Sport Psychology Consulting with Athletes with Disabilities
Amanda Leibovitz, MA, LPC, CC-AASP, Threshold Performance Consulting
Becky Clark, PhD, LCSW-R, CC-AASP, CGRS, WoBold Sports Consulting
The World Health Organization (WHO, 2011) estimates that approximately 15% of the world’s population lives with some form of disability. The Convention on Rights for Persons with Disabilities (CRPD, 2006), also known as the “Disability Treaty”, includes Article 30.5 that specifically addresses inclusion, accessibility, and integration for people with disabilities in sport and exercise (Kiuppis, 2016).
Competitive sports for athletes with disabilities (AWD) have dramatically increased over the past two decades in both disability-specific competitions and mainstream sporting events alongside able-bodied competitors. In response to the increased number and variety of athletic opportunities, the individual accomplishments of athletes with disabilities have grown in a similar manner (DePauw & Gayron, 2005). Though athletes with disabilities experience many of the same concerns, motivations, slumps, and other performance challenges as able bodied athletes, they may also have specific concerns about their disability as it impacts sport performance (Hanrahan, 1998; Martin, 2005; Vost, Clark, & Sachs, 2013).
The increased media exposure of recent events such as the Paralympics, Deaflympics, Special Olympics, and the Invictus Games, has helped to raise public awareness of various adaptive sport opportunities for disabled and nondisabled individuals alike (Martin 2016; Woods, 2011). Moreover, athletes with disabilities are gaining increased recognition as athletes first and persons with disabilities second (DePauw & Gayron, 2005). However, it appears that the field of sport and exercise psychology has yet to embrace this population, as evidenced by a gap in both research and applied services addressing the psychosocial and performance needs of these athletes (Clark & Sachs, 1991; Dieffenbach & Statler, 2012; Gregg, 2013; Hanrahan, 2015; Larsen, 2014; Martin, 2005, 2015; Martin & Malone, 2013; Vose et al., 2013).
As such, the purpose of this article is to provide an overview of sport for individuals with disabilities (also known as disabled sports, disability sport, adaptive sport, deaf sport, etc.) so that all classifications of athletes with disabilities may be included in our discourse as a profession. Though an in-depth analysis of every aspect of disability sport is beyond the scope of this article, we hope it will serve as an introduction that will hopefully inspire continuing education, encourage engagement with adaptive athletes in professional practice, and promote the inclusion of athlete with disabilities in research.
Physical Disabilities
In 1960, 400 athletes from 23 countries competed in Rome, Italy for the first Paralympic Games (International Paralympic Committee [IPC], 2017). Since then, the Games have grown to become the second biggest sporting event in the world; the 2016 Summer Paralympic Games hosted in Rio de Janeiro, Brazil, saw more than 4300 athletes from 159 countries compete in 528 medal events across 22 sports (IPC, 2017).
Physical disabilities can be congenital or acquired and cover a broad scope of impairments. Categories of physical disabilities for sport classification include impaired muscle power, impaired passive range of movement, limb deficiency, leg length difference, short stature, hypertonia, ataxia, athetosis, visual impairment, and some intellectual impairments (IPC, 2017). Some of the more common physical disabilities include, but are not limited to, amputation, spinal cord injury, cerebral palsy, spina bifida, and visual impairment/blindness. It is important to remember that not all disabilities are visible, and conditions such as stroke, traumatic brain injury, and sensory impairments may significantly impact daily functioning and sport performance for athletes.
According to the IPC (2017), eligible para-sport athletes (i.e., those who meet the minimum disability criteria) are assessed by a classification panel and assigned to a specific sport class based on the severity of their impairment(s). If different impairments cause similar activity limitation, athletes with these impairments can compete together because the competition is considered equitable. Each sport has a different number of sport classes; while some sports include all impairment types, others are specific to one impairment type or a selection of impairment types.
Sport and exercise psychology consultants working with athletes with physical disabilities at any level should keep in mind that the performance needs of these individuals are much like those of nondisabled athletes and exercisers (Dieffenbach & Statler, 2012; Jeffries, Gallagher, & Dunne, 2012; Kenttä & Corban, 2014; Martin, 2015). In some cases, additional considerations may be necessary depending on whether the disability is acquired or degenerative and the athlete’s acceptance of the disability. Furthermore, the necessity of adaptive equipment (i.e., wheelchairs, prostheses, guides) for some athletes, degree of access to quality resources (i.e., coaches, facilities), and the evolving landscape of adaptive sport (i.e., changing classification system, increased popularity) can present challenges unique to para-athletes at all levels of competition. However, these challenges and goals can be successfully addressed within the context of a creative and individualized mental skills training program.
