People with mild mental disorders have improved their performances in cognitive and motoric tasks through visualization (Screws & Surburg, 1997). The combination of physical training and visualization in people with mental disorders has shown to be more effective compared to only physical exercise (Surburg, Porretta & Sutlive, 1995).

Positive thinking training

During mental preparation we also include the technique control of positive thinking. It is important that we guide an athlete with a disability to positive thoughts and self-managing them. This can be achieved by training positive thoughts and positive self-talking. The consequences of negative thinking cause low self-esteem, increase anxiety and worsen performance. The athlete uses different autosuggestion during the training of positive thinking, which is also the most important part of the positive thinking. Suggestions must be realistic and specific, some are focused on correcting problems that arise from negative thoughts, and some suggestions prevent misconception. Important are also the suggestions that improve self-confidence and self-esteem of the athlete.

Routine

When developing preliminary routines for athletes with physical problems, it is important to pay attention to the problems associated with accessories for example wheelchairs and allow longer time for transportation and solving problems with accessibility at the competition location (De Bress, De Guast et al., 2013).

Communication as a challenge for facilitators and persons with disabilities

When working with athletes with disabilities, communication is extremely important. For example, it is important that a psychologist, as well as a coach or assistant talk with an athlete in a wheelchair on the same level.

As cerebral palsy often affects muscle control, which is necessary for a clear speech (Nordberg, Miniscalco, Lohmander & Himmelmann, 2013), it is sometimes difficult to understand athletes, who are strongly affected by it. Some athletes have assistants who can take part in sports events and training with them. If assistants play together with an athlete, make sure that you continue to maintain eye contact and communicate with athlete not with the assistant. When communicating with a disabled person, be patient when they speak and avoid finishing their sentences.

When communicating with athletes with disabilities, it is always important that we are aware of the extent to which individuals can see or hear, and what forms of communication are best for them (for example, reading from lips, large fonts…). It is also useful to establish methods for gaining attention (eg. flashing lights, touch on the shoulder, beeping).

When working with athletes who have vision or hearing disorders, it is important to reduce background noise. Individuals with visual impairments rely on hearing aids and those with hearing impairments (but they are not completely deaf) will struggle if the voice overlies noise from the background.

We must consider that the level of communication and understanding is adapted to the abilities of athlete with intellectual disabilities. If necessary, give the athlete more time to understand and respond, talk slowly using short sentences and wait long enough before asking a new question. Ensure our sentences are clear and we need to speak to them gradually, it may be necessary to clarify and explain multiple times the purpose of the tasks and the instructions for work. We combine verbal instructions with other ways of providing information. The instructions should be simple, short and accurate. Longer and more complex instructions should be divided into shorter sequences or steps.

When working with people with mental disorders it is important to provide additional time for mental training and gradually prepare them for particular mental ability, each one according to the situation and behaviour. Learning and training more than one mental skill at a time can be too difficult for them (Gregg et al., 2004). This is the most common mistake sports psychologists, trainers and assistants are dealing with. For example: to play tennis, they may explicitly learn to avoid going on the other side of the field during the game to get the ball.

If a person with intellectual disability is illiterate, we should consider using audio records or drawings instead of writing when setting goals or performing other activities that usually involve writing (Hanrahan, 2004).

Often, creativity is needed to pass the messages effectively to individuals with intellectual disabilities. It is also important to make sure that the messages are correctly understood. As people with mental disorders often agree or accept positive answers (Gregg, 2013), it is better to avoid asking yes/no questions (because the answer will likely be ‘’no’’, regardless of the question). Instead, we ask questions that require an individual to show understanding of the answer, or ask the athlete to repeat information or message.

In the case where a sport psychologist has limited contact with a team or the athlete, it is useful to explain to the coach or to other relevant professionals what the team or individual athlete has learned from psychological preparation or intervention (Gregg, 2013), to repeat, train and strengthen it during exercises and competitions. Patience and numerous repetitions are important when working with people with intellectual disabilities.

When working with people with acquired brain injury (ABI), facilitators of the sports activities should be aware of the numerous consequences caused by ABI and abide by the recommendations of the professional body accordingly. The consequences of the brain injury, which may affect the sport activity of an athlete with ABI, can influence the physical activity performance as well as mental functioning. Thus, we have to devote special attention to the problems in executive functioning, motivation, confrontation, problems of setting goals and creating realistic expectations etc…

Athletes with ABI often have difficulty in planning and organizing their activities. Problems have been identified in determining the steps required to achieve the goal and their order (what happens sooner or later). They initiate an activity with difficulty and often need detailed or additional instructions before performing the activity.

