This article reviews the literature dealing with problems brought by student-athletes to college counseling and mental health centers. Among the issues discussed are fear of success; identity conflict; social isolation; poor athletic performance; academic problems; and career or vocational concerns. In addition, the authors examine the paradox that although athletes experience as much or more psychological distress as nonathletes, research indicates that athletes use professional services less often than nonathletes. Finally, the authors review approaches to psychological intervention, including short-term psychotherapy, very brief interventions, cognitive behavioral therapy, and career/vocational counseling, and discuss special considerations for conducting therapy with athletes.
Annual college mental health service statistics reveal that 50% to 60% of all students served are seen for very brief psychological interventions--5 or fewer sessions. A substantial portion of the students benefit from these very brief contacts. The authors review the selection criteria for student and therapist that make very brief intervention possible. The student must be motivated for and seek a brief encounter and must enter the therapeutic relationship with the capacity for trust already in place and the professional qualifications of the therapist already established. The problem presented should be sufficiently clear and manageable to be resolved, or to begin being resolved, in a few sessions. Finally, the student must have the capacity for rapid insight and learning. The therapist brings to the relationship a belief in the value of very limited sessions, the capacity to develop a positive relationship quickly, and the ability to determine when it is appropriate to work in such a short time frame and to use the time most effectively. Four ways that students may benefit from very brief psychological interventions include (1) psychodynamic therapy, (2) crisis intervention, (3) mental health consultation, and (4) managed referral. Case illustrations and clinical methods are presented.
Scattered reports of favorable outcomes from a single psychotherapy sessions have appeared over a long time period. This literature is collected. Case vignettes are presented illustrating three situations in which one session may suffice. Patient characteristics and therapist attitudes are briefly discussed.
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