Sensory Disabilities
Athletes with sensory disabilities include those who are blind or visually impaired and/or deaf or hard of hearing. Though blind or visually impaired (B/VI) athletes compete under the umbrella of Paralympic sport, athletes who are deaf and hard of hearing compete under the rules and regulations of the Deaflympics, which are governed by the International Committee of Sports for the Deaf (ICSD) and recognized by the International Olympic Committee (IOC).
The Deaflympics, formerly known as the World Games for the Deaf, were established in Paris in 1924 and hosted athletes from nine European nations (ICSD, 2017). This event, called the Silent Games, was the first ever for any group of people with disabilities. Moreover, it was also one of the first internationally-competed games of any kind, second only to the Olympic Games (ICSD, 2017). Today, the ICSD boasts a membership of 108 national federations and continues to grow.
The most notable difference between the Deaflympics and the Paralympic Games is that competing athletes who are deaf and hard of hearing are otherwise able-bodied (Ammons & Eickman, 2011). To be eligible to compete in the Deaflympics, athletes must have a hearing loss of at least 55 decibels in the better ear. Athletes are forbidden to use hearing aids of any kind during competition to avoid any possible unfair advantage. As such, sport competitions follow the same rules as those upheld in the Olympic Games except for using visual stimuli, rather than auditory stimuli, to signify the start of events.
In addition to the previously mentioned recommendations for applied work with athletes with physical disabilities, athletes with sensory disabilities may require some additional considerations. For example, blind and visually impaired athletes might not be able to read printed materials or information posted on non-accessible websites and will need auditory adaptations. Similarly, athletes who are deaf or hard or hearing will need visual communication access.
Intellectual Disabilities
The Special Olympics is the world’s largest sport organization for people with intellectual disabilities. An intellectual disability is commonly characterized by three criteria: 1) an IQ below 70-75, 2) significant limitations in cognitive functioning and skills, and 3) the condition presents before the age of 18 (Special Olympics, 2017).
With the help of more than one million volunteers, the Special Olympics provides opportunities for more than 4.7 million athletes from 169 countries to find joy, confidence, and fulfillment through sport as well as raise awareness and inspire the greater community (Special Olympics, 2017). The 30+ individual and team sports offered are modeled after Olympic events and engage both recreational and competitive athletes of all ages.
Working with Special Olympics athletes calls for many of the same skills as working with nondisabled athletes. However, it is necessary to consider the developmental age of the individual when designing and implementing a mental skills training program for an athlete with an intellectual disability, and it is likely that a parent or guardian will be involved in the process. Staying mindful of the athletes’ unique challenges and goals regarding communication, emotional regulation, motor function, and sport performance can help sport and health psychology consultants to most holistically and appropriately meet their specific needs.
Conclusion
Sport and exercise participation rates for persons with disabilities continue to rise globally and present tremendous opportunities for sport psychology consultants to work with this population. Working with AWD is much like working with nondisabled athletes; the primary focus is on mental skills development and performance enhancement. The athlete’s disability is rarely an issue unless the athlete raises it as a concern in the consulting session. Practitioners who have worked to develop competence will be better equipped to successfully navigate relationships with disabled athletes.
How do we begin to develop competence? Sport psychology consultants working with AWD should explore their own beliefs and perceptions about disability and confront any stereotypes or biases they might have toward this population. Furthermore, developing an awareness of their own worldview, knowledge, and expertise is essential, as these aspects may directly affect their ability to build an effective working relationship (Schinke & Hanrahan, 2009).
In addition to developing competence, some “best practices” for sport psychology consultants include attending to accessibility needs, researching and selecting appropriate interventions, advocating for resources, and building effective relationships with athletes, coaches, and other sport professionals. The more comfortable we can become in our understanding of the needs and goals of athletes with disabilities, the more we can work together to broaden the inclusion of this population within our field.