After brain injury, injured victims face a range of memory problems. The most common and highly unpleasant form of memory disorder is a problem with short-term or ‘’working’’ memories. This means that it is difficult to remember new facts, new names, faces, agreements, forget where they left belongings, obligations they have.

When working with athletes with ABI it is important (as with people with developmental disorders etc.) to avoid excessive stimulation, such as several people speaking at the same time, and address him/her directly, slowly, clearly and comprehensively. It is crucial to eliminate as much as possible stimuli in terms of sounds from the background or environment (radio, noise in the room, etc.). We need to carry out numerous repetitions and behavioural trainings due to user’s memory problems and diminished learning ability.

Motivation and setting goals techniques

Practical approaches to motivating athletes with disabilities derive from different theoretical directions, similar to those for athletes without disabilities (for example, productivity motivation theory, theoretical directions explained by behaviour, theories based on incentive motivation, goal setting theory, etc…).

The basic characteristics of motivation are encouraging and guidance (Kajtna & Jeromen, 2013). One of the most important factors in the process of motivation is setting goals. It is a planned choice of specified goals, which must be precisely defined, realistic and achievable. This technique is used in sports most of the time.

An athlete sets goals and tries to achieve them with appropriate behaviour. Goals should meet athlete’s needs. Motives are goal focused reasons for behaviour. Needs arise and maintain motives until satisfaction occurs (Tušak & Tušak, 2003).

Specific goals affect activity more accurately than general goals. The coach sets them up with the athlete, and they have to define strategies for achieving the set goals. In this approach the feedback given by the coach to the athlete after the analysis play an important role. If it shows positive progress, the technique will be more successful.

Setting short-term and long-term goals has a significant impact on maintaining motivation. Sub- targets (sub-goals) lead to the main goal and when one of them is not achieved, this is a sign of the need to change the strategy to achieve an ultimate goal.

The athlete must believe that he/she is able to achieve set goals. Setting goals does not only serve as a tool to increase motivation, but also to improve concentration and effective time managing (Tušak, Misja & Vičič, 2003).

This technique of setting goals in sport is equally applicable in sports for people with disabilities, regardless of whether it is a competitive sport, recreational sport or rehabilitation. At the same time it is important to understand why an athlete with disabilities is attracted by sport. Disabled and healthy athletes have similar incentive systems (incentive are attractive goals). According to Tušak and Tušak (2013), from existing research we can recognize 7 incentive systems that explain the motivation of the athlete to participate in sports:

  • Desires for achievement and success,
  • Desire for socialising,
  • Desires for sensual satisfaction,
    excitement,
  • Curiosity
  • Aggression
  • Power
  • Independence.

The importance of certain incentives varies from individual to individual. The first two are extremely important for everyday life, socialization, entertainment and achievements. We can connect them with the individual’s need for experience and activation.

Self-concept and self-confidence of an athlete with disabilities as challenge for facilitators

Self-confidence is by definition an athlete’s conviction or a sense of confidence about the possibility of successful performance. It is a subjective factor that arises from an athlete and has a major impact on his sports engagement.

In some sports studies of people with disabilities, the positive benefits of sports participation have been identified to include better self-image, feelings of belonging and many benefits to health (DePauw & Gavon, 2005).

Sports psychologist can help both athletes with disabilities or those without with psychological preparation to develop psychological resistance and build self-confidence and appropriate motivation.

The process of achieving high self-confidence in an athlete with disabilities can last for many years and the psychologist has a role of counsellor. An athlete must set an environment around him/her that includes people who always believe in him/her. Repeated positive sport experiences can contribute greatly for achieving global and balanced self-confidence (Tušak, 2001).

By analysing the self-confidence of an athlete, we can determine his/her personality. Individuals with low self-confidence are afraid of defeats, have negative thoughts, doubt their abilities and feel that they will not succeed. Those with too high self-confidence do not see their mistakes and do not want to fix them, they think they are better than they really are, and in case of failure always find excuses. Such problems can often be faced by athletes with ABI, as a result of the injury and inability to create a real image of oneself and one’s abilities (Žini, 2018).

