Addressing Mental Health Challenges for Olympic and Elite Athletes

Contact: Kelly Craine, 254-297-9065
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When the world tunes into the Olympic Games, they will celebrate elite athletes’ physical excellence, discipline and competitive spirit. These Olympians push the boundaries of human performance, breaking records and achieving feats that inspire millions. However, behind the scenes of their triumphant victories and grueling training sessions lies a less visible yet equally critical aspect of their lives – mental health. The intense pressure to perform, the constant scrutiny from media and fans and the sacrifices made in personal lives can take a significant toll on their psychological well-being.

Baylor University researchers have studied how strategies involving Cognitive-Behavioral Therapy (CBT), an evidence-based approach that promotes skill development that reduces symptoms of anxiety, depression, substance use and other mental health struggles, may also enhance the performance of elite athletes at the collegiate, professional and Olympic levels. Combined, CBT skills for athletes may have promise as a primary prevention strategy for mental health symptoms, a secondary prevention strategy by offering referral for more serious symptoms and may earn buy in from coaches and athletes due to the potential for enhancing athletic performance.

Lead author Cali Werner, LCSW, M.S.W. ’19, current Ph.D. student in social work at Baylor and former doctoral research assistant for the Baylor IMPACT Lab-Houston, understands the subject quite well as an elite collegiate athlete herself. Along with colleagues Danielle Parrish, Ph.D., M.S.W., professor and director of the Baylor IMPACT Lab in the Diana R. Garland School of Social Work, and Elizabeth McIngvale, Ph.D., MSW, director of the OCD Institute of Texas, reviewed the latest literature on the topic to understand how to best meet the unique mental health challenges these top athletes. Their findings, The Future of Mental Health in Sport: CBT and Athletes, were published in Sports Social Work Journal.

Elite athletes at higher risk

Collegiate and elite athletes are at higher risk of developing anxiety, depression and substance abuse disorders due to unique stressors such as balancing social life, sport and mental health biases. In particular, Olympic athletes face stressors and pressures that may be unlike any other, especially given the unique celebrity-like status and opportunity and pressure to represent their country that this affords them, the researchers said. 

"Our research highlights the urgent need to address mental health in sports with the same dedication as physical health. CBT offers a practical, evidence-based solution that can help athletes not only perform better but also live healthier, more balanced lives," Werner said.

Benefits of Cognitive-Behavioral Therapy (CBT)

Anxious athletes may focus on negative thoughts that lead them to become overwhelmed with high-level competition due to perfectionism, or their own or others’ unrealistic expectations, the researchers said in their study.

With CBT, athletes are taught to change negative thought patterns and behaviors by setting realistic, achievable goals, monitoring their thoughts, emotions and behaviors to enhance self-awareness, and identifying and challenging negative thoughts to foster more positive and constructive thinking, Werner said. While it can reduce symptoms of anxiety, depression and substance use, it potentially can enhance athletic performance, including perfectionism and burnout.

“Confidence often leads to success, and so cognitive behavioral therapy at its core is the restructuring of negative thoughts into more positive ones,” Werner said.

Werner experienced the positive results of CBT herself as an elite long-distance runner. Improving her mental outlook by letting go of perfectionistic thoughts improved her athletic performance.

“I had my best race ever, and it was the first time I said if it takes me doing these compulsions to do well in this race, I don't want it,” Werner said. “I've been so scared to say that my whole life, my whole running career. It was the breakthrough and I got a personal record.”

Recommendations

Werner advocates incorporating CBT into athletic training routines, which could  enhance athletes' resilience, self-efficacy and overall mental well-being. Future research should develop and test the effectiveness of team-based mental health primary and secondary prevention models on both mental health and performance outcomes.

“Although CBT is not a ‘one size fits all’ approach, it may be a starting point to helping athletes reduce mental health risks, and if needed, begin the therapeutic process of obtaining specialized care instead of suffering in silence,” the researchers said.

ABOUT THE AUTHOR

Cali Werner, LCSW, is an athlete, advocate and clinician in Houston. Her research while obtaining her Ph.D. at Baylor University focuses on competitive athletes with debilitating anxiety that negatively impacts their performance. Werner has her own private practice, Athlete Rising LLC, where she helps athletes obtain appropriate mental health skills to prevent burnout and decrease anxiety in sport. Specifically, she specializes in performance anxiety, OCD, perfectionism, specific phobias and social anxiety. As a Division I athlete at Rice University, Werner won nine conference championships and was named an honorable mention All-American in the 10k. She also competed in the U.S. Olympic Trials in 2020. Her own OCD diagnosis led her to a career path of providing evidence-based care. She hopes to help others with mental illness know that they are not alone, and that appropriate treatment is available to reobtain the joy that mental illness takes away.

ABOUT THE DIANA R. GARLAND SCHOOL OF SOCIAL WORK AT BAYLOR UNIVERSITY

Baylor University’s Diana R. Garland School of Social Work is home to one of the leading graduate social work programs in the nation with a research agenda that explores humanity, engages spirituality and promotes equality. Upholding its mission of preparing social workers in a Christian context for worldwide service and leadership, the School offers a baccalaureate degree (BSW); a Master of Social Work (MSW) degree available in Waco or online; three joint-degree options, MSW/MBA, MSW/MDiv and MSW/MTS, through a partnership with Baylor’s Hankamer School of Business and George W. Truett Theological Seminary; and an online Ph.D. program. Visit the School of Social Work website to learn more. 

ABOUT BAYLOR UNIVERSITY

Baylor University is a private Christian University and a nationally ranked Research 1 institution. The University provides a vibrant campus community for more than 20,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating University in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 100 countries to study a broad range of degrees among its 12 nationally recognized academic divisions.