Web Resources
Special Olympics - http://www.specialolympics.org/
International Paralympic Committee - https://www.paralympic.org/
Deaflympics - https://www.deaflympics.com/
Team USA Paralympics - http://www.teamusa.org/US-Paralympics/
Athletics for All - https://athleticsforall.net/
Commit to Inclusion - http://committoinclusion.org/
Disabled Sports USA - http://www.disabledsportsusa.org/
The Lakeshore Foundation - http://www.lakeshore.org/
Challenged Athletes Foundation - http://www.challengedathletes.org/
United States Association of Blind Athletes - http://usaba.org/
Great Lakes Adaptive Sports Association - http://www.glasa.org/
USA Deaf Sports Federation - https://usdeafsports.org/
Valor Games - https://www.va.gov/opa/speceven/valor_games/
Department of Defense Warrior Games - http://warriorgames.dodlive.mil/
International Federation of Intellectual Disability Sport - http://www.inas.org/
Invictus Games - https://invictusgamesfoundation.org/
United Nations’ Convention on the Rights of Persons with Disabilities - http://www.ohchr.org/EN/HRBodies/CRPD/Pages/ConventionRightsPersonsWithDisabilities.aspx - 30
Threshold Performance Consulting – www.thresholdpc.com
WoBold Sports Consulting – www.woboldsports.com
References
Ammons, D., & Eickman, J. (2011). Deaflympics and the Paralympics: Eradicating misconceptions. Sport in Society, 14(9), 1149-1164. doi:10.1080/17430437.2011.614772
Clark, R. A., & M. L. Sachs (1991). Challenges and opportunities in psychological skills training in deaf athletes. The Sport Psychologist 5(4), 392-398.
DePauw, K., & Gavron, S. (2005). Disability and sport. Champaign, IL: Human Kinetics.
Dieffenbach, K. D., & Statler, T. A. (2012). More similar than different: The psychological environment of Paralympic sport. Journal of Sport Psychology in Action, 3, 109-118. DOI: 10.1080/21520704.2012.683322
Kiuppis, F. (2016). Inclusion in sport: Disability and participation. Sport in Society, DOI: 10.1080/17430437.2016.1225882
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.
Hanrahan, S. J. (1998). Practical considerations for working with athletes with disabilities. The Sport Psychologist, 12, 346-357.
Hanrahan, S. J. (2015). Psychological skills training for athletes with disabilities. Australian Psychologist, 50(2), 102-105. doi:10.1111/ap.12083
International Committee of Sports for the Deaf. (2017). About the ICSD [Website]. Retrieved from https://www.deaflympics.com/icsd.asp
International Paralympic Committee. (2017). The IPC - Who we are [Website]. Retrieved from https://www.paralympic.org/the-ipc/history-of-the-movement
Jefferies, P., Gallagher, P., & Dunne, S. (2012). The Paralympic athlete: A systematic review of the psychosocial literature. Prosthetics and Orthotics International, 3, 278-289.
Kenttä, G., & Corban, R. (2014). Psychology within the Paralympic context - Same, same or any different? Olympic Coach, 25, 15-25.
Larsen, C. H. (2014). Preparing for the European Championships: A six-step mental skills training program in disability sports. Journal of Sport Psychology in Action, 5(3), 186-197. doi:10.1080/21520704.2014.971989
Martin, J. (2015). Determinants of elite disability sport performance. Kinesiology Review, 4, 91-98.
Martin, J. (2012). Mental preparation for the 2014 winter Paralympic games. Clinical Journal of Sport Medicine, 22, 70-73.
Martin, J. J. (2005). Sport psychology consulting with athletes with disabilities. Sport & Exercise Psychology Review, 1(2), 32-38.
Martin, J. J. (2016). The psychology of Paralympians and mental preparation. In Y. C. Vanlandewijck & W. R. Thompson (Eds.) Handbook of sports medicine and science: Training and coaching the Paralympic athlete (pp. 96-107). Oxford, UK: Wiley.
Martin, J., & Malone, L. (2013). Elite wheelchair rugby players’ mental skills and sport engagement. Journal of Clinical Sport Psychology, 7, 253-263.
Schinke, R. J., & Hanrahan, S. J. (2009). Cultural sport psychology. Champaign, IL: Human Kinetics.
Special Olympics. (2017). What we do [Website]. Retrieved from http://www.specialolympics.org/Sections/What_We_Do/What_We_Do.aspx
UN (United Nations). 2006. Convention on the rights of persons with disabilities. New York, NY: United Nations.
Vose, J. E., Clark, R. A., & Sachs, M. L. (2013). Athletes who are blind/visually impaired or deaf/hard of hearing. In S. J. Hanrahan & M. B. Andersen (Eds.), Routledge handbook of applied sport psychology: A comprehensive guide for students and practitioners (pp. 450-459). London: Routledge.
WHO (World Health Organization) and World Bank 2011. “World Report on Disability.” Retrieved from http:// www.refworld.org/docid/50854a322.html.
Woods, R. B. (2011). Social issues in sport (2nd ed.). Champaign, IL: Human Kinetics.