Parents, relatives, coaches and personal assistants have the strongest influence on the individual’s self-confidence and self-esteem. The right approach includes positive encouragement, praise, positive experience and emotional support.

Self-concept is a set of individual’s opinions and attitudes towards oneself based on experience and beliefs, reflected in the individual’s relationship with oneself. As a consequence one forms values about oneself and the environment he/she lives in. The one with good self-concept has high self-confidence and vice versa, low self-concept comes from low self-esteem.

Self-concept depends on the perception and knowledge of one’s own strengths and weaknesses, depends on the individual’s opinion of his/hers abilities and the people the individual compares with. We separate physical, social and academic self-concept.

The physical self-concept of an athlete with a disability can be largely influenced by sports activities. Sport can be an important stimulus, which increases the competence of their performance and improves their physical abilities. Unfortunately, in practice, it often happens that poorly coordinated individuals with disabilities are less active in sports and recreation, spend more time watching other better coordinated individuals with disabilities, consequently limiting their chances of improvement.

Coping with stress

A successful athlete must have the ability to effectively cope with stress, and this also applies to athletes with disabilities. Several techniques are known to adequately solve problems caused by stressors.

In order to reduce stress we introduce training, which include a program for reducing the harmful effects of stress. It involves learning self-talk, observing one’s thoughts, problem solving skills and focusing attention.

It has three phases:

  1. Education about this principle of training,
  2. Multiple exercises that involve planning and problem solving, relaxation and changing thinking patterns.
  3. Testing of acquired skills in a controlled environment (Tušak, Misja and Vičič, 2003).

Sport as an environment where a person with disabilities can develop connections and reduce loneliness can be described as an extremely positive activity and a tool for improving the quality of life. However, in everyday life they may be limited by their disability due to their physical abilities and consequently experience stress and low self-confidence.

Coping with stress in paralympic sports

The Paralympic Games, like the Olympic Games, are considered to be the highest level of competition an athlete with a disability can aim for. The increased attention paid to the Paralympic Games and the importance that society, coaches and support staff all attribute to the winners of the Paralympic Games, therefore influence the experience of the Paralympic Games as very exciting and stressful. Athletes with disabilities experience similar pressures as athletes without disabilities to achieve victory. First often experience increased stress as a result of increased attention of media and family (Disability and Sport, 2018)

In addition to related sources of stress experienced by both athletes with disabilities or without disabilities, we can identify some are unique to disabled athletes, e.g. those in wheelchairs or with prosthetics, such as: problems travelling to the competition, how to get on the plane, transfers from seat to wheelchair to toilets and back and personal care, how to proceed from a long evening trip to competition, gastrointestinal problems, etc. Often, a longer absence from home can also be stressful. Athletes with disabilities miss their important ones who help them and support them socially (Disability and Sport, 2018).

Paralympic athletes spend considerable time in the Paralympic village. Athletes, who compete at the end of games, have to spend a critical amount of time in an unknown environment. They sleep in a bed they are not used to. A study on Brazilian Paralympic athletes who participated in the Paralympic Games in Beijing, shows that most of them had poor quality of sleep. Anxiety was associated with poor sleep, 72% of athletes had a medium degree of anxiety, while only 28% of athletes who were sleeping well were less anxious. Members of the British team also reported that they were dealing with issues about room sharing and how well they would compete after a poor sleep (Martin & Wheeler, 2011).

Athletes with disabilities often have less access to sports psychologists and coaches compared to athletes without disabilities. Similarly, access to doctors, therapists, masseurs and athletic trainers is also limited. They usually have only coaches and assistants available.

Athletes with disabilities are ranked by functionality and competitors are also assigned in this way. Ranking that occurs before the competition can be stressful as athletes may expect classification at a different level. If athletes reclassify, they will have to compete with better athletes. It is clear that such a scenario can reduce confidence and increase anxiety in key times (Disability and Sport, 2018).

Drug testing has also become an essential part of the Paralympic Games and can be a new and therefore stressful experience. Testing in Paralympic Games may be more complicated compared to the testing of healthy athletes. For example, many athletes urinate with catheters. Some may need to ask for exceptions to the use of illicit substances as part of their treatment in relation to their disability.

Some suffer chronic pain and can be treated with medical marijuana, which can be legally permitted at home, but is prohibited in Paralympic Games.

