What Makes Us Tick: The Essential Knowledge, Skills, Abilities, and Attitudes of Sports Psychiatrists
By: Dr. Carla Edwards, MD, FRCPC, Sports Psychiatrist
Although not (yet) plentiful, most Sports Psychiatrists in Canada work alongside, and with, Sports and Exercise Medicine Physicians. Psychiatrists share common pathways of medical training with SEM physicians, and subsequent areas of specialization create a perfect fit for both types medical experts in supporting athletes and the sporting environment.
While a history in sport is not a prerequisite to practice in Sports Psychiatry, an understanding of sport variables and the socioecological aspects of sports enhance the Sports Psychiatrist’s ability to assess and manage mental health challenges in that environment. Sports Psychiatrists can obtain Certificates of Additional Training or Experienced Practitioner Certification through the International Society for Sports Psychiatry.
International Society for Sports Psychiatry
The International Society for Sports Psychiatry is an organization that has been advancing the field of Sports Psychiatry for several decades. Many of its leaders have been instrumental contributors to the development of the IOC Consensus Guidelines on the Mental Health of Elite Athletes, the NCAA Mental Health Best Practice Guidelines, and exploration of the Intersection of Mental Health and Relative Energy Deficiency in Sports (REDS). With two CASEM members among its leadership ranks (myself- President since 2021 and chair of Youth Sports Committee, Dr. Pam Weatherbee- Board of Directors and co-chair of Outreach Committee), the ISSP recognizes the importance of the relationship between Sports Psychiatry and Sports and Exercise Medicine. The official journal of the ISSP, Sports Psychiatry, is published by Hoegrefe and features seminal papers such as the Mental Health Considerations for Athlete Removal from Play and Return to Play Planning.
First International Consensus Statement on Sports Psychiatry
In October 2022, the ISSP hosted the inaugural International Summit in Sports Psychiatry, which included delegates from 8 countries (Canada, USA, Brazil, UK, Switzerland, Austria, Australia, Malaysia). By Summer 2023, the alliance grew to 13 countries and included Egypt, India, South Africa, Japan, and Chile. The ISSP Board now boasts it greatest diversity to date- with 4 countries represented (Canada, US, Switzerland, South Africa), 33% female, 25% identifying as POC, 2 early-career, 5 mid-career, and 2 late-career professionals. Following the 2023 Summit meetings, the group of international delegates published the First International Consensus Statement on Sports Psychiatry. This paper identified that three major fields of activity can be distinguished within Sports Psychiatry:
- Mental health and disorders in competitive and elite sports
- Sports and exercise in prevention of and treatment for mental disorders
- Mental Health and sports-specific mental disorders in recreational sports.
Each of these fields is associated with its own essential knowledge, skills, and abilities (and attitudes)( eKSA+A). Understanding the definition of Sports Psychiatry and sports psychiatrists, in addition to the framework of key eKSA+A s in the different fields of activity in Sports Psychiatry will assist in expanding, unifying, and standardizing the future development of the field. It will also help to establish competencies and standards within Sports Psychiatry and neighboring disciplines (such as Sports and Exercise Medicine) and should be included in sports psychiatry education and training.
Defining Sports Psychiatry
As defined by the alliance, sports psychiatry is a medical and psychiatric specialty that uses the essential knowledge, skills, and abilities (plus attitudes, eKSA+A) of medicine, neuroscience, and psychiatry to promote mental health in athletes of all abilities and physical activity as a therapeutic element in the prevention for and treatment of mental disorders. (1-7). Further, the Consensus Statement recognizes that “sports and exercise medicine combine the medical eKSA+As of physicians from various specialties in the context of sport and exercise, and sport psychiatry with its eKSA+A should also be considered in the cross-sectional field of sport and exercise medicine. This is similar to other disciplines in sports and exercise medicine, such as sports cardiology.”
Thus the discussion of the relationship between Sports Psychiatry and SEM is important in the overall consideration of all elements of sports and exercise from a medical perspective.
Further reading of the Consensus Statement will provide additional insights into the role, KSAs, and relationships that should be built between SEM and Sports Psychiatry
Major takeaways from the Consensus Statement:
- The sports psychiatrist has essential knowledge, skills, and abilities (plusattitudes, eKSA+A) within medicine, psychiatry, psychotherapy, sports psychiatry, and potentially sports and exercise medicine, that give him or her a crucial role and function in the three fields of activity of sports psychiatry: competitive and elite sports, health sports, and recreational sports.
- The eKSA+Aof the sport psychiatrist in these fields of activity will overlap with the eKSA+A of professionals of the neighboring disciplines. The sports psychiatrist is committed to interdisciplinary and professional care.
- The sports psychiatrist is committed to lifelong continuing education and training, evidence-based and guideline-supported medicine, as well as research, education, and teaching of students and young professionals.
References
Pensgaard AM, Sundgot-Borgen J, Edwards C, et al. Intersection of mental health issues and Relative Energy Deficiency in Sport (REDs): a narrative review by a subgroup of the IOC consensus on REDs. British Journal of Sports Medicine 2023;57:1127-1135
Reardon CL, Hainline B, Aron CM, et al Mental health in elite athletes: International Olympic Committee consensus statement (2019). British Journal of Sports Medicine 2019;53:667-699.
https://ncaaorg.s3.amazonaws.com/ssi/mental/SSI_MentalHealthBestPractices.pdf
Claussen MC, Currie A, Koh Boon Yau E, Nishida M, Martínez V, Burger J, Creado S, Schorb A, Nicola RF, Pattojoshi A, Menon R, Glick I, Whitehead J, Edwards C, Baron D. First international consensus statement on sports psychiatry. Scand J Med Sci Sports. 2024 Apr;34(4):e14627. doi: 10.1111/sms.14627. PMID: 38610076.
Glick I, Stull T, Currie A. Development of sports psychiatry in the United States and internationally. Sports Psychiatry. 2022; 1(1): 3-5. doi:10.1024/2674-0052/a000002
International Society for Sports Psychiatry [ISSP web site]. https://www.sportspsychiatry.org.
Claussen MC. Sports psychiatry: discipline and fields of activity. Dtsch Z Sportmed. 2021; 72: 1-2. doi:10.5960/dzsm.2021.483
McDuff DR, Garvin M. Working with sports organizations and teams. Int Rev Psychiatry. 2016; 28(6): 595-605. doi:10.1080/09540261.2016.1212820
Stull T, Glick I, Kamis D. The role of a sport psychiatrist on the sports medicine team, circa 2021. Psychiatr Clin North Am. 2021; 44(3): 333-345. doi:10.1016/j.psc.2021.04.001
Edwards C. Sports psychiatry clinical curriculum for sports and exercise medicine fellows in one Canadian university. Sports Psychiatry. 2023; 2(3): 89-94. doi:10.1024/2674-0052/a000054
Edwards C. Mental health considerations for athlete removal from play and return to play planning. Sports Psychiatry. 2023;1–15. https://doi.org/10.1024/2674-0052/a000058