Most elite athletes are influenced by the events and conditions of their sports world. However, Paralympic athletes must deal with a number of unique conditions and challenges that can hinder their optimal functioning.

Well-developed psychological abilities help disabled athletes cope with stress. Furthermore sports psychologists play an important role in the psychological preparation and training.

References

De Bressy de Guast, V., Golby, J., Van Wersch, A., & d’Arripe-Longueville, F. (2013). Psychological skills training of an elite wheelchair water-skiing athlete: A single-case study. Adapted Physical Activity Quarterly,30, 351–372

Disability in Sport, pridobljeno junij 2018 iz http://psychology.iresearchnet.com/sports-psychology/disability-in-sport/

Gregg, M. (2013). Working with athletes with intellectual disabilities. In S. J. Hanrahan & M. B. Andersen (Eds.), Routledge handbook of applied sport psychology: A comprehensive guide for students and practitioners, (pp. 441–449). London: Routledge

Gregg, M. J., Hrycaiko, D., Mactavish, J. B., & Martin, G. L. (2004). Amental skills training package for Special Olympic athletes: Apreliminary study. Adapted Physical Activity Quarterly,21, 4–18.

Hanrahan, S. J. (2004). Sport psychology and athletes with disabilities. In T. Morris & J. Summers (Eds.), Sport psychology: Theory, applications and issues (2nd ed., pp. 572–583). Milton, Queensland: John Wiley & Sons.

Hanrahan, S. J. (2007). Athletes with disabilities. In G. Tenenbaum & R. C. Eklund (Eds.), Handbook of sport psychology (3rd ed., pp. 845–858). Hoboken, NJ: Wiley.

Hanrahan, Stephanie J., Psychological Skills Training for Athletes With Disabilities, First published: 09 March 2015, https://doi.org/10.1111/ap.12083

James H. Rimmer, PhD, Barth Riley, PhD, Edward Wang, PhD, Amy Rauworth, MS, Janine Jurkowski, PhD, Physical activity participation among persons with disabilities: Barriers and facilitators. Available from: https://www.researchgate.net/p... [accessed Jul 05 2018].

Kajtna, T. in Jeromen, T. (2013). Šport z bistro glavo – utrinki iz športne psihologije za mlade

Malouin, F., & Richards, C. L. (2010). Mental practice for relearning locomotor skills.Physical Therapy, 90, 240–251.doi:10.2522/ptj.20090029

Malouin, F., Richards, C. L., Durand, A., Descent, M., Poire, D., Fremont, P., Doyon, J. (2009). Effects of practice, visual loss, limb amputation, and disuse on motor imagery vividness. Neurorehabilitation and Neural Repair, 23, 449–467. doi:10.1177/1545968308328733

Martin, J. J. (2013). Athletes with physical disabilities. In S. J. Hanrahan &M. B. Andersen (Eds.), Routledge handbook of applied sport psychology: A comprehensive guide for students and practitioners (pp. 432–440). London: Routledge.

Martin, J. J., & Wheeler, G. (2011). Psychology. In Y. Vanlandewijck & W. Thompson (Eds.), The Paralympic athlete (pp. 116–136). London: International Olympic Committee)

Screws, D. P., & Surburg, P. R. (1997). Motor performance of children with mild mental disabilities after using mental imagery. Adapted Physical Activity Quarterly, 14, 119–130.

Stephanie J Hanrahan, (2014), Psychological Skills Training for Athletes With Disabilities, Schools of Human Movement Studies and Psychology, The University of Queensland, Australia.

Tušak, M., Misja, R. in Vičič, A. (2003). Psihologija ekipnih športov. Ljubljana: Fakulteta za šport, Inštitut za šport.

Tušak, M.[Maks]in Tušak, M. [Matej](2003). Psihologija športa. Ljubljana: Znanstveni inštitut Filozofske fakultete

Vešligaj Damiš, J., Majcenovič Cipot D., Čeh, M., (2017). PRIPOROČILA IZVAJALCEM »ReSport« aktivnosti, Center Naprej (Internal book), Maribor

Žilni, S., 2018. PSIHOLOŠKA PRIPRAVA V KONJENIŠTVU, DIPLOMSKO DELO, UNIVERZA V LJUBLJANI, FAKULTETA ZA ŠPORT, Kineziologija, Ljubljana